OpenMed/multicare-articles huggingface dataset:
Identification and characterization of invasive multi-drug-resistant (MDR) Bacteroides genomospecies in Canada
Authors: Christopher Graham, Alireza Eshaghi, Alicia Sarabia, Sandra Zittermann, Patrick Stapleton, Julianne V Kus, Samir N Patel
Journal: Access Microbiol (2020)
Keywords: bacteroides, anaerobic bacteria, genomospecies, metronidazole, multi-drug resistance
MeSH terms: Case Reports

We identified and characterized a genome of the multi-drug-resistant Bacteroides genomospecies recovered from an invasive specimen from a hospitalized patient in Canada. The strain was resistant to penicillin, pipercillin-tazobactam, meropenem, clindaymycin and metronidazole. The strain harboured a plasmid containing the nimE gene, which has been shown to be associated with metronidazole resistance. The study highlights the importance of being vigilant in suspecting antimicrobial drug resistance when a patient is not improving on therapy.
Lingual Raynaud's Phenomenon after Surgical and Radiotherapeutic Intervention for Oral Squamous Cell Carcinoma
Authors: Nicholas J Murphy, Loay S Kabbani, Alexander D Shepard, Farzan Siddiqui
Journal: Case Rep Vasc Med (2022)
MeSH terms: Case Reports

Raynaud's phenomenon of the tongue after radiation therapy with or without chemotherapy is an exceedingly rare complication. Symptoms are similar to Raynaud's disease of other sites and involve pallor and discomfort on exposure to cold temperatures that resolve with rewarming. Presentation occurs approximately 18-24 months after radiotherapy on average and can usually be managed effectively with lifestyle modification and pharmacotherapy. Here, we present a case of lingual Raynaud's following surgery and adjuvant radiation therapy in a patient with squamous cell carcinoma of the oral cavity.
A Single Liver Metastasis From Adenoid Cystic Carcinoma of the Parotid Gland: Case Report
Authors: Ines Zemni, Nesrine Tounsi, Imene Bouraoui, Maher Slimene, Ghada Sahraoui, Mohamed Ali Ayadi, Riadh Chargui, Khaled Rahal
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: adenoid cystic carcinoma, liver metastasis, salivary gland
MeSH terms: Carcinoma, Adenoid Cystic / pathology, Liver Neoplasms / secondary, Parotid Neoplasms / pathology, Case Reports, Adult, Female, Humans, Liver Neoplasms / diagnostic imaging, Liver Neoplasms / pathology, Magnetic Resonance Imaging, Tomography, X-Ray Computed

Adenoid cystic carcinoma is an uncommon malignant neoplasm of the salivary gland. Liver metastasis from salivary gland cancer is a rare situation. In this article, we report the case of a 29-year-old woman treated 5 years previously for adenoid cystic carcinoma of the parotid gland by surgery and radiotherapy, who presented for a large hypervascularized hepatic metastasis of 20 cm. After 3-cycle chemotherapy stability, hepatic surgery was successfully performed. The patient maintained disease-free period of 12 months after the surgical treatment. This rare case represents a therapeutic challenge for oncologists and surgeons. Through this case and a review of the literature, we try to better detail the management of this uncommon entity.
A Rare Report of Infectious Emphysematous Aortitis Secondary to Clostridium septicum without Prior Vascular Intervention
Authors: Ciel Harris, Joseph Geffen, Keyrillos Rizg, Stuart Shah, Aaron Richardson, Cherisse Baldeo, Avinash Ramdass
Journal: Case Rep Vasc Med (2017)
MeSH terms: Case Reports

