OpenMed/multicare-articles huggingface dataset:
Case Report: Cerebrovascular Events Associated With Bacterial and SARS-CoV-2 Infections in an Adolescent
Authors: Charles de Marcellus, Laurent Dupic, Charles-Joris Roux, Imane El Aouane El Ghomari, Perrine Parize, Romain Luscan, Florence Moulin, Manoelle Kossorotoff
Journal: Front Neurol (2021)
Keywords: covid-19, lemierre syndrome, sars-cov-2, cerebral vasculitis, cerebral venous thrombosis, stroke
MeSH terms: Case Reports

Neurologic manifestations associated with Covid-19 are increasingly reported, especially stroke and acute cerebrovascular events. Beyond cardiovascular risk factors associated with age, some young adults without medical or cardiovascular history had stroke as a presenting feature of Covid-19. Suggested stroke mechanisms in this setting are inflammatory storm, subsequent hypercoagulability, and vasculitis. To date, a handful of pediatric stroke cases associated with Covid-19 have been reported, either with a cardioembolic mechanism or a focal cerebral arteriopathy. We report the case of an adolescent who presented with febrile meningism and stupor. Clinical, biological, and radiological features favored the diagnosis of Lemierre syndrome (LS), with Fusobacterium necrophorum infection (sphenoid sinusitis and meningitis) and intracranial vasculitis. The patient had concurrent SARS-CoV-2 infection. Despite medical and surgical antimicrobial treatment, stroke prevention, and venous thrombosis prevention, he presented with severe cerebrovascular complications. Venous thrombosis and stroke were observed, with an extension of intracranial vasculitis, and lead to death. As both F. necrophorum and SARS-CoV-2 enhance inflammation, coagulation, and activate endothelial cells, we discuss how this coinfection may have potentiated and aggravated the usual course of LS. The potentiation by SARS-CoV-2 of vascular and thrombotic effects of a bacterial infection may represent an underreported cerebrovascular injury mechanism in Covid-19 patients. These findings emphasize the variety of mechanisms underlying stroke in this disease. Moreover, in the setting of SARS-CoV-2 pandemic, we discuss in what extent sanitary measures, namely, lockdown and fear to attend medical facilities, may have delayed diagnosis and influenced outcomes. This case also emphasizes the role of clinical assessment and the limits of telemedicine for acute neurological condition diagnosis.
Single-incision bilateral laparoscopic oophorectomy
Authors: Deepraj Bhandarkar, Avinash Katara, Vinay Deshmane, Gaurav Mittal, Tehemton E Udwadia
Journal: J Minim Access Surg (2011)
Keywords: laparoscopy, oophorectomy, single port access, single-incision
MeSH terms: Case Reports

Although single-incision laparoscopic surgery made an appearance on the surgical scene only recently, it is being increasingly applied in the treatment of a variety of disorders. We report single-incision bilateral laparoscopic oophorectomy and salpingooophorectomy performed in two patients who had previously undergone breast conservation surgery for early breast cancer. Each procedure was undertaken using two 5-mm and one 3-mm ports inserted through a 2-cm transverse supraumbilical incision and standard laparoscopic instruments. The operative time was 50 and 65 min respectively and the blood loss negligible. The patients were discharged 36 and 24 h after surgery, required minimal postoperative analgesia and remain well at a follow up of 19 and 17 months, respectively. With the benefit of improved cosmesis, the single-incision approach holds the potential to replace the traditional bilateral laparoscopic oophorectomy.
Deletion of the CYP2D6 gene as a likely explanation for the serious side effects of the antipsychotic drug pimozide: a case report
Authors: Fernando Facal, Begoña Portela, Almudena Gil-Rodríguez, Francisco Barros, Olalla Maroñas, Angel Carracedo
Journal: Front Pharmacol (2023)
Keywords: extrapyramidal syndrome, parkinsonism, pharmacogenetics, pimozide, risperidone, severe adverse reactions, transaminases
MeSH terms: Case Reports

