OpenMed/multicare-articles huggingface dataset:
Multisystem inflammatory syndrome in Indian adolescents associated with SARS-CoV-2 infection: a case report
Authors: Rahul D Bhiwgade, M C Nischitha, Bhushan Shahare, Shobhna Bitey
Journal: Egypt J Intern Med (2021)
Keywords: adolescents, covid-19, inflammatory markers, multisystem inflammatory syndrome, sars-cov-2, shock
MeSH terms: Case Reports

Background:
Adolescents with coronavirus disease 2019 (COVID-19) associated multisystem inflammatory syndrome (MIS) can present with shock and myocardial injury and mimic Kawasaki disease.
Case presentation:
We describe 4 previously well adolescents (age 13-14 years), presenting with clinical features of MIS in children (MIS-C). All patients had nearly similar clinical presentation. Hematological investigations revealed elevated inflammatory markers, anemia, thrombocytopenia, and decreased neutrophil:lymphocyte ratio. All patients were negative on real-time polymerase chain reaction against severe acute respiratory syndrome coronavirus 2, but had elevated immunoglobulin G titers. Two patients had atypical Kawasaki disease. Three patients had severe disease with hypotensive shock and required intensive care with fluids and inotropes. Two patients required non-invasive respiratory support for dyspnea and one patient had biventricular dysfunction. All received empiric antibiotics, low-molecular weight heparin, steroids, and intravenous immunoglobulin. One patient succumbed, while others recovered well.
Conclusions:
MIS-C may be a late presentation in adolescent with COVID-19. Individualized treatment with empiric antibiotics, immunomodulation, and thromboprophylaxis can result in significantly better outcome.
Interferon-α induced remission in three patients with eosinophilic granulomatosis and polyangiitis. A case study
Authors: B Seeliger, M Foerster, T Neumann, A Moeser, J Happe, N Kehler, C Kroegel
Journal: Respir Med Case Rep (2013)
Keywords: anca, antineutrophil cytoplasmatic antibodies, autoimmunity, bal, bronchoalveolar lavage, dmards, disease modifying anti-rheumatic drugs, egpa, eosinophilic granulomatosis with polyangiitis, eosinophils, ifn-α, interferon-alpha, interferon, mu, million units, pnp, polyneuropathy, vasculitis

Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic small vessel vasculitis associated with asthma and eosinophilia. Optimal therapy for maintenance of remission is yet to be defined. We present a case-series of three patients with EGPA in whom IFN-α, an immunomodulatory cytokine induced remission, which was maintained even after discontinuation of the drug. In all patients (ages 60, 51, and 50 years), remission was associated with normalisation of eosinophil counts and IgE-levels. Moreover, the patients remained in remission for one to four years. Two patients did not need further immunosuppression, one patient required low dose maintenance therapy. Although reversible side effects occur, IFN-α-therapy induces long-term remission of EGPA even after discontinuation of treatment.
Untreated Active Tuberculosis in Pregnancy with Intraocular Dissemination: A Case Report and Review of the Literature
Authors: Shadi Rezai, Stephen LoBue, Daniel Adams, Yewande Oladipo, Ramses Posso, Tiffany Mapp, Crystal Santiago, Manisha Jain, William D Marino, Cassandra E Henderson
Journal: Case Rep Pulmonol (2015)

Background. Tuberculosis (TB) is a disease that affects hundreds of millions of people across the world. However, the incidence in developed countries has decreased over the past decades causing physicians to become unfamiliar with its unspecific symptoms. Pregnant individuals are especially difficult because many symptoms of active TB can mimic normal physiological changes of pregnancy. We present a case report of a 26-year-old multiparous woman, G4P3003, at 38-week gestation with a history of positive PPD who emigrated from Ghana 6 years ago. She came to the hospital with an initial complaint of suprapubic pain, pressure, and possible leakage of amniotic fluid for the past week. Patient also complained of a productive cough for the past 3 to 4 months with a decrease in vision occurring with the start of pregnancy. Visual acuity was worse than 20/200 in both eyes. Definitive diagnosis of active TB was delayed due to patient refusal of chest X-ray. Fortunately, delay in diagnosis was minimized since patient delivered within 24 hours of admission. Active TB was confirmed with intraocular dissemination. Patient had optic atrophy OS (left eye) and papillitis, choroiditis, and uveitis OD (right eye) due to TB infiltration. Fetus was asymptomatic and anti-TB therapy was started for both patients.
A case of acute non-typeable Hemophilus influenza infective endocarditis in a patient with hypocomplementemia
Authors: Parth Patel, Delvis Fogwe, Tarang Patel, Sachin Patil, Andres Bran-Acevedo, Yuji Oba, William Roland
Journal: IDCases (2023)
Keywords: hemophilus influenzae, hypocomplementemia, infective endocarditis, invasive
MeSH terms: Case Reports