The term "mycotic aneurysm" was first used by Osler in 1882 to describe a mushroom-shaped aneurysm in subacute bacterial endocarditis. Mycotic aneurysms account for only 2.6% of all aneurysms of the aorta. Rarer still are anaerobic infections secondary to organisms such as Clostridium septicum, which results in emphysematous aortitis. The vast majority of emphysematous aortic infections occur as a result of instrumentation; however, in this case we present an infection de novo. A 75-year-old male presented with a 2-week history of progressive fatigue and chest pain that then developed into constitutional symptoms. Chest radiograph demonstrated an obvious widened mediastinum. CT angiogram of his chest then confirmed this finding as well as significant periaortic gas and focal outpouching. Numerous diverticuli with inflammatory changes consistent with diverticulitis was observed on CT abdomen. Blood cultures returned positive for Clostridium septicum. Definitive treatment was discussed including debridement and graft insertion; however, patient decided on conservative management and was discharged on intravenous antibiotics. Unfortunately, as in most cases of emphysematous aortitis that do not undergo surgical management, the patient succumbed to his illness. The lesson provided will be the epidemiology of emphysematous aortitis, presentation, diagnosis, management, and prognosis through a case report.
Case Report: Whole Exome Sequencing Identifies Compound Heterozygous Variants in TSFM Gene Causing Juvenile Hypertrophic Cardiomyopathy
Authors: Jamie O Yang, Hapet Shaybekyan, Yan Zhao, Xuedong Kang, Gregory A Fishbein, Negar Khanlou, Juan C Alejos, Nancy Halnon, Gary Satou, Reshma Biniwale, Hane Lee, Glen Van Arsdell, Stanley F Nelson, Marlin Touma, UCLA Clinical Genomics Center, UCLA Congenital Heart Defects-BioCore Faculty
Journal: Front Cardiovasc Med (2022)
Keywords: coxpd3, tsfm, hypertrophic cardiomyopathy, mitochondrial cardiomyopathy, mitochondrial hyperplasia, whole exome sequencing
MeSH terms: Case Reports

We report a case of hypertrophic cardiomyopathy and lactic acidosis in a 3-year-old female. Cardiac and skeletal muscles biopsies exhibited mitochondrial hyperplasia with decreased complex IV activity. Whole exome sequencing identified compound heterozygous variants, p.Arg333Trp and p.Val119Leu, in TSFM, a nuclear gene that encodes a mitochondrial translation elongation factor, resulting in impaired oxidative phosphorylation and juvenile hypertrophic cardiomyopathy.
Traumatic Pseudoaneurysm of Superior Rectal Artery - an Unusual Cause of Massive Lower Gastrointestinal Bleed: A Case Report
Authors: Javid Iqbal, Lileswar Kaman, Mahesh Parkash
Journal: Gastroenterology Res (2011)
Keywords: bleeding, embolization, superior rectal artery, traumatic pseudoaneurysm
MeSH terms: Case Reports

Traumatic pseudoaneurysm of superior rectal artery is an unusual cause of massive lower gastrointestinal bleed. We are reporting the first case as we could not come across any similar report in the literature. Patient underwent exploratory laparotomy, diversion sigmoid loop colostomy, perineal wound debridement and antiseptic dressing for traumatic perineal wound. Patient had repeated episode of massive lower gastrointestinal bleeding and was diagnosed as a case of bleeding from superior rectal artery pseudoaneurysm which was managed by selective superior rectal artery embolization after failure of surgical treatment.
Myasthenia Gravis Masquerading as an Idiopathic Unilateral Facial Paralysis (Bell's Palsy)-A Very Rare and Unique Clinical Find
Authors: Marwa Elnazeir, Siddharth Narayanan, Pradeepthi Badugu, Abid Hussain, Tamour Tareen, Alexi R Hernandez, Wei Liu, Adriana E Palade, Martin E Brown
Journal: Front Neurol (2020)
Keywords: acetylcholine, autoimmune, facial palsy, muscle weakness, stroke
MeSH terms: Case Reports

