OpenMed/multicare-articles huggingface dataset:
Metagenomic next-generation sequencing-assisted diagnosis of a rare case of primary cutaneous acanthamoebiasis in an HIV patient: a case report
Authors: Wei Fan, Pin Li, Qihao Wei, Xinru Liu, Yuxiang Cai, Bin Li, Yaping Lu
Journal: Front Cell Infect Microbiol (2024)
Keywords: acanthamoeba, hiv, cutaneous acanthamoebiasis, metagenomic nextgeneration sequencing, skin ulcer
MeSH terms: Acanthamoeba / genetics, Acanthamoeba / isolation & purification, Amebiasis / diagnosis, Amebiasis / drug therapy, Amebiasis / parasitology, HIV Infections / complications, High-Throughput Nucleotide Sequencing, Metagenomics / methods, Case Reports, Female, Humans, Middle Aged, Skin / parasitology, Skin / pathology, Treatment Outcome

Pathogenic and free-living Acanthamoeba are widely distributed in the environment and have been reported to cause keratitis and universally fatal encephalitis. Primary cutaneous acanthamoebiasis caused by Acanthamoeba is exceedingly rare and presents as isolated necrotic cutaneous lesions without involvement of the cornea or central nervous system. Cutaneous acanthamoebiasis often occurs in immunocompromised patients and is likely overlooked or even misdiagnosed only by cutaneous biopsy tissue histopathological analysis. Here, we report a HIV-infected 63-year-old female with oral leukoplakia for 4 months and scattered large skin ulcers all over the body for 2 months. The cause of the cutaneous lesions was unclear through cutaneous specimens histopathological analysis, and subsequently Acanthamoeba were detected by metagenomic next-generation sequencing (mNGS), which may be the cause of cutaneous lesions. Based on the mNGS results, a pathologist subsequently reviewed the previous pathological slides and found trophozoites of Acanthamoeba so that the cause was identified, and the skin ulcers improved significantly after treatment with multi-drug combination therapy. Acanthamoeba is also a host of pathogenic microorganisms. The presence of endosymbionts enhances the pathogenicity of Acanthamoeba, and no other pathogens were reported in this case. mNGS is helpful for rapidly diagnosing the etiology of rare skin diseases and can indicate the presence or absence of commensal microorganisms.
Posterior Reversible Encephalopathy Syndrome, not so Uncommon in Pediatric Patients with Renal Involvement: A Case Series
Authors: Ana-Maria Roxana Koller, Alexandra Man, Carmen Muntean
Journal: J Crit Care Med (Targu Mures) (2024)
Keywords: children, clinico-radiological findings, posterior reversible encephalopathy syndrome, renal involvement
MeSH terms: Case Reports

Introduction:
Posterior reversible encephalopathy syndrome (PRES) primarily shows neurological symptoms and is more frequent in males, often occurring in oncological patients. It can also be associated with renal conditions like post-streptococcal glomerulonephritis, a common cause of pediatric hypertension. Management involves blood pressure and seizure treatment. In some cases, it may lead to irreversible and severe complications. Early treatment is essential for prevention.
Presentation of case series:
In the past six months, we have documented the cases of two patients, aged 15 and 10, both of whom presented with PRES and renal disease. These patients were admitted because of general malaise, headaches, nausea, vomiting, visual disturbances, and elevated blood pressure. Subsequently, both patients experienced epileptic episodes. Only the first patient required transfer to the Pediatric Intensive Care Unit (PICU). Cerebral magnetic resonance imaging (MRI) scans revealed distinct PRES lesions in both cases. Following comprehensive investigations, both cases were diagnosed with PRES in the context of acute post-streptococcal glomerulonephritis.
Conclusions:
The patients showed improvement following the administration of antihypertensive and anticonvulsant medications, along with treatment for the underlying renal condition.
Case Report: Autoimmune encephalitis and other neurological syndromes with rare neuronal surface antibody in children after hematopoietic stem cell transplantation
Authors: Ming-Min Zhang, Jing Wang, Dan Sun, Jing-Xuan Wang, Jun-Hong Zhang, Jia-Wei Xu
Journal: Front Immunol (2023)
Keywords: autoimmune encephalitis, epilepsy, graft-versus-host disease, hematopoietic stem cell transplantation, metabotropic glutamate receptor 5
MeSH terms: Autoimmune Diseases of the Nervous System, Encephalitis / diagnosis, Encephalitis / drug therapy, Encephalitis / etiology, Hashimoto Disease / diagnosis, Hashimoto Disease / therapy, Hematopoietic Stem Cell Transplantation / adverse effects, Case Reports, Child, Female, Humans, Receptors, Antigen, B-Cell, Syndrome, Receptors, Antigen, B-Cell, Hashimoto's encephalitis

