OpenMed/multicare-articles huggingface dataset:
Atropa belladonna intoxication: a case report
Authors: Mohamed Adnane Berdai, Smael Labib, Khadija Chetouani, Mustapha Harandou
Journal: Pan Afr Med J (2012)
Keywords: intoxication, anticholinergic toxidrome, atropa belladonna, atropine, child
MeSH terms: Atropa belladonna / poisoning, Plant Poisoning / diagnosis, Case Reports, Atropa belladonna / physiology, Atropine / poisoning, Child, Cholinergic Antagonists / adverse effects, Cholinergic Antagonists / poisoning, Cholinergic Antagonists / therapeutic use, Female, Humans, Jaundice / complications, Jaundice / drug therapy, Plant Poisoning / etiology, Plants, Toxic / poisoning, Cholinergic Antagonists, Atropine

Atropa belladonna is a poisonous plant also called deadly nightshade. Its roots, leaves and fruits contain alkaloids: atropine, hyocyamine and scopolamine. The risk of poisoning in children is important because of possible confusion with other berries. Atropa belladonna acute intoxication is a severe condition, it's should be considered in the presence of anti-cholinergic toxidrome, the differential diagnosis include other plants or psychoactive drugs containing atropine. The treatment is mainly symptomatic including gastrointestinal decontamination with activated charcoal. In severe cases, physostigmine can be used as an antidote. We report the case of 11 year old girl with Atropa belladonna poisoning which was administrated in a therapeutic purpose as a remedy to jaundice. The child presented essentially a central anti-cholinergic syndrome. She was admitted in the intensive care unit, the progression was favorable with symptomatic treatment.
Case report: A successful re-challenge report of GLS-010 (Zimberelimab), a novel fully humanized mAb to PD-1, in a case of recurrent endometrial cancer
Authors: Yeshan Chen, Ai Huang, Qin Yang, Jing Yu, Guiling Li
Journal: Front Immunol (2022)
Keywords: gls-010, endometrial cancer, immune checkpoint inhibitors, myocarditis, re-challenge
MeSH terms: Antineoplastic Agents, Immunological / adverse effects, Endometrial Neoplasms / drug therapy, Case Reports, Antibodies, Monoclonal, B7-H1 Antigen, Female, Humans, Immune Checkpoint Inhibitors / adverse effects, Immunologic Factors, Neoplasm Recurrence, Local / drug therapy, Programmed Cell Death 1 Receptor, Programmed Cell Death 1 Receptor, Immune Checkpoint Inhibitors, Antineoplastic Agents, Immunological, B7-H1 Antigen, zimberelimab, Antibodies, Monoclonal, Immunologic Factors

With the widespread use of immune checkpoint inhibitors (ICI), there is growing concern about reports of immune-related adverse events (irAE). In clinical practice, patients who experience severe toxicities by ICI-based therapies would require utmost caution in resuming ICI therapy because of the potential risk of serious irAEs caused by the reintroduction of immunotherapy. In this study, we report a case of recurrent endometrial cancer patient with PD-L1 positive as well as dMMR suffering from immunotherapy-associated myocarditis after first-line treatment with ICI combined with a multi-targeted anti-angiogenic agent. After symptomatic treatment, the patient was in complete remission from treatment toxicities. Subsequently, through MDT discussions, we selected a new PD-1 agent, zimberelimab, for rechallenge therapy, and the patient achieved a sustained disease remission without any treatment-related toxicities. To date, the manner and timing of the ICI re-challenge has been a subject of iterative deliberation. We believe that our experience could shed some light on ICI rechallenge therapy, and we look forward to more literatures to refine the ICI rechallenge scenarios.
Case Report: retained gutta-percha as a cause for persistent maxillary sinusitis and pain
Authors: Benjamin L Hodnett, Berrylin Ferguson
Journal: F1000Res (2014)

