OpenMed/multicare-articles huggingface dataset:
Esthetic improvement of a cutaneous sinus tract of odontogenic origin
Authors: Yousra Zemmouri, Saliha Chbicheb
Journal: Pan Afr Med J (2020)
Keywords: esthetic improvement, cutaneous sinus tract, odontogenic infection
MeSH terms: Cutaneous Fistula / diagnosis, Dental Fistula / diagnosis, Drainage / methods, Case Reports, Adolescent, Cutaneous Fistula / surgery, Dental Fistula / surgery, Esthetics, Female, Humans

A cutaneous sinus tract of dental origin is relatively uncommon and may easily be misdiagnosed because of its unusual occurrence and absence of dental symptoms. Extraoral drainage depends on the location of the affected tooth as well as on specific factors such as the virulence of the microorganism, resistance of the patient's body, and the relationship between anatomy and muscle facial attachments.
Failure to Control Caries in an AIDS-Affected Individual: A Case Report
Authors: Karen A Nedwick-Castro, Alexandre R Vieira
Journal: Case Rep Dent (2012)
MeSH terms: Case Reports

Many patients today are living longer with certain health issues like human immunodeficiency virus (HIV). These patients take numerous medications (HAART: highly active antiretroviral therapy) that cause xerostomia, which increases caries risk. There are particular challenges when treating HIV-positive patients with decreased immune systems, which can also accelerate the progression of periodontal disease. This paper discusses one such case that was followed from 2002 to 2010 at the University of Pittsburgh School of Dental Medicine, where an HIV patient lost all his teeth despite investing thousands of dollars. It is also common sense that just performing restorations to decayed teeth is not enough to control the disease, but recommending a personalized preventive maintenance program to the patient is a must.
Risk Prediction Model for Uncontrolled Hypertension in Chinese Community
Authors: Zhiping Gao, Shiqun Chen, Xiaoyu Huang, Jianfeng Ye, Jin Liu, Zhidong Huang, Jiyan Chen, Liwen Li, Yong Liu, Shuguang Lin
Journal: Front Cardiovasc Med (2022)
Keywords: community, prediction model, risk factor, screen, uncontrolled hypertension
MeSH terms: Case Reports

Background:
Uncontrolled hypertension rate was still high across China. This study develops and validates an index to help quantify the combination of socio-behavioral aspects to screen high-risk patients in uncontrolled hypertension in Chinese primary care.
Methods:
A cross-sectional study included 1,039 of patients with hypertension in the Chinese community. We assessed independent risk factors of uncontrolled blood pressure (defined as having a blood pressure ≥140/90 mmHg, even with antihypertensive therapy) and develop a risk prediction model.
Results:
Among the 1,039 patients (53.9% male, the average age was 61 ± 13 years), 452 (43.5%) were uncontrolled hypertensive. Multivariable analysis showed that worker (odds ratio, OR: 1.98, 95% CI: 1.46-2.69), no health insurance (OR: 3.47, 95% CI: 2.08-5.80), non-marital status (OR: 2.01, 95% CI: 1.35-3.27), and other socio-behavioral aspects were independent risk factors of uncontrolled hypertension, which were included the final prediction model (C-static: 0.781). With internal validation by the bootstrap method, the risk score showed good discriminating ability and predicting ability for the incidence of uncontrolled hypertension (C-static: 0.771).
Conclusions:
This study showed that nearly half of the patients suffered from uncontrolled hypertension in the Chinese community. We established a prediction model with good predictability to help quantify the combination of socio-behavioral aspects and screen high-risk patients with uncontrolled hypertension.
First case report of spigelian hernia containing the appendix after liver transplantation: Another cause for chronic abdominal pain
Authors: Lucas Faraco Sobrado, Lucas Ernani, Daniel Reis Waisberg, Luiz Augusto Carneiro-D'Albuquerque, Wellington Andraus
Journal: Int J Surg Case Rep (2020)
Keywords: abdominal pain, amyand hernia, appendix, liver transplantation, spigelian hernia, surgery
MeSH terms: Case Reports

