OpenMed/multicare-articles huggingface dataset:
Acute Lung Edema as a Presentation of Severe Acute Reentry High-Altitude Illness in a Pediatric Patient
Authors: Alfredo Merino-Luna, Julio Vizcarra-Anaya
Journal: Case Rep Pediatr (2020)
MeSH terms: Case Reports

Acute high-altitude pulmonary edema (HAPE) is a pathology involving multifactorial triggers that are associated with ascents to altitudes over 2,500 meters above sea level (m). Here, we report two pediatric cases of reentry HAPE, from the city of Huaraz, Peru, located at 3,052 m. The characteristics of both cases were similar, wherein acclimatization to sea level and a subsequent return to the city of origin occurred, and we speculate that it was caused by activation of predisposing factors to HAPE. The diagnosis and management associated with pulmonary hypertension became a determining factor for therapy.
Dystrophic calcinosis cutis in chronic venous disease of the lower limbs
Authors: Carolina Heil Arostegui Pacheco, Carmen Lucia Lascasas Porto, Juliana de Miranda Vieira, Ana Leticia de Mattos Milhomens, Rossano Kepler Alvim Fiorelli, Stenio Karlos Alvim Fiorell, Marcos Arêas Marques
Journal: J Vasc Bras (2022)
Keywords: calcinosis, leg ulcer, skin ulcer, varicose ulcer, venous insufficiency, wound healing
MeSH terms: Case Reports

Lower limb ulcers secondary to chronic venous disease (CVD) are a significant public health problem in Brazil and account for about 70% of these ulcers. Despite recent technological advances and the various therapeutic options for treatment of these chronic injuries, several factors may be involved in resistance to treatment. Dystrophic calcinosis cutis (DCC) is a rare and often underdiagnosed condition that, when in conjunction with CVD, may be associated with a refractory healing process. In this article, we report a case of DCC in a patient with CVD and discuss its etiology, pathophysiology and possible treatment options.
First reported case of Staphylococcus condimenti infection associated with catheter-related bacteraemia
Authors: Y Misawa, A Yoshida, S Okugawa, K Moriya
Journal: New Microbes New Infect (2014)
Keywords: catheter-related bacteraemia, staphylococcus condimenti, coagulase test, latex agglutination test, lecithinase and lipase reaction
MeSH terms: Case Reports

We report a case of a patient who experienced a catheter-related bloodstream infection caused by Staphylococcus condimenti, which was first isolated from soy sauce mash. This is the first reported case of human infection. Although blood culture isolates and the catheter tip tube did not reveal coagulase or clumping factor, false-positive results were obtained from latex agglutination tests for clumping factor and protein A due to self-agglutination. Care is needed when performing only latex agglutination test without a coagulase test. Further studies are needed to determine the pathogenic potential of S. condimenti based on appropriate identification.
Case report: The spectrum of SMPD1 pathogenic variants in Hungary
Authors: Maria Judit Molnar, Tamas Szlepak, Ildikó Csürke, Szendile Loth, Rita Káposzta, Melinda Erdős, Antal Dezsőfi
Journal: Front Genet (2023)
Keywords: asmd, niemann-pick disease type a/b, smpd1, acid sphingomyelinase deficiency type a/b, intermediate-type acid sphingomyelinase deficiency
MeSH terms: Case Reports

Acid sphingomyelinase deficiency (ASMD) is an autosomal recessive disease caused by biallelic pathogenic variants in the sphingomyelin phosphodiesterase-1 (SMPD1) gene. Acid sphingomyelinase deficiency is characterized by a spectrum of disease and is broadly divided into three types (ASMD type A, ASMD type A/B, and ASMD type B). More than 220 disease-associated SMPD1 variants have been reported, and genotype/phenotype correlations are limited. Here we report the first description of all six diagnosed acid sphingomyelinase deficiency cases in Hungary. Nine SMPD1 variants are present in this cohort, including 3 SMPD1 variants (G247D, M384R, and F572L), which have only been described in Hungarian patients. All described variants are deemed to be pathogenic. Eight of the variants are missense, and one is a frameshift variant. The treatment of an ASMD type A/B patient in this cohort using hematopoietic stem cell transplantation is also detailed. This study may help to support diagnosis, patient genetic counseling, and management of acid sphingomyelinase deficiency.
Giant filarial retroperitoneal cyst: a diagnostic dilemma
Authors: Pawan Lal, Lovenish Bains, Gaurish Sawant, Rahul Saini, Shramana Mandal
Journal: Trop Med Health (2019)
Keywords: computed tomography, cyst, filariasis, lymphatic, retroperitoneal
MeSH terms: Case Reports

