OpenMed/multicare-articles huggingface dataset:
Defibrillator-Induced Tricuspid Abscess Presenting as Diabetic Ketoacidosis and Wound Ulceration
Authors: Rafay Khan, Sabrina Arshed, Amar Ahmed, Shuvendu Sen, Abdalla Yousif
Journal: J Clin Med Res (2016)
Keywords: abscess, endocarditis, foreign body
MeSH terms: Case Reports

Right-sided endocarditis is predominantly seen in patients with a history of intravenous drug abuse. However, it is well shown in the literature to be associated with patients containing foreign bodies such as pacemakers, central venous lines, and in those with congenital heart disease. In patients with pacemaker leads and in those with automatic implantable cardioverter defibrillators (AICDs), it is important to suspect foreign body infection when there are signs and indications of bacteremia. When these leads become infected, they can spread the infection to the tricuspid valve resulting in vegetations. The proper management is removal of the infected lead and foreign body along with a prolonged course of antibiotics. However, it is unusual and a relatively rare entity to see foreign body infection resulting from a wound ulcer resulting in not only endocarditis but also abscess formation on the tricuspid valve. Here we report a case of a 60-year-old male with recent AICD placement presenting as diabetic ketoacidosis due to tricuspid abscess formation as a result of a foot ulcer.
A Conservative Management Approach for Unusual Presentation of Oral Actinomycosis
Authors: Qamar Hashem
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Actinomycosis is gram-positive saprophytic infection that is characterized by chronic suppurative and granulomatous lesion. It could be found in the oral cavity, lungs, colon, and genital area. In the oral cavity, it is commonly associated with infected root canals presented as persistent infections. This case reports demonstrate an atypical presentation of actinomycosis in the lower left mandibular canine/premolar area showing painless soft tissue lesion associated with bone sequestration. Nonsurgical curettage of the lesion followed by nonsurgical root canal treatment and retreatment to the offended teeth was determined as the treatment modality for this case.
The Unmasking Effect: Propofol-Induced Brugada Pattern in a Critically Ill Patient
Authors: Esiemoghie Akhigbe, Ebubechukwu Ezeh, Benjamin Dao, Kelechukwu Okoro, Paul Okhumale
Journal: Case Rep Cardiol (2022)
MeSH terms: Case Reports

Brugada syndrome is a known cause of dysrhythmias and sudden cardiac death. It is linked to mutations in myocardial sodium channel leading to hyperexcitable cardiac myocytes. The use of this sedative has been linked to the development of inducible Brugada via blockade of sodium currents in cardiac myocytes. Although propofol is usually avoided in patients with known Brugada syndrome, some patients might have undiagnosed Brugada syndrome and thus are at risk for complications. We present a case of propofol induced Brugada in a critically ill patient.
Euglycemic Ketoacidosis in a Patient with Metastatic Non-Small-Cell Lung Adenocarcinoma and Concomitant Pulmonary Embolism
Authors: Robert Sean O'Neill, Lauren Tyack, Mary Freeman, Hussein Soudy Hussein
Journal: Case Rep Endocrinol (2020)
MeSH terms: Case Reports

Euglycemic ketoacidosis is a recognised side effect secondary to sodium-glucose cotransporter 2 inhibitor use in the treatment of type 2 diabetes mellitus; however, there is scarce evidence to suggest whether preexisting comorbid conditions contribute to the development of this potentially life-threatening complication. We describe a case of euglycemic ketoacidosis in a patient with type 2 diabetes mellitus in the context of empagliflozin use after a recent diagnosis of metastatic lung adenocarcinoma. The diagnosis was complicated by a pulmonary embolism and hospital-acquired pneumonia, and was subsequently established after an anion-gap metabolic acidosis was identified on arterial blood gas and serum ketone measurement. The patient required admission to the intensive care unit for fluid resuscitation and regular intravenous insulin to ensure resolution of acidosis and maintenance of normoglycaemia. The patient was discharged to home for outpatient single-agent pembrolizumab for treatment of his lung adenocarcinoma. This article highlights the importance or awareness of oral hypoglycaemic medications and their side effects, along with providing further evidence for the potential contribution of malignancy to the development of euglycemic ketoacidosis in a patient with type 2 diabetes mellitus.
Gastric Emphysema in a Critically Ill Patient Successfully Treated without Surgery
Authors: Hiromi Ihoriya, Tetsuya Yumoto, Masaya Iwamuro, Noritomo Fujisaki, Takaaki Osako, Hiromichi Naito, Atsunori Nakao
Journal: Case Rep Crit Care (2019)
MeSH terms: Case Reports

