OpenMed/multicare-articles huggingface dataset:
Atypical Kawasaki Disease in an Adolescent with Multivisceral Involvement
Authors: Zohair El Haddar, Aziza El Ouali, Ayad Ghanam, Maria Rkain, Noufissa Benajiba, Abdeladim Babakhouya
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

Kawasaki disease (KD) is a vasculitis mostly seen in children aged less than 5 years. It can involve different organs and tissues. Its diagnosis is based on the clinical criteria of the American Heart Association (AHA). We report a case of a Moroccan adolescent with an atypical presentation of KD initially treated as typhoid fever. Gastrointestinal, renal, and pulmonary signs were the main clinical findings that made the diagnosis of KD challenging and delayed. The consequence was a severe cardiac damage with myocarditis and coronary artery dilation. KD is uncommon in adolescents, and it is important to recognize the atypical forms and the different presentations of KD in order to prevent the delay of diagnosis and treatment, and hence the cardiac complications.
Case Report: A case of ultra-late recurrence of KIF13A-RET fusion non-small cell lung cancer response to selpercatinib
Authors: Ha-Young Park, Joo-Heon Park, Myung-Geun Shin, Seung Jung Han, Yong-Sok Ji, Hyung-Joo Oh, Young-Chul Kim, Taebum Lee, Yoo-Duk Choi, In-Jae Oh
Journal: Front Oncol (2023)
Keywords: ret fusion, choroidal metastasis, non-small cell lung cancer, recurrence, selpercatinib
MeSH terms: Case Reports

Background:
Cancer recurrence remains a significant problem, and most postoperative recurrences of non-small cell lung cancer (NSCLC) develop within 5 years after resection. We present a rare case of ultra-late recurrence of NSCLC accompanying choroidal metastasis with KIF13A-RET fusion 14 years after the definitive surgery.
Case description:
A 48-year-old female patient who had never-smoked presented with decreased visual acuity. She had been treated with right upper lobe lobectomy followed by adjuvant chemotherapy 14 years prior. Fundus photographs revealed bilateral choroidal metastatic lesions. Positron emission tomography-computed tomography (PET-CT) scans showed extensive bone metastases and focal hypermetabolism in the left uterine cervix. An excision biopsy of the uterus showed primary lung adenocarcinoma with immunohistochemistry of TTF-1+. Plasma next-generation sequencing (NGS) identified the presence of KIF13A-RET fusion. After 6 months of selpercatinib therapy, PET-CT revealed a partial response for bone and uterine metastasis and stable disease for choroidal lesions.
Conclusion:
In this case report, we are reporting a rare case of ultra-late recurrence of NSCLC in a patient with choroidal metastasis. Furthermore, the diagnosis of NSCLC with RET fusion was based on liquid-based NGS rather than tissue-based biopsy. The patient showed a good response to selpercatinib, which supports the efficacy of selpercatinib as a treatment for RET-fusion-positive NSCLC with choroidal metastasis.
Extensive Colonic Pneumatosis, Pneumoperitoneum, Pneumomediastinum and Subcutaneous Emphysema - a Rare Pattern of Complications in Acute Lymphoblastic Leukemia
Authors: Ana T Vilares, Bárbara Viamonte, António J Madureira
Journal: J Belg Soc Radiol (2022)
Keywords: acute lymphoblastic leukemia, colonic pneumatosis, pneumomediastinum, pneumoperitoneum, treatment complications
MeSH terms: Case Reports

Teaching Point: Intestinal pneumatosis associated with pneumoperitoneum, pneumomediastinum, and subcutaneous emphysema is an extremely rare complication of leukemia; even though its imaging appearance can be alarming, a benign treatment-associated etiology should always be considered in this subset of patients so that unnecessary interventions can be avoided.
Mesh trimming and suture reconstruction for wound dehiscence after huge abdominal intercostal hernia repair: A case report
Authors: Yuta Takeuchi, Yo Kurashima, Yoshitsugu Nakanishi, Toshimichi Asano, Takehiro Noji, Yuma Ebihara, Soichi Murakami, Toru Nakamura, Takahiro Tsuchikawa, Keisuke Okamura, Toshiaki Shichinohe, Satoshi Hirano
Journal: Int J Surg Case Rep (2018)
Keywords: abdominal intercostal hernia, mesh exposure, wound dehiscence

