OpenMed/multicare-articles huggingface dataset:
Elizabethkingia miricola Causes Intracranial Infection: A Case Study
Authors: Hongguang Gao, Tian Li, Li Feng, Shu Zhang
Journal: Front Med (Lausanne) (2021)
Keywords: elizabethkingia miricola, bacterial infection, case report, intracranial infection, neurology
MeSH terms: Case Reports

Background: Elizabethkingia miricola is a rarely encountered bacterium in clinical practice. It is a rare gram-negative rod-shaped bacterium associated with lung and urinary tract infections, but never found in cerebrospinal fluid. This paper reports a case of an adult patient infected by E. miricola via an unknown route of infection causing a severe intracranial infection. Elizabethkingia miricola was detected by culture and Metagenomic next generation sequencing in CSF. Early identification of this strain and treatment with sensitive antibiotics is necessary to reduce morbidity and mortality. Case Report: A 24-year-old male was admitted to a West China Hospital because of headache and vomiting for 2 months. Symptom features included acute onset and long duration of illness. Notably, headache and vomiting were the primary neurological symptoms. Routine cerebrospinal fluid culture failed to identify the bacterium; however, Elizabethkingia miricola bacterium was detected via second-generation sequencing techniques. Elizabethkingia miricola was found to be a multi-drug resistant organism, hence, treatment with ceftriaxone, a commonly used drug for intracranial infections was ineffective. This strain eventually caused severe intracranial infection resulting in the death of the patient. Conclusion: In summary, this study comprehensively describes a case of an adult patient infected by E. miricola and discusses its early identification as well as application of sensitive antibiotics in the emergency setting.
Synchronous triple primary malignant tumours in the bladder, prostate, and lung harbouring TP53 and MEK1 mutations accompanied with severe cardiovascular diseases: A case report
Authors: Zhi-Ke Li, Qiang Zhao, Ning-Fu Li, Jing Wen, Bang-Xian Tan, Dai-Yuan Ma, Guo-Bo Du
Journal: Open Med (Wars) (2022)
Keywords: pd-1, tp53 mutations, multiple primary malignancies, non-small cell lung cancer, severe cardiovascular disease
MeSH terms: Case Reports

Although the incidence of multiple primary malignancies (MPMs) is increasing, synchronous triple primary malignant tumours with prostate, bladder and lung is rarely reported. Gene mutation is thought to be a reason for MPMs, and severe cardiovascular diseases may interrupt the cancer treatment. Here we reported a 64-year-old male patient with synchronous triple primary malignant tumours of the bladder urothelial carcinoma, prostate adenocarcinoma, and non-small cell lung cancer (NSCLC) with mutations in TP53 and MEK1, all the three malignancies were diagnosed within 10 days. Although being interrupted by severe cardiovascular diseases (including myocardial infarction, venous thrombosis, and aneurism of the aortic root), he was successfully treated with radical cystoprostatectomy, chemotherapy plus pembrolizumab (a PD-1 antibody), and radiotherapy of the lung lesion, followed by maintenance monotherapy of pembrolizumab, overall survival was more than 26 months. In conclusion, a patient of synchronous triple primary malignant tumours with prostate, bladder, and lung harbouring TP53 and MEK1 mutations accompanied with severe cardiovascular diseases was treated successfully, which may suggest that comprehensive treatment, especially radical treatment such as operation and radiation, is very important for MPMs.
Intermittent alien hand syndrome and callosal apraxia in multiple sclerosis: implications for interhemispheric communication
Authors: A Lunardelli, A Sartori, P Mengotti, R I Rumiati, V Pesavento
Journal: Behav Neurol (2014)
MeSH terms: Alien Limb Phenomenon / complications, Apraxias / complications, Corpus Callosum / physiopathology, Functional Laterality / physiology, Multiple Sclerosis / complications, Case Reports, Agraphia / complications, Agraphia / physiopathology, Alien Limb Phenomenon / physiopathology, Apraxias / physiopathology, Female, Humans, Middle Aged, Multiple Sclerosis / physiopathology