Background:
Filarial infections are common in most tropical and subtropical regions of the world. Lymphatic filariasis is caused by either Wuchereria bancrofti, Brugia malayi, or Brugia timori. Extralymphatic filariasis presenting as a primary retroperitoneal mass is very rare despite filariasis being endemic in many regions of India. On review of literature, only a few isolated case reports have been described.
Case presentation:
We report a case of a huge retroperitoneal cystic mass in a 46-year-old patient who presented with a long-standing, painless progressive abdominal swelling. On examination, there was a large, non-tender, firm swelling of size around 20 × 15 cm occupying the left upper and lower quadrant. The computed tomography of the abdomen was suggestive of thin-walled hypodense cyst of size 25.7 × 15 × 14.3 cm. Laboratory investigations and cyst aspirate were inconclusive for a definite diagnosis. On exploration, a 3-kg cystic mass was removed. The diagnosis of filarial origin was confirmed by the demonstration of microfilaria in the cyst wall and immunochromatographic test (ICT) which was positive.
Conclusion:
Retroperitoneal lymphatic cyst of filarial origin is very unusual and requires a high index of suspicion if the patient is an inhabitant of an endemic area. The clinical dilemma cannot be resolved with imaging modalities alone, unless a disease-specific manifestation is there. The retroperitoneal cysts often pose a challenge in their diagnosis and management. Small cysts might respond to medical management, whereas large symptomatic cysts will require excision for the final diagnosis and treatment.
Unusual Complication of Hemodialysis Cuffed Catheter Tunnel Infection and Unconventional Therapeutical Decision: A Report of Two Cases
Authors: Biser K Borisov, Stela P Linkova
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Introduction:
Infectious complications are the most common chronic complications observed in patients undergoing hemodialysis with central venous catheters. However, despite the efforts of a large number of medical professionals, tunnel catheters are increasingly being used for hemodialysis in the everyday practice.
Case report:
We describe two cases of an equal complication of a tunnel infection wherein the catheter becomes naked after self-rupture of the purulent secretion. We did not replace the tunnel catheter but applied a skin plastic by rotation flaps over the affected area, which proved to be sufficient. Six months after the intervention, the patients continue their hemodialysis treatment using the same cuffed catheters; the taken chemocultures do not give rise only to bacterial growth and skin plastic has been healed primary.
Conclusions:
The two cases described by us represent one treatment option, which may be discussed with reference to such specific two cases in practice.
Hypoglycemic syndrome in a patient with proinsulin-only secreting pancreatic adenoma (proinsulinoma)
Authors: Gian Paolo Fadini, Alberto Maran, Anna Valerio, Francesco Meduri, Mariarosa Pelizzo, Diego Miotto, Cristiano Lanza, Giuseppe Altavilla, Angelo Avogaro
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

We describe an unusual case of hypoglycemic syndrome in a 69-year old woman with a proinsulin-only secreting pancreatic endocrine adenoma. The clinical history was highly suggestive of an organic hypoglycemia, with normal or relatively low insulin concentrations and elevated proinsulin levels. Magnetic resonance and computed tomography of the abdomen showed a 1 cm pancreatic nodule and multiple accessory spleens. The diagnosis was confirmed by selective angiography, showing location and vascularization of the nodule, despite no response to intra-arterial calcium. After resection, the hypoglycemic syndrome resolved. The surgical specimen was comprised of a neuroendocrine adenomatous tissue with high proinsulin immunoreactivity. Study of this unusual case of proinsulinoma underlines (i) the need to assay proinsulin in patients with hypoglycemia and normal immunoreactive insulin, (ii) the differential diagnosis in the presence of accessory spleens, (iii) the unresponsiveness to intra-arterial calcium stimulation, and (iv) the extensive evaluation needed to reach a final diagnosis.
Acute Intoxication following Dimethyltryptamine Ingestion
Authors: Matthew H Bilhimer, Rachel F Schult, Kristan V Higgs, Timothy J Wiegand, Rachel M Gorodetsky, Nicole M Acquisto
Journal: Case Rep Emerg Med (2018)
MeSH terms: Case Reports

Ayahuasca is a hallucinogenic tea that is most commonly comprised of the vine Banisteriopsis caapi alone or in combination with other plants such as Psychotria viridis. This concoction results in an orally active form of dimethyltryptamine (DMT), a hallucinogenic amine. Despite use in South America as a medicinal agent and component in religious ceremonies, interest in its recreational use and spiritual effects has led to increased use in the United States. We describe a unique case following ingestion of ayahuasca tea in a patient with history of schizophrenia resulting in personal injury and property damage. A review of ayahuasca toxicity and evaluation of serious adverse effects is also presented.
Mobile Right Atrial Thrombi in a Patient with the Hemoglobin SC Disease
Authors: H O Savage, N Ding, O Eso, B Sachdev, D L Lefroy
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