Myasthenia gravis (MG) is an uncommon autoimmune neuromuscular junction disorder manifesting as fluctuating weakness of skeletal muscles. To add to its repertoire of mimicking a wide range of neurological disorders, the present case report is, to the best of our knowledge, the very first to describe MG masquerading as an idiopathic unilateral facial paralysis (Bell's palsy, BP). Our case report is distinct, highlights a novel clinical occurrence, offers new insights of how different neurological disorders may overlap with each other, and reminds neurologists to have a very broad and thorough comprehension for effective diagnoses and treatment plans. Several other conditions that produce facial nerve palsy identical to BP have also been discussed.
Anti-CD19 chimeric antigen receptor T-cell followed by interferon-α therapy induces durable complete remission in donor cell-derived acute lymphoblastic leukemia: A case report
Authors: Jing Ni, Junjie Zhou, Zhangbiao Long, Xin Chen, Xiaowen Chen, Jian Hong, Xinglin Liang, Qingsheng Li, Ruixiang Xia, Jian Ge
Journal: Front Oncol (2022)
Keywords: chimeric antigen receptor t cell, donor cell-derived leukemia, durable complete remission, interferon-α, post-transplant recurrence
MeSH terms: Case Reports

Donor cell-derived leukemia (DCL) is a special type of relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Patients with DCL generally have a poor prognosis due to resistance to conventional chemotherapy. Here, we report a case of donor cell-derived acute lymphoblastic leukemia after umbilical cord blood transplantation. The patient didn't respond to induction chemotherapy. She then received anti-CD19 CAR-T cell therapy and achieved MRD-negative complete remission (CR). However, MRD levels rose from negative to 0.05% at 5 months after CAR-T cell therapy. Higher MRD levels were significantly associated with an increased risk of leukemia recurrence. Afterward, preemptive interferon-α treatment was administrated to prevent disease recurrence. To date, the patient has maintained MRD-negative CR for 41 months. Our results suggested that anti-CD19 CAR-T cells followed by interferon-α therapy are effective in treating donor cell-derived acute lymphoblastic leukemia. This report provides a novel strategy for the treatment of DCL.
Atypical Eclampsia in a Pregnant Woman Infected by COVID-19
Authors: Maha Ahmad Odeh, Yousef S Abuzneid, Omar Badareen, Khaled Masarweh
Journal: Case Rep Obstet Gynecol (2022)
MeSH terms: Case Reports

The coronavirus disease 2019, also called (COVID-19), is an infectious disease which is caused by a virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first report was in December 2019, and on March 12, 2020, the World Health Organization (WHO) declared this disease a pandemic. COVID-19 targets many major organs causing life-threatening systemic complications. It can cause lung damage and respiratory failure in addition to systemic inflammation and immune dysregulation. Hypercoagulable state and numerous neurological abnormalities also have been reported due to this condition. Going through the literature review, we found some cases of pregnant women with novel coronavirus infection, being mostly mild illnesses, and most of these cases were focused on maternal-fetal transmission and neonatal outcomes. In this case report, we present the case of a COVID-19 positive woman who came to our emergency department at 34 weeks of gestation with tonic-clonic seizures. This case was a challenge for us because we faced a new an unknown manifestation of both COVID and eclampsia.
Intra-abdominal angiosarcoma developing in a capsule of a foreign body: report of a case with associated hemorrhagic diathesis
Authors: Young-Tae Joo, Chi-Young Jeong, Eun-Jung Jung, Young-Joon Lee, Soon-Chan Hong, Sang-Kyung Choi, Soon-Tae Park, Woo-Song Ha
Journal: World J Surg Oncol (2005)

