OpenMed/multicare-articles huggingface dataset:
Cryptogenic Cirrhosis and Hepatopulmonary Syndrome in a Boy with Hepatic Hemangioma in Botswana: A Case Report and Review of the Literature
Authors: Francis Msume Banda, Jeremy S Slone, Alan Anderson, Marisa Beretta, Priya Walabh, Jerome Loveland, Simon Nayler, Farirai Fani Takawira
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Hepatic hemangiomas are considered to be the most common benign tumors of the liver. They are often found incidentally while investigating for other causes of liver disease. Hemangiomas that are less than 10 cm are not expected to cause any problems. Typically, they do not enlarge and, apart from regular follow-up, no definitive treatment is indicated. This is a posthumous case report of a male child with a medium-sized hemangioma from infancy, complicated by cryptogenic cirrhosis and hepatopulmonary syndrome. It demonstrates the challenges of managing a child with such complicated conditions in a resource-limited setting.
Resuscitation Following a Bupivacaine Injection for a Cervical Paravertebral Block
Authors: Saulius Vosylius, Valentinas Uvarovas, Saulė Svediene, Igoris Satkauskas
Journal: Open Med (Wars) (2019)
Keywords: cardiopulmonary resuscitation, fat emulsions, intravenous, local anaesthetic, ventricular fibrillation

Background:
Cardiac arrest related to nerve blockade using a local anaesthetic is a rare event. We report a case of bupivacaine severe cardiovascular toxicity following cervical paravertebral nerve block.
Case presentation:
A 44-year-old female was admitted to Republican Vilnius University Hospital, with symptoms of sustained severe pain in her neck that radiated to both arms. Multiple cervical intervertebral hernias with spinal stenosis were confirmed by magnetic resonance imaging. Following infiltration of the subcutaneous tissue with a 0.5 % bupivacaine solution, an 18-gauge spinal needle was used to perform the paravertebral block at the C6 level. Bupivacaine was injected in incremental doses to a total of 10 mL. Rapid loss of consciousness and cardiovascular collapse suggested a neuraxial injection of bupivacaine. Long-lasting cardiopulmonary resuscitation, including chest compressions, defibrillation attempts for refractory ventricular fibrillation, medications, mechanical ventilation, and intravenous lipid emulsion infusion, was successful. No severe adverse outcomes other than acute kidney injury and chest pain related to prolonged chest compressions were documented.
Conclusions:
This case report emphasizes the necessity of ensuring adequate safety precautions to avoid local anaesthetic systemic toxicity. Lipid emulsion preparations should be available in all hospital settings where local anaesthetics are used for regional anaesthesia or pain management.
Two for the Price of One: A Case of Methicillin-Resistant Staphylococcus aureus (MRSA) Brain Abscess With Atypical Lymphoplasmacytic Infiltrate With Underlying Clonal Lymphoproliferative Process in a Patient Infected With HIV
Authors: Frailyn J Nunez, Shorabh Sharma, Michelle Dahdouh
Journal: Cureus (2023)
Keywords: clonal lymphoproliferative process, hiv, lymphoplasmacytic infiltrates, mrsa brain abscess, ring-enhancing lesions
MeSH terms: Case Reports

Multiple etiologies can coexist and trigger CNS symptoms in individuals infected with HIV. This article reviews a case of a cerebellar mass in an HIV patient who, on biopsy, grew methicillin-resistant Staphylococcus aureus (MRSA) and by pathology, showed an atypical lymphoplasmacytic infiltrate concerning a clonal lymphoproliferative process, which may be a precursor of CNS lymphoma. The patient, a 36-year-old male with multiple comorbidities including HIV Infection, presented to the hospital for evaluation of a one-week course of headache and photophobia. Remarkable physical examination findings included dilated pupils and anisocoria. Initial CT brain imaging revealed vasogenic edema seen throughout the left cerebellar hemisphere provoking mass effect on the fourth ventricle and pontocerebellar cistern resulting in mild hydrocephalus, new findings compared to prior. MRI brain displayed a T1 isointense, T2 hypointense ring-enhancing lesion in the left cerebellar hemisphere, with restricted diffusion, and surrounding vasogenic edema resulting in mass effect over the fourth ventricle, left cerebellar peduncle, and pontocerebellar cistern causing mild hydrocephalus. The patient underwent left suboccipital craniotomy with evacuation of the cerebellar lesion by neurosurgery. Tissue cultures grew MRSA. Pathology was sent to New York-Presbyterian Columbia University Irving Medical Center due to the presence of atypical lymphoplasmacytic infiltrates. The final diagnosis was polyclonal B-cell population in the sample; however, prominent peaks were also seen above the polyclonal background, possibly representing a clonal proliferation. Therefore, the lymphoplasmacytic infiltrates remained atypical and the possibility of the underlying clonal lymphoproliferative process could not be entirely ruled out.
An obstructing endobronchial lipoma simulating COPD
Authors: Pradeesh Sivapalan, Magnus Gottlieb, Merete Christensen, Paul Frost Clementsen
Journal: Eur Clin Respir J (2014)
Keywords: asthma, benign tumors, chest ct, chronic obstructive pulmonary disease, surgical resection
MeSH terms: Case Reports

