OpenMed/multicare-articles huggingface dataset:
Case Report: Kingella kingae causing prosthetic joint infection in an adult
Authors: Katherine Wensley, Damian McClelland, Natalie Grocott, Gopikanthan Manoharan, Seema Desai
Journal: Access Microbiol (2023)
Keywords: kingella kingae, immunocompromised, prosthetic joint infection
MeSH terms: Case Reports

Introduction:

Kingella kingae is a Gram-negative micro-organism that is rarely isolated as a pathogen in the adult population. Although widely reported to affect prosthetic heart valves, there have been no previously reported cases of K. kingae infecting prosthetic joints in adults.
Case presentation:
A 61-year-old patient with a history of rheumatoid arthritis presented with insidious onset of pain and swelling in her right shoulder, which had progressed to a discharging sinus. The patient had undergone a total shoulder replacement 11 years previously and had not developed any prior post-operative infections. She had been taking anti-TNF medication for 5 years prior to review for her rheumatoid disease. The patient underwent a two-stage revision replacement procedure, including implant removal, sinus excision and debridement. Deep tissue samples grew K. kingae post-operatively. The patient was commenced on intravenous ceftriaxone for 14 days, followed by a further 28 days of oral ciprofloxacin. A second-stage custom shoulder replacement was undertaken 10 months following the first stage and the patient made a good functional recovery.
Conclusion:
The authors suggest that clinicians should be attuned to K. kingae as a potential pathogen for prosthetic joint infection, particularly in patients who are immunosuppressed. Two-stage revision procedures can ensure a favourable outcome and eradication of this pathogen from the joint. Beta lactams remain the principal antibiotic of choice.
Successful Treatment of an Elderly Patient With Combined Small Cell Lung Cancer Receiving Anlotinib: A Case Report
Authors: Yuying Gan, Pingli Liu, Tao Luo
Journal: Front Oncol (2021)
Keywords: anlotinib, combined small cell lung cancer, elderly, long progression-free survival, the first-line therapy
MeSH terms: Case Reports

Combined small-cell lung cancer (C-SCLC) is a relatively rare subtype of SCLC and is defined by the combination of SCLC and any elements of non-small-cell lung carcinoma. Anlotinib is a novel oral multitarget tyrosine kinase inhibitor that led to significant improvements in progression-free survival and overall survival in third-line therapy of advanced SCLC in the ALTER1202 study. Antiangiogenic therapy with anlotinib in C-SCLC has not previously been reported. An 80-year-old man was admitted with a 20-day history of blood-stained sputum. Chest computed tomography revealed a soft mass (45 × 43 mm) in the right upper lobe and a mediastinal lymph node and additional lung lesions in the homo lung. Pathology confirmed C-SCLC after an ultrasound-guided percutaneous puncture biopsy of the right lung tumor. The elderly patient was given anlotinib monotherapy at a dose of 10 mg/day on days 1-14 of a 21-day cycle after providing informed consent, and the outcome was assessed as continued partial response. As of the last follow-up evaluation, the patient's progression-free survival was more than 7 months, and the treatment showed satisfactory safety. Our findings provide direct evidence of the efficacy of anlotinib in an elderly patient with C-SCLC. More studies are needed to confirm our observations.
Laparoscopic resection of an intra-abdominal esophageal duplication cyst: a case report and literature review
Authors: Ikuo Watanobe, Yuzuru Ito, Eigo Akimoto, Yuuki Sekine, Yurie Haruyama, Kota Amemiya, Fumihiro Kawano, Shohei Fujita, Satoshi Omori, Shozo Miyano, Taijiro Kosaka, Michio Machida, Toshiaki Kitabatake, Kuniaki Kojima, Asumi Sakaguchi, Kanako Ogura, Toshiharu Matsumoto
Journal: Case Rep Surg (2015)