Hemophilus influenzae is a gram-negative bacteria responsible for significant cases of invasive infections, especially in the pediatric population and in immunosuppressed adult patients. Before vaccination, most cases were frequently caused by capsulated or typeable variants. Due to the absence of effective vaccination against the nontypeable variant, it is now responsible for most invasive infections. Predisposing risk factors in adults include asplenia, hypocomplementemia, cancer, human immunodeficiency virus infection, and chronic cardiopulmonary disease. Immunity to the nontypeable variants causing disease is perplexing and not yet wholly described as they are genetically diverse. Infective endocarditis (IE) is a cardiac infection with devastating consequences if not detected earlier and treated appropriately. Gram-positive bacteria are the primary cause of IE overall, followed by gram-negative bacteria. Hemophilus species belong to the HACEK group of gram-negative bacteria responsible for causing IE in the pediatric population more than in adults. Hemophilus species, especially the nontypeable variant, is a rare cause of IE in adults. Here we present a case of IE due to Nontypeable Hemophilus influenzae in a 49-year-old caucasian male with hypocomplementemia.
Possible Iodine-Induced Thyrotoxicosis in a Previously Healthy Adolescent following Administration of Iodinated Contrast Media
Authors: Jennifer Apsan, Zoltan Antal
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Introduction. Jod-Basedow Syndrome refers to a paradoxical phenomenon in which large loads of iodine can cause hyperthyroidism. It is most commonly seen in populations already at risk for thyroid disease or those with underlying kidney disease. Case Presentation. We present a case of an acutely ill 17-year-old boy with symptomatic hyperthyroidism following an iodinated contrast CT scan to rule out appendicitis. Discussion/Conclusion. This case underscores the importance of recognizing this phenomenon even in the pediatric population and in those with no preexisting history of thyroid disease. Course complications including bronchospasm, hypertension, transaminitis, and bilateral palmar desquamating rash are rare and highlight the complexities involved in the disease state and in managing side effect profiles of treatment.
Inflammatory pseudotumor of the head presenting with hemiparesis and aphasia
Authors: K Saifudheen, James Jose, V Abdul Gafoor
Journal: Case Rep Neurol Med (2011)
MeSH terms: Case Reports

Inflammatory pseudotumor most commonly occurs in the orbit and produces orbital pseudotumor, but extension into brain parenchyma is uncommon. We report a case of inflammatory pseudotumor involving sphenoid sinus, cavernous sinus, superior orbital fissure, orbital muscle, and intracranial extension into left temporal lobe producing right hemiparesis and wernicke's aphasia. The patient improved clinically and radiologically with steroid administration. This paper provides an insight into the spectrum of involvement of inflammatory pseudotumor and the importance of early diagnosis of the benign condition.
Massive Cervicothoracic Subcutaneous Emphysema and Pneumomediastinum Developing during a Dental Hygiene Procedure
Authors: Gabriele Bocchialini, Serena Ambrosi, Andrea Castellani
Journal: Case Rep Dent (2017)
MeSH terms: Case Reports

Subcutaneous emphysema is rare during or after dental procedures (usually extractions). Here, we describe the case of a 65-year-old woman who developed massive cervicothoracic subcutaneous emphysema and pneumomediastinum during a dental hygiene procedure employing an artificial airflow. She was diagnosed based on clinical manifestations and computed tomography (CT). CT revealed massive subcutaneous emphysema extending from the superior left eyelid to the diaphragm. We describe the clinical and radiological characteristics of this rare case.
An obscure cause of gastrointestinal bleeding: Recurrent duodenal variceal hemorrhage treated with intramuscular octreotide in the absence of portal hypertension
Authors: Robert S O'Neill, William J Wang, Patrick Chan, Vincent Ho, Christine Verdon, Ian Turner, Priya Acharya
Journal: JGH Open (2022)
Keywords: duodenal varices, endoscopy, haemorrhage, radiology, varices
MeSH terms: Case Reports