Dental sources of infection can produce acute and chronic maxillary sinusitis. In some cases, the source of the infection may be related to the presence of endodontic materials in the oral cavity. In this article, we report a case of retained gutta-percha in the maxillary sinus resulting in chronic sinusitis.
Right Upper Lobe Shadow and Tracheobronchopathia Osteochondroplastica Confined to Right Main Bronchus: A Case Report and Literature Review
Authors: Stylianos A Michaelides, George D Bablekos, George Ionas, Stephanie Vgenopoulou, Maria Chorti
Journal: Case Rep Med (2015)

Tracheobronchopathia osteochondroplastica (TO) is a well documented benign entity of endoscopic interest. We describe a case of 76-year-old patient who presented with fever, cough, purulent sputum during the past four days, and presence of an ovoid shadow in right upper zone of his chest X-ray. Medical history included diagnosis of colon diverticuli identified by colonoscopy 3 months ago. Chest CT revealed a compact elongated lesion containing air-bronchogram stripes. Bronchoscopy showed normal upper airways and trachea but presence of unequal sized mucosal nodules, protruding into the lumen, along the entire length of the right main bronchial mucosa. No other abnormal findings were detected. Moreover, brushing and washing smears from the apical segment of right upper lobe (RUL), where the compact lesion was located, were negative for malignancy. Biopsy from the mucosal nodules of right main bronchus showed presence of cartilaginous tissue in continuity through thin pedicles with submucosal cartilage. This finding posed the diagnosis of TO while RUL lesion was cleared by antibiotic treatment. Case is reported because, to our knowledge, it represents a unique anatomic location of TO which was confined exclusively in the right main bronchus mucosa without affecting trachea.
New-Onset Systemic Capillary Leak Syndrome in an Adult Patient with COVID-19
Authors: Daniel B Knox, Vivian Lee, Lindsay Leither, Samuel M Brown
Journal: Case Rep Crit Care (2021)
MeSH terms: Case Reports

Systemic capillary leak syndrome (SCLS) is a rare disorder manifesting as shock, hemoconcentration, and hypoalbuminemia, which may be either idiopathic or secondary to an underlying disease process. We report a case of an adult with COVID-19 infection associated with new onset SCLS. Our case joins only two other cases of new SCLS associated with COVID-19 infection reported in the literature. The clinical and laboratory findings in this case are distinct from findings seen in COVID-19 cytokine storm syndrome. Whether our therapeutic approach was efficacious is unknown. Further research into causes and therapies for these syndromes is urgently indicated.
Rhinosporidiosis: A Rare Cause of Proptosis and an Imaging Dilemma for Sinonasal Masses
Authors: Amit Kumar Dey, Rajaram Sharma, Kartik Mittal, Puneeth Kumar, Vivek Murumkar, Sumit Mitkar, Priya Hira
Journal: Case Rep Otolaryngol (2016)

Background. Rhinosporidiosis is a common disease entity in tropical countries; however, it can be encountered in other parts of the world as well due to increasing medical tourism. It may mimic other more malignant and vigorous pathologies of the involved part. Case Report. We present a case of a 36-year-old male presenting with proptosis due to involvement of nasolacrimal duct which is rare. We will discuss typical CT and MRI features of the disease which were present in the case. Conclusion. For a surgeon and a radiologist, this is a necessary differential to be kept in mind for sinonasal masses. CT and MRI are invaluable investigations. However, FNAC is confirmatory. Both clinical and radiological aspects are required to reach correct diagnosis.
Efficacy and safety of ketamine for neonatal refractory status epilepticus: case report and systematic review
Authors: Jacopo Norberto Pin, Letizia Leonardi, Margherita Nosadini, Maria Elena Cavicchiolo, Chiara Guariento, Anna Zarpellon, Giorgio Perilongo, Alessia Raffagnato, Irene Toldo, Eugenio Baraldi, Stefano Sartori
Journal: Front Pediatr (2023)
Keywords: antiseizure medication response, ketamine, neonatal seizure treatment, neonatal status epilepticus, refractory status epilepctius (rse)
MeSH terms: Review

