OpenMed/multicare-articles huggingface dataset:
Bronchiectatic Actinomycosis with Osseous Metaplasia Masquerading as Lung Cancer
Authors: Archana Bhat, Manjunath J, Don Mascarenhas
Journal: Turk Patoloji Derg (2024)
MeSH terms: Actinomycosis / diagnosis, Actinomycosis / pathology, Bronchiectasis / diagnosis, Lung Neoplasms / diagnosis, Lung Neoplasms / pathology, Metaplasia, Case Reports, Anti-Bacterial Agents / therapeutic use, Diagnosis, Differential, Female, Humans, Middle Aged, Anti-Bacterial Agents

Bronchial involvement in pulmonary actinomycosis is rare and has been reported in the literature rarely. However, these reports describe endobronchial actinomycosis secondary to foreign body aspiration (for example, a fish bone). Our case did not have any history or clinical evidence suggesting foreign body aspiration, which makes it even more rare. A 55-year-old woman presented with complaints of on and off haemoptysis and cough for three weeks. In view of the haemoptysis and consolidation seen on imaging, a bronchoalveolar lavage was done and sent for cytological assessment. Few atypical cells with nuclear hyperchromasia and prominent nucleoli were noted. In view of the persistent haemoptysis, worsening symptoms, and non-resolution of the consolidation despite antibiotics, and the finding of atypical cells, segmental resection was done. A final diagnosis of bronchiectatic actinomycosis with osseous metaplasia was given. The patient was started on prolonged antibiotics with good response and recovery. Other risk factors associated with pulmonary actinomycosis include alcoholism, diabetes, haematological diseases, human immunodeficiency viral infection, use of immunosuppressants, and rarely chronic lung diseases, such as bronchiectasis. Our case had this rare association of bronchiectasis with bronchial actinomycosis. Bronchiectatic actinomycosis is a rare infection and it can mimic several lung disorders like unresolving pneumonia, pulmonary tuberculosis, foreign body, and even lung tumours. The pathologists and clinicians should be aware of this entity and thus help in the early diagnosis and better management of patients with this disease.
Manifestation of subacute cutaneous lupus erythematosus during treatment with anti-PD-1 antibody cemiplimab - a case report
Authors: Simon Fietz, Anne Fröhlich, Cornelia Mauch, Luka de Vos-Hillebrand, Tanja Fetter, Jennifer Landsberg, Friederike Hoffmann, Judith Sirokay
Journal: Front Immunol (2023)
Keywords: anti-pd-1 antibody, case report, cutaneous lupus erythematosus, cutaneous squamous cell carcinoma, immunotherapy
MeSH terms: Carcinoma, Squamous Cell / chemically induced, Carcinoma, Squamous Cell / diagnosis, Carcinoma, Squamous Cell / drug therapy, Hepatitis, Lupus Erythematosus, Cutaneous / chemically induced, Lupus Erythematosus, Cutaneous / diagnosis, Lupus Erythematosus, Cutaneous / drug therapy, Case Reports, Research Support, Non-U.S. Gov't, Antibodies, Monoclonal, Humanized / adverse effects, Humans, Antibodies, Monoclonal, Humanized, cemiplimab

Introduction:
The anti-programmed cell death protein 1 (PD-1) antibody cemiplimab has shown promising results in the treatment of unresectable or metastatic squamous cell carcinoma, however, frequently leads to immune-related adverse events limiting therapy efficacy. Although cutaneous side effects are common, only very few cases of cutaneous lupus erythematosus have been reported under anti-PD-1 immunotherapy. So far, no case of cutaneous lupus has been described under treatment with cemiplimab.
Case report:
For the first time, we report the case of a patient with advanced squamous cell carcinoma, who developed clinical and histological findings in sun-exposed skin that were consistent with anti-SS-A/Ro antibody-positive subacute cutaneous lupus erythematosus (SCLE) under treatment with cemiplimab. Additionally, laboratory chemical analyses revealed a severe immune-related hepatitis without clinical symptoms. Both, the SCLE and the hepatitis, resolved after the administration of topical and systemic steroids and the discontinuation of anti-PD-1 therapy.
Conclusion:
Treatment with cemiplimab can be associated with the appearance of cutaneous lupus erythematosus in sun-exposed areas. Application of topical and systemic glucocorticoids can lead to a rapid resolution of the skin eruptions. Moreover, our case illustrates the possibility of simultaneously occurring severe immune-related adverse events. This highlights the importance of additional diagnostics to avoid overlooking additional immune-related adverse events.
Combined use of intravitreal bevacizumab and oral steroid treatment in three diabetic papillopathy patients: a diagnostic and treatment challenge
Authors: Burcu Taşkıran Kandeğer, Mehmet Argun, Levent Tök, Özlem Tök
Journal: GMS Ophthalmol Cases (2024)
Keywords: anti-vascular endothelial growth factor, optic disc edema, oral steroid, vision loss
MeSH terms: Case Reports

