OpenMed/multicare-articles huggingface dataset:
Post-procedural Bacillus cereus septic arthritis in a patient with systemic lupus erythematosus
Authors: Barend Mitton, Roxanne Rule, Nontombi Mbelle, Wesley van Hougenhouck-Tulleken, Mohamed Said
Journal: Afr J Lab Med (2020)
Keywords: bacillus cereus, maldi-tof ms, matrix-assisted laser desorption/ionisation mass spectrometry, arthroscopy, musculoskeletal infection, septic arthritis, systemic lupus erythematosus

Introduction:

Bacillus species are often considered as contaminants when cultured from clinical samples. Bacillus cereus may be a pathogen in certain circumstances and is known to cause musculoskeletal infections. This report aims to educate clinicians and clinical microbiology laboratories on B. cereus musculoskeletal infections and to heighten awareness that Bacillus species should not always be dismissed as contaminants.
Case presentation:
We report the case of a patient who presented to a tertiary hospital in Pretoria, South Africa, in November 2018 with B. cereus septic arthritis and underlying systemic lupus erythematosus (SLE). The isolate would otherwise have been dismissed as a contaminant had it not been for the crucial interaction between the laboratory and the treating clinicians. To our knowledge, this is the first case report of septic arthritis caused by B. cereus in an SLE patient where the organism was cultured from the joint specimen. Identification of the organism was performed using matrix-assisted laser desorption/ionisation mass spectrometry.
Management and outcome:
Definitive treatment was with intravenous vancomycin, continued for four weeks, in addition to arthroscopy and management of the underlying SLE. The patient had a good clinical outcome and regained full mobility.
Conclusion:
Musculoskeletal infections, specifically septic arthritis caused by B. cereus, are exceedingly rare infections. Immune suppression, trauma, prosthetic implants and invasive procedures are important risk factors for B. cereus musculoskeletal infections. Close collaboration with a multi-disciplinary team approach will effect the best outcome for complicated patients with B. cereus infections.
Clinical Profiles and Factors Associated with Death in Adults with Dengue Admitted to Intensive Care Units, Minas Gerais, Brazil
Authors: Frederico Figueiredo Amâncio, Tiago Pires Heringer, Cristina da Cunha Hueb Barata de Oliveira, Liliane Boaventura Fassy, Frederico Bruzzi de Carvalho, Daniela Pagliari Oliveira, Claudio Dornas de Oliveira, Fernando Otoni Botoni, Fernanda do Carmo Magalhães, José Roberto Lambertucci, Mariângela Carneiro
Journal: PLoS One (2015)
MeSH terms: Dengue / epidemiology, Hospital Mortality, Intensive Care Units, Multicenter Study, Research Support, Non-U.S. Gov't, APACHE, Adolescent, Adult, Aged, Aged, 80 and over, Brazil / epidemiology, Dengue / diagnosis, Dengue / mortality, Female, Humans, Longitudinal Studies, Male, Middle Aged, ROC Curve, Risk Factors, Severity of Illness Index, Young Adult