The formation of Intracardiac thrombi is rare in the absence of structural heart disease or atrial fibrillation. We describe a case of spontaneous right atrial thrombus formation that occurred in a patient with a hypercoagulable condition who had been sub optimally anticoagulated.
You are never too old for a congenital disease!
Authors: Mukul Khanna, Saro Sarkisian, Phu Tran, Ibrahim I Ghobrial
Journal: J Community Hosp Intern Med Perspect (2013)
Keywords: aberrant right subclavian artery, barium esophagogram, chest pain, congenital anomaly, dysphagia, extrinsic esophageal compression
MeSH terms: Case Reports

Congenital diseases are sometimes overlooked by physicians because of their rarity or because of late onset of symptoms, which may delay treatment plans. This is illustrated in our patient who presented with dysphagia along with chest pain and who was found to have a congenital vascular anomaly, detected in her fifth decade of life.
Case Report: Two Myxomas of Different Echodensities on Transthoracic Echocardiography in One Patient
Authors: Ling-Yun Kong, Xiao-Zheng Cui, Wei Xiang, Ling-Ling Chen, Li Li, Fang Liu
Journal: Front Cardiovasc Med (2022)
Keywords: cardiac myxoma, cardiac neoplasm, cardio-oncology, carney complex, pulmonary embolism, right ventricular mass, solid echodensity
MeSH terms: Case Reports

We report a rare case of coincidental left atrial and right ventricular myxomas manifesting as masses with different echodensities on transthoracic echocardiography. This patient had a history of left atrial myxoma, left intra-left internal carotid artery myxoma, and facial cutaneous myxoma 3 years prior to admission. A Carney complex was suspected, and the patient subsequently tested positive for PRKAR1A mutations. The patient was followed up regularly by a biannual echocardiography, which was free from abnormalities until the date of admission. A repeat transthoracic echocardiography revealed a massive left atrial mass of solid echodensity, and a minute hypoechoic entity in the right ventricular outflow tract. Both masses were confirmed for existence by an enhanced cardiac CT. Chest CT also revealed multiple pulmonary emboli. Successful surgical repair was performed revealing that both masses were hemorrhagic nipple-like lesions and that the pulmonary emboli were myxomatous in nature. Postoperative recovery was uneventful. Postoperative echocardiography showed a clear heart chamber, and the 1-year follow-up showed no abnormalities. Further research is needed to clarify the echocardiographic characteristics of multiple myxomas when they occurred simultaneously in different chambers.
Human Resources for Treating HIV/AIDS: Are the Preventive Effects of Antiretroviral Treatment a Game Changer?
Authors: Till Bärnighausen, David E Bloom, Salal Humair
Journal: PLoS One (2016)
MeSH terms: Acquired Immunodeficiency Syndrome / drug therapy, Anti-HIV Agents / therapeutic use, Antiretroviral Therapy, Highly Active / methods, HIV Infections / drug therapy, Acquired Immunodeficiency Syndrome / economics, Adolescent, Anti-HIV Agents / economics, Antiretroviral Therapy, Highly Active / economics, Communicable Diseases / drug therapy, Communicable Diseases / economics, Communicable Diseases / virology, Female, HIV Infections / economics, Humans, Male, Models, Theoretical, South Africa, Universal Health Insurance / economics, Anti-HIV Agents

Shortages of human resources for treating HIV/AIDS (HRHA) are a fundamental barrier to reaching universal antiretroviral treatment (ART) coverage in developing countries. Previous studies suggest that recruiting HRHA to attain universal ART coverage poses an insurmountable challenge as ART significantly increases survival among HIV-infected individuals. While new evidence about ART's prevention benefits suggests fewer infections may mitigate the challenge, new policies such as treatment-as-prevention (TasP) will exacerbate it. We develop a mathematical model to analytically study the net effects of these countervailing factors. Using South Africa as a case study, we find that contrary to previous results, universal ART coverage is achievable even with current HRHA numbers. However, larger health gains are possible through a surge-capacity policy that aggressively recruits HRHA to reach universal ART coverage quickly. Without such a policy, TasP roll-out can increase health losses by crowding out sicker patients from treatment, unless a surge capacity exclusively for TasP is also created.
Case Report: A Programmed Cell Death-1 Inhibitor-Related Abdominal Fibroinflammatory Reaction Affecting Multiple Organs in A Non-Small-Cell Lung Cancer Patient
Authors: An-Tian Chen, Yue-Quan Shi, Bei Tan, Liang Zhu, Ya-Ping Luo, Wei Zhong, Meng-Zhao Wang, Yan Xu
Journal: Front Immunol (2022)
Keywords: fibroinflammatory reaction, immune-related adverse events, immunothearpy, non-small-cell lung cancer, pembrolizumab
MeSH terms: Carcinoma, Non-Small-Cell Lung / pathology, Lung Neoplasms / pathology, Case Reports, Research Support, Non-U.S. Gov't, Abdomen, Apoptosis, B7-H1 Antigen, Humans, B7-H1 Antigen

