OpenMed/multicare-articles huggingface dataset:
Massive Pulmonary Thromboembolism in Patients with COVID-19; Report of Three Cases
Authors: Mehdi Pishgahi, Zahra Ansari Aval, Behzad Hajimoradi, Rama Bozorgmehr, Saeed Safari, Mahmoud Yousefifard
Journal: Arch Acad Emerg Med (2020)
Keywords: covid-19, pulmonary embolism, clinical deterioration, severe acute respiratory syndrome coronavirus 2, thrombolytic therapy, venous thromboembolism
MeSH terms: Case Reports

COVID-19 is a novel infectious disease, which has challenged people all around the world. As of today, healthcare practitioners and researchers have made great effort to understand the characteristics and clinical presentations of the disease; however, the existing literature is still incomplete in this regard. A growing body of evidence indicates that coagulopathies and thromboembolic events are of utmost importance in COVID-19 patients and are related to poor prognosis. Here, we report three ICU admitted cases of COVID-19, in which massive pulmonary thromboembolism (PTE) occurred a few days after disease onset. Unfortunately, one of the patients did not survive and two were treated; one with thrombectomy and other with antithrombotic agents. It seems that severe cases of COVID-19 are at risk for developing PTE and in-charge physicians should be prepared and plan for anticoagulant prophylaxis using low-molecular-weight heparin (LMWH).
Benign myoepithelioma of the lung - a case report and review of the literature
Authors: Jihene Kourda, Olfa Ismail, Bel Hssan Smati, Aida Ayadi, Tarek Kilani, Faouzi El Mezni
Journal: Cases J (2010)

Introduction:
Benign myoepithelioma is extremely rare in the lung, to the best of our knowledge; only five cases have been reported in the literature.
Case report:
An 18-years woman complained from tiredness and fever during four months. Laboratory findings and fibroscopies were normal. CT of the thorax demonstrated a nodule in the left segment of the Fowler. Left inferior lobectomy was performed comporting a firm nodule of 25 mm, lifting the bronchial mucous membrane. Histologically, there was a proliferation of small cells of a plasmocytoid-type, with a predominantly whorled pattern. No mitotic activity or necrosis was seen in the tumor. Immuhistochemically, the tumor cells positive for smooth muscle actin, vimentine, and S100 protein. They were negatives for cytokeratine, chromogranine and HMB45. The diagnosis of benign myoepithelioma of the lung is so confirmed. The patient recovered well at 6 months follow-up.
Conclusion:
Benign myoepithelioma is a rare pulmonary neoplasm distinct from pleomorphic adenoma, which should be considered in the differential diagnosis of lung nodules.
Using primary care parenting interventions to improve outcomes in children with developmental disabilities: a case report
Authors: Cassandra L Tellegen, Matthew R Sanders
Journal: Case Rep Pediatr (2012)

Parenting is central to the health and well-being of children. Children with developmental disabilities have been shown to be at increased risk of developing emotional and behavioral problems. Parent training programs are effective interventions for improving child behavior and family functioning. This paper describes the outcomes of a brief 4-session parenting intervention (Primary Care Stepping Stones Triple P) targeting compliance and cooperative play skills in an 8-year-old girl with Asperger's disorder and ADHD combined type. The intervention was associated with decreases in child behavior problems, increases in parenting confidence, and decreases in dysfunctional parenting styles. This paper demonstrates that low-intensity parenting interventions can lead to significant improvements in child behavior and family functioning. Such brief interventions are cost effective, can be widely disseminated, and have been designed to be delivered within primary health care settings. Pediatricians can play a key role in identifying parents in need of assistance and in helping them access evidence-based parenting interventions.
A forgotten parasitic infestation in an immunocompromised patient-a case report of crusted scabies
Authors: Martin Agyei, Afua Ofori, Elliot Koranteng Tannor, John Jude Annan, Betty Roberta Norman
Journal: Pan Afr Med J (2020)
Keywords: crusted scabies, sarcoptes scabiei var hominis mite, immunocompromised, neglected tropical disease
MeSH terms: HIV Infections / complications, Immunocompromised Host, Scabies / diagnosis, Case Reports, Adult, Female, Humans, Skin Diseases / diagnosis