The purpose of our study was to describe the clinical profile of dengue-infected patients admitted to Brazilian intensive care units (ICU) and evaluate factors associated with death. A longitudinal, multicenter case series study was conducted with laboratory-confirmed dengue patients admitted to nine Brazilian ICUs situated in Minas Gerais state, southeastern Brazil from January 1, 2008, to December 31, 2013. Demographic, clinical and laboratory data; disease severity scores; and mortality were evaluated. A total of 97 patients were studied. The in-ICU and in-hospital mortality rates were 18.6% and 19.6%, respectively. Patients classified as having severe dengue according to current World Health Organization classifications showed an increased risk of death in a univariate analysis. Nonsurvivors were older, exhibited lower serum albumin concentrations and higher total leukocyte counts and serum creatinine levels. Other risk factors (vomiting, lethargy/restlessness, dyspnea/respiratory distress) were also associated with death in a univariate analysis. Multivariate analysis indicated that in-hospital mortality was significantly associated with Acute Physiology and Chronic Health Evaluation II and the Sequential Organ Failure Assessment score. The ICU and in-hospital mortality observed in this study were higher than values reported in similar studies. An increased frequency of ICU admission due to severe organ dysfunction, higher severity indices and scarcity of ICU beds may partially explain the higher mortality.
Peritoneal carcinomatosis, an unusual and only site of metastasis from lung adenocarcinoma
Authors: Kloub Hanane, Benhmida Salma, Bellahammou Khadija, Elghissassi Ibrahim, Boutayeb Saber, M'rabti Hind, Errihani Hassan
Journal: Pan Afr Med J (2016)
Keywords: lung cancer, chemotherapy, peritoneal carcinomatosis
MeSH terms: Adenocarcinoma / pathology, Lung Neoplasms / pathology, Palliative Care / methods, Peritoneal Neoplasms / secondary, Case Reports, Adenocarcinoma / drug therapy, Adenocarcinoma of Lung, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Fatal Outcome, Humans, Laparoscopy, Lung Neoplasms / drug therapy, Male, Middle Aged, Peritoneal Neoplasms / diagnostic imaging, Peritoneal Neoplasms / pathology, Prognosis, Tomography, X-Ray Computed

Isolated peritoneal metastases of lung adenocarcinoma are very rare, even exceptional, occurring most often in the context of a multi-metastatic disease. This report presents a rare clinical case of isolated peritoneal metastasis from lung adenocarcinoma. We report a 56-year-old male who was monitored for lung adenocarcinoma whose evolution has been marked by an isolated metastatic recurrence in the peritoneum objectified by an abdominal-pelvic computed tomography (CT) and confirmed by a laparoscopy with abiopsy of the peritoneal nodules. The patient had received palliative chemotherapy with gemcitabine, cisplatin and bevacizumab. The evolution was marked by a progressive deterioration of the general condition and death two months after the third treatment cycle. Peritoneal carcinomatosis from lung adenocarcinoma is a very rare event, and is often associated with a poor prognosis.
Severe hypothyroidism causing pre-eclampsia-like syndrome
Authors: Annalisa Inversetti, Audrey Serafini, Marco F Manzoni, Anna Dolcetta Capuzzo, Luca Valsecchi, Massimo Candiani
Journal: Case Rep Endocrinol (2012)
MeSH terms: Case Reports

Objective. Analyzing and managing pre-eclampsia-like syndrome due to severe hypothyroidism. Methods. Presentation of a case of severe hypothyroidism due to Hashimoto's syndrome, associated with a severe early-onset preeclampsia-like syndrome, managed in our Gynecology Department. Results. Severe pre-eclampsia led to miscarriage at 24 weeks of gestational age in a 42-year-old woman, although we attempted to correct hypothyroidism with increasing doses of levothyroxine and liothyronine sodium. Conclusion. Recognizing pre-eclampsia-like syndrome caused by overt hypothyroidism from other forms of pregnancy-induced hypertension is essential for choosing the correct treatment.
Mediastinal Hepatoid Adenocarcinoma Treated With Arterial Interventional Therapy: A Case Report and Review of Literature
Authors: Guiyuan Zhang, Chunyong Wen, Bin Chen, Haitao Dai, Run Lin, Yonghui Huang, Xianhong Xiang
Journal: Front Oncol (2022)
Keywords: arterial infusion, hepatoid adenocarcinoma, interventional radiology, mediastinal, prognosis
MeSH terms: Case Reports