Background:
Evidence-based data on treatment of neonatal status epilepticus (SE) are scarce. We aimed to collect data on the efficacy and safety of ketamine for the treatment of neonatal SE and to assess its possible role in the treatment of neonatal SE.
Methods:
We described a novel case and conducted a systematic literature review on neonatal SE treated with ketamine. The search was carried out in Pubmed, Cochrane, Clinical Trial Gov, Scopus and Web of Science.
Results:
Seven published cases of neonatal SE treated with ketamine were identified and analyzed together with our novel case. Seizures typically presented during the first 24 h of life (6/8). Seizures were resistant to a mean of five antiseizure medications. Ketamine, a NMDA receptor antagonist, appeared to be safe and effective in all neonates treated. Neurologic sequelae including hypotonia and spasticity were reported for 4/5 of the surviving children (5/8). 3/5 of them were seizure free at 1-17 months of life.
Discussion:
Neonatal brain is more susceptible to seizures due to a shift towards increased excitation because of a paradoxical excitatory effect of GABA, a greater density of NMDA receptors and higher extracellular concentrations of glutamate. Status epilepticus and neonatal encephalopathy could further enhance these mechanisms, providing a rationale for the use of ketamine in this setting.
Conclusions:
Ketamine in the treatment of neonatal SE showed a promising efficacy and safety profile. However, further in-depth studies and clinical trials on larger populations are needed.
A Gigantic Anal Mass: Buschke-Löwenstein Tumor in a Patient with Controlled HIV Infection with Fatal Outcome
Authors: Sanjog Bastola, Alexandra Halalau, Ojbindra Kc, Anju Adhikari
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Buschke-Löwenstein tumor of anorectal and perianal area is a rare but highly aggressive tumor, frequently associated with human papillomavirus (HPV) types 6 and 11. It often grows over years in immunocompetent patients and can be highly destructive to local tissue. We present a case of a 61-year-old male with HIV infection who presented with worsening pain and swelling in the anorectal area for one-year duration. Exam revealed a 15 × 10 cm mass in the anorectal area with multiple sinuses and fistulas. MRI revealed extension of the mass through pelvic structures. Biopsy showed squamous epithelium with koilocytes and histochemistry positive for P16, suggestive of HPV infection. Biopsy was negative for malignant transformation. He was not a candidate for surgery or radiation due to extensive infiltration of deeper structures and multiple fistulas. He refused interferon therapy, and diverting colostomy was placed for palliation. He presented two months later with overwhelming sepsis and died despite maximal medical therapy.
Concurrent IDH1 and IDH2 mutations in glioblastoma: A case report
Authors: Ali S Haider, Chibawanye I Ene, Paolo Palmisciano, Maryam Haider, Ganesh Rao, Leomar Y Ballester, Gregory N Fuller
Journal: Front Oncol (2023)
Keywords: glioblastoma, histopathology, isocitrate dehydrogenase, somatic mutation, tumor progression
MeSH terms: Case Reports