Duplication of the alimentary tract is a rare congenital malformation that occurs most often in the abdominal region, whereas esophageal duplication cyst develops typically in the thoracic region but occasionally in the neck and abdominal regions. Esophageal duplication cyst is usually diagnosed in early childhood because of symptoms related to bleeding, infection, and displacement of tissue surrounding the lesion. We recently encountered a rare adult case of esophageal duplication cyst in the abdominal esophagus. A 50-year-old man underwent gastroscopy, endoscopic ultrasonography, computed tomography, and magnetic resonance imaging to investigate epigastric pain and dysphagia that started 3 months earlier. Imaging findings suggested esophageal duplication cyst, and the patient underwent laparoscopic resection followed by intraoperative esophagoscopy to reconstruct the esophagus safely and effectively. Histopathological examination of the resected specimen revealed two layers of smooth muscle in the cystic wall, confirming the diagnosis of esophageal duplication cyst.
Case report: Clinical course and treatment of SARS-CoV-2 in a pediatric CAR-T cell recipient with persistent hypogammaglobulinemia
Authors: Howard Sanders, Christina Callas, Helaine St Amant, Jong Chung, Victoria R Dimitriades, Natasha A Nakra
Journal: Front Pediatr (2023)
Keywords: car-t cell therapy, covid-19, sars-cov-2, hypogammaglobulinemia, pediatric, remdesivir, virus neutralizing monoclonal antibody
MeSH terms: Case Reports

This report describes a pediatric patient who underwent chimeric antigen receptor (CAR) T-cell therapy for refractory B-cell acute lymphoblastic leukemia (B-ALL) four years prior, with resultant hypogammaglobulinemia for which he was receiving weekly subcutaneous immune globulin. He presented with persistent fever, dry cough, and a tingling sensation in his toes following a confirmed COVID-19 infection 3 weeks prior. His initial nasopharyngeal SARS-CoV-2 PCR was negative, leading to an extensive workup for other infections. He was ultimately diagnosed with persistent lower respiratory tract COVID-19 infection based on positive SARS-CoV-2 PCR from bronchoalveolar lavage (BAL) sampling. He was treated with a combination of remdesivir (antiviral) and casirivimab/imdevimab (combination monoclonal antibodies) with immediate improvement in fever, respiratory symptoms, and neurologic symptoms.
Colonoscopic titanium clipping to Maddress appendiceal stump leakage: a case report
Authors: Jianjun Liu, Huayan Yuan, Xiulian Xu, Longkuan Yin, Wei Wang, Wenhai Fan, Xiangyu Bai, Pan Wang
Journal: Front Surg (2023)
Keywords: appendectomy, appendiceal stump leakage, case report, colonoscope, titanium clipping
MeSH terms: Case Reports

The incidence of appendiceal stump leakage (ASL) is extremely low and heterogeneous, which has been reported to be approximately 0.5%-1.0%. It is a catastrophic complication with high mortality rate despite its low morbidity. Once it occurs, it will put the doctor in a passive position because dealing with the leakage is much more cumbersome than appendectomy. We extensively reviewed the literature on ASL, focusing on the management and prognosis. Unsurprisingly, all of the physicians advocated extended resection, which apparently gave them sufficient confidence. However, partial cecum resection, cecostomy, or terminal ileectomy is extremely invasive and destructive. So, the patients had to experience great mental and physical trauma, longer hospital stays, higher rates of wound infection, more costs, and even a third surgery. Therefore, are there any better approaches for ASL? In this article, we report a case of ASL who successfully underwent endoscopic treatment. A 70-year-old male was admitted with gangrenous perforated appendicitis with a large iliopsoas abscess. Appendectomy, iliopsoas abscess debridement and sufficient drainage, appendicular stump repair and closure, and terminal ileostomy were performed. Three months later, the patient was readmitted and the stoma reversal was performed as scheduled. Seven days later, ASL was found when a liquid diet was applied routinely due to right lower quadrant pain and low fever. Finally, with the periappendiceal abscess completely drained, we clamped the appendiceal orifice with five titanium clips under an electronic colonoscope, which eventually sealed the leakage and avoided extended resection.
A Case Report of Subcutaneously Injected Liposomal Cannabidiol Formulation Used as a Compassion Therapy for Pain Management in a Dog
Authors: Yael Shilo-Benjamini, Ahuva Cern, Daniel Zilbersheid, Atara Hod, Eran Lavy, Dinorah Barasch, Yechezkel Barenholz
Journal: Front Vet Sci (2022)
Keywords: cbd, analgesia, cannabidiol, dog, liposomes, pharmacokinetics, prolonged release
MeSH terms: Case Reports