Diabetic papillopathy (DP), a form of optic disc edema, is characterized by decreased visual acuity and mild to severe visual field defects. While there is no consensus about treatment, some publications report that intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection may be beneficial. To our knowledge, however, no research reports on the effects of combining anti-VEGF injection and oral steroids in DP treatment. In this case report we present three DP cases that showed rapid improvement following therapy with intravitreal bevacizumab and oral steroids. Optic disc edemas were significantly decreased, and visual acuities were markedly increased in the first week of treatment. This report suggests that combined use of these therapies may be safely used in patients diagnosed with DP.
Case Report: Pericardial patch repair of mitral annulus and mitral valve for a left atrial dissection caused by parasitic infective endocarditis
Authors: PeiShan Chu, Yi Tang, XinPei Liu, Qi Miao
Journal: Front Cardiovasc Med (2023)
Keywords: infectious endocarditis, left atrial dissection, parasite, patch repair for left atrial dissection, patch repair of mitral annulus and valve
MeSH terms: Case Reports

Introduction:
Left atrial dissection is a rare event, typically associated with cardiac manipulation. We report the first case of a left atrial dissection caused by parasitic infectious endocarditis, which required the use of patch repair for the damaged mitral annulus and valve.
Case presentation:
To treat heart failure in a 43-year-old man with left atrial dissection, we performed a patch repair of the mitral annulus and valve using autologous pericardium.
Conclusion:
We encourage novel surgery for complicated infectious endocarditis.
Case report: Sphenoid wing dural arteriovenous fistula draining into ophthalmic veins inducing pulsatile tinnitus as the sole symptom and its spontaneous closure
Authors: Yue-Lin Hsieh, Jiake Zhong, Xi Chen, Wuqing Wang
Journal: Front Neurol (2024)
Keywords: dural arteriovenous fistula, pulsatile tinnitus, sphenoid wing, spontaneous closure, superior ophthalmic vein
MeSH terms: Case Reports

This case report discusses a unique instance of pulsatile tinnitus (PT) caused by a rare type of intracranial dural arteriovenous fistula (DAVF) located in the sphenoid wing (SW) region, with PT being the sole presenting symptom. The patient initially received multiple misdiagnoses and sought medical attention at various hospitals before being correctly diagnosed. Imaging studies revealed the DAVF's presence in the SW region, which led to the patient's referral to interventional radiology/neurology, although she chose conservative observation without surgical intervention. Remarkably, the patient's PT spontaneously ceased after 30 months without any apparent cause, and follow-up imaging confirmed the absence of DAVF-related abnormalities. The case highlights the importance of considering DAVF as a potential cause of PT, even when there are no evident abnormalities in proximity to the auditory apparatus. It also emphasizes the need for otolaryngologists to extend their examination to include regions beyond the temporal bone, such as the sphenoid bone and orbital areas, when PT is the exclusive symptom. The case underscores the significance of early detection and intervention for DAVFs, as they can lead to debilitating complications, despite the rare occurrence of spontaneous symptom resolution in this case.
Case Report: RNF213 variant and choroidal anastomosis as potential risk factors for early stroke in moyamoya syndrome associated with Down syndrome
Authors: Keisuke Yamamoto, Yasuyuki Kaku, Hiroshi Koga
Journal: Front Pediatr (2023)
Keywords: cerebrovascular accident, collateral circulation, moyamoya disease, trisomy 21, ubiquitin-protein ligases
MeSH terms: Case Reports

