OpenMed/multicare-articles huggingface dataset:
Durable response to the combination of pembrolizumab and nab-paclitaxel in a metastatic extrahepatic cholangiocarcinoma: A case report and literature review
Authors: Sirui Tan, Jing Yu, Qiyue Huang, Nan Zhou, Xianze Xiong, Hongfeng Gou
Journal: Front Pharmacol (2022)
Keywords: cholangiocarcinoma, immunotherapy, nab-paclitaxel, pembrolizumab, tumor microenvironment
MeSH terms: Case Reports

Background: Cholangiocarcinoma (CCA) is a highly aggressive malignant tumor with poor overall survival. Although the first-line standard chemotherapy (gemcitabine plus cisplatin) combined with immunotherapy has yielded positive results with survival prolongation, the efficacy remains unsatisfactory, and new treatment modalities need to be explored. Case presentation: We report the case of a patient with metastatic extrahepatic CCA who achieved a durable response and good tolerance to the combination treatment of pembrolizumab and nab-paclitaxel following progression on gemcitabine plus capecitabine chemotherapy. The tumor samples of the patient revealed low TMB, MSS, negative PD-L1 expression, and negative CD8+ TIL expression. This patient was treated with 3 cycles of pembrolizumab plus nab-paclitaxel and cisplatin, followed by 5 cycles of pembrolizumab plus nab-paclitaxel. Finally, 10 cycles of pembrolizumab monotherapy were administered. The patient survived for over 27 months after the initiation of combined therapy and was still in continuous remission at the last follow-up. Conclusion: As far as we know, this is the first report that pembrolizumab plus nab-paclitaxel successfully treated a patient with advanced CCA. This combination therapy might be a potential treatment option for patients with cholangiocarcinoma, and further clinical trials are needed to explore the outcomes.
Phaeohyphomycosis caused by Diaporthe phaseolorum in an immunocompetent patient in Thailand: a case report
Authors: Kulwadee Laosakul, Sirida Youngchim, Mati Chuamanochan, Rujira Rujiwetpongstorn, Napatra Tovanabutra, Siri Chiewchanvit
Journal: Access Microbiol (2020)
Keywords: black fungi, diaporthe phaseolorum, phaeohyphomycosis, skin
MeSH terms: Case Reports

Phaeohyphomycosis is caused by a large, heterogeneous group of darkly pigmented fungi. It is an infrequent infection in humans. However, the prevalence has been increasing in recent years especially in immunocompromised patients. Diaporthe phaseolorum is a common black fungal pathogen of plants, which rarely causes human infection. We report the first case of cutaneous infection caused by Diaporthe phaseolorum in an immunocompetent host and the first in Asia. Although, the review of the literature revealed two previous cases of cutaneous infection caused by this organism, both of them were in immunocompromised hosts. A slow-growing asymptomatic nodule was the major clinical feature. Histopathological examination showed granulomatous inflammation and pigmented septate hyphae and yeast-like cells. The fungal isolation was identified by morphological characteristics and DNA sequencing. The lesion was resolved after complete surgical excision and oral fluconazole for two months. This report highlights the potential role of Diaporthe phaseolorum as an emerging cause of infection in immunocompetent patients.
Vaginal laparoscopically assisted radical trachelectomy in cervical clear cell adenocarcinoma
Authors: Sara Iacoponi, Maria Dolores Diestro, Ignacio Zapardiel, María Serrano, Javier De Santiago
Journal: Ecancermedicalscience (2013)
Keywords: cervical adenocarcinoma, clear cell carcinoma, fertility sparing, radical trachelectomy
MeSH terms: Case Reports

Adenocarcinoma of the cervix is a rare condition that has shown an increase in incidence, especially in the 20- to 34-year-old group. Adenocarcinoma represents about 5-10% of all tumours in this area, and, among these, the clear cell type accounts for 4-9%. This type of tumour affects mainly postmenopausal women but also occurs in young women with a history of prenatal exposure to diethylstilbestrol (DES). The prognosis for adenocarcinoma of the cervix is poor overall and worse for the clear cell variety. This article discusses a case of clear cell adenocarcinoma of the cervix, unrelated to intrauterine exposure to DES, in a woman of childbearing age who wished to preserve her fertility and was therefore treated by radical vaginal trachelectomy and pelvic lymphadenectomy.
Neuroschistosomiasis mimicking lower back pain: case report of a rare differential diagnosis in a pediatric patient
Authors: Abdulrahman Hamad Al-Abdulwahhab, Abdulaziz Mohammad Al-Sharydah, Sari Saleh Al-Suhibani, Saeed Ahmad Al-Jubran, Ali Khalaf Al-Haidey, Abdulkhaliq Ibrahim Al-Hifzi, Wissam Al-Issawi
Journal: Patient Saf Surg (2018)
Keywords: conus medullaris, magnetic resonance imaging, myelitis, neuroschistosomiasis
MeSH terms: Case Reports