A 14-year-old intact mixed breed dog (26 kg) was submitted for a novel cannabidiol (CBD) analgesic treatment. The dog was cachectic and had a testicular neoplasia, hip and elbow osteoarthritis and severe cervical pain. Analgesic treatment included canine osteoarthritic supplement, robencoxib and gabapentin. An additional liposomal CBD injectable formulation at 5 mg/kg was administered subcutaneously between the shoulder blades. The dog was monitored using an activity monitoring collar (PetPace), owner wellbeing questionnaire (Canine Brief Pain Inventory; CBPI), pain interactive visual analog scale (iVAS), blood work and CBD plasma concentrations. A week from the injection and up to 3 weeks afterwards the dog had improved CBPI and iVAS pain scores, and increased collar activity scores. CBD was quantified in plasma for 28 days. Due to disease progression, further difficulty to rise and walk, and relapse to pain after 3 weeks, the owners requested a second liposomal CBD injection, which was performed 4 weeks following the first injection using 3 mg/kg dose. Two days later, the dog was found dead in the yard under direct sun, while environmental temperature was 37°C. Major findings on necropsy revealed evidence of heat stroke and severe cervical disc protrusion with spinal hematoma, none related to liposomal CBD. In conclusion, subcutaneous liposomal CBD produced quantifiable CBD plasma concentrations for 28 days and may be an effective additional treatment as part of multimodal pain management in dogs.
Pleomorphic Adenoma of the Submandibular Gland: A Case Report
Authors: Prakash Khanal
Journal: JNMA J Nepal Med Assoc (2019)
MeSH terms: Adenoma, Pleomorphic / diagnosis, Submandibular Gland Neoplasms / diagnosis, Case Reports, Review, Adenoma, Pleomorphic / pathology, Adult, Humans, Male, Submandibular Gland Neoplasms / pathology

Salivary gland tumours are relatively rare and constitute about 3-4% of head and neck tumours. Most of the tumours arise from parotid glands. Submandibular gland tumours are very rare. Pleomorphic adenoma of the submandibular gland is exceedingly rare tumour. Very few studies have been reported in the literature that is exclusively conducted on pleomorphic adenoma affecting submandibular gland. Patients usually present with a slow growing, painless and mobile mass without any other associated symptoms. Radiologic studies are usually unable to differentiate benign from malignant tumours in most cases. Recurrence is rare with complete en bloc excision of the tumour along with submandibular gland. Prognosis is excellent except for the rare cases of malignant transformation. This paper describes a case of pleomorphic adenoma affecting submandibular gland with brief review of current literature on submandibular gland tumours. Keywords: pleomorphic adenoma; salivary gland; submandibular gland tumours.
Recurrence of macular corneal dystrophy on the graft 50 years after penetrating keratoplasty
Authors: Mona Bischoff-Jung, Elias Flockerzi, Andrea Hasenfus, Arne Viestenz, Pinio Matoula, Ursula Schlötzer-Schrehardt, Berthold Seitz
Journal: GMS Ophthalmol Cases (2020)
Keywords: hereditary corneal stromal dystroph, macular corneal dystrophy, penetrating keratoplasty, recurrence
MeSH terms: Case Reports