Duodenal varices (DVs) are ectopic gastrointestinal varices (ECVs) associated with portal hypertension (PH). We present the case of an 82-year-old woman who presented with symptomatic anemia secondary to DV hemorrhage diagnosed on oesophagogastroduodenoscopy. This lesion was treated with endoscopic adrenaline injection and clip application. The patient re-presented on multiple occasions with bleeding recurrence localized to the duodenum, which was managed with intramuscular octreotide and oral beta-blockade resulting in sustained remission of bleeding. This case highlights a rare cause of upper gastrointestinal hemorrhage and highlights the value of somatostatin analogues for conservative treatment of DVs.
Sporadic MM-1 Type Creutzfeldt-Jakob Disease With Hemiballic Presentation and No Cognitive Impairment Until Death: How New NCJDRSU Diagnostic Criteria May Allow Early Diagnosis
Authors: Lorenzo Saraceno, Vito A G Ricigliano, Michele Cavalli, Alessandro Cagol, Giovanna Bosco, Fabio Moda, Paola Caroppo, Giovanni Meola
Journal: Front Neurol (2018)
Keywords: cjd diagnostic criteria, creutzfeldt-jakob disease, ncjdrsu, cognitive impairment, hemiballic syndrome, methionine/methionine polymorphism, prion disorders
MeSH terms: Case Reports

Sporadic Creutzfeldt-Jakob disease is the most common human prion disorder. Although associated with heterogeneous clinical phenotypes, its distinctive feature is the presence of a rapidly progressive multidomain cognitive impairment. We describe the atypical case of a patient affected by sporadic Methionine/Methionine type 1 Creutzfeldt-Jakob disease (typically associated with early cognitive decline) who presented with an isolated hemiballic syndrome and no signs of cognitive involvement until death. We review sporadic Creutzfeldt-Jakob disease diagnostic criteria and their updates since their first formulation, highlighting their limitations in clinical diagnostic work-up. Finally, we discuss the recently introduced National Creutzfeldt-Jakob Disease Research and Surveillance Unit diagnostic criteria, suggesting how their application could support an early clinical diagnosis, even in atypical cases, such as the one presented.
Four cases report: Treatment of knee joint cartilage defects using autologous chondrocyte patch implantation
Authors: Le Wang, Han Li, Yiguo Cao, Cheng Song, Qi Chen, Jun Hao, Weiguo Zhang, Kang Tian
Journal: Front Surg (2022)
Keywords: aci, maci, autologous chondrocyte patch implantation, cartilage defect, cartilage repair, sandwich technique
MeSH terms: Case Reports

Introduction:
Autologous chondrocyte implantation (ACI) is a crucial method for the treatment of defects in articular cartilage. However, the extant methods for the preparation of autologous chondrocyte patch are relatively complicated and money-consuming. Therefore, an efficient, reliable, easy-to-follow, and cost-effective technique is needed to overcome constraints. This case report aims to introduce an autologous chondrocyte patch fabrication technique to repair knee joint cartilage defects and report our typical cases with a 2-year follow-up.
Case presentation:
We described four cases in which patients complained of knee joint pain. According to radiological examination, the patients were diagnosed as knee joint cartilage defect. Arthroscopy and autologous chondrocyte patch implantation were performed as well as a 2-year follow up of patients. The autologous chondrocyte patch for knee joint cartilage repair was fabricated using a "sandwich" technique. The preoperative and postoperative knee function was evaluated by four subjective evaluation systems. MRI was performed for all patients to achieve more intuitionistic observation of the postoperative radiological changes of defect sites. The quality of repaired tissue was evaluated by Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART). Postoperative follow-up showed improvement in clinical and MOCART scores for all patients. However, one patient complained of knee joint pain after walking for a long time or recreational activities from 12- to 18-month postoperatively. The location of pain for this patient was not in accordance with the location of cartilage defect.
Conclusion:
The patients undergoing autologous chondrocyte patch implantation demonstrated clinical improvement and good quality of repaired tissue postoperatively. The procedure is an efficient and cost-effective treatment for knee joint cartilage defect in this report. In addition, patients with osteoarthritis carry the risk of a poor outcome after the procedure, and whether to have a procedure should be considered carefully.
Nonoperative treatment of avulsion fracture of the anterior tibia with proximal fibular fracture: A case report
Authors: Jian Yu, Chao Zhang, Xu Wang, Xin Ma, Jiazhang Huang
Journal: Front Surg (2023)
Keywords: maisonneuve fracture, ankle instability, avulsion fracture of the anterior tibia, nonoperative management, proximal fibular fracture
MeSH terms: Case Reports