Background:
Spinal myelitis is an infrequent manifestation of spinal cord infection. It is caused by the Schistosoma species, which are endemic in South America, part of the Middle East, and Africa.
Case presentation:
We report the case of a 13-year-old male adolescent complaining of progressive lower back pain and weakness of the lower extremities for 3 days. Initial magnetic resonance imaging revealed typical transverse myelitis. Subsequently, parasite serology showed a markedly elevated level of Schistosoma antibody titers, and cerebrospinal fluid analysis yielded normal results. Because of our presumptive diagnosis of neuroschistosomiasis, the patient was prescribed an empirical regimen of an anti-parasitic agent, after which his neurological deficit promptly subsided. The patient was followed for 1 year and showed a complete long-term resolution of symptoms.
Conclusions:
This case highlights the increasing prevalence of neuroschistosomiasis in recent years, particularly in patients with a history of travel to endemic regions. Moreover, the study reports the clinicoradiological features of this enigmatic disorder. This rare occurrence potentiates further studies to address unanswered questions about neuroschistosomiasis.
Oral Corticosteroid Relieves Post-COVID-19 Anosmia in a 35-Year-Old Patient
Authors: Sam K Touisserkani, Azin Ayatollahi
Journal: Case Rep Otolaryngol (2020)
MeSH terms: Case Reports

Coronavirus disease 2019 (COVID-19) is a highly infectious respiratory illness caused by SARS-CoV-2. Not much is yet known about this new viral disease. In our early encounter with the COVID-19, before the pandemic and during the early days of dealing with this novel viral disease in our country, we saw some cases of anosmia in patients infected by SARS-CoV-2. In many cases, this chemosensitive dysfunction persisted after the negativization of the nasopharyngeal swab. We report effective treatment of anosmia by oral corticosteroid therapy in a patient recovered from COVID-19.
Unusual Presentation of Cutaneous Leishmaniasis: Ocular Leishmaniasis
Authors: Masoud Doroodgar, Moein Doroodgar, Abbas Doroodgar
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

The leishmaniases are parasitic diseases that are transmitted to humans by infected female sandflies. Cutaneous leishmaniasis (CL) is one of 3 main forms of the disease. CL is the most common form of the disease and is endemic in many urban and rural parts of Iran and usually caused by two species of Leishmania: L. major and L. tropica. We report a case of unusual leishmaniasis with 25 lesions on exposed parts of the body and right eyelid involvement (ocular leishmaniasis). The patient was a 75-year-old male farmer referred to health care center in Aran va Bidgol city. The disease was diagnosed by direct smear, culture, and PCR from the lesions. PCR was positive for Leishmania major.
Case Report: A case of cervical spinal epidural abscess combined with cervical paravertebral soft tissue abscess
Authors: Jun Cao, Jincheng Fang, Xuefei Shao, Jun Shen, Xiaochun Jiang
Journal: Front Surg (2022)
Keywords: case report, decompression, spinal epidural abscess, surgery, treatment
MeSH terms: Case Reports