Endobronchial lipomas are rare benign tumors of the respiratory tract. Bronchial occlusion may cause parenchymal damage and lead to a misdiagnosis of chronic obstructive pulmonary disease or malignancy. Therefore, both accurate diagnosis and radical treatment of endobronchial lipomas are essential. We describe the case of a 61-year-old man with a history of smoking (40 pack years), dyspnea in exertion, and cough during the past 6 months due to an endobronchial lipoma. Chest computed tomographic (CT) scan revealed a circumscribed polypoid lesion partially obstructing the left lower lobe. The endobronchial lipoma was removed by flexible bronchoscopy, and the patient had complete resolution of symptoms following the procedure. Flexible bronchoscopy was normal at the 3-month follow-up. In addition, clinical characteristics, diagnosis, and treatment of endobronchial lipomas are discussed.
Multiple-system atrophy with cerebellar predominance presenting as respiratory insufficiency and vocal cords paralysis
Authors: Ramon Andrade Bezerra de Mello, Diana Ferreira, José Manuel Dias da Costa, Maria José Rosas, João Manuel Quinaz
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Background. MSA (Multiple System Atrophy) may be associated either with Parkinsonism or with cerebellar ataxia (MSA-c subtype). It is considered a rare disease, but many patients are misdiagnosed as suffering from idiopathic Parkinson's disease. In this paper, we report a case of a patient admitted with respiratory failure and vocal cords paralysis due to MSA-c. Case Report. A 79-year-old Caucasian woman was admitted in March 2010 with dyspnea, asthenia, stridor, and respiratory failure needing noninvasive ventilation. She had orthostatic blood pressure decline, constipation, insomnia, daytime sleepiness, and snoring. The neurologic examination revealed cerebellar ataxia. A laryngoscopy revealed vocal cord paralysis in midline position and tracheostomy was performed. The Brain Magnetic Resonance Imaging revealed atrophy of middle cerebellar peduncles and pons with the "hot cross bun sign." Conclusion. Although Multiple-system atrophy is a rare disease, unexplained respiratory failure, bilateral vocal cord paralysis, or stridor should lead to consider MSA as diagnosis.
Assessing geographic controls of hair isotopic variability in human populations: A case-study in Canada
Authors: Clement P Bataille, Michelle M G Chartrand, Francis Raposo, Gilles St-Jean
Journal: PLoS One (2020)
MeSH terms: Biological Variation, Population, Carbon Isotopes / analysis, Hair / chemistry, Nitrogen Isotopes / analysis, Sulfur Isotopes / analysis, Research Support, Non-U.S. Gov't, Adult, Canada, Diet / statistics & numerical data, Female, Humans, Male, Carbon Isotopes, Nitrogen Isotopes, Sulfur Isotopes