Gastric emphysema is a relatively rare clinical entity caused by injury to the gastric mucosa. A 62-year-old Japanese male with a history of heavy alcohol consumption and smoking was admitted to the emergency intensive care unit due to severe hypercapnic respiratory acidosis. His body mass index was only 12.6. Ten days after initiation of enteral feeding, he complained of abdominal pain. Computed tomography revealed intraluminal air in the distended gastric wall. Esophagogastroduodenoscopy showed diffuse edema, redness, and erosion throughout the stomach. Based on the findings of narrow angle and short distance of the aorta-superior mesenteric artery, the patient was diagnosed with gastric emphysema associated with superior mesenteric artery syndrome. He was successfully managed nonoperatively with treatments including intravenous antibiotics, gastric decompression, and bowel rest. Physicians should be aware of this unusual condition in such critically ill patients complaining of abdominal pain and needing close monitoring and observation to exclude gastric necrosis or perforation.
Trichophyton as a Rare Cause of Postoperative Wound Infection Resistant to Standard Empiric Antimicrobial Therapy
Authors: Sheema Gaffar, John K Birknes, Kenji M Cunnion
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Fungal infections are rare causes of acute surgical wound infections, but Candida is not an infrequent etiology in chronic wound infections. Trichophyton species is a common cause of tinea capitis but has not been reported as a cause of neurosurgical wound infection. We report a case of Trichophyton tonsurans causing a nonhealing surgical wound infection in a 14-year-old male after hemicraniectomy. His wound infection was notable for production of purulent exudate from the wound and lack of clinical improvement despite empiric treatment with multiple broad-spectrum antibiotics targeting typical bacterial causes of wound infection. Multiple wound cultures consistently grew Trichophyton fungus, and his wound infection clinically improved rapidly after starting terbinafine and discontinuing antibiotics.
"I am not promiscuous enough!": Exploring the low uptake of HIV testing by gay men and other men who have sex with men in Metro Manila, Philippines
Authors: Jan W de Lind van Wijngaarden, Andrew D Ching, Edmund Settle, Frits van Griensven, Rolando C Cruz, Peter A Newman
Journal: PLoS One (2018)
MeSH terms: HIV Infections / diagnosis, Homosexuality, Male, Sexual Behavior / psychology, Sexual and Gender Minorities / psychology, Social Stigma, Research Support, Non-U.S. Gov't, Adult, Attitude, Emotions, Fear / psychology, Humans, Male, Mass Screening, Philippines, Risk-Taking, Socioeconomic Factors, Young Adult

The Philippines faces a severe HIV epidemic among gay and other men who have sex with men (MSM). HIV testing uptake remains low. A case series of 12 men from Metro Manila were interviewed to explore barriers to uptake of HIV testing services. Most did not see the need to get tested for HIV despite significant risk, based on the misconception they were feeling well or showed no symptoms. Being of a higher socioeconomic class, feeling morally superior to other gay men, distance of the testing facility, fear of what will happen once infected, fear of HIV- and sexual stigma, fear of side effects of antiretroviral drugs and fear of high health care expenses after testing positive for HIV were key reasons why MSM kept postponing their test. Misconceptions about HIV risk, disease, and treatment and care need to be addressed in order to increase uptake of HIV services in this population.
Hyalinizing trabecular tumor of the thyroid gland and its significant diagnostic issue
Authors: Dustin J Jones, Christopher R Kieliszak, Sanjay S Patel, Christopher R Selinsky
Journal: Thyroid Res (2017)
Keywords: cytopathology, hyalinizing trabecular tumor, thyroid mass, thyroid nodule
MeSH terms: Case Reports