We report a case of a 47-year-old woman with 35-year history of multiple sclerosis, who showed alien hand signs, a rare behavioural disorder that involves unilateral goal-directed movements that are contrary to the individual's intention. Alien hand syndrome has been described in multiple sclerosis (MS) only occasionally and is generally suggestive of callosal disconnection. The patient presented also with bilateral limb apraxia and left hand agraphia, raising the possibility of cortical dysfunction or disconnection, in addition to corpus callosum and white matter involvement. Her specific pattern of symptoms supports the role of the corpus callosum in interhemispheric communication for complex as well as fine motor activities and may indicate that it can serve as both an inhibitory and excitatory function depending on task demands.
Peri-Contrast Staining as a Marker of Stent Failure: Restenosis, Thrombosis, and Fracture
Authors: Fakilahyel S Mshelbwala, Brittany Fuller, Khaldoon Alaswad, Mir B Basir
Journal: Case Rep Cardiol (2021)
MeSH terms: Case Reports

Peri-stent contrast staining (PSS), defined as contrast staining around the stent struts, has been identified as an indicator of future stent failure in first generation, sirolimus-eluting coronary stents. 1 PSS has been associated with in-stent restenosis, stent thrombosis, stent fracture, and the development of coronary aneurysm. As the frequency of patients with first generation sirolimus-eluting coronary stents becomes infrequent; PSS may go unrecognized. Herein, we present a patient with a decade of longitudinal follow-up, who developed PSS identified on coronary angiogram with recurrent stent failure.
Acute urinary retention due to benign prostatic hyperplasia associated with cystitis glandularis in a 22-year-old patient
Authors: Skander Zouari, Khaireddine Bouassida, Khaled Ben Ahmed, Ahlem Bdioui Thabet, Mohamed Amine Krichene, Chawki Jebali
Journal: Pan Afr Med J (2018)
Keywords: benign prostate, cystitis glandularis, dysuria, hyperplasia, young male
MeSH terms: Cystitis / diagnosis, Prostatic Hyperplasia / diagnosis, Urinary Bladder / pathology, Urinary Retention / etiology, Case Reports, Biopsy, Cystoscopy / methods, Follow-Up Studies, Humans, Hydronephrosis / diagnosis, Male, Prostatic Hyperplasia / complications, Ultrasonography, Urinary Catheterization, Young Adult

A 22-year-old man has consulted in emergency for acute urinary retention and left renal colic. Bladder catheterization was performed. Symptomatic treatment was provided with no improvement. MRI showed a pseudotumoral bladder wall thickening associated with vesical floor budding with prostate median lobe infiltration. The patient got an endoscopy that concluded to an inflammatory aspect of the bladder mycosa and a solid mass in the bladder neck arising. The biopsy during examination concluded to a glandular cystitis. Ultrasonography performed six months later still showed an enlarged prostate of 60g volume, post void residue of 280ml and bilateral hydronephrosis. A second cystoscopy showed an obstructive prostate with a median lobe. A transurethral resection of this lobe was performed. The pathological examination concluded to a benign prostate hyperplasia. This case is likely to be the first reported so far about a BPH in a young male associated with Cystitis Glandularis. Neither etiology nor evidence of the cause behind this case has been identified so far. Although Benign Prostate Hypertrophia is rare among young males, its ethiopathogenesis is not well known, its relation with cystitis glanduralis in young patients has never been described before. Both medical and surgical approaches remain similar to the adults.
In utero diagnosis of agenesis of the ductus arteriosus in a twin pregnancy: an unusual case presentation
Authors: Kecia Gaither, Andrea Ardite, Sarita Dhuper
Journal: ISRN Obstet Gynecol (2011)
MeSH terms: Case Reports