Hepatoid adenocarcinoma (HAC) is an extremely rare extrahepatic carcinoma, which is pathologically featured by hepatocellular carcinoma (HCC) and marked by producing alpha-fetoprotein (AFP). HAC of mediastinum is extremely rare. For inoperable patients, the curative treatment options have not been established, and the outcome of HAC is usually poor. Here, we present a case of mediastinal HAC with normal serum AFP level who achieved well-controlled and good response after local-regional interventional approach combined with systemic PD-1 inhibitor. A 53-year-old male who complained of chest pain was admitted to our hospital in February 2021. A chest CT scan revealed several tumors in his mediastinum. The laboratory data showed normal serum AFP level. HAC was diagnosed through pathological assessment of biopsy. Surgery was not available due to the infiltration of sternum. Local regional FOLFOX chemotherapy was given by transarterial infusion, followed by transcatheter arterial chemoembolization, and thereafter combined with systemic anti-PD-1 treatment. The patient achieved favorable disease control and apparent symptom relief. So transarterial interventional therapy combined immunotherapy may be a possible and promising treatment for mediastinal HAC.
Anastomosing haemangioma with fatty changes in the perirenal space: a lesion mimicking liposarcoma
Authors: Naotaka Kishida, Kazuhiro Sentani, Hiroaki Terada, Yukiko Honda, Keisuke Goto, Yui Hatanaka, Kenichi Kohashi, Yoshinao Oda, Jun Iwata, Wataru Yasui, Shunsuke Shinmei, Tetsutaro Hayashi, Jun Teishima, Akio Matsubara, Yuko Nakamura, Makoto Iida, Kazuo Awai
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

Anastomosing haemangioma is a rare subtype of capillary haemangioma. Pathologically, anastomosing haemangioma presents with anastomosing sinusoidal capillary-sized vessels in an architecture reminiscent of the splenic parenchyma. Its anastomosing architecture pathologically can lead to concern for angiosarcoma. Many cases of anastomosing haemangioma, which often occurred in the retroperitoneum, were well circumscribed, hyperdense on plain CT, revealed avid contrast enhancement and some of them exhibited fatty changes. In cases of tumours with fat of retroperitoneal occurrence, images frequently do not allow for easy differentiation from liposarcoma. Although anastomosing haemangioma with fatty changes and liposarcoma can be difficult to differentiate, no previous report has addressed this diagnostic difficulty. We have encountered a case of anastomosing haemangioma with fatty changes occurring in the perirenal space that was difficult to differentiate from liposarcoma. With retroperitoneal tumours accompanied by fatty changes and including a strongly enhanced area, the possibility of anastomosing haemangioma-which is a benign tumour-may also be considered. In such cases, biopsy is an effective means of diagnosis.
Oxaliplatin for metastatic colon cancer in a patient with renal failure
Authors: Kenji Katsumata, Tetsuo Sumi, Tatehiko Wada, Yasuharu Mori, Masayuki Hisada, Hideaki Kawakita, Masanori Enomoto, Shoji Suzuki, Daisuke Matsuda, Akihiko Tsuchida, Tatsuya Aoki
Journal: Clin Med Oncol (2008)
Keywords: colorectal cancer, hemodialysis, oxaliplatin, renal failure
MeSH terms: Case Reports