Background:
Hyalinizing trabecular tumors (HTT) are rare follicular cell-derived tumors of the thyroid gland that are infrequently reported in otolaryngology literature. We present here an interesting case of HTT which provides the basis for review of this entity's clinical characteristics, criteria useful in making the diagnosis, and any currently available therapeutic modalities.
Case presentation:
A 70-year-old Caucasian female underwent a CT scan of her chest and was incidentally found to have a nodule within the right thyroid lobe. Gross examination of the excised thyroid lobe revealed a circumscribed and encapsulated lesion (tan / gritty in texture), confined to the gland. Histologic sections of the lesion revealed a circumscribed neoplasm with a trabecular and organoid architecture associated with abundant dystrophic calcification. Neoplastic cells showed a spindled morphology with clumped chromatin and ample eosinophilic cytoplasm.
Conclusions:
Histologically, HTT is a follicular cell-derived tumor composed of neoplastic cells arranged in a trabecular pattern with hyalinization and calcification of extracellular material. Distinguishing features of HTT include minimal cytologic atypia with a low nuclear: cytoplasmic ratio, cellular aggregates around hyalinized material, and nuclei with clumped chromatin and occasional grooves and/or pseudoinclusions. Though debated in the literature, the general consensus is that this tumor is a benign entity. It is our hope that additional clinical research will elicit awareness of these rare tumors.
A young Botswana patient with congenital iris ectropion uvea
Authors: Jemal Zeberga Shifa, Othokawa Nkomazana, Negussie Alula Bekele, Mamo Woldu Kassa
Journal: Pan Afr Med J (2016)
Keywords: congenital, glaucoma, iris ectropion
MeSH terms: Ectropion / congenital, Iris / abnormalities, Pigment Epithelium of Eye / abnormalities, Uvea / abnormalities, Case Reports, Anterior Chamber, Botswana, Humans, Male, Young Adult

Congenital iris ectropion is a rare condition; non-progressive anomaly characterised by the presence of iris pigment epithelium on the anterior surface of the iris stroma and is frequently associated with anterior iris insertion, dysgenesis of the drainage angle and glaucoma. This paper describes unusual case of bilateral case of congenital iris ectropion in adult patient with pupillary abnormality, normal anterior chamber angle structure and with no evidence of glaucoma.
Aplasia Cutis Congenita as a Sole Manifestation of Congenital Varicella Syndrome
Authors: Alexander K C Leung, Kin Fon Leong, Joseph M Lam
Journal: Case Rep Pediatr (2020)
MeSH terms: Case Reports

Aplasia cutis congenita following maternal varicella is well known. On the other hand, aplasia cutis congenita as the sole manifestation of congenital varicella syndrome is very rare. A perusal of the literature revealed only one case. We report two infants with aplasia cutis congenita as the sole manifestation of congenital varicella syndrome.
A case of pemphigus herpetiformis in a 12-year-old male
Authors: O Hocar, I Ait Sab, N Akhdari, M Hakkou, S Amal
Journal: ISRN Pediatr (2011)
MeSH terms: Case Reports

Pemphigus herpetiformis (PH) is one of the less common forms of pemphigus. PH in children is unreported. We describe a case of a child who developed PH. Observation. A 12-year-old boy was seen at our department with erosive plaques, vesicles, and crusted cutaneous lesions associated with severe itching persisting for six months. Histologic examination showed an intraepidermal bulla containing rare acantholytic epidermal cells with eosinophilic spongiosis. Direct immunofluorescence demonstrated intercellular Ig G and C3 deposit. The serum titer of antibodies against intercellular epidermal was 1/200 UI/l. Diagnosis of PH was made, and treatment with Dapsone 2 mg/kg per day resulted in total clinical remission. However, two months later, new vesicles reappeared and treatment was begun with prednisone at a dose of 2 mg/kg daily. There was a very good response. Discussion. Childhood pemphigus herpetiformis is a rare disease, often initially misdiagnosed. It must not be forgotten that the disease is a possible cause of erosive mucocutaneous disease in children.
The Therapeutic Challenge of Disseminated Bone Marrow Metastasis From HR-Positive HER2-Negative Breast Cancer: Case Report and Review of the Literature
Authors: Giovanna Garufi, Luisa Carbognin, Armando Orlandi, Antonella Palazzo, Giampaolo Tortora, Emilio Bria
Journal: Front Oncol (2021)
Keywords: cdk4/6 inhibitor, bone marrow metastasis, breast cancer, case report, endocrine therapy, visceral crisis
MeSH terms: Case Reports