CYP2D6 analysis prior to the prescription of pimozide is required above a certain dose by the Food and Drug Administration in order to detect individuals with the poor metabolizer status. This precautionary measure aims to prevent the occurrence of serious adverse drug reactions. This study presents a case of a patient diagnosed with schizophrenia spectrum disorder. The patient suffered re-admission in the psychiatry ward because of severe secondary symptoms due to the antipsychotic drug pimozide, previously prescribed on a first admission. In order to assess the patient's medication profile, real-time PCR was performed to analyze the main genes responsible for its metabolization, namely, CYP2D6 and CYP3A4. The pharmacogenetic study revealed that the patient is a poor metabolizer for CYP2D6, presenting deletion of both copies of the gene (diplotype *5/*5). Fortunately, the symptomatology disappeared after the withdrawal of the responsible drug. In conclusion, abiding by the pharmacogenetic clinical practice guidelines and the pharmacogenetic analysis of CYP2D6 when prescribing pimozide would have probably saved the patient from the consequences of severe side effects and the health system expenditure. There is an important need for more training in the pharmacogenetic field for specialists in psychiatry.
Pregnancy complicated with adrenal adenoma causing ACTH-independent Cushing's syndrome, accompanied by obstetric antiphospholipid syndrome and severe pre-eclampsia: case report and literature review
Authors: Shenghan Xu, Miao Liu, Jiamu Xu, Bangwei Che, Wenjun Zhang, Wei Li, Tao Huang, Ying Yu, Cheng Zha, Zheng Peng, Kunyuan Huang, Kaifa Tang
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: adrenocortical adenoma, antiphospholipid syndrome, cushing’s syndrome, obstetric antiphospholipid syndrome, pregnancy
MeSH terms: Adrenal Gland Neoplasms / pathology, Adrenal Gland Neoplasms / surgery, Antiphospholipid Syndrome / complications, Cushing Syndrome / blood, Cushing Syndrome / complications, Pre-Eclampsia / pathology, Pregnancy Complications / pathology, Review, Case Reports, Research Support, Non-U.S. Gov't, Adrenocorticotropic Hormone / blood, Adult, Female, Humans, Pregnancy, Pregnancy Outcome, Adrenocorticotropic Hormone

This case report shares the management experience of a patient with pregnancy combined with adrenal adenoma causing ACTH-independent Cushing's syndrome (CS), accompanied by obstetric antiphospholipid syndrome (OAPS) and severe pre-eclampsia. The case was a 26-year-old that presented with typical clinical symptoms and signs of CS. The patient had a history of 4 spontaneous abortions in the last 4 years. The 24-hour urinary free cortisol was significantly increased, an abnormal cortisol circadian rhythm was demonstrated by a high late-night salivary cortisol, blood ACTH was suppressed (< 1ng/dL), anticardiolipin antibody was positive, and imaging examination showed an adrenal tumor. The patient underwent laparoscopic adrenal tumor resection under general anesthesia at 23 weeks of gestation. The tumor was pathologically confirmed to be an adrenocortical adenoma. The patient underwent a cesarean section at 39 weeks of gestation to give birth to a healthy baby girl with an Apgar score of 10. Pregnancy complicated by CS is clinically rare, easily masked by normal physiological changes of pregnancy, and is difficult to diagnose. The determination of 24-hour urinary free cortisol, the circadian rhythm of serum cortisol, ultrasound, and MRI can be helpful in the diagnosis of CS during pregnancy. Surgery is the first choice for the treatment of CS during pregnancy. As a subtype of antiphospholipid syndrome, patients with OAPS are prone to thrombotic events and recurrent miscarriages if not treated accordingly. To our knowledge no cases of CS with OAPS and severe pre-eclampsia have been reported. We summarize the experience of the treatment of this patient and review the literature to improve clinicians' awareness of this disease.
Pelvic Abscess after Cesarean Section Treated with Laparoscopic Drainage
Authors: Yumi Murayama, Tomohito Tanaka, Hiroshi Maruoka, Atsushi Daimon, Shoko Ueda, Masahide Ohmichi
Journal: Case Rep Obstet Gynecol (2021)
MeSH terms: Case Reports