Introduction:
Abdominal ventral hernias are common in chronic liver disease due to increased abdominal pressure and sarcopenia. Following liver transplantation, diagnosis of chronic abdominal pain is challenging because it may relate to immunosuppression, scaring or opportunistic infections.
Presentation of case:
A 62 years-old male presented with chronic abdominal pain one year following liver transplantation due to hepatocellular carcinoma. After work-up he was diagnosed with a Spigelian hernia containing the appendix. We did hernia repair with mesh but appendectomy was not performed since it showed no signs of inflammation. On follow-up the patient had complete resolution of the pain.
Discussion:
This is the first case of spigelian hernia containing the appendix following liver transplantation. Mesh repair can be safely performed in this setting but incidental appendectomy is controversial due to higher morbidity and mortality. In this case report we discuss the relationship between liver transplantation, abdominal hernias and the pitfalls of incidental appendectomy.
Conclusion:
Uncommon ventral hernias are a possible cause for chronic abdominal pain after surgery and should be investigated with imaging studies. Mesh repair is safe but incidental appendectomy in the immunosuppressed is not encouraged due to increased morbidity.
Chronic Non-infectious Osteomyelitis Mimicking Scurvy as the Presenting Sign of Crohn's Disease: Case Report
Authors: Alexa Goldfarb, Stefan Breitling, Owen Amadasun, Bridget Kiernan, Gabrielle Gold-von Simson, Selin T Sagalowsky
Journal: Front Pediatr (2022)
Keywords: autism spectrum disorder (asd), case report, inflammatory bowel disease, nutrition, osteomyelitis
MeSH terms: Case Reports

Chronic non-infectious osteomyelitis (CNO) is a rare, inflammatory process associated with pediatric inflammatory bowel disease (IBD). Signs and symptoms of CNO parallel scurvy, a nutritional deficiency that can affect children with autism spectrum disorder (ASD). This is the first report of a child initially thought to have scurvy, then subsequently diagnosed with CNO as the presenting manifestation of Crohn's disease. This case enhances the literature elucidating extra-intestinal manifestations of IBD and pediatric nutritional deficiencies.
Compartmentalized Histoplasma capsulatum Infection of the Central Nervous System
Authors: Albert J Eid, John D Leever, Kathrin Husmann
Journal: Case Rep Infect Dis (2015)

Background. Histoplasmosis is a common fungal infection in the southeastern, mid-Atlantic, and central states; however, its presentation can be atypical. Case Presentation. We report a case of Histoplasma capsulatum infection presenting as slowly progressive weakness in the lower extremities, followed by the development of numbness below the midthoracic area, urinary incontinence, and slurred speech. Brain MRI showed leptomeningeal enhancement, predominantly linear, involving the basal cisterns, the brainstem, and spinal cord. Cerebrospinal fluid analysis showed lymphocytic pleocytosis. Discussion. CNS histoplasmosis is usually seen in patients with disseminated histoplasmosis. Isolated CNS histoplasmosis is rarely seen, especially in immunocompetent patients. Conclusions. Histoplasmosis should be considered in the differential diagnosis of patients experiencing slowly progressive neurological deficit.
Recovery from rabies, a universally fatal disease
Authors: S Manoj, A Mukherjee, S Johri, K V S Hari Kumar
Journal: Mil Med Res (2016)
Keywords: anti-rabies serum, encephalitis, mortality, rabies, recovery

Background:
Rabies is a zoonosis transmitted via the bites of various mammals, primarily dogs and bats. Known since antiquity, this disease may have the deadliest human fatality rates and is responsible for approximately 65,000 deaths worldwide per year.
Case presentation:
We report the case details of a 13-year-old boy from India belonging to a South Asian ethnicity, who presented with altered sensorium one month following a dog bite. He did not receive the active rabies immunization and was managed with supportive therapy. The patient had extensive T2W (T2 weighted)/fluid attenuation and inversion recovery (FLAIR) hyper intensities involving the deep gray matter of the cerebral hemispheres, hippocampus, brainstem, and cerebellum. The diagnosis was confirmed by the demonstration of the rabies antigen from a nuchal skin biopsy and a corneal smear. The patient had a slow but significant recovery over four months and was discharged from the hospital in stable condition with severe neurological sequelae.
Conclusion:
We report a unique case of survival after infection with a universally fatal disease.
Case report: Cystic hygroma accompanied with campomelic dysplasia in the first trimester caused by haploinsufficiency with SOX9 deletion
Authors: Xijing Liu, Jianmin Wang, Mei Yang, Tian Tian, Ting Hu
Journal: Front Genet (2022)
Keywords: sox9, campomelic dysplasia, chromosomal microarray analysis, cystic hygroma, ultrasound
MeSH terms: Case Reports