The efficacy and safety of the combination of endocrine therapy (ET) and CDK4/6 inhibitors for patients with hormone receptor (HR)-positive HER2-negative metastatic breast cancer (BC) presenting with visceral crisis or life-threatening conditions represent a challenge for daily clinical practice. Indeed, the peculiarity of this clinical presentation (signs and symptoms of rapidly progressive disease) does not allow to include such patients in a trial aiming for drug approval. On the basis of the scientific evidence available so far, chemotherapy represents the standard of care according to guidelines, on the basis of the more rapid activity in comparison with ET alone. Besides, the combination of ET and CDK4/6 inhibitors have demonstrated in clinical trials to have clinically impactful activity in a short time, thus suggesting a potential role in advanced tumors that require rapid response. Herein, we report the clinical history of a young woman with HR-positive HER2-negative metastatic BC and a pancytopenia due to carcinomatosis of the bone marrow receiving letrozole and leuprorelin plus the CDK4/6 inhibitor palbociclib, who significantly derived clinical benefit from treatment. Considering that these peculiar cases are excluded from clinical trials, the estimation of the magnitude of the benefit of the newer ET combination may potentially represent a practical question for large case series and real-world studies.
Successful treatment of a Caucasian case of multifocal Castleman's disease with TAFRO syndrome with a pathophysiology targeted therapy - a case report
Authors: Silvia Tedesco, Laura Postacchini, Lucia Manfredi, Gaia Goteri, Michele M Luchetti, Antonella Festa, Armando Gabrielli, Giovanni Pomponio
Journal: Exp Hematol Oncol (2015)
Keywords: castleman’s disease, chemotherapy, multicentric, pres, rituximab, tafro syndrome, tocilizumab

Background:
Castleman-Kojima disease (TAFRO Syndrome) is characterized by Thrombocytopenia, Anasarca, myeloFibrosis, Renal dysfunction, Organomegaly, multiple lymphadenopathy and histopathology pattern of atypical Castleman's disease (CD). Only few cases of this recently identified unique variant of Multicentric CD (MCD) are described in literature, all Japanese. It therefore poses serious diagnostic and therapeutic challenges.
Case description:
We describe a 21 year old woman with fever, asthenia, bilateral pleural effusion, ascites, hypoalbuminemia, severe thrombocytopenia, anemia, renal failure and proteinuria, whereas microbiological tests, immune serology (except ANA) and bone marrow biopsy were all negative. A CT-scan showed multiple lymphadenopathy and tissue samplings of mediastinal lymph nodes was compatible with a mixed-type CD. The diagnosis of MCD with TAFRO syndrome was made, but after an initial improvement with high dose corticosteroid therapy, clinical and laboratory features worsened. Based upon the high serum IL-6 levels and the high number of CD20-lymphocytes in lymph nodes tissue, we started tocilizumab (partial benefit), followed by rituximab combined with CVP (cyclophosphamide, vincristine and prednisone) chemotherapy, achieving a complete response. A total of six cycles of R-CVP were administered monthly, followed by maintenance with monthly rituximab. A complete remission persists at the 12th month of follow-up.
Conclusions:
In patients with massive immune system activation and lymphadenopathy it is mandatory to rule out Castleman-Kojima disease. In our patient a therapy aimed at the prominent pathophysiological abnormalities has been successful so far. However, since the rarity of TAFRO Syndrome, a multicenter registry is strongly desirable for a better understanding of the disease mechanisms, hopefully leading to evidence-based therapeutic choices.
Left Atrial Appendage Thrombus Formation in a Patient on Dabigatran Therapy Associated With ABCB1 and CES-1 Genetic Defect
Authors: Zhi-Chun Gu, Xiao-Wei Ma, Xiao-Yuan Zheng, Long Shen, Fang-Hong Shi, Hao Li
Journal: Front Pharmacol (2018)
Keywords: abcb1, ces-1, dabigatran, drug-drug interaction, genetic polymorphism, left atrial appendage thrombus
MeSH terms: Case Reports