Cesarean section (CS), the rate of which is increasing worldwide, may be associated with complications. Although pelvic abscess after CS is rare, it is difficult to treat. We herein report two cases of pelvic abscess treated laparoscopically after CS. The abscesses of the patients were located in the pouch of Douglas and the uterine scar after CS, respectively. Several days after CS, the patients presented with lower abdominal pain and fever. Laparoscopic drainage was performed because imaging revealed a pelvic abscess that was not amenable to drainage through interventional radiology. The patients recovered from infection and were discharged four days after drainage.
Neuropathy Dermatitis following Surgical Nerve Injury
Authors: Khalifa E Sharquie, Adil A Noaimi, Ali S Alaboudi
Journal: Case Rep Dermatol Med (2011)
MeSH terms: Case Reports

Background. Cutting nerve during operations like saphenous vein grafting and knee joint surgery are common surgical procedures. Objective. To report cases of dermatitis at the site of neuropathy following skin incision for saphenous vein grafting and knee joint surgery. Patients and Methods. This case report work was done in the Department of Dermatology, Baghdad Teaching Hospital, during 2009-2010, seven cases were recorded, six following saphenous vein grafting and one case after knee surgery. Five males and two females, their ages ranged from 50 to 66 (58 ± 5.033223) years. Detailed history and full clinical examination were done for each patient regarding all points related to their conditions. Results. All cases presented around 2-3 months following the operation with dermatitis at the site of operational incision. The dermatitis appeared on one side of the operational scar and at area of neuropathy, and the rash did not cross to contralateral side. The dermatitis was well-defined plaque or patch erythematous slight scaly and nonitchy and subsided within few weeks with or without topical therapy. Conclusions. Neuropathy dermatitis is apparently a new variant of dermatitis that follows nerve cut during surgery.
Endometriosis of the Vermiform Appendix within a Hernia Sac Infiltrating the Pubic Bone
Authors: Damian Ziaja, Tomasz Bolkowski, Krzysztof Januszewski, Wioletta Skrzypulec-Plinta, Jerzy Chudek, Krzysztof Ziaja
Journal: Case Rep Surg (2015)

Purpose. Appendicular endometriosis mimicking appendicitis is a rare finding. Inguinal tumor in the course of appendicular endometriosis located within an inguinal hernia sac and infiltrating the periosteum of the pubic bone has not yet been described. Case Report. This paper describes a case of a rapidly enlarging, solid, unmovable, very painful upon palpation inguinal tumor, in a 36-year-old nulliparous woman. During surgery, a hard (approximately 4 cm in diameter) tumor infiltrating the periosteum of the right pubic bone and continuous with the inguinal hernia sac was dissected. The distal segment of the vermiform appendix was an element of the dissected tumor. Histological examination revealed endometriosis of the distal vermiform appendix. After 6 months of hormone treatment, she was referred for reoperation due to tumor recurrence. Once again histological examination of the resected tissue revealed endometriosis. There was no further recurrence of the disease with goserelin therapy. In addition to the case report, we present a review of the literature about endometriosis involving the vermiform appendix and the inguinal canal (Amyand's hernia). Conclusion. This case expands the list of differential diagnoses of nodules found in the inguinal region of women.
Bilateral Severely Stenotic Jugular Foramen: Diagnosis and Management from the Otologist/Neurotologist Point of View
Authors: Raquel Acinho Bento, David Rodrigues, João Levy, Tiago Eça, Vitor Oliveira, Leonel Luís
Journal: Case Rep Otolaryngol (2020)
MeSH terms: Case Reports

Bilateral jugular foramen stenosis with jugular bulb and vein aplasia is rare in nonsyndromic craniosynostosis and usually diagnosed during childhood. We present a case of bilateral jugular foramen stenosis with jugular bulb and vein aplasia, with subsequent persistence and enlargement of the fetal venous anastomosis in the middle and posterior cranial fossa, along with a review of the literature about this anatomical abnormality, highlighting the surgical challenges and management from the otologist/neurotologist point of view.
Myasthenia Gravis following Low-Osmolality Iodinated Contrast Media
Authors: Luca Bonanni, Michele Dalla Vestra, Andrea Zancanaro, Fabio Presotto
Journal: Case Rep Radiol (2014)