Introduction:
Neuronal surface antibody syndromes (NSAS) encompass a growing set of autoimmune neurological disorders, with their predominant clinical presentation being autoimmune encephalitis (AE). The most extensively documented form within NSAS is anti-N-methyl-D-aspartate receptor (NMDAR) autoimmunity. In contrast, other NSAS, such as anti-metabotropic glutamate receptor-5 (mGluR5) autoimmunity, are less common and less comprehensively characterized, particularly in pediatric cases.
Case description:
In this instance, we present the case of a 7-year-old girl who exhibited abnormal behaviors following hematopoietic stem cell transplantation (HSCT). She received a diagnosis of anti-mGluR5 AE, and her Electroencephalogram (EEG) displayed an increased number of generalized slow waves during wakefulness. Treatment involved intravenous administration of gamma globulin and methylprednisolone, followed by oral prednisone tablets. Levetiracetam was introduced as an antiepileptic therapy during the pulse steroid therapy. Notably, the abnormal behaviors exhibited significant improvement after treatment.
Conclusions:
To the best of our knowledge, this is the first report of rare pediatric NSAS involving anti-mGluR5 AE following HSCT. Enhancing our understanding and characterization of this condition may facilitate its recognition and treatment in children. Serum antibody testing could enable early identification and treatment of anti-mGluR5 AE.
Calvarial Tuberculosis With Skin Tuberculosis in a Child: A Rare Case Report
Authors: Shikha Swaroop, Preeti Srivastava, Kumar Diwakar, Sumeet Biswal
Journal: Cureus (2024)
Keywords: calvarial tuberculosis, skeletal tuberculosis, skin tuberculosis, tuberculosis verrucosa cutis, tuberculous meningitis
MeSH terms: Case Reports

Calvarial tuberculosis (TB) is an uncommon form of skeletal TB. Early diagnosis can be challenging as they may exhibit diagnostic dilemmas. Another rare kind of skin TB is called TB verrucosa cutis. In this case, both of these uncommon forms were observed simultaneously and were effectively treated with first-line antitubercular therapy.
A Clinical Suspicion of Quetiapine-Induced Psychosis: A Case Report and Literature Review
Authors: Michael J Valentine, Ankur Kayastha, Takara R Newsome-Cuby, Anh Thu N Nguyen, Riley G Fisher, Hanh M Pham, Saif A Meimon, Alexander Phu, Connor A Parry, Joshua J Nelson, Ethan C Hayes, Sunita Muranjan
Journal: Cureus (2024)
Keywords: brief psychotic disorder, drug-induced psychosis, hallucinations, naranjo scale, naranjo score, psychosis, quetiapine, seroquel, substance-induced psychosis, ziprasidone
MeSH terms: Case Reports

Quetiapine, a pharmacological agent within the class of atypical antipsychotics, is characterized by its efficacy in mood stabilization and its role in the modulation of serotonergic and dopaminergic pathways. Its therapeutic utility is broad, encompassing the management of acute psychotic episodes, schizophrenia, bipolar disorder, and treatment-resistant depressive states. Quetiapine's effectiveness extends to depressive disorders that do not exhibit classic psychotic features, with a side effect profile that is less burdensome than many alternative psychotropic medications. Its versatility in addressing a range of psychiatric conditions is useful in the psychopharmacological management of mood and thought disorders. However, like all drugs, quetiapine may have different effects relative to the individual. It is imperative to approach the administration of quetiapine carefully, ensuring any adverse effects are ameliorated for beneficial therapeutic outcomes. In this case report, we present a psychosis-naive 42-year-old male who developed psychotic symptoms after beginning a quetiapine regimen in order to manage major depressive disorder with suicidal ideation. Clinical suspicion of quetiapine-induced psychosis was a diagnosis considered due to symptom remission secondary to ziprasidone in the place of quetiapine. The determination of a suspected adverse drug reaction can utilize the Naranjo scale to demonstrate the likelihood of an adverse drug reaction. This patient scored a three on the Naranjo scale, indicating a possible adverse effect from quetiapine. Other potential etiologies of psychosis include medication-induced psychosis, major depressive disorder exacerbation, cocaine use/withdrawal, and brief psychotic disorder. Quetiapine-induced psychosis has not been described in the current literature, and therefore, this case report is solely based on clinical evaluation and is intended for educational purposes due to possible confounding factors and etiologies.
Refractory massive chylothorax following robot-assisted laparoscopic splenectomy with pericardial devascularization treated with trans-jugular intrahepatic portosystemic shunt: a case report
Authors: Xiang Deng, Jun Xia
Journal: Front Med (Lausanne) (2024)
Keywords: lspd, gastric fundus varices, massive chylothorax, portal hypertension, tips
MeSH terms: Case Reports