Agenesis of the ductus arteriosus is a rare congenital cardiac anomaly which should be considered within the differntial prenatal diagnosis of hydrops fetalis.
Deficiency of Interleukin-1 Receptor Antagonist: A Case with Late Onset Severe Inflammatory Arthritis, Nail Psoriasis with Onychomycosis and Well Responsive to Adalimumab Therapy
Authors: Necil Kutukculer, Anne Puel, Sanem Eren Akarcan, Kunihiko Moriya, Neslihan Edeer Karaca, Melanie Migaud, Jean-Laurent Casanova, Guzide Aksu
Journal: Case Reports Immunol (2019)
MeSH terms: Case Reports

DIRA (deficiency of the IL-1Ra) is a rare condition that usually presents in the neonatal period. Patients with DIRA present with systemic inflammation, respiratory distress, joint swelling, pustular rash, multifocal osteomyelitis, and periostitis. Previously, we reported a patient with a novel mutation in IL1RN with a healthy neonatal period, a late-onset of pustular dermatosis, inflammatory arthritis, and excellent response to canakinumab treatment. Herein, we are presenting a new case of late-onset DIRA syndrome, carrying a different mutation and showing different clinical findings. This patient is the first one in the literature with the inflammatory arthritis, nail psoriasis, and onychomycosis and with her remarkable response to monoclonal antibodies. The case responded well and fully recovered after treatment with adalimumab, but not with canakinumab. The DIRA disease can lead to death from multiple organ failures and if recognized early, the treatment with replacement of the deficient protein with biologic agents induces rapid and complete remission. Therefore, clinical symptoms should be learned exactly by the pediatricians, pediatric rheumatologists, and immunologists; and molecular analysis targeting this defect must be performed as early as possible.
A Challenging Diagnosis of Atypical Glut1-DS: A Case Report and Literature Review
Authors: Miaomiao Yu, Jing Miao, Yudan Lv, Xue Wang, Wuqiong Zhang, Na Shao, Hongmei Meng
Journal: Front Neurol (2021)
Keywords: glut1-ds, slc2a1, intracranial infection, ketogenic diet, paroxysmal exercise-induced dyskinesia, paroxysmal non-kinesigenic dyskinesia
MeSH terms: Case Reports

Glucose transporter type 1 deficiency syndrome (Glut1-DS) is a rare neurometabolic disorder caused by mutations of the SLC2A1 gene. Paroxysmal exercise-induced dyskinesia is regarded as a representative symptom of Glut1-DS. Paroxysmal non-kinesigenic dyskinesia is usually caused by aberrations of the MR1 and KCNMA1 genes, but it also appears in Glut1-DS. We herein document a patient with Glut1-DS who suffered first from paroxysmal exercise-induced dyskinesia and subsequently paroxysmal non-kinesigenic dyskinesia and experienced a recent worsening of symptoms accompanied with a low fever. The lumbar puncture result showed a decreased glucose concentration and increased white blood cell (WBC) count in cerebrospinal fluid (CSF). The exacerbated symptoms were initially suspected to be caused by intracranial infection due to a mild fever of <38.0°C, decreased CSF glucose, and increased CSF WBC count. However, the second lumbar puncture result indicated a decreased glucose concentration and normal WBC count in CSF with no anti-infective agents, and the patient's symptoms were not relieved apparently. The continuous low glucose concentration attracted our attention, and gene analysis was performed. According to the gene analysis result, the patient was diagnosed with Glut1-DS finally. This case indicates that the complex paroxysmal dyskinesia in Glut1-DS may be confusing and pose challenges for accurate diagnosis. Except intracranial infection, Glut1-DS should be considered as a differential diagnosis upon detection of a low CSF glucose concentration and dyskinesia. The case presented here may encourage clinicians to be mindful of this atypical manifestation of Glut1-DS in order to avoid misdiagnosis.
Incidental Finding of Intraperitoneal Tuberculosis in a Patient Presenting with a Large Ovarian Mass
Authors: Ayla Green, Samer Elmasry, Himali Ihalagama, Saman Senaratne
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