Isocitrate dehydrogenase (IDH) mutations are cornerstone diagnostic features in glioma classification. IDH mutations are typically characterized by mutually exclusive amino acid substitutions in the genes encoding for the IDH1 and the IDH2 enzyme isoforms. We report our institutional case of a diffuse astrocytoma with progression to secondary glioblastoma and concurrent IDH1/IDH2 mutations. A 49-year-old male underwent a subtotal resection of a lobular lesion within the right insula in 2013, revealing a WHO grade 3 anaplastic oligoastrocytoma, IDH1 mutated, 1p19q intact. Symptomatic tumor progression was suspected in 2018, leading to a surgical tumor biopsy that demonstrated WHO grade 4 IDH1 and IDH2 mutant diffuse astrocytoma. The patient subsequently underwent surgical resection followed by medical management and finally died in 2021. Although concurrent IDH1/IDH2 mutations have been rarely reported in the current literature, further study is required to better define their impact on patients' prognoses and their response to targeted therapies.
The eleventh reported case of Mulvihill-Smith syndrome in the literature
Authors: Paulo Breinis, Flavio Geraldes Alves, Camila A E Alves, Rafael G Cintra, Débora Almeida, Priscila C Passarelli, Camila Domingues, Talita Gerbim, Régia Gasparetto, Luiz Carlos de Abreu, Vitor E Valenti, Adriana Gonçalves de Oliveira, Carlos Bandeira de Mello Monteiro, Rubens Wajnzstejn
Journal: BMC Neurol (2014)
MeSH terms: Growth Disorders / diagnosis, Growth Disorders / psychology, Nevus, Pigmented / diagnosis, Nevus, Pigmented / psychology, Progeria / diagnosis, Progeria / psychology, Case Reports, Research Support, Non-U.S. Gov't, Review, Humans, Male, Young Adult, Progeria short stature pigmented nevi

Background:
The Mulvihill-Smith Syndrome was first recognized in 1975. After the recognition of the Mulvihill-Smith Syndrome, ten cases have been described.
Case presentation:
This article describes the eleventh case of this syndrome in a male patient, 24 years-old with short stature and microcephaly with mild cognitive impairment, deafness and allergic conjunctivitis. The patient was hospitalized several times for repeated infections, and the presence of multiple melanocytic nevi on his skin was noticed.
Conclusions:
Based on the entire set of signs and symptoms presented in our study, it was diagnosed the patient with Mulvihill-Smith Syndrome.
Modified Tunnel Procedure to Facilitate Ridge Reconstruction of an Extraction Socket Associated with Buccal Dehiscence and Gingival Recession: A Case Report with a 6-year Follow-Up
Authors: Felice Ascenzi, Andrell Hosein, Emily Ming-Chieh Lu
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Introduction:
Extraction sockets associated with buccal dehiscences and gingival recessions pose particular surgical and restorative challenges. In these cases, unassisted healing following flapless tooth extraction results in severe bone and soft tissue deformities and an aesthetic compromise. Root coverage procedures prior to ridge reconstruction may enable predictable alveolar augmentation. Case Presentation. This is the first case report describing the utilisation of modified tunnel procedure to facilitate ridge reconstruction consisting of ovate pontic and xenograft, of tooth #25 in a 38-year-old-male. The 6 months and 1-year reviews showed optimal soft tissue aesthetics, 100% root coverage of the tooth #25, and bone augmentation, which enabled placement of 10.0 mm × 4.0 mm (3i) implant in a prosthetically driven position. The 6-year review continued to show favourable clinical outcomes.
Conclusion:
Compromised extraction sockets containing buccal dehiscence and associated with gingival recessions may benefit from soft tissue augmentation procedures to enhance the clinical outcome of ridge reconstruction.
Granular Cell Tumor of Rectum: A Very Rare Entity
Authors: Tagore Sunkara, Savitha V Nagaraj, Vinaya Gaduputi
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

Granular cell tumors are predominantly benign, occurring more commonly in women, with about 10% developing in the gastrointestinal tract. Rectal location of this tumor is very rare. We herein report one such case of a 61-year-old man with granular cell tumor in the rectum who underwent endoscopic curative resection.
Dermoscopic Features of Pigmented Bowen's Disease in a Japanese Female Mimicking Malignant Melanoma
Authors: Takayuki Inoue, Ken Kobayashi, Mizuki Sawada, Sumiko Ishizaki, Haruo Ito, Mariko Fujibayashi, Masaru Tanaka
Journal: Dermatol Res Pract (2010)
MeSH terms: Case Reports