Introduction:
Abdominal intercostal hernia repair for huge incisional hernia after thoracoabdominal surgery involves a complex anatomical structure. Hence, it is difficult to apply the laparoscopic approach to large hernias in the lateral upper abdomen. Further the optimal approach to mesh exposure without infection after incisional hernia repair is still controversial. Herein, we describe our experience of repairing a huge abdominal intercostal hernia by mesh trimming and suture reconstruction for wound dehiscence.
Presentation of case:
A 73-year-old man presented with an incisional hernia in the left flank from just below the eight intercostal space to the transverse umbilical region 6 months after thoracoabdominal aortic aneurysm surgery. Computed tomography revealed an incisional hernia orifice of 17 × 13 cm located on the left flank around the ninth rib. We chose the open approach as treatment because the hernia orifice was large, and we created a mesh placement space in the extraperitoneal cavity and placed expanded polytetrafluoroethylene mesh there with 1-0 nonabsorbable monofilament suture. At postoperative day 26, we observed mesh exposure due to wound dehiscence. Mesh trimming and suture reconstruction for wound dehiscence was performed because there were no signs of wound infection. The postoperative course was uneventful including infection and dehiscence. The patient has been well without recurrence for 14 months since last operation.
Conclusions:
Optimal treatment for repair of a large abdominal intercostal hernia with thoracoabdominal location is necessary. Moreover, partial mesh removal may be one of the treatment options for mesh exposure if conditions are met.
Massive femoral osteolysis secondary to loosening of a cemented roughened long stem: a case report
Authors: Yasuaki Tamaki, Tomohiro Goto, Daisuke Hamada, Toshihiko Nishisho, Kiminori Yukata, Suzue Naoto, Hiroshi Egawa, Koichi Sairyo
Journal: Case Rep Orthop (2014)

The surface finish of a femoral stem plays an important role in the longevity of cemented total hip arthroplasty. In efforts to decrease the rate of aseptic loosening, some prostheses have been designed to have a roughened surface that enhances bonding between the prosthesis and cement, but clinical outcomes remain controversial. We present a rare case of massive osteolysis with extreme femoral expansion that developed after cemented revision total hip arthroplasty. The destructive changes in the femur were attributable to abnormal motion of the stem and were aggravated by the roughened precoated surface of the long femoral component. Revision surgery using a total femur prosthesis was performed because there was insufficient remaining bone to fix the new prosthesis. The surgical technique involved wrapping polypropylene meshes around the prosthesis to create an insertion for the soft tissue, which proved useful for preventing muscular weakness and subsequent dislocation of the hip.
Coronary sinus to left atrial communication
Authors: Vandhana Scheller, Wojciech Mazur, James Kong, Eugene S Chung
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Congenital coronary sinus anomalies are rare in clinical practice, partly due to the lack of symptoms. We present a case of coronary sinus anomaly causing a right-to-left intracardiac shunt in a 46 years/old African American female with a past medical history of obstructive sleep apnea, diabetes mellitus, hypertension, coronary artery disease, and ischemic cardiomyopathy who presented with hypoxia. In the months prior to her presentation, she had suffered an inferior myocardial infarction with right ventricular involvement, as well as resulting severe tricuspid regurgitation. In conclusion, further investigations revealed a communication between the coronary sinus (CS) and left atrium (LA).
Guillain-Barré Syndrome due to CMV Reactivation after Cardiac Transplantation
Authors: Christina Maria Steger, Herwig Antretter, Daniel Höfer
Journal: Case Rep Cardiol (2012)
MeSH terms: Case Reports

A 40-year-old male patient suffered from end-stage heart failure due to ischemic cardiomyopathy and received orthotopic cardiac transplantation in June 2005. The instantaneous postoperative course was uneventful, but, seven months later, he suffered from paralysis in the lower extremities finally resulting in quadriplegia and was admitted to hospital. After laboratory testings the diagnosis of a Guillain-Barré syndrome due to cytomegalovirus reactivation was confirmed.
Hyperkalemia Induced Brugada Phenocopy: A Rare ECG Manifestation
Authors: Muhammad Ameen, Ghulam Akbar, Naeem Abbas, Ghazi Mirrani
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Brugada syndrome (BrS) is an inherited disorder of cardiac ion channels characterized by peculiar ECG findings predisposing individuals to ventricular arrhythmias, syncope, and sudden cardiac death (SCD). Various electrolyte disturbances and ion channels blocking drugs could also provoke BrS ECG findings without genetic BrS. Clinical differentiation and recognition are essential for guiding the legitimate action. Hyperkalemia is well known to cause a wide variety of ECG manifestations. Severe hyperkalemia can even cause life threatening ventricular arrhythmias and cardiac conduction abnormalities. Most common ECG findings include peaked tall T waves with short PR interval and wide QRS complex. Since it is very commonly encountered disorder, physicians need to be aware of even its rare ECG manifestations, which include ST segment elevation and Brugada pattern ECG (BrP). We are adding a case to the limited literature about hyperkalemia induced reversible Brugada pattern ECG changes.
Unusual CT and MR Imaging Characteristics of Splenic Lymphoma
Authors: Chhavi Kaushik, Nitin Relia, Kedar Jambhekar, Tarun Pandey
Journal: Case Rep Oncol Med (2011)
MeSH terms: Case Reports