Crusted scabies is a rare and highly contagious form of Sarcoptes scabiei var hominis infestation whose incidence may increase in the near future due to increasing use of immunosuppressive therapies and a general lack of awareness about the condition. It is misdiagnosed as psoriasis, irritant dermatitis or eczema. Delays in diagnosis lead to widespread transmission amongst contacts leading to potential community outbreak. Crusted scabies is extremely difficult to treat and there are growing concerns of possible resistance to current treatment. This case report describes a 44-year-old Ghanaian woman with human immunodeficiency virus (HIV) infection and diagnosed with skin scrapings. Treatment was initiated but the patient died from HIV related complications. Crusted scabies, though rare, should be an issue of global concern due to the potential for widespread dissemination. Adequate resources need to be channeled into scabies eradication as well as education of health personnel to promptly identify and treat cases.
COVID-19 Vaccine-Induced Latent Autoimmune Diabetes in Adults
Authors: Klynt Bally, Beisi Ji, Lina Soni
Journal: Cureus (2023)
Keywords: covid-19, lada, latent autoimmune diabetes in adults, pfizer, vaccination
MeSH terms: Case Reports

Since 2019, COVID-19 has plagued the world with its unfortunate death toll; however, with the introduction of multiple COVID vaccines, mortality and morbidity rates have severely declined. There have been misconceptions surrounding these vaccines, and at the same time, many documented conditions precipitated by the vaccines. This case highlights a speculated relationship between new-onset Latent Autoimmune Diabetes in Adults (LADA) (presenting with diabetic ketoacidosis) and the COVID-19 vaccine. There have been articles suggesting the precipitation of diabetic ketoacidosis /hyperosmolar hyperglycemic syndrome, as well as new-onset diabetes mellitus (DM) with the COVID-19 vaccines but no documented link between LADA and the vaccine. The endpoint of this case is not only to highlight a newfound side-effect of the vaccine but also to urge primary care providers and physicians to closely monitor glucose levels and patient's A1C after vaccine administration to prevent the formation of these hyperglycemic crises, as well as to consider autoimmune conditions in the differential diagnosis post-vaccination.
Case Report: Paroxysmal hyperhidrosis as an initial symptom in a patient with anti-LGI1 encephalitis
Authors: Tingting Qiao, Lanlan Chen, Li Jiang, Hua Wei, Xin Chen, Xiaobo Li, Yingzhu Chen, Yao Xu
Journal: Front Immunol (2022)
Keywords: anti-lgi1 encephalitis, autoimmune encephalitis, autoimmune epilepsy, case report, hyperhidrosis
MeSH terms: Dyskinesias / drug therapy, Encephalitis / diagnosis, Encephalitis / drug therapy, Encephalitis / etiology, Glioma, Hyperhidrosis / diagnosis, Hyperhidrosis / drug therapy, Hyperhidrosis / etiology, Limbic Encephalitis / diagnosis, Case Reports, Anticonvulsants / therapeutic use, Humans, Immunoglobulins, Intravenous / therapeutic use, Intracellular Signaling Peptides and Proteins, Leucine, Male, Middle Aged, Steroids / therapeutic use, Anticonvulsants, Immunoglobulins, Intravenous, Intracellular Signaling Peptides and Proteins, Steroids, Leucine

Anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis is the second most common cause of autoimmune encephalitis and is characterized by cognitive impairment, psychiatric disorders, and faciobrachial dystonic seizures. In recent decades, literature reports have expanded the phenotypic spectrum associated with the LGI1 autoantibody. The present report describes the case of a 58-year-old man who presented with repetitive unilateral hyperhidrosis of the body and arm as an initial symptom and gradually developed psychiatric symptoms, involuntary movements of the face and arms, and progressive cognitive decline. Anti-LGI1 antibodies were positive in both the serum and cerebrospinal fluid at approximately 2 months after symptom onset, and the patient was, therefore, diagnosed with anti-LGI1 encephalitis. His symptoms, namely hyperhidrosis and involuntary movements, were not relieved by antiepileptic drug treatment, but responded favorably to high-dose steroid therapy and intravenous immunoglobulin. We interpreted the repetitive unilateral hyperhidrosis as possible epilepsy. Based on this case, unilateral hyperhidrosis of the body and arm as a rare neurological presentation can be added to the phenotypic spectrum of anti-LGI1 encephalitis, and early recognition of this manifestation might support timely diagnosis and treatment.
A diagnostic dilemma: Pedunculated mesenteric lipodystrophy mimicking Meckel's diverticulum. A case report and literature review
Authors: Alessandra Mirabile, Marco Moschetta, Nicola Lucarelli, Michele Telegrafo, Arnaldo Scardapane, Amato Antonio Stabile Ianora
Journal: Int J Surg Case Rep (2020)
Keywords: ct, computed tomography, meckel’s diverticulum, mesenteric lipodystrophy, mesenteric panniculitis, sclerosing mesenteritis
MeSH terms: Case Reports