Introduction:
Recent studies have suggested associations between RNF213 variants and the formation of periventricular anastomosis among patients with moyamoya disease, leading to early onset of cerebral hemorrhage and rebleeding.
Case description:
We report herein the case of a boy with Down syndrome and moyamoya syndrome. Exome sequencing identified a heterozygous RNF213 R4810K variant. After ischemic stroke occurred at 9 years old, indirect surgical revascularization was performed for the left cerebral hemisphere and improved ischemic symptoms and cerebral hypoperfusion, while the left choroidal anastomosis remained. At 13 years old, he presented with left thalamic hemorrhage attributed to the anterior choroidal artery, with rebleeding observed four days after the initial hemorrhage under strict blood pressure control. The patient was discharged without neurological deficits 20 days after the hemorrhagic stroke.
Conclusion:
Presence of an RNF213 variant and choroidal anastomosis may represent risk factors for cerebral hemorrhage in patients with Down syndrome and moyamoya syndrome, as well as in patients with moyamoya disease.
Vibrio vulnificus infection from insect bites in Shanghai: a case report
Authors: Xiaojie Hu, Huafa Que
Journal: Front Med (Lausanne) (2024)
Keywords: shanghai, vibrio vulnificus, case report, coastal city, insect
MeSH terms: Case Reports

Background:
Infection with Vibrio vulnificus is associated with high rates of amputation and mortality. Alterations in the global climate have heightened the risk of atypical infections caused by this pathogen.
Case presentation:
In the case report we describe, a 75-year-old man residing in a coastal city contracted Vibrio vulnificus secondary to an insect bite.
Discussion and conclusion:
This case underscores the importance for clinicians of recognizing that early administration of appropriate antibiotics in patients with non-traditional routes of Vibrio vulnificus infection can significantly reduce rates of amputation and mortality.
Case report: A family of atypical hemolytic uremic syndrome involving a CFH::CFHR1 fusion gene and CFHR3-1-4-2 gene duplication
Authors: Yuko Tasaki, Hiroshi Tsujimoto, Tadafumi Yokoyama, Naotoshi Sugimoto, Shinji Kitajima, Hiroshi Fujii, Yoshihiko Hidaka, Noritoshi Kato, Shoichi Maruyama, Norimitsu Inoue, Taizo Wada
Journal: Front Immunol (2024)
Keywords: cfh
MeSH terms: Atypical Hemolytic Uremic Syndrome / diagnosis, Atypical Hemolytic Uremic Syndrome / genetics, Complement Factor H / genetics, Case Reports, Research Support, Non-U.S. Gov't, Blood Proteins / genetics, Complement C3b Inactivator Proteins / genetics, Complement System Proteins / genetics, Female, Gene Duplication, Humans, Infant, Mutation, Complement Factor H, Complement System Proteins, CFHR3 protein, human, Blood Proteins, CFHR1 protein, human, Complement C3b Inactivator Proteins

Mutations in the complement factor H (CFH) gene are associated with complement dysregulation and the development of atypical hemolytic uremic syndrome (aHUS). Several fusion genes that result from genomic structural variation in the CFH and complement factor H-related (CFHR) gene regions have been identified in aHUS. However, one allele has both CFHR gene duplication and CFH::CFHR1 fusion gene have not been reported. An 8-month-old girl (proband) presented with aHUS and was treated with ravulizumab. Her paternal grandfather developed aHUS previously and her paternal great grandmother presented with anti-neutrophil cytoplasmic antibody-associated vasculitis and thrombotic microangiopathy (TMA). However, the proband's parents have no history of TMA. A genetic analysis revealed the presence of CFH::CFHR1 fusion gene and a CFHR3-1-4-2 gene duplication in the patient, her father, and her paternal grandfather. Although several fusion genes resulting from structural variations of the CFH-CFHR genes region have been identified, this is the first report of the combination of a CFH::CFHR1 fusion gene with CFHR gene duplication. Because the CFH-CFHR region is highly homologous, we hypothesized that CFHR gene duplication occurred. These findings indicate a novel pathogenic genomic structural variation associated with the development of aHUS.
An Avoidable Cognitive Error in Chest Radiography
Authors: Laura Haddad, Hanna Salame, Denis Tack
Journal: J Belg Soc Radiol (2023)
Keywords: chest radiography, diagnostic accuracy, interpretation error, missed foreign body, training
MeSH terms: Case Reports

Teaching Point: Awareness in radiology reporting of cognitive errors such as the alliterative bias can help minimize the delay to diagnosis and accelerate adequate patient care.
Potential S1 Nerve Root Blocks Associated with Sacroiliac Joint Injections
Authors: Andrew Ng, Jesse Lou, Dajie Wang
Journal: Pain Res Manag (2024)
MeSH terms: Nerve Block / methods, Sacroiliac Joint / diagnostic imaging, Sacroiliac Joint / drug effects, Adult, Aged, Aged, 80 and over, Anesthetics, Local / administration & dosage, Cone-Beam Computed Tomography, Female, Humans, Injections, Intra-Articular, Low Back Pain / drug therapy, Male, Middle Aged, Retrospective Studies, Spinal Nerve Roots / diagnostic imaging, Spinal Nerve Roots / drug effects, Anesthetics, Local