Introduction: Campomelic dysplasia (CD) is a rare autosomal dominant skeletal malformation syndrome characterized by shortness and bowing of the lower extremities with or without XY sex reversal. Diagnosis using ultrasonography is most often made in the latter half of pregnancy. Intragenic heterozygous mutations in SOX9 are responsible for most cases of CD. CD caused by SOX9 deletion is a rare condition. Case presentation: We present a single case report of an individual with cystic hygroma accompanied by CD, which was detected by ultrasound in the first trimester. Chromosomal microarray analysis (CMA) was performed to determine copy number variants, whereas whole exome sequencing (WES) was performed to elucidate single-nucleotide variants. Chorionic villus sampling was performed to enable such analyses. Ultimately, CMA detected a 606 kb deletion in the 17q24.3 region with only one protein-coding gene (SOX9). However, no mutation in the SOX9 protein-coding sequence was detected by WES. Conclusion: When cystic hygroma is detected, prenatal diagnoses for skeletal dysplasia by ultrasound are likely to be confirmed in the first trimester. We propose a comprehensive prenatal diagnostic strategy that combines CMA and WES to diagnose fetuses with cystic hygroma accompanied by skeletal dysplasia.
Aggressive Disease Course of Multiple Myeloma with Concomitant ALK-Negative Anaplastic Large Cell Lymphoma: A Case Report with an Unusual Presentation
Authors: Michela Staderini, Lara Mannelli, Elisabetta Antonioli, Benedetta Puccini, Valentina Berti, Francesco Mungai, Federica Vergoni, Valentina Carrai, Luigi Rigacci, Alberto Bosi
Journal: Case Rep Hematol (2020)
MeSH terms: Case Reports

ALK-negative anaplastic large cell lymphoma is a rare T-cell neoplasm with an aggressive course requiring prompt diagnostic work-up and treatment. Few cases of concomitant multiple myeloma and T-cell neoplasm are described in the literature, mainly regarding primary cutaneous anaplastic large cell lymphoma. We present the case of a 65-year-old man, simultaneously diagnosed with ALK-negative anaplastic large cell lymphoma with extranodal localization in the gastrocnemius muscle (stage 1AE) and IgG lambda multiple myeloma (ISS 2, Durie-Salmon stage 3A). Both diseases required therapeutic intervention due to the high proliferative index of lymphoma and the presence of bone lesions attributable to myeloma. The therapeutic program initially included chemotherapy (cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone; CHOEP), radiotherapy on the leg, bortezomib, and then consolidation with autologous hematopoietic stem cell transplantation. Despite being on bortezomib treatment and waiting for transplantation, the patient experienced an early myeloma progression that turned out to be refractory to second-line lenalidomide-based treatment. To our knowledge, this is the first case of concurrent diagnosis of extranodal ALK-negative anaplastic large cell lymphoma of the muscle and multiple myeloma. Simultaneous onset can be challenging for clinicians as both diseases may have an aggressive course requiring multiple treatments with increased risk of toxicity and complicated management.
Staphylococcal Pericarditis Causing Pericardial Tamponade and Concurrent Empyema
Authors: Divya Kondapi, Danny Markabawi, Andrew Chu, Harvir Singh Gambhir
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Bacterial pericarditis is a rare presentation and is usually due to secondary infection from a hematogenous cause or can occur secondary to trauma, intrathoracic surgery, or due to spread of infection from a contiguous focus via ligaments that anchor the pericardium to its surrounding structures. Its course is fulminant characterized by a high mortality rate from sepsis, tamponade, and constriction. We describe a rare case of Staphylococcus aureus pericarditis with concurrent unilateral empyema. The patient rapidly developed tamponade and was successfully treated with antibiotics and urgent percutaneous pericardial drainage with placement of a temporary catheter. Treatment for bacterial pericarditis typically is 4-6 weeks long. Thoracic surgery should be consulted as soon as possible to determine need for surgical intervention, as fibrin deposition may occur, making percutaneous drainage incomplete and leading to complications of persistent purulent pericarditis or constrictive pericarditis.
Long-Term Zidovudine Therapy and Whether It is a Trigger of Vitamin B12 Deficiency: A Case Study of Megaloblastic Anemia at the University of Zambia Teaching Hospital
Authors: Natasha Mupeta Kaweme, Sahar Mounir Nagib Butress, Hamakwa Muluti Mantina
Journal: Case Rep Hematol (2022)
MeSH terms: Case Reports