Introduction:
Mesenteric lipodystrophy is a rare fibroinflammatory disease of unknown origin with clinical and radiological non specific findings.
Presentation of the case:
The case of a 42-years-old man affected by a pedunculated mesenteric lipodystrophy mimicking Meckel's diverticulum is reported. Clinical, imaging and histological findings are discussed.
Discussion:
Mesenteric lipodystrophy affects the mesenteric fat of the abdomen with a typical diffuse thickening of the mesentery, nodular thickening of the mesenteric root and presence of mass-like lesions. Ultrasound (US) and Multiphasic Computed Tomography (CT) represent the main imaging tools used for diagnosis. Clinical and imaging findings can mimick other pathological conditions affecting the mesenteric fat tissue. Contrast enhanced CT is the most accurate imaging technique for diagnosing mesenteric lipodystrophy due to the high panoramicity and accuracy with multiplanar imaging. Multiphasic technique helps to characterize the lesion and to recognize vascular anatomy. Oral administration of iodinated contrast medium may help to assess the relationship with bowel loops. All these diagnostic elements are crucial for the surgical timing and approach.
Conclusions:
Due to the heterogeneous mesenteric involvement, the nonspecific CT findings and the high number of diseases for differential diagnosis, the detection of mesenteric lipodystrophy is challenging and requires early clinical suspicion. An histological examination is always necessary.
Novel GALC Mutations Cause Adult-Onset Krabbe Disease With Myelopathy in Two Chinese Families: Case Reports and Literature Review
Authors: Junfei Zhong, Fei Jiang, Huan Yang, Jing Li, Jian Cheng, Qiuming Zeng, Qian Xu
Journal: Front Neurol (2020)
Keywords: krabbe disease, adult onset, literature review, myelopathy, novel galc mutations
MeSH terms: Case Reports

Krabbe disease (KD), also referred to as globoid cell leukodystrophy, is a rare autosomal recessive lysosomal storage disorder caused by β-galactocerebrosidase (GALC) deficiency. Most patients affected by this disease are infants, and <10% of cases suffer from adult-onset KD. In this study, two Chinese males presented with long-term progressive weakness in their limbs. Magnetic resonance imaging of the brain and spinal cord of these patients revealed lesions with abnormally high signal intensity on T2-weighted (T2W) and T2W fluid-attenuated inversion recovery images. Whole-exome sequencing was performed for both patients, and four GALC mutations were identified. Case 1 carried a novel deletion mutation (p.T633Tfs*2) and a known missense mutation (p.T529M), while case 2 carried a novel missense mutation (p.W355C) and a known missense mutation (p.P154H). Previous literature has rarely reported myelopathy in patients with KD; in this study, we report two cases of adult-onset KD who both experienced myelopathy. We also conducted a literature review of KD and its association with myelopathy. Our findings provide a better understanding of the phenotypic and genotypic profiles associated with adult-onset KD. We recommend that physicians consider KD as a possible diagnosis in cases showing progressive motor dysfunction or gait disorder in association with typical myelopathy.
Choriocarcinoma syndrome: a case report and a literature review
Authors: Khaled Baagar, Fahmi Yousef Khan, Einas Alkuwari
Journal: Case Rep Oncol Med (2013)