Background:
Avulsion fracture of the anterior tibia with proximal fibular fracture commonly occurs in Maisonneuve fracture, which generally involves ankle instability and requires surgical correction. Nonoperative treatment of this type of fracture has been rarely reported in the literature.
Case presentation:
A 48-year-old male reported pain in the lateral part of his left lower leg and ankle during a badminton play. Physical examination revealed tenderness and swelling of the lateral aspects of the left ankle, as well as the proximal aspect of the fibula. Preoperative plain x-ray image, computed tomography, and magnetic resonance imaging revealed an avulsion fracture of the anterior tibia by the anterior inferior tibiofibular ligament without medial and posterior fracture, rupture of the deltoid ligament, or interosseous membrane. Nonoperative management was performed and successful recovery was observed at a 6-month follow-up.
Conclusions:
Nonoperative management can be a better option for some variations of Maisonneuve fracture with a stable ankle joint. The selection of treatment options should be based on careful examination and radiological evaluation of the ankle.
Salvage Laparoscopic-Assisted Anorectoplasty after Failed Vestibular Fistula Repair Using Magnetic Resonance Image Guidance
Authors: Matthew W Ralls, Brian P Fallon, Maria Ladino-Torres, Peter F Ehrlich, Marcus D Jarboe
Journal: European J Pediatr Surg Rep (2019)
Keywords: anorectal malformation, image guidance, magnetic resonance imaging, posterior sagittal anorectoplasty, rectovestibular fistula
MeSH terms: Case Reports

Patients with vestibular fistula have a good functional outcome after posterior sagittal anorectoplasty (PSARP). While continence is often preserved, close follow-up and management of constipation are often required. Redo anorectal surgery has been associated with worse functional outcomes compared with primary procedures, possibly due to injury and scarring of the pelvic floor musculature and sphincter complex. Our group has a growing experience in the use of intraoperative real-time magnetic resonance imaging (MRI) for anorectal malformation repairs. We present a case of salvage operation of a failed PSARP for vestibular fistula.
Using Social Networking Sites in Research: An Emerging Approach to Engaging With Young People Who Have a Parent With a Mental Illness and/or Substance Abuse Disorder
Authors: Christine Grové
Journal: Front Psychiatry (2019)
Keywords: mental health practices, online research methods, recruitment, research ethics, research with young people, social networking sites, young people with parents with mental illness, youth at risk

The challenges involved in engaging young people who have a parent with a mental illness in research and in programs are well documented. Social networking sites provide a potentially useful medium to include at-risk youths and their families by removing some accessibility barriers that may prevent engagement and connection with individuals whose parents or family members have a mental illness. This paper examines how social networking sites can be used to recruit youths and/or their families and engage them in research. Applying a case study analysis, the implications of using social media as a tool for recruitment and data collection and the ethical considerations and limitations will be discussed. Results tentatively indicate that social networking sites may be an effective method to engage young people of parents with a mental illness. The study argues for more informed use of social platforms for the translation and dissemination of research and intervention prevention. Overall, this paper will contribute to public mental health practice through guidelines and policy about social media research with at-risk young people and their families.
A Dramatic Response of a Thyroid Lymphoma to R-CHOP Chemotherapy Reversing Mechanical Airway Obstruction and Respiratory Failure
Authors: Zeinab Alnahas, Mohamad H Horani
Journal: Case Rep Endocrinol (2022)
MeSH terms: Case Reports