Lymphoma is the most common malignancy of the spleen. The imaging features of splenic lymphoma are nonspecific and mostly lymphomas present as a diffusely enlarged spleen. Focal lesions are described but remain of low density or intensity on CT or MRI, respectively. We describe a histologically proven case of splenic lymphoma that showed an atypical hyperdense/hyperenhancing appearance on imaging suspicious for a vascular pathology. To the best of our knowledge and based on review of English literature, such an appearance of splenic lymphoma is extremely unusual and rare.
Topical dorzolamide treatment of macular cysts in the enhanced S-cone syndrome patient
Authors: Marta Kiszkielis, Wojciech Lubiński, Krzysztof Penkala
Journal: Doc Ophthalmol (2013)
MeSH terms: Cysts / drug therapy, Eye Diseases, Hereditary / drug therapy, Macular Edema / drug therapy, Retinal Degeneration / drug therapy, Sulfonamides / administration & dosage, Thiophenes / administration & dosage, Vision Disorders / drug therapy, Case Reports, Administration, Topical, Adult, Carbonic Anhydrase Inhibitors / administration & dosage, Cysts / diagnosis, Cysts / etiology, Electroretinography, Eye Diseases, Hereditary / complications, Eye Diseases, Hereditary / diagnosis, Follow-Up Studies, Humans, Macular Edema / diagnosis, Macular Edema / etiology, Male, Ophthalmic Solutions, Retinal Degeneration / complications, Retinal Degeneration / diagnosis, Tomography, Optical Coherence, Vision Disorders / complications, Vision Disorders / diagnosis, Visual Acuity, Carbonic Anhydrase Inhibitors, Ophthalmic Solutions, Sulfonamides, Thiophenes, dorzolamide, Enhanced S-Cone Syndrome

Purpose:
The purpose of the study was to evaluate the efficacy of a topical form of a carbonic anhydrase inhibitor (dorzolamide) on the foveal function and thickness in the eye of a patient with enhanced S-cone syndrome (ESCS) associated with macular cysts.
Methods:
Twenty-eight-year-old Polish man with ESCS and macular cysts appearance in the right eye was treated 3 times daily with 2.0 % dorzolamide drops for the period time equal to 6 months. Monthly controls included: best corrected distance visual acuity (BCDVA-logMAR), foveal thickness (optical coherence tomography, OCT) and foveal function (multi-focal electroretinography, mfERG).
Results:
Before treatment, BCDVA in the right eye was equal to 0.26 logMAR, improved to 0.1 logMAR during the first 3 months and remained stable for the next 3 months. After 6 months, foveal thickness decreased (from 482 to 224 μm) and foveal function improved (the amplitude of P1-wave density increased from 34.8 to 107.3 nV/deg(2)) and was between the ranges of normal values. Implicit time of P1-wave remained prolonged.
Conclusions:
The results of our short-term study suggest potential efficacy of topical dorzolamide treatment in ESCS patients with macular cysts.
Metastatic ureteral involvement of non-small cell lung cancer
Authors: Koichi Kodama, Tetsuya Imao, Kazuto Komatsu
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Metastases from a variety of malignant tumors can involve the ureters, but ureteral involvement by lung cancer is extremely rare and usually described at autopsy. We report a rare case of a 76-year-old man who presented with a three-month history of right flank dullness and was noted to have a nonhomogeneous retroperitoneal mass with hydronephrosis of the right kidney on computed tomography of the abdomen. Computed tomography of the thorax showed a nodule in the lower lobe, measuring 3 × 2 cm, in the right lung. After excluding the presence of other primary tumors and metastases, we reached a final diagnosis of solitary retroperitoneal metastasis of adenocarcinoma of the lung. Although rare, in patients of non-small cell lung cancer, presence of hydronephrosis should alert the physician to the possibility of metastasis.
Usage of intermingled skin allografts and autografts in a senior patient with major burn injury
Authors: Hongmin Luo, Huining Bian, Chuanwei Sun, Shaoyi Zheng, Bing Xiong, Zhifeng Huang, Zuan Liu, Lianghua Ma, Hanhua Li, Huade Chen, Wen Lai
Journal: Open Med (Wars) (2021)
Keywords: intermingled skin allografts and autografts, major burn injury, senior patients
MeSH terms: Case Reports