A 35-year-old Qatari man presented to our hospital with a 4-month history of mild abdominal pain, weight loss, and jaundice. He was found to have central intra-abdominal mass and a single testis in the scrotum. His investigations showed cholestatic jaundice and very high level of β -HCG (1131379 IU/L). CT scans of the chest and abdomen showed a huge pelvic-abdominal mass with extensive retroperitoneal lymphadenopathy, in addition to liver and lung metastases. CT-guided Tru-Cut biopsy of the mass showed mixed germ cell tumor. Chemotherapy was refused by the patient and his family. In the following days, the patient bled from his liver metastases leading to hemorrhagic shock, hemorrhage from metastatic sites of choriocarcinoma containing tumors is named choriocarcinoma syndrome. He was transferred to the medical intensive care unit, where he was intubated and resuscitated. Embolization of the right hepatic artery was done, but failed to control the bleeding, which continued with development of disseminated intravascular coagulopathy and a severe abdominal compartment syndrome, and eventually the patient died.
A case report: Intermittent catheterization combined with rehabilitation in the treatment of carbapenem-resistant Klebsiella pneumoniae catheter-associated urinary tract infection
Authors: Lihua Shen, Heng Wu, Huiying Chen, Yan Jiang
Journal: Front Cell Infect Microbiol (2022)
Keywords: carbapenem-resistant klebsiella pneumoniae, catheter-associated, intermittent catheterization, rehabilitation, urinary tract infection
MeSH terms: Carbapenem-Resistant Enterobacteriaceae, Catheter-Related Infections / drug therapy, Urinary Tract Infections / therapy, Case Reports, Research Support, Non-U.S. Gov't, Carbapenems / therapeutic use, Catheterization, Catheters, Humans, Klebsiella pneumoniae, Carbapenems

Catheter-related urinary tract infections, especially those caused by multidrug-resistant (MDR) bacteria, are extremely difficult to treat due to limited therapeutic choices. Therefore, removing catheters as soon as possible is pivotal to successful treatment. Herein, we report a case of catheter-related urinary tract infection caused by carbapenem-resistant Klebsiella pneumoniae (CRKP). Intermittent catheterization was used to reduce biofilm occurrence and exercise bladder function on the basis of an active and adequate anti-infection strategy. Simultaneously, combined with acupuncture treatment and strengthening the patient's pelvic floor muscle training to improve urinary retention, the catheter was eventually removed to obtain autonomous urination in this patient, and this led to the successful treatment for a CRKP catheter-related urinary tract infection.
Disseminated Necrotizing Leukoencephalopathy Complicating Septic Shock in an Immunocompetent Patient
Authors: Pedro Gaspar-da-Costa, Sofia Reimão, Sandra Braz, João Meneses Santos, Rui M M Victorino
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

Disseminated necrotizing leukoencephalopathy (DNL) is characterized by multiple microscopic foci of white matter necrosis. DNL was initially thought to be exclusively associated with immunosuppression conditions but it has been recently described in immunocompetent patients in septic shock. A 90-year-old immunocompetent woman with no previous neurological impairment presented with septic shock and drowsiness that responded well to therapy with clinical improvement and a full neurological recovery. Unexpectedly deterioration with progression to coma occurred. Investigation excluded other causes and Magnetic Resonance Imaging (MRI) was consistent with the diagnosis of DNL showing bilateral multifocal white matter lesions with a nonvascular pattern with restricted diffusion. Neurological impairment persisted with progression to death. DNL is an unexpected diagnosis in an immunocompetent patient. We compared the present case to those found in the literature of DNL complicating septic shock and discuss the antemortem diagnosis based on MRI findings.
Hydatid Cyst of the Adrenal Gland: Is Radical Surgery Necessary for Recurrent Hydatid Disease?
Authors: Sami Akbulut, Mehmet Yilmaz
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Hydatid cyst disease caused by E. granulosus is a zoonotic disease that may involve many body tissues and organs, mainly liver. Adrenal glands are rarely involved even in regions where hydatid cyst disease is endemic. A limited number of studies have been reported on adrenal gland involvement by hydatid cyst disease. Herein, we aimed to report a recurrent case of adrenal hydatid cyst that was misdiagnosed as a hepatic hydatid cyst. A 16-year-old boy with a history of partial cyst excision and evacuation for perforated adrenal hydatid cyst disease three years ago presented to our outpatient clinic with nonspecific abdominal pain. Ultrasonography and computed tomography showed a lesion with an approximate size of 70 × 70 mm compatible with a hydatid cyst, which originated from the segment 5-6 of the liver and extended to the posterior-inferior direction. A surgical intervention was scheduled after a 2-week prophylactic albendazole treatment. During laparotomy using the old incision, it was noted that the cystic lesion that reportedly located in liver was actually a recurrent right adrenal cyst. As dense adhesions existed, the cystic lesion was excised en bloc with the right adrenal gland. As the lesion was totally removed without getting ruptured, albendazole was not administered at the postoperative period. No recurrence was observed at one-year follow-up.
Case report: subacute thyroiditis after receiving SARS-CoV-2 vaccine, maybe not only adjuvants
Authors: Yizhou Huang, Xingyu Chen, Qing Wang, Xiaowei Lei, Lili Zhang
Journal: Front Med (Lausanne) (2022)
Keywords: sars-cov-2 vaccines, adverse vaccine reactions, case report, subacute thyroiditis, thyroid dysfunction
MeSH terms: Case Reports