Purpose: To report the recurrence of a macular corneal stromal dystrophy 50 years after penetrating keratoplasty (PKP). Methods: Observational case report Case description: A 76-year-old male patient presented with visual impairment in the right eye (OD) 50 years after PKP in 1962 (44 years after PKP also in the left eye (OS) in 1968) following explosion injury. His visual acuity had already been impaired before the trauma because of bilateral corneal opacities. The central corneal thickness of the graft measured 584 µm (OD) and 544 µm (OS), whilst the peripheral host thickness (8 mm zone), however, was 1233 µm (OD, cranial) and 1131 µm (OS, nasal). The original graft diameter measured 6 mm in both eyes and the recipient cornea was cloudy and gray. The endothelial cell count was measured centrally (OD 1162 c/mm2, OS 1320 c/mm2). The visual acuity was 20/100 (OD) and 20/40 (OS). After excimerlaser-assisted repeated PKP (8.0/8.1 mm, OD), the histological analysis of the former graft revealed deposits of acid mucopolysaccharides (AMP) subepithelially, within the interface, in the donor stroma, and in the endothelium, which proved the peripheral recurrence of a macular corneal stromal dystrophy on the graft. Conclusion: Recurrence of macular corneal stromal dystrophy is seldom, but it may occur many decades after PKP. In this patient, the host's stroma was twice as thick as that of the graft. This may be caused by the active production of acid mucopolysaccharides in the host endothelium with secondary endothelial decompensation. Thus, PKP remains the gold standard in the cure of macular corneal dystrophy for long-term visual rehabilitation.
Pharmacokinetics of Dantrolene in the Plasma Exchange Treatment of Malignant Hyperthermia in a 14-Year-Old Chinese Boy: A Case Report and Literature Review
Authors: Xiaoxiao Li, Chao Li, Yang Zhou, Zhengqian Li, Xin Xiong, Chuhui Wang, Congya Zhou, Bin Han, Li Yang, Xiangyang Guo
Journal: Front Med (Lausanne) (2022)
Keywords: dantrolene, general anesthesia, malignant hyperthermia, pharmacokinetics, plasma exchange
MeSH terms: Case Reports

Malignant hyperthermia (MH) is a rare life-threatening response that is triggered by exposure to specific anesthetics commonly used during surgical interventions. Dantrolene is a well-known drug used as the first-line therapy for MH. A 14-year-old Chinese boy with a mutation in type 1 Ryanodine receptor (RyR1) whose muscle biopsy diagnosis was central core disease (CCD) had an occurrence of MH after a cervical spine surgery, during which he was placed under general anesthesia without volatile anesthetics or succinylcholine. The MH crisis treatment workflow was started and intravenous dantrolene was used, which was soon combined with sequent continuous veno-venous hemofiltration (CVVH) and plasma exchange (PE) therapy. We explored the pharmacokinetic profile of dantrolene during PE treatment. It showed that a one-compartment model with first-order kinetics was sufficient to characterize dantrolene pharmacokinetics (PK). The renal clearance estimate for dantrolene was 0.33 mL/(min*kg) and the volume of distribution was 0.51 L/kg. Though a 4-h PE elevated about 27% off-clearance for dantrolene, it eliminated extra dantrolene by a mere 4% of the area under the curve (AUC). We made no recommendation with respect to adjusting dantrolene dosing for MH adolescents with a 4-h PE.
Immune-related ureteritis and cystitis induced by immune checkpoint inhibitors: Case report and literature review
Authors: Jun Li, Ya-Fen Yu, Xiao-Wei Qi, Yuan Du, Chun-Qing Li
Journal: Front Immunol (2023)
Keywords: case report, glucocorticiods, immune checkpoint inhibitors, immune-related adverse, literature review
MeSH terms: Cystitis / chemically induced, Cystitis / diagnosis, Gastrointestinal Diseases, Urinary Tract Infections / drug therapy, Review, Case Reports, Glucocorticoids, Humans, Immune Checkpoint Inhibitors / adverse effects, Inflammation, Immune Checkpoint Inhibitors, Glucocorticoids