We describe the case of 79-year-old man admitted to our general hospital for a 6-week history of progressive dysphagia to solids and liquids associated with weight loss. To reach a diagnosis a total body CT scan with low-osmolality iodinate contrast agent was performed. Two hours later the patient developed an acute respiratory failure requiring orotracheal intubation and mechanical ventilation. The laboratory and neurological tests allow formulating the diagnosis of myasthenia gravis. In literature, other three case reports have associated myasthenic crisis with exposure to low-osmolality contrast media. This suggests being careful in administering low-osmolality contrast media in myasthenic patients.
Microscope integrated OCT (Mi-OCT) guided retrieval of intrastromal corneal foreign body
Authors: Ashish Markan, Kiran Chandra, Ramandeep Singh, Mohit Dogra
Journal: GMS Ophthalmol Cases (2023)
Keywords: mi-oct, intrastromal foreign body, sugarcane foreign body
MeSH terms: Case Reports

Introduction:
To describe the role of microscope integrated optical tomography (Mi-OCT) in removal of intrastromal corneal foreign body.
Methodology:
A young male presented with trauma to the right eye with sugarcane stick. Ocular examination revealed two sugarcane particles, approximately 3.5 mm in greatest dimension, embedded in the corneal stroma. For removal of foreign body, Mi-OCT was switched on and the area of interest was focused. Sugarcane particles appeared as hyperreflective structures embedded in the corneal stroma with everted edges of the overlying corneal epithelium and anterior stroma.
Results:
Both the sugarcane particles were removed successfully under real time images provided by Mi-OCT without causing any inadvertent damage to the corneal stroma.
Conclusion:
Mi-OCT can be used as an adjunct in emergency surgical procedures like removal of intrastromal corneal foreign bodies with accurate precision.
A Case Report of Extensive Cerebral Venous Sinus Thrombosis as a Presenting Sign of Relapsing Nephrotic Syndrome
Authors: Janet K Lee, Kathleen Murray, Swetha Renati
Journal: Case Rep Neurol Med (2019)
MeSH terms: Case Reports

Nephrotic syndrome is defined by three characteristic features including proteinuria of >3 g in 24 hours, hypoalbuminemia of less than 3 g/dL, and peripheral edema. Multiple nephropathies can result in nephrotic syndrome. Most commonly, minimal change disease is seen in children under the age of 10, while adults are more commonly found to have membranous nephropathy. Hypercoagulability and thrombotic sequela can be seen in nephrotic syndrome, regardless of underlying etiology, and thrombosis is most commonly seen in deep veins of the lower extremities and renal veins. Our case identifies an adult with previously diagnosed and treated for minimal change disease who presented with weight gain, peripheral edema, foamy urine, headache but no neurologic deficits. The patient was found to have near to complete occlusion of the entire superior sagittal sinus, near complete occlusion of the left transverse and sigmoid sinuses, and nonocclusive thrombus in the right sigmoid sinus. She was treated with heparin and IV steroids then transitioned to warfarin and PO steroids, respectively, with resolution of symptoms. This case report emphasizes on the importance of recognizing CVST as a potential complication of nephrotic syndrome at both initial presentation and relapse.
Facial localization of malignant chondroid syringoma: a rare case report
Authors: Deniz Tural, Fatih Selçukbiricik, Feray Günver, Abdülkadir Karışmaz, Süheyla Serdengecti
Journal: Case Rep Oncol Med (2013)

First described by Hirsch and Helwig in 1961, chondroid syringomas (CSs) are rare, benign tumors of the skin arising from the eccrine sweat glands with tumor differentiation in the epithelial and mesenchymal tissues. They most commonly occur in the head and neck, although they may be also found in the axilla, trunk, limbs, and genitalia. The incidence of CS is <0.01% of all primary skin tumors. Malingnant chondroid syringomas (MCS), which are also called malignant mixed tumors of the skin, are extremely uncommon. MCSs commonly involve the limbs and rarely head and neck. In this article, we present a case of malignant chondroid syringoma localized in the face at the left nasolabial region in the light of literature review.
Abdominal wall hydatid cyst: case report and review of literature
Authors: V Abhishek, Vijayraj S Patil, Ullikashi Mohan, B S Shivswamy
Journal: Case Rep Surg (2012)