Mortality rate in older adults following extensive burn injury is extremely high, and management of these patients is challenging. One of the main problems is that autologous split-thickness skin grafts are scarce and the wounds cannot be covered quickly and effectively. Intermingled skin grafting is a low-tech and economic method, which not only maximizes the use of precious autologous skin but also prevents the wounds from infection and consumption. Herein we present a case of extensive burn injury in a 68-year-old female successfully treated with intermingled skin grafting. The patient was accidentally burned by gas flame, resulting in a major burn injury covering 80% of her total body surface area. Early burn wound excision was performed and the wound was temporarily covered with irradiated porcine skin in the first week after injury. Autologous stamp-like skin grafts were applied to the wound bed 4 weeks after injury. In this operation, the results were not satisfactory. The take rate of the skin grafts is only about 50%. We covered the wounds with intermingled skin allografts and autografts 8 weeks after injury: autografts (0.5 cm × 0.5 cm) + fresh close relative's allografts (1 cm × 1 cm) + cryopreserved allografts (2 cm × 2 cm).
A Rare Cause of Sleep-Disordered Breathing: ROHHAD Syndrome
Authors: Gizem Özcan, Elif Özsu, Zeynep Şiklar, Nazan Çobanoğlu
Journal: Front Pediatr (2020)
Keywords: rohhad syndrome, childhood, hypothalamic dysfunction, hypoventilation, sleep disordered breathing
MeSH terms: Case Reports

Rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation (ROHHAD) syndrome; is a rare but crucial disorder. Sleep-disordered breathing can occur at the beginning or after of obesity. A disease-specific test for diagnosis is not yet available. Neural crest tumors (ganglioneuroma, ganglioneuroblastoma) have been reported in 40% of patients. In our study, three patients diagnosed as having ROHHAD syndrome are presented from our hospital. In the evaluation of the hypothalamic functions of the patients, one of them had growth hormone deficiency and hyperprolactinemia; recurrent hypernatremia reflecting irregular water balance was detected in another. One of the patients had abnormal pupil reflex and heart rate irregularity while another had excessive sweating as autonomic dysfunction. One of the patients was diagnosed with paravertebral ganglioma accompanying ROHHAD syndrome. Non-invasive ventilation treatment was started in all patients because there was a sleep-disorder breathing clinic diagnosis. ROHHAD syndrome deserves a multidisciplinary team approach as it can affect more than one organ system. In these patients, should be sleep-disorder breathing determined early and appropriate treatment should be initiated immediately to reduce morbidity and mortality.
Voriconazole Induced Hallucinations and Visual Disturbances in a Female Child: A Case Report and Literature Review
Authors: Rujiang Zheng, Yu Li, Chuyi Guo, Yuxin Pei, Zhiyong Ke, Libin Huang
Journal: Front Pediatr (2021)
Keywords: children, hallucinations, side-effects, visual disturbance, voriconazole
MeSH terms: Case Reports