A 52-year-old postmenopausal female of Filipino heritage presented with a three-day history of increasing abdominal bloating, vomiting, and fever. A CT scan revealed a 22 cm ovarian mass and ascites. Her laboratory results were unremarkable except for CA-125 and CA-19.9 which were slightly elevated. Due to suspicion of ovarian neoplasm, she underwent a laparotomy where multiple inflammatory deposits were observed throughout the pelvis. Histology confirmed florid granulomatous inflammation with caseous necrosis, and peritoneal fluid culture was positive for tuberculosis. She was treated with standard antimycobacterial therapy and made an uneventful recovery.
Labor dystocia as first presentation of pelvic malignancy
Authors: Dennis van Hamont, Petra L M Zusterzeel
Journal: Case Rep Obstet Gynecol (2011)
MeSH terms: Case Reports

The underlying causes of labor dystocia can be various. Lack of expulsive forces or fetal malpresentation are amongst the most common ones. However, pelvic masses are described as well. Here we describe two cases of labor dystocia as first presentation of pelvic malignancy.
A new treatment for frostbite sequelae; Botulinum toxin
Authors: Arne Johan Norheim, James Mercer, Frauke Musial, Louis de Weerd
Journal: Int J Circumpolar Health (2017)
Keywords: frostbite, angiography, army, botulinum toxin, cold injury, military, non-freezing cold injury, quantitative sensory testing, thermography, vasospastic disorder
MeSH terms: Botulinum Toxins / therapeutic use, Frostbite / drug therapy, Hand / blood supply, Hand / innervation, Military Personnel, Case Reports, Arctic Regions, Botulinum Toxins / administration & dosage, Humans, Male, Norway, Young Adult, Botulinum Toxins

Frostbite sequelae are a relevant occupational injury outcome for soldiers in arctic environments. A Caucasian male soldier suffered frostbite to both hands during a military winter exercise. He developed sensory-motor disturbances and cold hypersensitivity. Angiography and thermography revealed impaired blood flow while Quantitative Sensory Testing indicated impaired somato-sensory nerve function. Two years after the initial event, he received an off label treatment with Botulinum toxin distributed around the neurovascular bundles of each finger. After treatment, cold sensitivity was reduced while blood flow and somato-sensory nerve function improved. The successful treatment enabled the soldier to successfully pursue his career in the army.
Immune checkpoint inhibitor-induced aseptic meningitis and encephalitis: a case-series and narrative review
Authors: Laure Thouvenin, Timothée Olivier, Giuseppe Banna, Alfredo Addeo, Alex Friedlaender
Journal: Ther Adv Drug Saf (2021)
Keywords: aseptic meningitis, autoimmune meningitis, immune checkpoint inhibitors, immune toxicity, meningoencephalitis, neurological adverse events

Background:
Along with the increasing use of immune checkpoint inhibitors comes a surge in immune-related toxicity. Here, we review the currently available data regarding neurological immune adverse events, and more specifically aseptic meningitis and encephalitis, and present treatment and diagnostic recommendations. Furthermore, we present five cases of immunotherapy-induced aseptic meningitis and encephalitis treated at our institution.
Recent findings:
Neurological immune-related adverse events, including aseptic meningitis and encephalitis, secondary to checkpoint inhibitors are a rare but complex and clinically relevant entity, comprising a wide range of diseases, most often presenting with symptoms with a wide range of differential diagnoses. Our case-series highlights the challenges of such entities and the importance of properly identifying and managing aseptic meningitis and encephalitis.
Summary:
Checkpoint inhibitor-induced meningoencephalitis warrants prompt investigations and treatment. Properly diagnosing aseptic meningitis, encephalitis, or mixed presentations may guide the treatment decision, as highlighted by our case-series. After rapid exclusion of alternative diagnoses, urgent corticosteroids are the therapeutic backbone but this could change in favour of highly specific cytokine-directed treatment options.
Plain language summary:

Aseptic meningitis and encephalitis with immune checkpoint inhibitors: a single centre case-series and review of the literature Over the course of the past decade, checkpoint inhibitors have revolutionized cancer care. With their favourable toxicity profile and potential for durable and deep responses, they have become ubiquitous across the field of oncology. Furthermore, combination checkpoint inhibitors are also gaining ground, with increased efficacy and, unfortunately, immune-related toxicity. While there are guidelines based on extensive clinical experience for frequent adverse events, uncommon entities are less readily identified and treated. Neurological immune-related adverse events secondary to checkpoint inhibitors are a rare but complex entity, comprising a wide range of diseases, most often presenting with aspecific symptoms. In this paper, we discuss a single institution case-series of patients with autoimmune aseptic meningitis and encephalitis, and we perform a narrative literature review on this subject. We conclude with our treatment recommendations based on available evidence.
Tenon's patch graft to the rescue during COVID-19 pandemic
Authors: Suchitra Panigrahi, Bidisha Mahapatra, Swarnamayee Baskey
Journal: GMS Ophthalmol Cases (2023)
Keywords: covid-19, mooren’s ulcer, tenon’s graft, amniotic membrane
MeSH terms: Case Reports

Objective:
To report a case of bilateral Mooren's ulcer with impending corneal perforation in the right eye and perforated peripheral corneal ulcer in the left eye which successfully underwent Tenon's patch graft (TPG) with multilayered amniotic membrane grafting (AMG) as globe salvaging procedure during COVID-19 pandemic.
Methods:
Conjunctival resection was done on both the eyes followed by autologous Tenon's grafting with overlay amniotic membrane grafting in the left eye with perforation and multilayered AMG with AMG overlay in the right eye with impending perforation. Post-operatively topical antibiotics and steroids were prescribed.
Results:
At one month follow-up, the Tenon's graft and multilayered AMG were well-integrated with the surrounding healthy cornea with a good anatomical and visual outcome.
Conclusion:
Autologous Tenon's patch graft is a simple and cost-effective alternative to preserve globe integrity and prevent complications in emergency cases when immediate access to cornea transplantation is practically challenging.
Anti-PD-1 Therapy-A Potential Treatment for Myocardial Metastasis From Nasopharyngeal Carcinoma: A Case Report
Authors: Xiaowan Tang, Weijun Zhou, Danjiang Huang, Lili Chen, Guangwen Zhang
Journal: Front Immunol (2021)
Keywords: anti-pd-1 therapy, head and neck tumor, immunotherapy, myocardial metastasis, nasopharyngeal carcinoma
MeSH terms: Heart Neoplasms / drug therapy, Immune Checkpoint Inhibitors / therapeutic use, Nasopharyngeal Carcinoma / pathology, Nasopharyngeal Neoplasms / pathology, Case Reports, Review, Antibodies, Monoclonal, Humanized / administration & dosage, Heart Neoplasms / secondary, Humans, Immunotherapy / methods, Male, Middle Aged, Prognosis, Antibodies, Monoclonal, Humanized, Immune Checkpoint Inhibitors, sintilimab