Objective:
Oxaliplatin, a key part of the standard regimen for colorectal cancer in Western countries, has become available in Japan. In a hemodialysis patient with cecal cancer, we investigated the efficacy, safety, pharmacokinetics, and dialysability of oxaliplatin.
Methods:
A 65-year-old man who had cecal cancer was treated with oxaliplatin (40 mg/m(2)) and l-leucovorin(l-LV) (200 mg/m(2)), which were administered simultaneously over 120 min via the side and main arms of a Y-tube, respectively. Then 5-FU (400 mg/m(2)) was administered rapidly via the side tube, followed by 5-FU (2,000 mg/m(2)) over 46 hours via the main tube. The patient had chronic renal failure due to diabetic nephropathy and hemodialysis was performed 3 times a week. Blood samples were collected from the dialyzer before and after each hemodialysis session to examine platinum clearance.
Results:
The patient received 3 courses of oxaliplatin before he died of cancer. During hemodialysis, the platinum level fell from 0.32 μg/mL to 0.15 μg/mL.
Conclusion:
Since patients with renal failure have various associated disorders and oxaliplatin has a long half-life, it is necessary to obtain more pharmacokinetic data to investigate its accumulation and dialysability during long-term treatment. Such data will assist in treating the rapidly increasing number of hemodialysis patients with colorectal cancer.
A rare renal epithelial tumor: mucinous cystadenocarcinoma case report and review of the literature
Authors: Abdulkadir Tepeler, Mehmet Remzi Erdem, Omer Kurt, Ramazan Topaktas, Isin Kilicaslan, Abdullah Armağan, Sinasi Yavuz Onol
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Primary renal mucinous cystadenocarcinoma is a very rare lesion of kidney which originates from the metaplasia of the renal pelvic uroepithelium. Only one case with primary mucinous cystadenocarcinoma has been reported in the English literature. We report second case of mucinous cystadenocarcinoma which was radiologically classified as type-IIF Bosniak cyst in peripheral localization. We aimed to present this extreme and unusual entity with its radiological, surgical, and pathologic aspects under the light of literature.
Case report: A STAT1 gain-of-function mutation causes a syndrome of combined immunodeficiency, autoimmunity and pure red cell aplasia
Authors: Yifan Xie, Fenli Shao, Juan Lei, Na Huang, Zhidan Fan, Haiguo Yu
Journal: Front Immunol (2022)
Keywords: stat1 gain-of-function mutation, stat1 phosphorylation, autoimmunity, immunodeficiency, pure red cell aplasia
MeSH terms: Autoimmune Diseases, Primary Immunodeficiency Diseases / genetics, Red-Cell Aplasia, Pure / genetics, Case Reports, Research Support, Non-U.S. Gov't, Autoimmunity / genetics, Gain of Function Mutation, Humans, Leukocytes, Mononuclear / metabolism, Mutation, Nitriles, Pyrazoles, Pyrimidines, STAT1 Transcription Factor / metabolism, Syndrome, Nitriles, Pyrazoles, Pyrimidines, STAT1 Transcription Factor, STAT1 protein, human, ruxolitinib

Inherited autosomal dominant gain-of-function (GOF) mutations of signal transducer and activator of transcription 1 (STAT1) cause a wide range of symptoms affecting multiple systems, including chronic mucocutaneous candidiasis (CMC), infections, and autoimmune disorders. We describe a rare case of STAT1 mutation with recurrent CMC, lung infections, and anemia. According to the whole-exome sequencing (WES), the patient was genetically mutated in STAT1 GOF (c.854A>G, p.Q285R), and bone marrow biopsy suggested pure red cell aplasia (PRCA). As a functional verification, STAT1 levels and phosphorylation (p-STAT1) of peripheral blood mononuclear cells (PBMCs) following IFN-γ stimulation in STAT1 GOF patient was higher than in the healthy control. Combination therapy of blood transfusion, antimicrobials, intravenous immunoglobulin, methylprednisolone, and the Janus Kinase (JAK) specific inhibitor ruxolitinib was used during treatment of patients. The patient also received a hematopoietic stem cell transplant (HSCT) to help with infections and anemia. This is the first reported case of STAT1 GOF disease complicated with PRCA. This complication might be attributed to immune disorders caused by STAT1 GOF. Furthermore, ruxolitinib may be a viable therapeutic option before HSCT to improve disease management.
Rapidly progressive and fatal distant spontaneous gas gangrene due to Clostridium septicum after biopsy of malignant cecal mass
Authors: Geetha Sivasubramanian
Journal: IDCases (2021)
Keywords: clostridium septicum, colon cancer, spontaneous gas gangrene
MeSH terms: Case Reports