Various structures have been reported for dermoscopic features of pigmented Bowen's disease (BD), which could be a mimic of various pigmented skin lesions. A 79-year-old Japanese woman presented with a 3-year history of brown-black macule on her right upper arm without symptom. Dermoscopic examination demonstrated irregular flossy streaks, irregular brown dots/globules, blue-whitish regression structures, and overlaying whitish scaly areas. We suspected pigmented skin lesions including seborrheic keratosis, pigmented eccrine poroma, and malignant melanoma and excised completely with a 5 mm margin. Histopathological features were consistent with a diagnosis of pigmented BD. Although similar dermoscopic features might be revealed in pigmented skin lesions and it may occasionally be difficult to distinguish between pigmented BD and other pigmented skin lesions, dermoscopy would be useful in speculating pathologic features of pigmented BD.
Successful Control of Hepatitis B Virus Reactivation following Restart of Ibrutinib in Chronic Lymphocytic Leukaemia
Authors: Sara Kristina Viberg Tjønnfjord, Eirik Brekka Tjønnfjord, Zbigniew Konopski, Geir Erland Tjønnfjord
Journal: Case Rep Hematol (2021)
MeSH terms: Case Reports

Ibrutinib is a targeted therapy drug that blocks the activity of Bruton's tyrosine kinase, and it is an approved treatment for several mature B-cell malignancies including chronic lymphocytic leukaemia (CLL). Side effects include infections, cytopenia, nausea, and diarrhoea. In this report, we describe a case of hepatitis B reactivation in a female CLL patient undergoing treatment with ibrutinib. Diagnosis was confirmed with highly elevated hepatitis B virus DNA and a prior blood sample confirmed previous exposure. Ibrutinib was paused, and antiviral therapy was initiated with prompt clinical improvement. Ibrutinib was reinitiated shortly after clinical improvement. Thus, our case report demonstrates that systematic HBV screening is essential before starting treatment with ibrutinib. We suggest that antiviral prophylaxis is considered for patients at risk of reactivation, and ibrutinib may be continued following HBV reactivation with proper antiviral treatment.
Anaphylactic shock following intraurethral lidocaine administration during transurethral resection of the prostate
Authors: M Sinha, R Sinha
Journal: Indian J Urol (2008)
Keywords: anaphylactic shock, intraurethral, lidocaine
MeSH terms: Case Reports

Anaphylactic shock was noted following an apparently uneventful transurethral resection of the prostate (TURP). Lidocaine jelly was used prior to urethral dilatation and before placement of three-way Foley. Lidocaine sensitivity was diagnosed serendipitously when lidocaine jelly was used for application of ECG electrodes. Anaphylaxis may be one of the rare differentials to be considered in a patient with postoperative shock following TURP. This report highlights a potentially fatal complication of an apparently innocuous and ubiquitous urological use of lidocaine.
Use of Point-of-Care Ultrasound for Early Identification of Acute Aortic Root Dissection
Authors: Kristina Thomas, Omar Amr
Journal: Case Rep Crit Care (2022)
MeSH terms: Case Reports

Point-of-care ultrasound (POCUS) is becoming a frequently utilized imaging tool in the emergency department (ED) as it can aid in early diagnosis of many pathologies. This is a case report of a 55-year-old male who presented to the emergency department by ambulance for sudden onset chest pain followed by a syncopal episode. Point-of-care echocardiogram revealed a large pericardial effusion with a significantly dilated aortic root, concerning for aortic dissection. Patient was emergently taken for a computed tomography (CT) scan, which was only remarkable for an ascending thoracic aortic aneurysm but failed to show an aortic dissection flap. On repeat POCUS, a dissection intimal flap, large pericardial effusion with tamponade physiology, and aortic regurgitation were identified and later confirmed on transesophageal echocardiogram. This case report details a rare pathology that was correctly identified on initial POCUS before it was seen on CT scan.
Successful treatment of deep vein thrombosis caused by iliac vein compression syndrome with a single-dose direct oral anti-coagulant
Authors: Naoya Nakashima, Daisuke Sueta, Yusuke Kanemaru, Seiji Takashio, Eiichiro Yamamoto, Shinsuke Hanatani, Hisanori Kanazawa, Yasuhiro Izumiya, Sunao Kojima, Koichi Kaikita, Seiji Hokimoto, Kenichi Tsujita
Journal: Thromb J (2017)
Keywords: direct oral anti-coagulant, iliac vein compression syndrome, thromboembolism
MeSH terms: Case Reports