Myocardial metastasis of nasopharyngeal carcinoma (NPC) is rarely reported in the literature. Some autopsy studies found metastases in more than 10% of cases with malignant neoplasm. However, patients are often diagnosed during the postmortem because myocardial metastasis is often asymptomatic, and its Cardiac complications tend to be severe and fatal. Patients with Cardiac metastases are often treated with chemotherapy or surgical intervention, although the prognosis is poor. Immunotherapy with anti-programmed cell death receptor-1 or ligand-1 (PD-1 or PD-L1) inhibitors has recently been reported to be therapeutically significant in multiple cancers, including melanoma, nonsmall cell lung cancer, and NPC, but the treatment of myocardial metastasis of NPC has not been reported. This study described the case of a 50-year-old male patient who presented initially with NPC and received radiotherapy as first-line therapy. For 20 years, he had recurrent Cardiac metastasis of NPC. The pathological examination suggested tPD-L1 expression. Therefore, off-label sintilimab (200 mg every 21 days) was administered. After 10 cycles of treatment, myocardial metastasis shrank and the enlarged mediastinal lymph nodes disappeared. This case report demonstrated that Cardiac metastasis of NPC expressing PD-L1 might have a sustained response to PD-L1 inhibitor-directed therapy.
Pneumococcal meningitis during pregnancy: a case report and review of literature
Authors: Lisa M Landrum, Angela Hawkins, Jean Ricci Goodman
Journal: Infect Dis Obstet Gynecol (2009)
MeSH terms: Meningitis, Pneumococcal / microbiology, Pregnancy Complications, Infectious / microbiology, Streptococcus pneumoniae / isolation & purification, Case Reports, Adult, Anti-Bacterial Agents / therapeutic use, Anti-Inflammatory Agents / therapeutic use, Dexamethasone / therapeutic use, Female, Humans, Meningitis, Pneumococcal / drug therapy, Pregnancy, Pregnancy Complications, Infectious / drug therapy, Anti-Bacterial Agents, Anti-Inflammatory Agents, Dexamethasone

Background:
Bacterial meningitis is a medical emergency for which prompt diagnosis and treatment are imperative to reducing the rate of death and long-term neurologic compromise. Few cases of meningitis have been reported during pregnancy, many of which had devastating outcomes for mother, neonate, or both.
Case:
A 38-year-old multigravida at 35 weeks of gestation presented with mental status changes, fever, and preterm contractions. Lumbar puncture revealed gram positive cocci consistent with S. pneumoniae. Patient was intubated and admitted to ICU where she was given antibiotics and adjunctive therapy with dexamethasone. Continuous fetal monitoring was utilized throughout her course of her hospitalization. Patient was discharged home after ten days in the hospital and had an uncomplicated vaginal birth after caesarean section (VBAC) at 38 weeks. Both she and the infant are doing well with no permanent neurologic sequelae.
Conclusion:
A review of literature indicates only isolated cases of pneumococcal meningitis being described during pregnancy. An extended period of time between onset of maternal illness and delivery appears to reduce the risk of neonatal transmission and improve both maternal and fetal outcomes.
Culture Negative Listeria monocytogenes Meningitis Resulting in Hydrocephalus and Severe Neurological Sequelae in a Previously Healthy Immunocompetent Man with Penicillin Allergy
Authors: Shahin Gaini, Gunn Hege Karlsen, Anirban Nandy, Heidi Madsen, Debes Hammershaimb Christiansen, Sanna Á Borg
Journal: Case Rep Neurol Med (2015)

A previously healthy 74-year-old Caucasian man with penicillin allergy was admitted with evolving headache, confusion, fever, and neck stiffness. Treatment for bacterial meningitis with dexamethasone and monotherapy ceftriaxone was started. The cerebrospinal fluid showed negative microscopy for bacteria, no bacterial growth, and negative polymerase chain reaction for bacterial DNA. The patient developed hydrocephalus on a second CT scan of the brain on the 5th day of admission. An external ventricular catheter was inserted and Listeria monocytogenes grew in the cerebrospinal fluid from the catheter. The patient had severe neurological sequelae. This case report emphasises the importance of covering empirically for Listeria monocytogenes in all patients with penicillin allergy with suspected bacterial meningitis. The case also shows that it is possible to have significant infection and inflammation even with negative microscopy, negative cultures, and negative broad range polymerase chain reaction in cases of Listeria meningitis. Follow-up spinal taps can be necessary to detect the presence of Listeria monocytogenes.