The development of a chylothorax after robot-assisted laparoscopic splenectomy combined with pericardial devascularization (LSPD) is rare. The robot-assisted procedure is similar to the standard LSPD, but surgeons must remain vigilant about potential chylothorax caused by recurrence of portal hypertension in patients with cirrhosis, an event that leads to variceal bleeding in the gastric fundus or a massive chylothorax caused by a thoracic duct fistula. We report a rare case of massive chylothorax after robot-assisted LSPD and review the literature to help elucidate the mechanisms of portal hypertension after LSPD, reduce surgical complications, and improve long-term patient outcomes. After LSPD, portal pressure monitoring, coagulation function testing, and portal vein CT imaging help in excluding portal vein thromboses and ensuring appropriate anticoagulation to reduce the development of thoracic duct fistulas. If portal hypertension recurs after surgery and a high-output chylothorax develops, conservative treatment becomes ineffective. Treatment with an active trans-jugular intrahepatic portosystemic shunt (TIPS) is recommended to lower the portal pressure.
A Severe Alzheimer's Disease Patient Improved by Intravenous Mesenchymal Stem Cell Transplant
Authors: Takahiro Honda Pazili
Journal: Case Rep Neurol Med (2024)
MeSH terms: Case Reports

Alzheimer's disease (AD) is a progressive neurological disorder and is the most common form of dementia. The terminal stage of AD is characterized by severe cognitive and substantial functional decline, requiring extensive assistance with daily activities. As effective therapies at this stage are not fully available, development of therapeutics that can recover any symptoms would be important to improve the quality of life. Recently, stem cell therapy has gathered a lot of attention in several neurological diseases, including AD. Here, we report an AD patient at the terminal stage whose symptoms were improved by the intravenous administration of ex vivo-expanded bone marrow-derived mesenchymal stem cells (MSC). The case is a 61-year-old woman with severe Alzheimer's disease who had been admitted to the special nursing home. She could neither walk nor sit up independently. She also did neither smile nor gaze properly when talked to. Rigidity including neck motion was observed. She was on dysphagia diets. We cultured her bone-marrow-derived MSCs and intravenously administered 1,5 × 108 cells. After the treatment, smile loss, eye movement dysfunction, and neck immobility were improved. This is the first case report that showed the therapeutic effects of MSCs on terminal symptoms of AD.
Case Report: Right atrial mass arising from the Eustachian valve
Authors: Jalal Jolou, Jérôme Martineau, Hajo Müller, Mustafa Cikirikcioglu, Christoph Huber
Journal: Front Cardiovasc Med (2023)
Keywords: chiari network, eustachian valve, cardiac mri, intra-cardiac mass, right atrial mass, thrombi
MeSH terms: Case Reports