Macrocytic anemia is frequently observed in adult HIV-infected patients treated with nucleoside reverse transcriptase inhibitors and with vitamin B12 and folate deficiency. In this case report, we discuss a 52-year-old nonvegetarian male on long-term antiretroviral therapy for 5 years, presenting with severe macrocytic anemia (hemoglobin, 3.7 g/dL; mean corpuscular volume, 119.6 fL) and leukopenia (2.71∗109/L), who was diagnosed with megaloblastic anemia caused by vitamin B12 deficiency following laboratory investigations. Parenteral vitamin B12 replacement therapy was initiated, with an early response observed. Notwithstanding, the treatment response was not sustained as the patient later presented with refractory anemia and persistence of macrocytosis. Discontinuation of zidovudine with concurrent vitamin B12 administration promptly improved the patient's clinical deficiency symptoms. At the end of 3 months, the patient had a complete hematological recovery. The deficiency of vitamin B12 disrupts DNA synthesis inhibiting effective hematopoiesis in all cell lines, particularly erythroid precursors and further promotes reversible bone marrow failure. Long-term ART therapy with zidovudine causes cytotoxicity in myeloid and erythroid precursors and induces bone marrow suppression. Whether long-term zidovudine consumption induced lower levels of vitamin B12 and subsequent megaloblastic anemia requires in-depth research and exploration.
Multiple Nonfamilial Unilateral Trichoepitheliomas: Report of a Case-Mini Review of the Literature
Authors: I Mandekou-Lefaki, G Theodosiou, F-S Delli, D Oikonomou, M Papageorgiou
Journal: Case Rep Dermatol Med (2019)
MeSH terms: Case Reports

Trichoepitheliomas are benign skin tumors with follicular differentiation that present most commonly as solitary lesions. They can also present as multiple centrofacial papules due to several mutations in the CYLD gene. Multiple unilateral trichoepitheliomas in a linear or dermatomal distribution may rarely be seen. Herein, we report a case of multiple unilateral trichoepitheliomas on the face of a healthy 34-year-old woman of Caucasian origin.
Neuromyelitis Optica Spectrum Disorder with Tumefactive Demyelination mimicking Multiple Sclerosis: A Rare Case
Authors: Ujjawal Roy, Dinesh Satyanarayan Saini, Koushik Pan, Alak Pandit, Goutam Ganguly, Ajay Panwar
Journal: Front Neurol (2016)
Keywords: aquaporin-4, longitudinally extensive transverse myelitis, neuromyelitis optica spectrum disorder, therapeutic plasma exchange, tumefactive multiple sclerosis
MeSH terms: Case Reports

Neuromyelitis optica spectrum disorder (NMOSD) is a diverse condition which not only encompasses isolated longitudinally extensive transverse myelitis (LETM) and optic neuritis but also includes area postrema syndrome, acute brainstem syndrome, symptomatic narcolepsy or acute diencephalic clinical syndrome, and symptomatic cerebral syndrome. Imaging may reveal periependymal lesions surrounding the ventricular system or involvement of corticospinal tracts, area postrema, diencephalon, and corpus callosum. Rarely, there may be hemispheric tumefactive lesions that enhance in a "Cloud-like" fashion on gadolinium injection unlike in tumefactive multiple sclerosis where there is incomplete ring enhancement. Here, we present a case of aquaporin-4 positive relapsing NMOSD who presented to us with recurrent episodes of paraparesis with LETM and tumefactive lesions of brain on imaging, which enhanced in an incomplete ring like pattern resembling multiple sclerosis.
Unusual Suspect: A Case Report of Tubulocystic Renal Cell Carcinoma with Features of Cystic Renal Oncocytoma
Authors: Jacob D McFadden, Isabell A Sesterhenn, Sean Q Kern
Journal: Case Rep Urol (2019)
MeSH terms: Case Reports

Tubulocystic renal cell carcinoma is an uncommon subtype of renal cell carcinoma that was only recently acknowledged by the World Health Organization. There is a relatively small collection of literature dedicated to the features and clinical course of this lesion. Despite its rarity, this diagnosis should remain in the differential for all cystic renal masses. We present a case report of tubulocystic renal cell carcinoma (TC-RCC) with remarkable similarity to cystic renal oncocytoma, highlighting the diagnostic challenges associated with this unusual renal malignancy.
A Novel Technique of Stenting of the Renal Artery In-Stent Restenosis with GuideLiner® through Radial Approach
Authors: Maheedhar Gedela, Shenjing Li, Tomasz Stys, Adam Stys
Journal: Case Rep Vasc Med (2017)
MeSH terms: Case Reports