Background:
Sacroiliac (SI) joint dysfunction is a common cause of lower back pain. The diagnosis of SI joint pain remains challenging. Sacroiliac joint injection remains the gold standard of diagnosis of SI joint pain as well as providing therapeutic effect. One complication related to SI joint injection is temporary numbness and weakness of the leg.
Objectives:
To evaluate the anatomy of the SI joint and the flow of the contrast in the sacroiliac joint and to understand how local anesthetic can affect the nerve roots and cause temporary weakness and numbness of the leg. Study Design. Retrospective case series. Setting. Academic medical center.
Methods:
Patients who underwent SI joint injection with three-dimensional cone beam computed tomography with fluoroscopy (3D-CBCT) imaging were identified through retrospective review of two providers' case log from the electronic medical record. The cone beam CT images were reviewed to study the contrast spread and flow in the SI joint.
Results:
27/32 patients with the mean age of 56 years (range 39-87 years), 20 females, and 7 males were included in this study. After reviewing cone beam CT images, 4/27 (14.8%) patients showed contrast spread in the SI joint and spread into the S1 posterior neuroforamen. The remainder 23/27 (85.2%) patients had contrast localized in the SI joint. Limitations. Small population size, retrospective review of medical records.
Conclusion:
Our results indicate that the injection of lower concentration of local anesthetic with less volume may be necessary to decrease the risk of S1 nerve root block and epidural block. Furthermore, to improve the specificity of a diagnostic SI injection, an appropriate evaluation should be considered to rule out any S1 nerve pathology as a significant pain generator.
Navigating the Endodontic Challenge of a 40 mm Canine and Its Technical Adaptations
Authors: Siavash Moushekhian, Pooya Saeedi, Zoha Sahebnasagh
Journal: Case Rep Dent (2024)
MeSH terms: Case Reports

Aim. The aim of this case report is to present the successful endodontic management of an abnormally long right maxillary canine diagnosed with symptomatic irreversible pulpitis, highlighting the technical adaptations employed during treatment. Summary. Technical adaptations included modifying the handle of the endodontic hand file and utilizing a side-vented microcannula for irrigation using positive and negative pressure technique. Despite the challenges posed by the abnormal tooth length, the procedure achieved a working length of 40.7 mm, and periapical radiography confirmed the master gutta-percha reaching full working length. Notably, the patient remained asymptomatic during the six-month follow-up, highlighting the efficacy of the treatment. This article also reviews the current literature, examining comparable cases and techniques documented in scholarly sources.
Hybrid Telehealth Pediatric Constraint Induced Movement Therapy Compared to In-person Intervention: A Case Series
Authors: Teressa Garcia Reidy, Nicole Whiston Andrejow, Erin Naber, Joan Carney
Journal: Int J Telerehabil (2023)
Keywords: constraint induced movement therapy, hemiplegia, hybrid intervention protocol, pediatrics

Constraint induced movement therapy is an established, evidence-based intervention for children with hemiplegia. This case series describes the feasibility and clinical opportunities of using a hybrid telehealth and onsite model to deliver pediatric constraint induced movement therapy during the COVID-19 pandemic. These cases support that a hybrid model had a similar effect on upper extremity improvement compared to a traditional, in-person model and may be an option when access to in-person care is not available.
Case report: Pyrotinib in the treatment of advanced scrotal EMPD combined with sweat gland carcinoma
Authors: Liquan Zhu, Haoqiang Wang, Donghai Cheng, Wei Wang, Yue Lei, Ning Yang, Lijun Peng, Peng Liu, Juan Zhou, Bo Xie
Journal: Front Oncol (2024)
Keywords: extramammary paget disease (empd), human epidermal growth factor receptor 2, pyrotinib, sweat gland carcinoma, targeted therapy
MeSH terms: Case Reports