Immune checkpoint inhibitors (ICIs), including anti-cytotoxic T lymphocyte-associated protein 4 (anti-CTLA4) and anti-programmed death cell protein 1 (anti-PD-1), are increasingly prescribed in metastatic carcinoma therapy. ICI-related kidney injury is gradually recognized by clinicians. However, immune-related ureteritis and cystitis easily go undiagnosed. We report three cases of PD-1 monoclonal antibody (mAb)-related ureteritis and cystitis. We further carried out a review of the literature about ICI-related ureteritis and cystitis. The cases in our reports manifest urinary irritation, sterile pyuria, gross hematuria, hydronephrosis, dilation of the ureters, and acute kidney injury. Urinary irritation improved effectively; urinalysis and renal function returned to normal after glucocorticoid therapy. During ICI therapy, urinalysis and renal function and urinary imaging examination are recommended to be monitored regularly. It contributes to identify immune-related ureteritis/cystitis earlier to efficiently alleviate urinary symptoms and immunologic urinary tract injury through glucocorticoid therapy while avoiding the abuse of antibiotics.
Acute left main coronary artery occlusion
Authors: K Mehmet Burgazli, Mehmet Bilgin, Nedim Soydan, Ridvan Chasan, Ali Erdogan
Journal: Pak J Med Sci (2013)
Keywords: acute left main occlusion, bypass surgery, percutaneous coronary angioplasty
MeSH terms: Case Reports

The treatment of an acute left main coronary artery occlusion still poses a challenge. In this case report we present a 50-year-old patient with an acute occlusion of the left main artery. After a successful angioplasty without "stenting" due to the complexity of the stenosis the patient underwent a successful bypass surgery. We discuss the therapeutic options of acute left main occlusion regarding medical, interventional and surgical options.
To Cross or Not to Cross: Using MRI-Histology to Characterize Dense Collagenous Plaque in Critical Limb Ischemia
Authors: Kajol J Shah, Bright Benfor, Christof Karmonik, Alan B Lumsden, Trisha L Roy
Journal: Methodist Debakey Cardiovasc J (2023)
Keywords: mra, mri, pad, angioplasty, atherosclerosis, endovascular treatment/therapy, magnetic resonance angiography, magnetic resonance imaging, peripheral artery disease, plaque morphology, ultrashort echo time sequence, vascular imaging
MeSH terms: Peripheral Arterial Disease / diagnostic imaging, Peripheral Arterial Disease / surgery, Plaque, Atherosclerotic / complications, Plaque, Atherosclerotic / surgery, Case Reports, Chronic Limb-Threatening Ischemia, Humans, Ischemia / diagnostic imaging, Ischemia / etiology, Ischemia / surgery, Limb Salvage / adverse effects, Magnetic Resonance Imaging, Retrospective Studies, Risk Factors, Treatment Outcome

Peripheral artery disease (PAD) is caused by atherosclerotic buildup in the lower extremities, leading to obstruction and inadequate perfusion to the peripheral vasculature. Impenetrable plaques initially treated with percutaneous vascular intervention (PVI) have led to worse secondary bypass outcomes and amputation in patients. In this case report, we discuss the importance of using magnetic resonance imaging (MRI) histology in PVI planning in a patient with critical limb ischemia. PVI attempts to recanalize the limb failed because of an impenetrable occlusion in the popliteal artery that was not identified on routine preoperative imaging. Subsequent bypass occluded multiple times eventually requiring an above-knee amputation. An MRI-histology protocol-using ultrashort echo time (UTE) and T2-weighted (T2W) sequences-that was performed prior to the index PVI identified the occlusion as a dense collagen plaque. Histology analysis of the amputated specimen confirmed the MRI finding. This imaging modality offers a novel approach to characterize plaque composition and morphology, thereby identifying lesions at greatest risk of PVI failure and potentially playing an important role in selecting the right candidates for an endovascular-first approach.
Schizophyllum commune a causative agent of fungal sinusitis: a case report
Authors: T Premamalini, B T Ambujavalli, S Anitha, L Somu, Anupma J Kindo
Journal: Case Rep Infect Dis (2011)
MeSH terms: Case Reports