Background:
Spinal epidural abscess (SEA) is a rare purulent infection of the central nervous system. Abscesses confined to the spinal canal can compress the spinal cord, causing nerve damage and even death in severe cases (1). Prompt diagnosis and treatment can relieve symptoms and prevent complications. To increase awareness of this rare disease, we report a case of a 58-year-old man with a cervical spinal epidural abscess combined with a soft tissue abscess in the neck and describe its clinical course, imaging feature, pathology, treatment, and patient prognosis.
Case description:
A 58-year-old male Chinese patient was admitted to our hospital because of neck pain for 2 months, which worsened for 4 days. On the third day of admission, the muscle strength of the limbs decreased, and MRI of the spinal cord showed abnormal signal shadows in the spinal canal at the C1-C7 level and in the surrounding soft tissue on the right side of spine, suggesting the possibility of inflammatory lesions with local abscess formation. We immediately performed decompression of the spinal canal on the patient and performed incision and drainage of the cervical abscess. During the operation, we found a large amount of pus in the epidural space of the spinal canal, and there was a fistula between the cervical abscess and the epidural abscess of the spinal canal. The patient underwent continuous drainage and anti-infective treatment with sensitive antibiotics after operation. No recurrence of the abscess was observed and the patient recovered well.
Conclusion:
Early diagnosis is the key to the treatment of SEA, so radiologists and neurosurgeons need to strengthen their understanding of this rare disease to avoid misdiagnosis. For SEA with definite diagnosis, decompression surgery should be performed in a timely manner when symptoms of nerve compression occur, continuous drainage should be performed after surgery, and sensitive antibiotics should be used for anti-infective treatment.
Clinicopathological findings of an MM2-cortical-type sporadic Creutzfeldt-Jakob disease patient with cortical blindness during a course of glaucoma and age-related macular degeneration
Authors: Yuichi Hayashi, Yasushi Iwasaki, Masahiro Waza, Hideaki Shibata, Akio Akagi, Akio Kimura, Takashi Inuzuka, Katsuya Satoh, Tetsuyuki Kitamoto, Mari Yoshida, Takayoshi Shimohata
Journal: Prion (2019)
Keywords: creutzfeldt-jakob disease, mm2-cortical-type sporadic creutzfeldt-jakob disease, cortical blindness, dementia, diffusion-weighted mri, elderly patient, ocular disease
MeSH terms: Blindness, Cortical / complications, Creutzfeldt-Jakob Syndrome / complications, Glaucoma / complications, Macular Degeneration / complications, Case Reports, Research Support, Non-U.S. Gov't, Aged, 80 and over, Blindness, Cortical / pathology, Brain / pathology, Creutzfeldt-Jakob Syndrome / pathology, Glaucoma / pathology, Humans, Macular Degeneration / pathology, Male, Prions / analysis, Prions, Creutzfeldt-Jakob Disease, Sporadic

Here, we report an autopsy-verified patient with MM2-coritical-type sporadic Creutzfeldt-Jakob disease (MM2C-type sCJD) presenting cortical blindness during a course of glaucoma and age-related macular degeneration, and focus on the difficulties involved in early clinical diagnosis. An 83-year-old man was admitted to our hospital 15 months after the onset of cortical blindness, and 9 months after the onset of progressive dementia. Neurological examination revealed dementia, frontal signs, visual disturbance, dysphagia, myoclonus and exaggerated tendon reflexes in the four extremities. Diffusion-weighted MRI (DW-MRI) showed cortical hyperintensities predominantly in the bilateral occipital lobes. PRNP gene analysis showed no mutations with methionine homozygosity at codon 129. Cerebrospinal fluid (CSF) examination revealed elevation of 14-3-3 and total tau protein. The symptoms progressed gradually, and the patient died of aspiration pneumonia, 30 months after the onset. Neuropathological examination revealed extensive large confluent vacuole-type spongiform changes in the cerebral cortices. Prion protein (PrP) immunostaining showed perivascular and plaque-type PrP deposits. We diagnosed our patient as MM2C-type sCJD. There are two difficulties in the early clinical diagnosis of MM2C-type sCJD with ocular disease in the elderly; delayed utilization of DW-MRI, and accompaniment of ocular disease. For early diagnosis of MM2C-type sCJD, we conclude that clinician should perform DW-MRI for patients with isolated dementia or cortical visual disturbance.
Acute Bilateral Stroke in a Moyamoya Patient With High Risk of Thrombosis Due to Multiple Myeloma With Chemotherapy
Authors: David F Castañeda-Hurtado, Daniela Perez-Samano, Mariana Rios-Gomez, Juan E Montes-Castañeda, Juan E Montes-Ramirez
Journal: Cureus (2023)
Keywords: arterial thrombosis, moyamoya disease, moyamoya syndrome, multiple myeloma, venous thromboembolism
MeSH terms: Case Reports