Background:
Although vein stenting is popular for treatment for venous thromboembolism due to mechanical compression, some cases are forced to avoid inserting align agents because of immunodeficiency.
Case presentation:
An 82-year-old man with left extremity redness and swelling presented to a hospital for a medical evaluation. The patient was immunodeficient because of the adverse effects of his treatment for Castleman's disease. A contrast-enhanced computed tomography scan revealed a venous thromboembolism in inferior vena cava and the left lower extremity. Magnetic resonance venography showed that the iliac artery was compressing the iliac vein. We were reluctant to place a stent in the iliac vein has because of the patient's immunodeficient status. Three months of treatment using single-dose edoxaban (30 mg daily) resulted in complete resolution of the thrombus. This is the first report demonstrating that single-dose edoxaban without acute-phase parenteral anticoagulation is effective in the treatment of iliac vein compression.
Conclusions:
A single-dose direct oral anti-coagulant without acute-phase parenteral anticoagulation is effective for mechanical compression.
Thoracoscopic approach for massive thymic hyperplasia in an infant: Case report and literature review
Authors: Jinghua Jiao, Jie Yu, Chenghao Chen, Tian Chen, Tiehua Zheng, Lejian He, Qi Zeng
Journal: Front Pediatr (2023)
Keywords: infant, massive thymic hyperplasia, minimally invasive surgery, thoracoscopy, thymectomy, true thymic hyperplasia
MeSH terms: Case Reports

Introduction:
Massive thymic hyperplasia (MTH) is a very rare entity, with fewer than 20 cases reported in the literature in infancy. Most patients have respiratory symptoms and the enlarged thymus gland occupies one side of the thoracic cavity. Posterolateral thoracotomy or median sternotomy is the main treatment for MTH in infants. We report a case of an infant with MTH in which the enlarged thymus occupied his bilateral thoracic cavity and he underwent video-assisted thoracoscopic surgery (VATS). In addition, we reviewed and summarized the relevant literature.
Case report:
A 4-month-old boy was admitted to the hospital with no apparent cause of dyspnea for 18 days, with cough and sputum. On examination, the patient was found to have cyanotic lips, diminished breath sounds in both lungs, and a positive three concave sign. There was no fever or ptosis. Preoperative imaging showed large soft tissue shadows in the bilateral thoracic cavity, with basic symmetry between the right and left sides. Tumor markers were within the normal range. Ultrasound-guided fine needle biopsy showed normal thymic structures with no evidence of malignancy. As his symptoms worsened, he eventually underwent unilateral thoracic approach video-assisted thoracoscopic exploratory surgery, during which a large mass occupying the bilateral thoracic cavity was removed in a separate block and part of the thymus in the left lobe was preserved. Pathological examination confirmed true thymic hyperplasia (TTH). No relevant complications occurred at the 2-month postoperative follow-up.
Conclusion:
In infants, MTH occupying the bilateral thoracic cavity can produce severe respiratory and circulatory symptoms due to occupying effects. Although a definitive preoperative diagnosis is sometimes difficult, after combining computed tomography (CT) and fine needle biopsy to exclude evidence of other malignancies, the enlarged thymus occupying the bilateral thoracic cavity can be resected via VATS. Whether the enlarged thymus occupies the bilateral thoracic cavity and the size of the thymus are not absolute contraindications to thoracoscopic surgery. The method is safe, feasible, and minimally invasive to the patient.