In-stent restenosis of the renal arteries is relatively common and its management is not well studied. An 83-year-old female with bilateral renal artery stenosis and balloon angioplasty and stenting bilaterally one year ago was found to have recurrent severe elevations in the blood pressure despite medical management. Renal artery duplex showed 60-99% stenosis of the right renal artery and 20-59% stenosis of the left renal artery. A subsequent angiography of the right renal artery revealed 80% in-stent restenosis at the ostium. We describe a new approach of balloon angioplasty and stenting through radial access site with the assistance of a GuideLiner in a complex in-stent restenosis of the renal artery.
POEMS Syndrome Diagnosed 10 Years after Disabling Peripheral Neuropathy
Authors: Viet H Nguyen
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Peripheral neuropathy is characterized as a generalized, relatively homogeneous process affecting many peripheral nerves and predominantly affecting distal nerves. The epidemiology of peripheral neuropathy is limited since the disease presents with varying etiology, pathology, and severity. Toxic, inflammatory, hereditary, and infectious factors can cause damage to the peripheral nerves resulting in peripheral neuropathy. Peripheral neuropathy is most commonly caused by diabetes, alcohol, HIV infection, and malignancy. We report a case of a 42-year-old female with 10-year history of progressively worsening peripheral neuropathy, hypothyroidism, and skin changes who presents with dyspnea secondary to recurrent pleural and pericardial effusions. Prior to her arrival, her peripheral neuropathy was believed to be secondary to chronic demyelinating inflammatory polyneuropathy (CDIP) given elevated protein in the cerebral spinal fluid (CSF) which was treated with intravenous immunoglobulin (IVIG) and corticosteroids. Unfortunately, her peripheral neuropathy did not have any improvement. Incidentally, patient was found to have splenomegaly and papilledema on physical exam. Serum protein electrophoresis showed a monoclonal pattern of IgA lambda. Patient met the diagnostic criteria for POEMS (polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes) syndrome. An underlying diagnosis of POEMS syndrome should be considered in patients with chronic debilitating neuropathy and an elevated protein in the CSF.
Progressive Nodular Histiocytosis: Report of a Case and Review of the Literature
Authors: Numbereye Numbere, Tatsiana Pukhalskaya, Blythe Bowman, Katelynn Campbell, Bruce Smoller
Journal: Case Rep Pathol (2021)
MeSH terms: Case Reports

Progressive nodular histiocytosis (PNH) is a rare condition characterized by progressive eruption of multiple yellowish-brown papules and nodules on the skin and mucous membranes. We present the case of a 37-year-old Caucasian man with gradually increased appearance of nodular lesions on the forehead and right temple. These lesions were initially diagnosed as xanthomas and did not respond to intralesional injections of triamcinolone. Additional biopsy revealed an intense dermal infiltrate of foamy mononuclear epithelioid cells with a minor admixture of plasma cells, lymphocytes, and scattered multinucleated giant cells. On immunohistochemical staining, the lesional cells were positive for CD163 and CD68 and negative for CD1a, thus confirming a mononuclear-macrophage lineage. The clinical presentation and the histological impression lead to the diagnosis of PNH. This condition could be challenging, mimicking microscopically similar lesions of the non-Langerhans cell histiocytosis group. Although uncommon, PNH stands out due to its clinical and microscopic features and should be taken into consideration in the differential diagnosis of cutaneous histiocytoses.
Revisiting Cementoblastoma with a Rare Case Presentation
Authors: Vijayanirmala Subramani, Malathi Narasimhan, Suganya Ramalingam, Soumya Anandan, Subhashini Ranganathan
Journal: Case Rep Pathol (2017)
MeSH terms: Case Reports

Cementoblastoma is a rare benign odontogenic neoplasm which is characterized by the proliferation of cellular cementum. Diagnosis of cementoblastoma is challenging because of its protracted clinical, radiographic features, and bland histological appearance; most often cementoblastoma is often confused with other cementum and bone originated lesions. The aim of this article is to overview/revisit, approach the diagnosis of cementoblastoma, and also present a unique radiographic appearance of a cementoblastoma lesion associated with an impacted tooth.
Case report: Using DNA short tandem repeats to confirm nongestational origin of pulmonary choriocarcinoma
Authors: Filipa Ferreira da Silva, Rita Barata, Inês Rolim, Catarina Carvalheiro, Nuno Gil, Marcos Pantarotto
Journal: Front Oncol (2022)
Keywords: choriocarcinoma, human chorionic gonadotropin, lung neoplasms, non-gestational trophoblastic disease, primary tumor
MeSH terms: Case Reports

Gestational trophoblastic neoplasias (GTN) are malignant neoplasms that occur in pregnant or recently pregnant women. Choriocarcinoma (CCA) is a highly aggressive and rare GTN, and cases outside the female genital tract are commonly seen as secondary manifestations of gynecologic disease. In this paper, we describe the case of a 40 years-old female patient with a primary pulmonary CCA who was surgically treated and for whom the confirmation of the primary origin of the tumor was possible using a DNA short tandem repeat genotyping. Distinction between gestational and non-gestational trophoblastic neoplasia is crucial as they require different therapeutic approach and have different prognoses.