Primary thyroid lymphoma is an extremely rare thyroid malignancy that usually occurs in patients with preexisting Hashimoto thyroiditis and commonly presents in older women. The most common type is non-Hodgkin's lymphoma of B-cell origin, particularly diffuse large B-cell lymphoma (DLBCL), which is primarily treated with chemotherapy and radiotherapy. We reported an 83-year-old woman with a past medical history of hypothyroidism who suffered dysphagia and dyspnea secondary to a large thyroid mass. Her CT neck scan showed an enlarged thyroid mass with pathological cervical lymphadenopathy and marked tracheal narrowing. The ultrasound-guided biopsy confirmed the diagnosis of DLBCL of the thyroid. A few days later, she experienced respiratory distress and failure that required endotracheal intubation and mechanical ventilation. She was not considered for tracheostomy or surgical interventions, and after discussion with her family, the decision was made to start R-CHOP therapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) which resulted in a marked reduction of the thyroid size and reversal of the mechanical airway obstruction, enabling her extubation. This case report demonstrated the dramatic response of a large thyroid lymphoma to R-CHOP therapy, reducing the thyroid size and its fatal obstructive complications, including mechanical airway obstruction, within a few days of the initiation of R-CHOP therapy.
Delayed enterocutaneous fistula formation secondary to an inverted non-absorbable suture post midline laparotomy closure
Authors: Danylo Yershov, Paul Murphy, Henry Ferguson
Journal: Int J Surg Case Rep (2020)
Keywords: enterocutaneous fistula, laparotomy, postoperative complications, sutures
MeSH terms: Case Reports

Introduction:
Enterocutaneous fistula is a well recognised complication of intra-abdominal surgery. Postoperatively, it may occur due to a small bowel injury or an anastomotic leak and usually presents within days or weeks after surgery.
Methods:
We present a case report. Information was obtained through a retrospective review of the notes, clinic letters, images and the histology report.
Results:
We present a case of a patient who developed an enterocutaneous fistula 34 years after panproctocolectomy for ulcerative colitis. Imaging was consistent with an enterocutaneous fistula arising from mid-small bowel. A laparotomy and small bowel resection was performed. The enterocutaneous fistula occurred due to an inverted non-absorbable suture post midline laparotomy closure.
Conclusion:
Suture-related enterocutaneous fistula can be a rare delayed complication of a midline laparotomy closure when a knot is inverted intra-peritoneally. Consideration should be given to either leaving a knot in the subcutaneous fat tissue or feeding it between the rectus sheath and the suture bites.
Lasting pathologic complete response to chemotherapy for ovarian cancer after receiving antimalarials for dermatomyositis
Authors: Isabella Cadena, Victoria P Werth, Pascale Levine, Annie Yang, Andrea Downey, John Curtin, Franco Muggia
Journal: Ecancermedicalscience (2018)
Keywords: antimalarials, autophagy, carboplatin sensitivity, dermatomyositis, ovarian cancer
MeSH terms: Case Reports

Could hydroxychloroquine and quinacrine antimalarial therapy for dermatomyositis later attributed to a paraneoplasic manifestation of an ovarian cancer enhance its subsequent response to chemotherapy? Five months after being diagnosed with dermatomyositis, while somewhat improved with hydroxychloroquine, quinacrine and methotrexate, this 63-year-old woman presented with an advanced intra-abdominal epithelial ovarian cancer documented (but not resected) at laparotomy. Neoadjuvant carboplatin/paclitaxel resulted in remarkable improvement of symptoms, tumour markers and imaging findings leading to thorough cytoreductive surgery at completion of five cycles. No tumour was found in the resected omentum, gynaecologic organs, as well as hepatic and nodal sampling thus documenting a complete pathologic response; a subcutaneous port and an intraperitoneal (IP) catheter were placed for two cycles of IP cisplatin consolidation. She remains free of disease 3 years after such treatment and her dermatomyositis is in remission in the absence of any treatment. We discuss a possible role of autophagy in promoting tumour cell survival and chemoresistance that is potentially reversed by antimalarial drugs. Thus, chemotherapy following their use may subsequently lead to dramatic potentiation of anticancer treatment.
Molecular and Genetic Predictors of Breast-to-Brain Metastasis: Review and Case Presentation
Authors: Zachary Medress, Melanie Hayden Gephart
Journal: Cureus (2015)
Keywords: brain metastasis, breast cancer, her2/neu, neurosurgery, oncology
MeSH terms: Review

Brain metastases are the most common intracranial malignancy, and breast cancer is the second most common cancer to metastasize to the brain. Intracranial disease is a late manifestation of breast cancer with few effective treatment options, affecting 15-50% of breast cancer patients, depending upon molecular subtype. In this review article, we describe the genetic, molecular, and metabolic changes in breast cancer cells that facilitate breast to brain metastasis. We believe that advances in the understanding of breast to brain metastasis pathogenesis will lead to targeted molecular therapies and to improvements in the ability to prospectively identify patients at increased risk for developing intracranial disease.