Voriconazole is a second-generation azole widely used for the prevention and treatment of fungal infection in leukemia patients. We report a case of 9-year-old girl with T-cell acute lymphoblastic leukemia who developed hallucinations and visual disturbance after using voriconazole twice. These symptoms began acutely after treatment with voriconazole and resolved rapidly when the voriconazole was stopped. No specific cause was identified, and thus the symptoms were considered to be the adverse drug reactions (ADRs) of voriconazole. Simultaneous development of hallucinations and visual disturbance caused by voriconazole in children rarely have been reported before and the causes of these ADRs are unknown. Several other cases of hallucinations and (or) visual disturbance caused by voriconazole among 15-81 years old patients have been reported in the literature, and are reviewed. Those patients reminded us of the importance of being aware of hallucinations and visual disturbance associated with voriconazole treatment. In addition, we speculate that the hallucinations and visual disturbance are not related to the dosage form of voriconazole. We emphasize that it is also important to monitor the concentration of voriconazole regularly to avoid potential toxicity.
Neonatal sepsis due to glycopeptide resistant Enterococcus faecium from colonized maternal gut- rare case evidence
Authors: Supram Hosuru Subramanya, Rajesh Amberpet, Dinesh Chaudhary, Niranjan Nayak, Shashiraja Padukone, Indira Bairy, Shishir Gokhale
Journal: Antimicrob Resist Infect Control (2019)
Keywords: gut colonization, neonatal sepsis, vre
MeSH terms: Anti-Bacterial Agents / pharmacology, Enterococcus faecium / drug effects, Neonatal Sepsis / microbiology, Vancomycin Resistance, Case Reports, Adult, Drug Resistance, Bacterial, Enterococcus faecium / classification, Enterococcus faecium / genetics, Enterococcus faecium / isolation & purification, Feces / microbiology, Female, Humans, Infant, Newborn, Intensive Care Units, Neonatal, Linezolid / administration & dosage, Male, Microbial Sensitivity Tests, Vancomycin / administration & dosage, Anti-Bacterial Agents, Vancomycin, Linezolid

Background:
Vancomycin-resistant enterococcal infections in the neonatal ICU are growing global problems. We report a case of neonatal septicemia by multidrug-resistant vancomycin-resistant Enterococcus faecium (VRE), the source of infection being the mother's gut.
Case presentation:
A newborn male child admitted to the neonatal intensive care unit (NICU) was diagnosed to have mild meconium aspiration syndrome, early onset neonatal septicemia, and bacteremia by multidrug and vancomycin-resistant Enterococcus faecium. Screening of gut flora of the baby and the mother were carried out to trace the source of infection. Stool cultures of the mother and the baby yielded Vancomycin-Resistant Enterococcus faecium. All three isolates of Enterococcus faecium had similar antibiogram, harbored the vanA gene and similar pulsed-field gel electrophoresis pattern. Baby responded to the 1 week therapy with oral linezolid suspension 20 mg/kg/day, 1 ml/t.d.s. No VRE was isolated from baby on a repeat stool culture 1 week after the linezolid therapy. He was discharged with the advice for the continuance of linezolid for seven more days.
Conclusion:
Isolation of MDR-VRE from the blood culture of the baby and stool specimens of the mother and the baby with the same antibiogram profile and clonal similarities reveals that maternal gut colonization was responsible for neonatal sepsis. Optimal infection control measures and the development of guidelines for monitoring VRE colonization in pregnant women might be useful in reducing the occurrence of neonatal sepsis.
Adenocarcinoma of the Colon Disguised as Abdominal Wall Abscess: Case Report and Review of the Literature
Authors: L Attar, N Trabulsi, A A Maghrabi, M Nassif
Journal: Case Rep Surg (2018)
MeSH terms: Case Reports

Introduction:
Abdominal wall invasion by cancerous cells arising from the colon with an overlying secondary infection that presents as an abdominal wall abscess has been encountered previously, but such a symptom is rarely the first presentation of colon cancer. There are very few cases reported in the literature.
Case presentation:
In this case report, we present a case of a 66-year-old male presenting with abdominal wall abscess that was refractory to treatment. The patient later was found to have an abdominal wall invasion by an underlying colonic carcinoma.
Conclusion:
The purpose of this review is to set forth the proper approach when encountering such cases and emphasize on the significance of keeping a high index of suspicion. We also highlight the need for utilizing proper diagnostic imaging modalities prior to invasive intervention.
A Case of Probable Amisulpride Induced Mania after Eight Months of Therapy
Authors: Prakash Thapa, Rajasee Sharma
Journal: Case Rep Psychiatry (2017)
MeSH terms: Case Reports

Development of manic symptoms during treatment with atypical antipsychotics can be a troublesome side effect that has been described with most atypical antipsychotics. However, reports of amisulpride induced mania have been rare. Here, we report the case of an 18-year-old male patient diagnosed with schizophrenia, who developed manic symptoms while on treatment with amisulpride. While previous reports have described occurrence of mania within days to three months of treatment with amisulpride, we report a case where manic symptoms occurred after around eight months of therapy. We have also attempted to describe the possible risk factors based on the available case studies.