A 60-year-old woman presented with a swelling in right paraumbilical region of one-year duration. Examination revealed a painless cystic swelling 15 × 10 cm with cough impulse. Ultrasound and CECT abdomen showed a subcutaneous cystic swelling with intramuscular extension. No other intraabdominal cystic lesions were found. Surgical exploration showed a cystic lesion adherent to peritoneum without any intraperitoneal extension. Cyst was carefully excised without any spillage. Gross specimen on opening showed multiple daughter cysts consistent with hydatid cyst, confirming the diagnosis of solitary abdominal wall hydatid cyst.
Hemophagocytic Lymphohistiocytosis Secondary to Disseminated Histoplasmosis in HIV Seronegative Patients: A Case Report and Review of the Literature
Authors: Hongchao Chen, Qing Yuan, Hangbin Hu, Jie Wang, Meihong Yu, Qing Yang, Tingting Qu
Journal: Front Cell Infect Microbiol (2022)
Keywords: hiv seronegativity, histoplasma capsulatum, hemophagocytic lymphohistiocytosis, histoplasmosis, immunocompetence, liposomal amphotericin b
MeSH terms: HIV Infections / complications, Histoplasmosis / complications, Histoplasmosis / diagnosis, Histoplasmosis / drug therapy, Lymphohistiocytosis, Hemophagocytic / complications, Lymphohistiocytosis, Hemophagocytic / etiology, Case Reports, Review, Amphotericin B / therapeutic use, Antifungal Agents / therapeutic use, Humans, Male, Middle Aged, Antifungal Agents, Amphotericin B

Hemophagocytic lymphohistiocytosis (HLH) secondary to Histoplasma capsulatum infection is a rare disorder with poor outcome. Although cases of patients with human immunodeficiency virus (HIV) infection have been well documented, little study has reported in the setting of HIV seronegative. In this study, we report a case of HLH secondary to histoplasmosis in an immunocompetent patient in China and review all cases on this situation. The objective was to summary their epidemiology, clinical characteristics, diagnostic approaches, and therapeutic response. A 46-year-old male cooker presented fever, fatigue, anorexia, and weight loss. Bone marrow examination suggest fungus organism and hemophagocytosis, and further, bone marrow culture confirmed Histoplasma capsulatum, as the etiology of HLH. The patient was successfully treated. We reviewed a total of the 13 cases (including our patient) of HLH with histoplasmosis in intact immunology patients. Twelve of the 13 patients are from endemic areas, and nine of the 12 cases are from emerging endemic areas, India and China. Three patients had sojourn history may related to the disease onset. Twelve of the 13 cases fulfilled HLH-2004 criteria. The diagnosis of Histoplasma capsulatum infection was established by histological examination (13 of 13), culture (4 of 13), molecular method (2 of 13), and antigen or serological assays (2 of 13). Amphotericin B, posaconazole, and itraconazole show favorable activity against the fungus, seven patients used specific treatment for HLH. For analysis of outcomes, two of the 13 patients died. Our present case report and literature review show that disseminated Histoplasma capsulatum infection with HLH in the immunocompetent population becomes increasingly common in emerging endemic areas and have high mortality. It is necessary for clinicians to improve the awareness of disease diagnosis due to the atypical population and disease presentation. Timely diagnosis and early use of antifungal agents will lead to favorable prognosis.
Posttraumatic cranial cystic fibrous dysplasia
Authors: Arata Tomiyama, Kazuya Aoki, Haruo Nakayama, Hideaki Izukura, Hitoshi Kimura, Jun-Ichi Harashina, Keisuke Ito, Morito Hayashi, Norihiko Saito, Takatoshi Sakurai, Toshiaki Oharaseki, Hitoshi Terada, Satoshi Iwabuchi
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

A 14-year-old was girl admitted to our hospital with a subcutaneous mass of the occipital head. The mass had grown for 6 years, after she had sustained a head injury at the age of 6, and was located directly under a previous wound. Skull X-ray Photograph (xp), computed tomography (CT), and magnetic resonance imaging (MRI) showed a bony defect and cystic changes in the skull corresponding to a subcutaneous mass. Bone scintigraphy revealed partial accumulation. The patient underwent total removal of the skull mass, and the diagnosis from the pathological findings of the cyst wall was fibrous dysplasia (FD). The radiographic findings for cystic cranial FD can be various. Progressive skull disease has been reported to be associated with head trauma, but the relationship between cranial FD and head trauma has not been previously reported. Previous studies have suggested that c-fos gene expression is a key mechanism in injury-induced FD.