Background:
Angiosarcoma occurs very rarely in the gastrointestinal tract and can present great diagnostic difficulty, especially when it is associated with intraabdominal abscess or granulation tissue.
Case presentation:
We report a case where the angiosarcoma was diagnosed after the occurrence of disseminated angiosarcoma and concurrent hemoperitoneum. The tumor developed in the fibrous capsule of a foreign body, which was possibly related to the previous appendectomy twenty years ago, and became a widely disseminated malignant neoplasm in the abdomen. After the operation, the patient's course was dominated by a fatal consumptive coagulapathy. Pathologic examination of the multiple intra-abdominal lesions showed the histological and immunohistological characteristics of the angiosarcoma.
Conclusion:
Even though angiosarcoma in the gastrointestinal tract is extremely rare, when dealing with intraabdominal abscess or the gastrointestinal bleeding in patients who have undergone surgery or radiation therapy in the past, the possibility of angiosarcoma should be considered. To make the definite diagnosis of angiosarcoma and to avoid the misdiagnosis of foreign body granuloma, thorough histological examination and immunohistochemical staining may be prerequisite.
Testicular infarction as a rare complication of pyogenic epididymoorchitis due to Pseudomonas aeruginosa: A case report and systematic literature review
Authors: Kazuhiro Ishikawa, Takahiro Matsuo, Tomoaki Nakamura, Fujimi Kawai, Yuki Uehara, Nobuyoshi Mori
Journal: IDCases (2021)
Keywords: pseudomonas aeruginosa, pyogenic epididymoorchitis, testicular infarction
MeSH terms: Case Reports

Background:
Testicular infarction is a known serious complication associated with epididymitis. It is known to be idiopathic in 70% of cases but the frequency, risk factors, and management are yet to be elucidated. This paper aims to report a case of testicular infarction secondary to pyogenic epididymoorchitis caused by Pseudomonas aeruginosa.
Case presentation:
A 64-year-old male with a past medical history of benign prostate hypertrophy using intermittent self-catheterization and a recent history of culture-negative pyogenic epididymoorchitis treated with oral cefpodoxime was admitted to our hospital due to a 4-week history of fever, right scrotal pain, and swelling. Scrotal ultrasonography showed a hypoechoic testis without testicular torsion. He was diagnosed with testicular infarction and a scrotal abscess due to Pseudomonas aeruginosa, and was treated with cefepime along with transcutaneous drainage. Despite the antimicrobial treatment, he experienced testicular loss with necrotic tissue. Because little is known about the risk factors, clinical characteristics, management, and prognosis of testicular infarction secondary to epididymitis, we performed a systematic review of the literature.
Conclusion:
This is a case of testicular necrosis during the treatment of epididymitis with negative urine culture and detection of Pseudomonas aeruginosa in tissue culture. Clinicians should perform frequent blood flow evaluation to the testis for early urologic intervention.
HHV8/EBV Coinfection Lymphoproliferative Disorder: Rare Entity with a Favorable Outcome
Authors: Dhouha Bacha, Beya Chelly, Houda Kilani, Lamia Charfi, Amel Douggaz, Samia Chatti, Emna Chelbi
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

HHV8/EBV-associated germinotropic lymphoproliferative disorder (GLD) is a challenging diagnosis given its rarity, the particular clinical presentation, and the lack of expression of markers usually used in establishing hematopoietic lineage. We report a new case of HHV8/EBV GLD in an immunocompetent 78-year-old woman. The diagnosis was made in an incidentally discovered lymphadenopathy. Histological examination showed a nodular lymphoid proliferation centered by aggregates of atypical plasmablastic cells admixed with small lymphoid cells. Tumor cells were strongly positive with EMA, HHV8, LMP1, CD38, CD138, and kappa light chains. They were negative with common lymphoma-associated markers (CD20, CD3, CD15, CD30, CD10, and bcl2). In situ hybridization confirmed the monotypic kappa light chains and the EBV infection (EBER+). A polyclonal pattern of Ig gene rearrangement was detected by PCR analysis. In the adjacent lymph node parenchyma, some germinal centers mimicked Castleman disease. In this case, the differential diagnosis was discussed with an early stage of large B-cell lymphoma arising in HHV8-associated multicentric Castleman disease. The clinical presentation, the immunophenotype, and the molecular results helped to make the accurate diagnosis. Through the review of the nine previously reported cases in literature, we discuss the clinical and pathologic features and the differential diagnosis of HHV8/EBV GLD.
Penile Fracture: Simultaneous Complete Urethral Rupture with Bilateral Corpora Cavernosa Rupture
Authors: Ibrahim Alnadhari, Osama Abdelhaleem Abdeljaleel, Venkata Ramana Pai Sampige, Ausama Abdulmuhsin, Ahmad Shamsodini
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