Immunotherapy utilizing programmed cell death-1 (PD-1)/PD-L1 inhibitors has been regarded as a rising hope for tumor patients, and their effects have been demonstrated in many clinical trials. However, immune-related adverse events also occur in patients and can sometimes have severe consequences. Pembrolizumab (Keytruda) is a humanized monoclonal anti-PD-1 antibody that has been approved by the US Food and Drug Administration for non-small-cell lung cancer. Here, we report a rare case of an abdominal fibroinflammatory reaction that affected multiple organs during anti-PD-1 immunotherapy using pembrolizumab in a non-small-cell lung cancer patient. The patient's case demonstrates that immunotherapy-related abdominal fibroinflammatory reactions need to be considered, especially for patients with a history of pre-existing conditions in the abdomen. Glucocorticoids may be useful as a treatment when a diagnosis is confirmed.
Spontaneous Retroperitoneal Hematoma: A Rare Presentation of Polyarteritis Nodosa
Authors: Asad Ullah, Asghar Marwat, Krithika Suresh, Ahmed Khalil, Saba Waseem
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: polyarteritis nodosa, retroperitoneal hematoma
MeSH terms: Hematoma / etiology, Polyarteritis Nodosa / complications, Renal Artery, Retroperitoneal Space, Case Reports, Aged, Computed Tomography Angiography, Humans, Male, Polyarteritis Nodosa / diagnostic imaging, Rupture, Spontaneous / complications, Rupture, Spontaneous / diagnostic imaging

Spontaneous retroperitoneal hematoma is a rare clinical entity that is most commonly caused by renal tumors and vascular disease. In this article, we present a case of spontaneous retroperitoneal hemorrhage caused by polyarteritis nodosa in a patient who presented with severe left flank pain. He underwent computed tomography angiography of his abdomen that showed left retroperitoneal hematoma, which was followed by arteriogram that showed multiple bilateral renal artery aneurysms with active extravasation, findings consistent with polyarteritis nodosa. The patient underwent successful coiling of the bleeding vessel that secured the bleeding and was started on high-dose prednisone, which resulted in resolution of his symptoms.
Splenic abscess complicated by pleural empyema: A rare case report from rural Nepal
Authors: Suman Baral, Raj Kumar Chhetri, Milan Gyawali, Neeraj Thapa
Journal: Int J Surg Case Rep (2020)
Keywords: empyema thoracis, splenic abscess, streptococcus pyogenes
MeSH terms: Case Reports

Introduction:
Splenic abscess generally occurs through hematogenous spread and typically follows endocarditis or seeding from contiguous sites of infection. This can be complicated by empyema thoracis. We present a rarer case of chronic alcoholic with splenic abscess along with empyema thoracis.
Presentation of a case:
A 39-year old alcoholic male presented with history of pain at left hypochondrium and difficulty breathing for 7 days. Abdominal examination revealed tenderness at left hypochondrium along with enlarged spleen and liver associated with decreased air entry of left chest. Chest X-ray showed complete white out lung field on left side. Contrast enhanced tomography abdomen and pelvis revealed splenic abscess involving lower pole of spleen along with peri splenic extension. Tube thoracostomy drainage on left chest was done followed by ultrasonography guided repeated aspiration of splenic entity. Pus culture sensitivity showed growth of Streptococcus pyogenes while splenic aspirate remained sterile. Patient got discharged on 8th day of admission with full recovery.
Discussion:
Splenic abscess is the rare entity which is commonly seen in immunocompromised individuals that might get complicated as empyema thoracis and management includes broad spectrum antibiotics along with tube thoracostomy and percutaneous drainage of splenic abscess if possible, in view of spleen being salvageable. Pleural collection revealed growth of Streptococcus pyogenes in our case which itself is the rare finding.
Conclusion:
Splenic abscess can be managed with percutaneous aspiration/drainage if lesion is unilocular in the view of salvaging spleen. Complicated empyema can be managed with tube thoracostomy along with broad spectrum antibiotics.
Medial Condyle Fracture (Kilfoyle Type III) of the Distal Humerus with Transient Fishtail Deformity after Surgery
Authors: Motoki Sonohata, Takema Nakashima, Hiroaki Suetsugi, Masaru Kitajima, Masaya Ueno, Masaaki Mawatari
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