Dabigatran, directly targeting thrombin, is widely used for the prevention of stroke in nonvalvular atrial fibrillation (NVAF). We reported a rare case of left atrial appendage thrombus formation in a persistent NVAF patient despite the 31 months uninterrupted treatment with dabigatran 110 mg twice daily. The patient is a carrier of ABCB1 variant alleles with 7 heterozygote single nucleotide polymorphisms (SNPs: rs4148738, rs2235046, rs1128503, rs10276036, rs1202169, rs1202168, rs1202167) as well as CES-1 variant alleles with 2 homozygote SNPs (rs2244613 and rs4122238) and 2 heterozygote SNPs (rs8192935 and rs4580160), which may contribute to the changes of dabigatran plasma concentration. In addition, Drug-drug interaction with atorvastatin may also play a role to decrease dabigatran plasma concentration. There are only four such cases till date, of which had thrombus in the left atrium, reported in the literature. We firstly reported the documented case in a Chinese patient carrying multiple alleles of ABCB1 and CES-1, who suffered from thrombus in the left atrial appendage despite long-term anticoagulation with dabigatran. More clinical data are required to elucidate the impact of CES-1 and ABCB1 polymorphism on dabigatran pharmacokinetics, especially for Asian.
Strong ERG Positivity in Papillary Intralymphatic Angioendothelioma of the Testis of a 24-Year-Old Male: A Case Report
Authors: Anne M Schultheis, Mareike Sandmann, Stefan Steurer
Journal: Case Rep Pathol (2013)

Papillary intralymphatic angioendothelioma is a rare, low-grade neoplasm of lymphatic channels that usually presents intradermally or subcutaneously. We report the case of a 24-year-old male presenting with an isolated intratesticular palpable mass and symptoms of testicular pain. Preoperative ultrasound examination showed an irregular, heterogeneous mass. Subsequent surgery and pathologic assessment revealed a papillary intralymphatic angioendothelioma (PILA), formerly known as Dabska tumor within the lymphatic spaces.
Ignatzschineria indica bacteremia in a patient with a maggot-infested heel ulcer: a case report and literature review
Authors: Vincent Deslandes, Colleen Haney, Kathryn Bernard, Marc Desjardins
Journal: Access Microbiol (2019)
Keywords: ignatzschineria indica, bacteremia, maggots
MeSH terms: Case Reports

An elderly patient was admitted with sepsis to a community hospital. The individual was found to have a foot wound infested with maggots, and clinical evidence of cellulitis. A blood culture was positive on day 2 with Ignatzschineria indica . The patient was treated successfully with a combination of antibiotics and manual removal of the maggots. Poor living conditions were central to his presentation.
Scar endometriosis: a mimic of acute abdominal emergencies
Authors: Dylan Paul Roi, Joel Lewis Schamroth, Lubna Khalid, Ajay Sahu
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

Scar endometriosis can be a great mimic of common surgical and gynaecological conditions in reproductive age females. The correct preoperative diagnosis is only achieved in a relatively low number of patients (20-50%). This uncommon condition presents diagnostic challenges and requires surgical excision in most cases. Ultrasound represents a useful tool to triage and direct management as well as further investigations. We present a case of scar endometriosis in a young female with a previous history of caesarean section.
A Postmenopausal Woman with Giant Ovarian Serous Cyst Adenoma: A Case Report with Brief Literature Review
Authors: Nishat Fatema, Muna Mubarak Al Badi
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Giant (>10 cm) ovarian cyst is a rare finding. In the literature, a few cases of giant ovarian cysts have been mentioned sporadically, especially in elderly patients. We report a 57-year-old postmenopausal woman with a giant left ovarian cyst measuring 43 × 15 × 9 cm. She was referred to us from the local health center in view of palpable pelvic mass for six-month period. Considering the age and menopausal state, we performed a total abdominal hysterectomy and bilateral salpingo-oophorectomy with excision of the giant left ovarian cyst intact and successfully without any significant complication. On histopathological examination, the cyst was confirmed as benign serous cystadenoma of the ovary. During the management of these high-risk cases of multidisciplinary approach, intraoperative and postoperative strict vigilance is necessary to avoid unwanted complications.
Idiopathic Granulomatous Mastitis Presenting as Bilateral Breast Abscesses
Authors: Jesper Dierickx, Sofie Dekeyzer, Filip Vanhoenacker
Journal: J Belg Soc Radiol (2021)
Keywords: mri, granulomatous mastitis, mammography, ultrasound
MeSH terms: Case Reports

Teaching point: Idiopathic granulomatous mastitis is a rare disease that may present as breast abscesses and may mimic other inflammatory, infectious, or neoplastic disorders on imaging.