Penile fracture is not uncommon blunt trauma to the penis. Here, we present a rare case of penile fracture during sexual intercourse. The patient presented with penile swelling, bleeding per urethra, and inability to pass urine. Retrograde urethrogram showed significant extravasation of contrast from anterior penile urethra and no contrast passing to proximal urethra. Surgical exploration showed complete urethral rupture and bilateral cavernosal rupture. This case represents the value of urethrogram to evaluate the urethral injury and the association of complete urethral injury with bilateral ventral cavernosal injury.
Giant scalp melanoma: a case report and review of the literature
Authors: Jessica A Ching, Lisa Gould
Journal: Eplasty (2012)

Introduction:
Among malignant melanoma lesions, those occurring on the scalp and neck have a particularly poor prognosis. In this case report, we present the largest melanoma of the head and neck and one of the largest melanomas of any anatomic site reported in the literature to date.
Methods:
The biopsy revealed left scalp melanoma with a Breslow's thickness of at least 14 mm, and final needle aspiration of lymphadenopathy was consistent with malignant melanoma. Preoperative staging was T4aN3Mx. Wide local excision with 3-cm margins was performed, which included excision of the left ear en-bloc, along with a selective left neck dissection. Reconstruction was performed with a Bilayer Wound Matrix (Integra, 311 Enterprise Drive, Plainsboro, New Jersey) and eventual thin split-thickness skin graft.
Results:
Final pathology of the left scalp en-bloc excision was a 14.5 × 10.4 cm malignant melanoma, Breslow's thickness of 18 mm. Numerous lymph nodes were positive for melanoma as well. Final pathologic staging was determined to be T4b N3 M1, Stage IV. Later the patient underwent split-thickness skin graft placement on the left scalp acellular dermal matrix, which healed with complete graft take.
Discussion:
This case report demonstrates a unique presentation of a giant melanoma. With few other cases reported for comparison, it appears our patient's prognosis is poor, despite treatment according to current guidelines.
Nivolumab for Metastatic Urothelial Cancer in a Renal Allograft Recipient With Subsequent Graft Rejection and Treatment Complete Remission: A Case Report
Authors: Didi Chen, Xinyi Wu, Congying Xie
Journal: Front Oncol (2021)
Keywords: complete remission, graft rejection, kidney transplantation, nivolumab, urothelial cancer
MeSH terms: Case Reports

Immune checkpoint inhibitors (ICIs) expanded the therapeutic options for several cancers. However, whether some special groups of patients including those with organ transplantation can receive ICIs remains unclear. In this report we presented an interesting case. A 54-year-old woman underwent kidney transplantation, developed metastasis 7 years after operation of the bladder tumor. Her disease progressed after chemotherapy and radiotherapy. Anti-PD-1 immunotherapy was then considered. After two cycles of nivolumab immunotherapy, the patient's renal function declined rapidly. Acute allograft rejection was considered. There was no significant decrease in creatinine after glucocorticoid pulse therapy. Third course of nivolumab was given, and regularly hemodialysis was simultaneously conducted. Two weeks later, the patient showed left abdominal pain. CT scan revealed a reduction in tumor burden, while enlarged volume of kidney graft. Immunotherapy stopped. Two months after the third course, CT demonstrated a complete remission to immunotherapy. 23 months after the third course, CT showed that the swelling transplanted kidney was smaller than previous, and no recurrence was observed.
Treatment of maxillary deficiency by miniplates: a case report
Authors: Rahman Showkatbakhsh, Abdolreza Jamilian, Mohammad Behnaz
Journal: ISRN Surg (2011)
MeSH terms: Case Reports