Clostridium species are known to cause myonecrosis and gas gangrene which are often fatal infections in the setting of trauma but also spontaneously in certain populations such as colorectal malignancy, immunosuppression, and neutropenia. We report a case of an 83-year-old male who developed fatal and rapidly progressive gas gangrene due to Clostridium septicum within 48 h after biopsy of suspected malignant cecal mass. To our knowledge, such a drastic, rapid and fatal presentation after a diagnostic biopsy of malignant mass has not been previously reported and is something to be watchful for in suspected colon cancer cases.
Concurrent Graves' Disease and TSH Secreting Pituitary Adenoma Presenting Suppressed Thyrotropin Levels: A Case Report and Review of the Literature
Authors: Jinrong Fu, Anhua Wu, Xiaoli Wang, Haixia Guan
Journal: Front Endocrinol (Lausanne) (2020)
Keywords: graves' disease, tsh secreting pituitary adenoma, tshoma, concomitant, thyrotropin
MeSH terms: Adenoma / pathology, Graves Disease / pathology, Pituitary Neoplasms / pathology, Thyrotropin / blood, Case Reports, Research Support, Non-U.S. Gov't, Review, Adenoma / blood, Adenoma / complications, Female, Graves Disease / blood, Graves Disease / complications, Humans, Middle Aged, Pituitary Neoplasms / blood, Pituitary Neoplasms / complications, Prognosis, Thyroid Function Tests, Thyrotropin

Background: Thyroid stimulating hormone (TSH) secreting pituitary adenoma (TSHoma) is a rare cause of hyperthyroidism. To date there have been only thirteen cases reporting the coexistence of TSHoma with Graves' disease (GD). The diagnosis and management for such hyperthyroidism due to both etiologies remain challenging. Case Report: A 55-year-old Chinese female presented with signs and symptoms of thyrotoxicosis. Thyroid function tests showed elevated thyroid hormones and mildly suppressed TSH values. Her anti-thyrotropin receptor antibody (TRAb) was positive. Octreotide suppression test successfully decreased her TSH. Magnetic resonance imaging showed a pituitary macroadenoma. She underwent endoscopic trans-sphenoidal resection and surgical pathology confirmed a TSH producing pituitary adenoma. Methimazole was prescribed after surgery and her clinical course was monitored. Conclusions: Here we report a case of a 55-year-old female with TSHoma and Graves' disease whose TSH level was mildly suppressed. This case emphasizes the importance of thoroughly evaluating the thyroid function test during the diagnosis of hyperthyroidism. It also highlights the challenges in the diagnosis and treatment of this rare condition.
Labial Adhesions Causing Recurrent Urinary-Tract Infections in an Elderly Woman
Authors: Masashi Takemaru, Noriko Aramaki-Hattori, Chisato Tsue, Kazuo Kishi
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

A 91-year-old postmenopausal woman with a prior history of two labial-adhesion separations suffered from recurrent urinary-tract infections. We were able to successfully treat her labial adhesions using surgery.
Diffuse large B-cell and follicular lymphoma presenting as a slowly growing compressive goiter: A case report and literature review
Authors: Nicole Lin, Susana Vargas-Pinto, Savanah Gisriel, Mina Xu, Courtney E Gibson
Journal: Int J Surg Case Rep (2020)
Keywords: case report, diffuse large b cell lymphoma, goiter, thyroid lobectomy, thyroid lymphoma
MeSH terms: Case Reports