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induced the new coronavirus disease 2019 (COVID-19) pandemic worldwide. SARS-CoV-2 vaccines are designed to control the transmission of the disease. However, post-vaccination subacute thyroiditis (SAT) also appears with increase vaccination rate. Three cases of SAT after SARS-CoV-2 vaccines are described in this study. We have reported the patients' clinical symptoms, laboratory tests, and thyroid imaging. Tests for COVID-19 were all negative, and the patients did not report thyroid-related diseases, autoimmune diseases, or preceding upper respiratory system infections in their medical history. Three female patients showed neck pain on physical examination. The laboratory test results and imaging findings were consistent with the diagnostic criteria of SAT. The patients were carried out a standardized treatment according to their symptoms, and we closely followed up their response to the treatment. Clinicians must be aware of the possibility of SAT after receiving the vaccines and make timely therapy.
Unusual Presentation of Polyautoimmunity and Renal Tubular Acidosis in an Adolescent With Hashimoto's Thyroiditis and Central Pontine Myelinolysis
Authors: Nora Bruns, Ilja Finkelberg, Ibrahim Al-Attrach, Peter F Hoyer, Rainer Büscher
Journal: Front Endocrinol (Lausanne) (2020)
Keywords: hashimoto's thyroiditis, sjögren's syndrome, autoimmune thyroiditis, case report, celiac disease, central pontine myelinolysis, distal renal tubular acidosis, hypokalemia
MeSH terms: Acidosis, Renal Tubular / complications, Autoimmune Diseases / complications, Hashimoto Disease / complications, Myelinolysis, Central Pontine / complications, Case Reports, Research Support, Non-U.S. Gov't, Acidosis, Renal Tubular / immunology, Adolescent, Celiac Disease / complications, Female, Humans, Myelinolysis, Central Pontine / immunology, Sjogren's Syndrome / complications, Vitiligo / complications

Background: Hashimoto's thyroiditis is frequently associated with other autoimmune diseases and may include renal involvement. Case description: A 17-year-old female with previously diagnosed Hashimoto's thyroiditis and vitiligo was admitted to a pediatric intensive care unit with hypokalemic paralysis and acidosis, after having suffered from recurrent muscular weakness for approximately one year. A few days later she developed central pontine myelinolysis. After initial stabilization she was also diagnosed with distal renal tubular acidosis (dRTA) and tubular proteinuria which can occur in Sjögren's syndrome. Extended screening for autoimmune diseases additionally revealed celiac disease. Treatment with Prednisone and substitution of potassium quickly lead to the resolution of proteinuria and dRTA, but unilateral paralysis of the sixth nerve as a result of central pontine myelinolysis was irreversible. Conclusions: This is the rare case of polyautoimmunity including autoimmune thyroiditis, Sjögren's syndrome, vitiligo and celiac disease in an adolescent with few disease-specific symptoms. The diagnoses were made via a complicating nephritis causing dRTA and proteinuria. Delay in diagnosis lead to permanent neurological damage. This case highlights the need for pediatricians to be aware of rare accompanying diseases and their complications in "common" pediatric autoimmune diseases like Hashimoto's thyroiditis and celiac disease.
Compression syndromes of the popliteal artery due to intramuscular ganglion cyst of the biceps femoris: A case report and literature review
Authors: Kai Zheng, Wentao Yang, Hualiang Ren, Shengxing Wang, Mingsheng Sun, Wangde Zhang, Chunmin Li
Journal: Front Cardiovasc Med (2022)
Keywords: biceps femoris long head, entrapment syndrome, ganglion cyst of knee joint, intramuscular (im), popliteal artery (pa)
MeSH terms: Case Reports

Intramuscular ganglion cyst (IMGC) is a very rare lesion with an unidentified pathogeny that originates within the muscle. We encountered a case of 49-year-old man who complained of intermittent claudication in the right lower limb for 2 months. An intramuscular ganglion cyst in the biceps femoris muscle was diagnosed and located by Computed tomography angiography (CTA) and magnetic resonance imaging (MRI), which compressed the popliteal artery and resulted in ischemia in the right lower limb. Six months after surgical resection, there was no recurrence of the cyst and the popliteal artery was patency. We describe this case with a review of the relevant literature.