We present a case of maxillary sinusitis caused by Schizophyllum commune, in a 50-year-old female. The patient presented with nasal obstruction, purulent nasal discharge from right side of the nose, cough, headache, and sneezing. Computed tomography revealed extensive opacity of the right maxillary sinus as well as erosion of the nasal wall and maxillary bone. Functional endoscopic sinus surgery was done, and fungal debris present on right side of the maxillary sinus was removed and sent to laboratory. Potassium hydroxide (KOH) examination of the nasal discharge showed hyaline, septate hyphae. Primary isolation on Sabouraud's dextrose agar (SDA) yielded a white woolly mould. Banana peel culture after 8 weeks showed macroscopically visible fan-shaped fruiting bodies. Lactophenol cotton blue (LPCB) mount of the same revealed hyaline septate hyphae, often with clamp connections. Identification was confirmed by the presence of clamp connections formed on the hyphae and by vegetative compatibility with known isolates.
An "Uncrimped" SMart Stapes Prosthesis: A Cause of Late Hearing Deterioration in Otosclerosis
Authors: Premjit S Randhawa, Nicholas Hamilton, Antony A Narula
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Statement of Problem. Stapedotomy is the treatment of choice for otosclerosis. Numerous techniques and prosthesis are available to perform this procedure. Success rates of surgery vary from 17% to 80%, and revision surgery carries an increased risk of complications as well as poorer hearing outcomes. Method of Study. Case report. Results. We report the first case of uncrimping of a SMart stapes prosthesis with no lateral displacement as a cause of late failure despite successful crimping and improvement in audiological outcomes after initial surgery. Conclusion. The SMart stapes prosthesis is widely used and has been shown to be safe and provide good hearing outcomes. Displacement of a stapes prosthesis is the commonest cause of failure. Our case shows that deterioration of hearing thresholds can occur from uncrimping of the prosthesis with no displacement. It is important to improve our understanding of stapedotomy failure as revision procedures are associated with poorer outcomes.
Endoprosthetic Reconstruction for a Displaced Atypical Femoral Fracture in a Cancer Patient with Poor Prognosis
Authors: Hironari Tamiya, Hiroki Hagizawa, Takaaki Nakai, Yoshinori Imura, Takaaki Tanaka, Kazuya Oshima, Toshikazu Ito, Norifumi Naka, Shigeyuki Kuratsu
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Zoledronate or denosumab treatment is beneficial for cancer patients with bone metastasis. However, each agent may trigger atypical femoral fractures. Incomplete atypical femoral fractures can be successfully treated with prophylactic intramedullary nailing. On the other hand, intramedullary nailing for displaced atypical femoral fractures occasionally causes problems with regard to bone healing, resulting in long-term treatment. In cancer patients with poor prognosis who experience atypical femoral fractures, improvement in activities of daily living should be the priority. Thus, we performed endoprosthetic reconstruction for a displaced atypical femoral fracture in a breast cancer patient with poor prognosis to enable walking in the early stage after the operation. Two weeks after the operation, she could successfully walk. The postoperative Musculoskeletal Tumor Society score was 47%, and it had improved to almost the preoperative level before injury (50%). In conclusion, endoprosthetic reconstruction for displaced atypical femoral fractures may be a first-line treatment approach to acquire early postoperative walking ability for improving activities of daily living in cancer patients with poor prognosis.