Introduction:
Neck ultrasonography with fine-needle aspiration cytology (FNAC) is the diagnostic modality of choice for clinicians who routinely work up a thyroid mass. Distinguishing chronic lymphocytic infiltration from a lymphoproliferative process with FNAC in patients with Hashimoto's thyroiditis presenting with a goiter can be particularly challenging.
Case description:
A 58 y.o. female with a history of a goiter showing interval growth and compressive symptoms over 18 months, was treated with a thyroid lobectomy. Surgical pathology demonstrated a thyroid lymphoma (TL) with mixed follicular and diffuse large B cell (DLBCL) components, not initially diagnosed by FNAC. Staging workup showed the involvement of chest lymph nodes only, consistent with Stage IIE disease. She was treated with combination chemotherapy and immunotherapy, followed by involved-field radiotherapy.
Discussion:
TL often arises in a background of chronic lymphocytic thyroiditis which can make its histological diagnosis a challenge. The disease is heterogeneous in histological subtype and progression.
Conclusion:
While TL usually presents as a rapidly growing neck mass, indolent types can present as a slow growing mass with subsequent transformation. Patients may benefit from avoiding unnecessary diagnostic steps, including surgery, and potential delays in treatment by performing a core needle biopsy when a lymphoproliferative process cannot be excluded if FNAC was initially performed.
Novel mutations in ACVR1 result in atypical features in two fibrodysplasia ossificans progressiva patients
Authors: Kirsten A Petrie, Wen Hwa Lee, Alex N Bullock, Jenny J Pointon, Roger Smith, R Graham G Russell, Matthew A Brown, B Paul Wordsworth, James T Triffitt
Journal: PLoS One (2009)
MeSH terms: Activin Receptors, Type I / genetics, Myositis Ossificans / genetics, Point Mutation, Case Reports, Research Support, Non-U.S. Gov't, Adolescent, Enzyme Activation, Female, Humans, Middle Aged, Mutation, Missense, Phenotype, Protein Kinases, Protein Kinases, ACVR1 protein, human, Activin Receptors, Type I

Fibrodysplasia Ossificans Progressiva (FOP) is a rare, heritable condition typified by progression of extensive ossification within skeletal muscle, ligament and tendon together with defects in skeletal development. The condition is easily diagnosed by the presence of shortened great toes and there is severe advancement of disability with age. FOP has been shown to result from a point mutation (c.617G>A) in the ACVR1 gene in almost all patients reported. Very recently two other mutations have been described in three FOP patients. We present here evidence for two further unique mutations (c.605G>T and c.983G>A) in this gene in two FOP patients with some atypical digit abnormalities and other clinical features. The observation of disparate missense mutations mapped to the GS and kinase domains of the protein supports the disease model of mild kinase activation and provides a potential rationale for phenotypic variation.
Churg-Strauss Syndrome following PTU Treatment
Authors: R A M Quax, A J G Swaak, M G A Baggen
Journal: Int J Rheumatol (2009)
MeSH terms: Case Reports

Propylthiouracil (PTU) is a frequently prescribed drug in the treatment of hyperthyroidism. The use of PTU is, however, accompanied by numerous potentially serious side effects including vasculitis. PTU-related vasculitides can present as haematuria, pulmonary haemorrhage, or cutaneous lesion together with aspecific symptoms such as fever, myalgia, arthralgia, and fatigue. Cerebral involvement is seldom observed. We present a 49-year-old female with Graves' disease and asthma, who developed paresis of the proximal extremities, eosinophilia, pulmonary, and cutaneous lesions following treatment with PTU. A cerebral vasculitis consistent with Churg-Strauss syndrome (CSS) was suspected. Although cerebral involvement is seldom observed with PTU treatment, cerebral vasculitis should be considered in patients developing CNS symptoms.
Becoming more oneself? Changes in personality following DBS treatment for psychiatric disorders: Experiences of OCD patients and general considerations
Authors: Sanneke de Haan, Erik Rietveld, Martin Stokhof, Damiaan Denys
Journal: PLoS One (2017)
MeSH terms: Deep Brain Stimulation, Obsessive-Compulsive Disorder / therapy, Personality, Female, Humans, Male, Obsessive-Compulsive Disorder / psychology

Does DBS change a patient's personality? This is one of the central questions in the debate on the ethics of treatment with Deep Brain Stimulation (DBS). At the moment, however, this important debate is hampered by the fact that there is relatively little data available concerning what patients actually experience following DBS treatment. There are a few qualitative studies with patients with Parkinson's disease and Primary Dystonia and some case reports, but there has been no qualitative study yet with patients suffering from psychiatric disorders. In this paper, we present the experiences of 18 patients with Obsessive-Compulsive Disorder (OCD) who are undergoing treatment with DBS. We will also discuss the inherent difficulties of how to define and assess changes in personality, in particular for patients with psychiatric disorders. We end with a discussion of the data and how these shed new light on the conceptual debate about how to define personality.