Multiple myeloma (MM) is a common hematologic malignancy. Multi-agent chemotherapy and anti-myeloma immunomodulatory drugs increase the incidence of arterial and venous thrombosis. We present a moyamoya patient with MM who had a stroke shortly after induction chemotherapy. We present the case of an adult female patient who arrived at the ER due to automatism seizures, dysarthria, and left hemiparesis. The patient had a medical history of MM and underwent six cycles of induction chemotherapy (cyclophosphamide, dexamethasone, thalidomide, and bortezomib). MRI of the brain showed bilateral watershed ischemic strokes. Angiogram showed occlusion at the supraclinoid segment of both internal carotid arteries consistent with moyamoya. The patient was discharged with full-dose anticoagulation, levetiracetam, and physical therapy. At three years of follow-up, the patient has no recurrent cerebrovascular disease. MM patients treated with thalidomide/lenalidomide in combination with high-dose dexamethasone, doxorubicin, or multiagent chemotherapy should be on anticoagulation for venous thromboembolism (VTE) prophylaxis. There are no clear recommendations for arterial thrombosis prevention. Moyamoya is a vasculopathy characterized by progressive intracranial artery stenosis with a high risk of ischemic stroke, ischemia recurrence, and intracerebral hemorrhage. Despite the risk of intracerebral hemorrhage, we decided on anticoagulation due to the high risk of thrombosis due to MM, multi-agent chemotherapy, and moyamoya.
Diabetic limb salvage procedure with bone allograft and free flap transfer: a case report
Authors: Alexandre L Godoy-Santos, Daniel T Amodio, André Pires, Ana L M Lima, Teng H Wei, Cesar de Cesar-Netto, David G Armstrong
Journal: Diabet Foot Ankle (2017)
Keywords: diabetic foot, free flap, reconstruction, soft-tissue allograft

The aim of this case report was to describe a successful diabetic limb salvage procedure in the treatment of an infected diabetic foot ulcer through a multidisciplinary team approach and complex surgical reconstruction involving a femoral head bone allograft and musculocutaneous latissimus dorsi free flap. The decision to proceed with aggressive staged efforts at diabetic limb salvage should be made only after careful consultation with the patient, his or her family, and the rest of the multidisciplinary healthcare team.
A giant intra-abdominal right testicular seminoma in a bilateral undescended testicle: a case report
Authors: Muhammad Faruk, Muhammad Asykar Palinrungi, Khoirul Kholis, Syakri Syahrir, Syarif Bakri, Abdul Azis
Journal: Pan Afr Med J (2023)
Keywords: cryptorchidism, case report, intra-abdominal, testicular cancer, undescended testicle
MeSH terms: Cryptorchidism / diagnosis, Seminoma / diagnosis, Testicular Neoplasms / diagnosis, Case Reports, Adult, Humans, Male, Orchiectomy / methods, Young Adult

Cryptorchidism is the most common congenital malformation of the male genitourinary tract. An undescended testicle has a 10% chance of developing cancer, with an intra-abdominal testicle having the highest risk. We present a 24-year-old man with a history of bilateral cryptorchidism, complaining of lower abdominal mass for two months. An abdominal computed tomography scan showed an intra-abdominal mass lesion measuring 13 x 9 cm and displacing the bladder caudally. Exploratory laparotomy revealed a right intra-abdominal testicular tumor. A right orchiectomy and left orchidopexy was performed. Histopathological examination revealed a testicular seminoma. The patient was discharged without complications and was referred to the oncology department for chemotherapy and further management. Our findings support the early treatment and close monitoring of cases of cryptorchidism due to the risk of malignancy as well as the necessity of routine scrotal examinations in all males presenting with an abdominal mass.
Reconstruction of necrotizing soft tissue infection in the auricle and temporal region: a case report
Authors: Junpei Saito, Shoichi Ishikawa, Shigeru Ichioka
Journal: Case Reports Plast Surg Hand Surg (2022)
Keywords: necrotizing soft tissue infection (nsti), auricle and temporal region, creation of an auriculotemporal sulcus, temporalis muscle flap
MeSH terms: Case Reports

A 43-year-old female patient had a necrotizing soft tissue infection in the temporal region. Because of the necrotic temporoparietal fascia, auricular reconstruction was attempted using the temporalis muscle flap; the flap was successfully placed. The use of the temporalis muscle flap was considered a treatment option for salvaging the auricle.
Short term outcomes and complications of distal ulnar ostectomy in 23 juvenile dogs with carpal valgus secondary to discordant radial-ulnar physeal growth
Authors: Scott Christopher
Journal: Front Vet Sci (2022)
Keywords: canine, limb deformity, orthopedics, ostectomy, surgery