A mass in the right atrium (RA) is an unusual finding that warrants further investigation. We report the case of a 72-year-old male patient who underwent a Bentall operation with a biological composite graft and closure of patent foramen ovale 18 months prior to his presentation with an incidental new RA mass during follow-up echocardiography. Transesophageal echocardiography and thoracic CT angiography confirmed a right atrial mass attached to the Eustachian valve and additionally revealed a non-occlusive pulmonary embolism in the inferior lobar artery of the left lung. Despite 2 months of anticoagulation treatment, the size of the mass did not decrease. Further MRI imaging showed a central mass enhancement which raised concerns about a tumoral lesion. Following a discussion with the local Heart Team, management with surgical treatment was decided. The intraoperative findings revealed a 2.5 cm × 2.1 cm mass arising from the Eustachian valve and a non-diagnosed Chiari network in the RA. Both were resected and sent for a frozen section procedure which excluded a malignancy. The final histopathological analysis described fibrotic tissues compatible with an organized thrombus. The patient was discharged on postoperative day 7 without any complications. Although imaging studies are useful for the initial and differential diagnosis of RA masses, it is not always possible to get the final diagnosis without surgery. In case of a suspicion of a potentially malignant pathology, surgical exploration and resection are necessary.
The Management of a Case With Mucin-Producing Adenocarcinoma Originating From the Urachus
Authors: Panagiotis Angelopoulos, Sotirios Kapsalos-Dedes, Ioannis Manolitsis, Stamatios Katsimperis, Themistoklis Bellos, Ioannis Kyriazis, Panagiotis Neofytou, Lazaros Tzelves, Marinos Berdempes, Andreas Skolarikos
Journal: Cureus (2024)
Keywords: adenocarcinoma, cystectomy, pelvic lymph node dissection, urachal cancer, urology and oncology
MeSH terms: Case Reports

Urachal cancer is a rare and aggressive type of cancer, frequently characterized by a lack of prominent symptoms. We herein report a case of a 50-year-old female with mucin-producing adenocarcinoma originating from the urachus who underwent partial cystectomy and the patient remains disease-free for 30 months after treatment.
Management of a Failed Distal Tibial Allograft Procedure for Anterior Shoulder Instability in a Patient With Epilepsy: A Case Report
Authors: John Grossi, Paul Danahy, Oren D Rosenthal, George P Ackerman
Journal: Cureus (2024)
Keywords: allograft, autograft, epilepsy, latarjet, shoulder dislocation
MeSH terms: Case Reports

Shoulder instability episodes are observed in high-energy injuries, such as seizures. In this case report, we highlight the management of a failed distal tibial allograft procedure for recurrent shoulder instability in a patient with a bony Bankart lesion and epilepsy. The patient was treated with an iliac crest autograft and a proximal humerus osteochondral allograft procedure. To our knowledge, the use of an iliac crest autograft for glenoid bone loss and a proximal humerus osteochondral allograft after several failed shoulder instability procedures in a patient with epilepsy has not been reported.
Peritoneal tuberculosis, an underestimated diagnosis: a case report
Authors: Leila Laamara, Elmostafa Benaissa, Amine Achemlal, Amal Bounakhla, Fatna Bssaibis, Yassine BenLahlou, Adil Maleb, Mariama Chadli, Mostafa Elouennass
Journal: Access Microbiol (2024)
Keywords: xpert mtb/rif assay, peritoneal tuberculosis, peritonitis
MeSH terms: Case Reports

Tuberculosis is an infectious disease that most often affects the lungs, caused by human-to-human transmission of Mycobacterium tuberculosis. Peritoneal tuberculosis is an extra-pulmonary form of the disease that usually manifests as an ascitic syndrome, with or without fever, in a context of altered general condition, often in endemic areas. The diagnosis of peritoneal tuberculosis is not always easy, as the clinical signs are often insidious and unspecific. We report a case of peritoneal tuberculosis in an 18-year-old female, who had presented for 10 days with a progressive increase in abdominal volume associated with vomiting and diarrhoea.
Anesthetic Management of a Patient With Central Core Disease Undergoing Thoracoscopic Lung Resection: The Importance of Neuromuscular Monitoring at the Masseter Muscle
Authors: Hiroko Baba, Ryo Wakabayashi, Hiroki Ichiyanagi, Aki Suzuki, Nobukazu Sato
Journal: Cureus (2024)
Keywords: central core disease, malignant hyperthermia, neuromuscular monitoring, residual neuromuscular block, total intravenous anesthesia
MeSH terms: Case Reports

Central core disease is a rare muscular disorder in which anesthetic considerations for the prevention of malignant hyperthermia and for avoidance of residual neuromuscular block are required. A 63-year-old woman with central core disease underwent thoracoscopic sublobar lung resection under total IV anesthesia with a prepared anesthetic workstation. The rocuronium-induced neuromuscular block was monitored by using acceleromyography at the left adductor pollicis muscle and the right masseter muscle. The recovery of neuromuscular block at the masseter was slower than that at the adductor pollicis. The patient showed no symptoms of malignant hyperthermia and residual neuromuscular block and had an uneventful postoperative course. In the present case, malignant hyperthermia was successfully prevented with general anesthesia that is free of triggering agents using a prepared anesthetic machine. The authors speculate that the masseter may be an auxiliary site for neuromuscular monitoring to ensure recovery from neuromuscular block in patients with central core disease.
Ovarian Torsion in a Young Adolescent with Rokitansky Syndrome
Authors: Francesco Fedele, Giovanna Esposito, Andrea Busnelli, Fabio Parazzini
Journal: Case Rep Obstet Gynecol (2024)
MeSH terms: Case Reports