Introduction. Numerous devices have been introduced for correction of Class III malocclusion and maxillary deficiency. Aim. To assess the dentoskeletal effects of miniplates combined with Class III traction in treating Cl III malocclusion and maxillary deficiency in growing patients. Methods. This case describes the treatment of a maxillary-deficient 11-year-old boy by using miniplates. The patient's parents rejected the use of extraoral appliances and major surgical correction; therefore the treatment was done by using Class III elastics connected from two mandibular miniplates to an upper removable appliance. Two miniplates were inserted in the anterior part of the mandible in the canine areas under local anaesthesia. The treatment lasted for 10 months after which favourable correction of the malocclusion was observed. Results. The SNA and ANB angles increased by 5.1° and 4.4°, respectively. Lower 1 to mandibular plane decreased by 3.4°. Conclusions. This case demonstrates that miniplates can be a suitable method to extraoral appliances and major surgery in maxillary deficiency cases.
Severe Stenosis of an Anomalous Circumflex Artery Mimicking a Chronic Total Occlusion
Authors: George Mawardi, Anbukarasi Maran
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

The prevalence of anomalous circumflex coronary arteries is rare. Identifying the presence of an anomalous coronary is quite easy when there is no severe stenosis. However, in the presence of severe stenosis, there is limited anterograde flow, which makes it challenging to visualize the course of the stenotic artery, and it can be assumed to be a chronic total occlusion (CTO). This case demonstrates how the anomalous circumflex artery with severe stenosis masqueraded as a CTO and the patient was treated medically for several years, despite continued symptoms. The retrograde filling of an anomalous circumflex has a specific angiographic pattern which should be recognized. This case is an excellent illustration of the said angiographic pattern.
Lamotrigine Reduces Stress Symptoms of Chronic Anxiety in the Times of the Covid-19 Natural Catastrophe-A Case Report
Authors: Thuylinh L Pham, George P Chrousos, Andreas Merkenschlager, Katja Petrowski, Enrico Ullmann
Journal: Front Psychiatry (2021)
Keywords: post-traumatic stress disorder, inflammation, lamotrigine, obesity, self-harm behavior
MeSH terms: Case Reports

The SARS-CoV-2 pandemic has been a worldwide chronic, stress-inducing natural catastrophe associated with increased emotional challenging. Patients with Post-traumatic stress disorder (PTSD), self-injury behavior, and obesity are predisposed to aggravation of their symptoms at this time, requiring new therapeutic approaches to balance their disrupted neuro-hormonal stress axis. Here we present our observations of an off-label treatment with lamotrigine in an adolescent girl with PTSD, self-injury behavior, and obesity. Lamotrigine was an efficacious pharmaceutical intervention that helped the patient deal with chronic stress and associated anxiety. The results are discussed based on our previous basic research outcomes in animals and humans that focused on the glutamate-cortisol circuits within the limbic brain.
Primary systemic amyloidosis and high levels of Angiotensin-converting enzyme: two case reports
Authors: J Praena-Segovia, A Sanchez-Gastaldo, M Bernabeu-Wittel, R Ocete-Pérez, R Avila-Polo, M L Martino
Journal: Case Rep Cardiol (2013)

Infiltrative heart diseases are caused by a heterogeneous group of disorders; amyloidosis and sarcoidosis are two frequent causes of myocardial infiltration, which differ in clinical and biological outcome and treatment issues. The presence of high levels of angiotensin-converting enzyme (ACE) in a patient with infiltrative heart disease may increase suspicion of sarcoidosis. Nevertheless, no mention about increased ACE levels in extracerebral primary systemic amyloidosis is available. We present two cases of primary systemic amyloidosis, which are cardiac involvement and elevated ACE levels.