Objective:
The goal of this study was to report short term clinical and radiographic outcomes after distal ulnar ostectomy in dogs with carpal valgus due to discordant radial-ulnar growth.
Study design:
Retrospective case study.
Sample group:
Client owned dogs under 1 year of age with carpal valgus and open distal radial physes pre-operatively.
Methods:
Medical records from four veterinary referral centers were searched from January 1, 2015 to January 1, 2022 for juvenile dogs that had been treated with distal ulnar ostectomy for carpal valgus due to premature closure of the distal ulnar physis. Patients were excluded if they were skeletally mature at the time of ostectomy; medical records were incomplete; radial physis was closed at surgery; or definitive corrective osteotomy was performed. Radiographs were evaluated pre-operatively and for short term follow up at ~8 weeks. Complications and short term clinical outcomes were evaluated also.
Results:
31 limbs from 23 dogs were evaluated. Patients ranged from 4 to 10.8 months of age. All dogs presented for visible carpal valgus and varying degrees of thoracic limb lameness. Sixty-four percent of patients showed resolution of lameness while an additional 13% showed an improvement in clinical lameness without complete resolution. Complications were seen in 32% of patients with 70% percent of those being minor, bandage related complications. Radiographically, 38% of limbs showed bridging callus formation of the ostectomy at an average of 7.5 weeks post operatively and 75% percent of patients with elbow incongruity improved radiographically. There was no significant difference in radial joint angles pre-operatively and at the time of follow up.
Conclusion:
Distal ulnar ostectomy ameliorates lameness in juvenile dogs with premature distal ulnar physeal closure and shows lack of progression of distal carpal valgus deformity, but does not improve joint angulation.
Clinical significance:
Distal ulnar ostectomy is associated with mild bandage-related complications and halting of progressive limb deformity within the time frame evaluated, and should therefore be considered a treatment for premature closure of the distal ulnar physis. It does not lead to deformity correction at 8 weeks following surgery but is associated with improved elbow congruity.
Intoxication due to Papaver rhoeas (Corn Poppy): Five Case Reports
Authors: Yahya Kemal Günaydın, Zerrin Defne Dündar, Bora Çekmen, Nazire Belgin Akıllı, Ramazan Köylü, Başar Cander
Journal: Case Rep Med (2015)

Introduction. In this paper, we aimed to present five Papaver rhoeas intoxication cases, which is very rare in the literature. Case 1. A 35-year-old female patient was admitted to our emergency room with the complaints of nausea, restlessness, and dyspnea developing 3 hours after eating Papaver rhoeas. On physical examination, her general condition was moderate; she was conscious and the vital findings were normal. The pupils were myotic. She was transferred to the toxicology intensive care unit as she experienced a generalized tonic clonic seizure lasting for three minutes. Case 2. A 41-year-old female patient was brought to our emergency room by 112 ambulance as she had contractions in her arms and legs, unconsciousness, and foam coming from her mouth two hours after Papaver rhoeas ingestion. On physical examination, she was confused, the pupils were myotic, and she was tachycardic. Arterial blood gases analysis revealed lactic acidosis. Case 3. A 38-year-old female patient was admitted to our emergency room with complaints of nausea and vomiting two hours after ingestion of Papaver rhoeas. Her physical examination and tests were normal. Case 4. A 34-year-old male patient was admitted to our emergency room with complaints of numbness and loss of power in his arms and legs one hour after Papaver rhoeas ingestion. He was hospitalized at the toxicology intensive care unit for follow-up and treatment. Dyspnea and bradycardia developed on the follow-up. The oxygen saturation without oxygen support was 90%. ECG revealed sinus bradycardia. The cardiac enzymes did not increase. Case 5. A 42-year-old female patient was brought to our emergency room by 112 ambulance with contractions in her arms and legs and unconsciousness two hours after Papaver rhoeas ingestion. On her physical examination, she was confused and the pupils were myotic. Arterial blood gases analysis revealed lactic acidosis. Conclusion. All patients were followed up for a few days and then discharged from the hospital with recovery. Unconscious consumption of Papaver rhoeas leads to a clinical condition resembling morphine intoxication, CNS depression, and epileptic seizures.
A Case of Acute Severe Ulcerative Colitis Triggered by COVID-19 Infection
Authors: Pankaj Nawghare, Shubham Jain, Sanjay Chandnani, Pravin Rathi
Journal: Cureus (2023)
Keywords: bloody diarrhea, covid-19, management, triggers, ulcerative colitis
MeSH terms: Case Reports

Ulcerative colitis is a chronic inflammatory bowel condition. One of the theories for its etiopathogenesis is gastrointestinal infections. Although COVID-19 primarily affects the respiratory tract, gastrointestinal involvement is also common. We have reported a case of a 28-year-old male who presented with bloody diarrhea, diagnosed with acute severe ulcerative colitis, triggered by COVID-19 infection after known triggers were excluded.