A case report of a premenarcheal patient with ovarian torsion and mullerian agenesis is presented. A 12-year-old prepubertal girl is presented with severe right lower quadrant abdominal pain and mild rebound. Laparoscopy showed mullerian agenesis and twisted right adnexa. Detorsion and cystectomy of the right ovary were done, and the ovary was fixed to the pelvic sidewall. The postoperative course was uneventful. An association between the lax attachment of the adnexa and torsion may be a contributing factor in this condition.
A Novel BCR::ABL1 Variant Detected with Multiple Testing Modalities
Authors: J Jean, M Sukhanova, D Dittmann, J Gao, L J Jennings
Journal: Case Rep Hematol (2024)
MeSH terms: Case Reports

Chronic myeloid leukemia (CML) is associated with several breakpoint regions that result in different BCR::ABL1 fusion transcripts. These include the major breakpoint region (M-BCR), minor breakpoint region (m-BCR), and mu breakpoint region (u-BCR) corresponding to p210, p190, and p230 fusion transcripts, respectively. This patient is a 38-year-old female with a new diagnosis of CML in chronic phase. A novel p210 fusion transcript splice variant was detected with qualitative reverse transcription PCR and capillary electrophoresis. Subsequent FISH study was performed, which revealed 86.5% positive for the BCR::ABL1 fusion. Quantitative real-time polymerase chain reaction (PCR) showed a negative result for the p210 fusion transcript. The variant was further characterized by Sanger sequencing. This variant is in-frame and predicted to be functional. This case illustrates the need for a combination of different testing techniques to fully characterize the rare BCR::ABL1 fusion transcripts.
Mepolizumab treatment in a patient with previous liver transplantation: One year follow-up
Authors: Claudio Candia, Francesco Coppa, Lucia Abagnale, Francesco Perna, Antonio Molino
Journal: Respir Med Case Rep (2023)
Keywords: liver transplantation, mepolizumab, severe asthma, tacrolimus
MeSH terms: Case Reports

Severe Asthma (SA) is characterized by inadequate disease control despite maximal inhalation therapy. In November 2021, a 68-years old female patient presented at our facility referring a worsening in her asthma-related symptoms and a high exacerbations rate. She reported a liver transplantation in 2015 and was in treatment with tacrolimus. We started treatment with Mepolizumab 100 mg once every 28 days and monitored her lung function as well as her lymphocytes subsets. After one year follow-up, the patient had a substantial improvement in lung function, exacerbation rate, daily OCS intake dose and no variation in the blood concentration of tacrolimus.
Coccidioidomycosis as a Potential Trigger for Sarcoidosis: A Case Study
Authors: Poonam Tawde, Salim Mohammad
Journal: Cureus (2024)
Keywords: chronic kidney disease, coccidioidomycosis, diagnostic challenges, hypercalcemia, interdisciplinary collaboration, sarcoidosis, valley fever
MeSH terms: Case Reports

This study explores the complex interplay between coccidioidomycosis (valley fever) and sarcoidosis through a detailed case study of a 54-year-old male patient. The patient presented with elevated calcium levels, chronic kidney disease (CKD), and unintended weight loss. Interdisciplinary collaboration between nephrologists and pulmonologists played a crucial role in navigating the intricate medical challenges, including hypercalcemia, renal dysfunction, and pulmonary anomalies. The diagnostic journey involved extensive laboratory findings uncovering the involvement of both infectious agents and granulomatous disorders. The patient exhibited positive cocci IgG antibodies, indicating coccidioidomycosis. Further complications included glomerulonephritis, as revealed by ongoing systemic inflammation. Tailored management strategies were implemented, including corticosteroid therapy for sarcoidosis-related inflammation and antifungal interventions for coccidioidomycosis. Vigilant monitoring of renal function, hypercalcemia, and weight loss was essential for comprehensive patient care. The study underscores the significance of interdisciplinary collaboration, systematic diagnostics, and personalized patient care in managing complex medical presentations and contributes to understanding the interplay between these two conditions.