A "Fishtail deformity" is one of the well-known complications following pediatric lateral condyle or supracondylar fractures of the humerus. We herein report a case of medial condyle fracture (Kilfoyle type III) in an 11-year-old boy. He had a transient "fishtail deformity" of the trochlear groove after open reduction and internal fixation. As occurred in the current case, the bone remodeling and the improvement of ischemia of the trochlea after medial condyle fracture may be associated with the likelihood of recovery from transient "fishtail deformity."
Recurrent Episodes of Paraphilic Behavior Possibly Associated With Olanzapine and Aripiprazole Treatment in a Patient With Schizophrenia
Authors: Maria-Ioanna Stefanou, Debora Vittore, Ines Wolz, Stefan Klingberg, Dirk Wildgruber
Journal: Front Psychiatry (2020)
Keywords: antipsychotic, aripiprazole, olanzapine, paraphilia, schizophrenia
MeSH terms: Case Reports

Background:
Hypersexual and paraphilic disorders have been frequently associated with concomitant psychiatric disorders, including schizophrenia. A growing number of published cases has recently indicated that hypersexual behavior may also arise in conjunction with treatment with second-generation antipsychotics. Although hypersexuality has been acknowledged as a possible side effect of antipsychotic treatment with partial dopamine agonists, including aripiprazole, only very few cases of olanzapine-associated hypersexuality have been reported in the literature.
Case presentation:
A 29-year-old man presented with delusions of persecution and reference, auditory hallucinations, and negative symptoms, and was diagnosed with paranoid-hallucinatory schizophrenia. One and a half months after initiation of antipsychotic treatment with olanzapine, he developed compulsive sexual behavior and paraphilia, without signs of akathisia. After olanzapine discontinuation, a full remission of the hypersexual behavior was noted within one week, and treatment was switched to risperidone. Due to hyperprolactinemia, adjunct treatment with low-dose aripiprazole was initiated and a severe recurrence of identical hypersexual behavior occurred. The hypersexual behavior resolved completely within a week after aripiprazole discontinuation.
Conclusion:
This case illustrates that hypersexuality may be a rare adverse effect of treatment with second-generation antipsychotics. Although aripiprazole is a drug with a well-established risk for hypersexuality, the question of whether a causal association between hypersexuality and olanzapine exists remains currently unresolved. As the currently limited amount of available evidence precludes any definitive conclusions, additional research is warranted to delineate the possible neurobiological substrates of hypersexual and paraphilic disorders in patients treated with second-generation antipsychotics.
Home-Based Peanut Oral Immunotherapy for Low-Risk Peanut-Allergic Preschoolers During the COVID-19 Pandemic and Beyond
Authors: Gilbert T Chua, Edmond S Chan, Lianne Soller, Victoria E Cook, Timothy K Vander Leek, Raymond Mak
Journal: Front Allergy (2021)
Keywords: canada, oit, home, peanut allergy, preschooler

The coronavirus disease 2019 (COVID-19) pandemic has led to the deprioritization of non-emergency services, such as oral food challenges and the initiation of oral immunotherapy (OIT) for food-allergic children. Recent studies have suggested that home-based peanut OIT could be a safe and effective option for low-risk peanut-allergic children. In the period between September 1, 2020, and January 31, 2021, nine preschoolers with a history of mild allergic reactions to peanut underwent home-based peanut OIT. Eight of them (88.9%) completed the build-up phase at home in 11-28 weeks, tolerating a daily maintenance dose of 320 mg peanut protein. During the build-up, six patients (75.0%) reported urticaria, three (33.3%) reported gastrointestinal tract symptoms, and one (14.3%) reported oral pruritis. None of the patients developed anaphylaxis, required epinephrine, or attended emergency services related to OIT. One or two virtual follow-up visits were completed per patient during the build-up phase. Our case series shows that home-based OIT could be offered to the low-risk preschoolers during the COVID-19 pandemic when non-emergency services are limited and could be considered beyond the pandemic, especially for the families living in the rural or remote areas that may otherwise be unable to access OIT.