Extramammary Paget disease (EMPD) is a rare cutaneous intraepithelial adenocarcinoma, which is mostly distributed in areas with sweat gland cells and mainly occurs in the anogenital skin of women. The male genital tract involvement is extremely rare and often occurs with other malignant tumors. Paget's disease in the scrotum with sweat gland carcinoma is even rarer. In the first report of scrotal endocrine sweat gland carcinoma associated with Paget disease by Saidi et al. in 1997, no more than 50 cases have been reported in the relevant research worldwide. Early EMPD combined with sweat gland carcinoma is mainly surgical treatment, and there is no standard treatment plan for advanced EMPD with sweat gland carcinoma. Previous article has reported that chemotherapy such as paclitaxel, fluorouracil, platinum, and vinblastine and molecular targeted therapy based on the genetic test results of patients have certain efficacy. Here, we report a 79-year-old male case diagnosed with human epidermal growth factor receptor 2 (HER-2) overexpression, which was effectively controlled by chemotherapy and anti-HER-2 treatment such as pyrotinib.
A Case Report of Primary Melanoma of the Urethra
Authors: Heong Jin C Ahn, Arsh N Patel, Albert Tine, Srivikram Margam S, Parth K Patel, Todd J Kendall
Journal: Cureus (2024)
Keywords: benign and malignant tumors, male urethra, malignant melanoma of male urethra, melanoma, urological malignancy
MeSH terms: Case Reports

We illustrate a notable case of an 83-year-old male who presents to a community hospital with abdominal pain and hematuria. A few days after admission, an ulcerated lesion was found to be visible toward the ventral aspect of the penis, as well as bright red blood at the urethral meatus. An excisional biopsy of the urethral meatus, mid-urethra, and urethral tissue was done, and immunohistochemistry helped support the diagnosis of primary melanoma of the urethra. The pathophysiology and guidelines for treatment are discussed. Our purpose in putting forward this case is to present a rare diagnosis of primary melanoma of the male urethra and to emphasize the importance of early recognition to reduce the occurrence of invasive malignancy.
Selective Caries Removal: A Case Report with 21-Year Follow-Up
Authors: José Carlos Pettorossi Imparato, Kelly Maria Silva Moreira, Suzana Cavalcanti Monteiro de Oliveira, Sandra Regina Echeverria Pinho da Silva, Daniela Prócida Raggio
Journal: Case Rep Dent (2024)
MeSH terms: Case Reports

Dental caries remains the most prevalent chronic disease globally, and its management should adhere to the principles of minimal intervention dentistry. This study reports a series of successful cases involving the selective removal of carious tissue in permanent molars, with follow-up periods of up to 21 years. Six permanent molars with severe and deep carious lesions were treated with selective caries removal and restored with high-viscosity glass ionomer cement. Clinical examination revealed that the teeth were free from pain and sensitivity. Follow-up assessments were conducted at 7 and 21 years posttreatment. Treatment success was defined by the absence of clinical and radiographic signs, symptoms of pulp alterations, and lesion arrest. Successful minimally invasive approaches were observed with selective removal of carious tissue and maintenance of pulp vitality for up to 21 years.
Isolated unilateral brachial plexus injury following carbon monoxide intoxication: a case report and literature review
Authors: Shu Liu, Houchao Sun, Shengyuan Wang, Jincheng Liao, Xu Yang, Zhiyou Cai
Journal: Front Neurol (2024)
Keywords: carbon monoxide intoxication, hyperbaric oxygen therapy, peripheral neuropathy, rehabilitation training, spinal cord ischemia
MeSH terms: Case Reports

Carbon monoxide (CO) is a gas that has no odor or color, making it difficult to detect until exposure leads to coma or death. CO poisoning is one of the most common and deadly poisonings around the world. CO poisoning is a common and often fatal form of poisoning worldwide. A toxic effect of CO is tissue hypoxia, which leads to systemic complications. Additionally, there may be severe neurological symptoms and delayed complications following CO poisoning. However, peripheral neuropathy is relatively rare after CO poisoning. Previously, only one case of unilateral plexopathy after CO poisoning, accompanied by rhabdomyolysis and cognitive dysfunction, has been reported. In this report, an isolated unilateral brachial plexopathy following CO intoxication is described. A key mechanism in this case may be CO-induced spinal cord ischemia. Immediate administration of hyperbaric oxygen therapy (HBOT) is crucial to prevent peripheral neuropathy after acute CO intoxication. Hyperbaric oxygen therapy (HBOT) should be administered immediately after acute CO intoxication to prevent peripheral neuropathy. Additionally, peripheral neuropathy following acute CO intoxication may benefit from consistent rehabilitation training.