Studying the isotope variability in fast-growing human tissues (e.g., hair, nails) is a powerful tool to investigate human nutrition. However, interpreting the controls of this isotopic variability at the population scale is often challenging as multiple factors can superimpose on the isotopic signals of a current population. Here, we analyse carbon, nitrogen, and sulphur isotopes in hair from 590 Canadian resident volunteers along with demographics, dietary and geographic information about each participant. We use a series of machine-learning regressions to demonstrate that the isotopic values in Canadian residents' hair are not only influenced by dietary choices but by geographic controls. First, we show that isotopic values in Canadian residents' hair have a limited range of variability consistent with the homogenization of Canadian dietary habits (as in other industrialized countries). As expected, some of the isotopic variability within the population correlates with recorded individual dietary choices. More interestingly, some regional spatial patterns emerge from carbon and sulphur isotope variations. The high carbon isotope composition of the hair of eastern Canadians relative to that of western Canadians correlates with the dominance of corn in the eastern Canadian food-industry. The gradient of sulphur isotope composition in Canadian hair from coast to inland regions correlates with the increasing soil pH and decreasing deposition of marine-derived sulphate aerosols in local food systems. We conclude that part of the isotopic variability found in the hair of Canadian residents reflects the isotopic signature associated with specific environmental conditions and agricultural practices of regional food systems transmitted to humans through the high consumption rate of intra-provincial food in Canada. Our study also underscores the strong potential of sulphur isotopes as tracers of human and food provenance.
Inherited Moderate Factor X Deficiency Presenting as Cardiac Tamponade
Authors: Tamer Othman, Ayman Abdelkarim, Karen Huynh, An Uche, Jennifer Lee
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

Factor X deficiency is a rare bleeding disorder that varies in the severity of its clinical manifestations. The symptoms of this disorder can occur at any age, although most severe cases appear in childhood. The rarity of this condition has not allowed for the establishment of evidence-based management guidelines, and thus, individuals afflicted with factor X deficiency are treated based on limited literature and the opinions of clinicians with extensive experience. In this case report, we discuss a unique presentation of a 38-year-old male who was found to have cardiac tamponade as a result of his newly diagnosed inherited moderate factor X deficiency. This was discovered by obtaining a factor X activity assay and confirmed with genetic testing which demonstrated a missense variant on the factor X gene on chromosome 13. His management involved correction of his factor X deficiency with fresh frozen plasma, a pericardiocentesis, and placement of a pericardial window. He has been asymptomatic and without hemorrhagic episodes for the 10 months following his discharge.
Mendelian Susceptibility to Mycobacterial Diseases (MSMD) in a 13-Year-Old Ethiopian Girl with Autosomal Dominant Interferon Gamma Receptor 1(IFN- γ R1) Defect: A Clinical Diagnostic and Treatment Challenge
Authors: Netsanet Azene Gebeyehu, Solomie Jebessa Deribessa, Freeman Alexandra, Messay Tesfaye Demissie, W Mihretu Gebre, Aklilu Melaku Gebremariam, Dagmawit Mitiku Engliz, Tizita Yosef Kidane, Lidya Million Bekele, Abate Yeshidinber Weldetsadik
Journal: Case Rep Infect Dis (2022)
MeSH terms: Case Reports

Background:
Mendelian susceptibility to mycobacterial diseases (MSMD) is an inborn error of immunity categorized as defects in intrinsic and innate immunity. MSMD is characterized by vulnerability to less virulent mycobacteria, such as Bacillus Calmette-Guérin (BCG) vaccine strains, as well as environmental mycobacteria (EM). The definitive diagnosis is made by genetic analysis. Treatments constitute antimycobacterial, interferon-gamma, surgery, and hematopoietic stem cell transplantation (HSCT), which is the only known curative treatment. The mortality rate ranges from 40% to 80% depending on the severity of the mutation.
Case:
A 13-year-old female patient had multiple hospital visits since the age of 6 months. The most striking diagnosis was repeated mycobacterial infections. She had tuberculosis affecting lymph nodes, skin and soft tissue, bone and joints, the lungs, and epidural and paraspinal regions. She has taken all the childhood vaccines, including BCG. She has been treated four times with first-line and once with second-line antituberculosis drugs. Currently, she is on treatment for nontuberculous mycobacteria and is receiving interferon-gamma. Genetic studies showed autosomal dominant Mendelian susceptibility to mycobacterial disease due to IFNG-R1 defect.
Conclusion:
To the authors' knowledge, this is the first case report of Mendelian susceptibility to mycobacterial diseases secondary to interferon gamma receptor 1(IFNG-R1) defect in Ethiopia. Although it has been immensely challenging, our multidisciplinary team has learned a lot from the clinical presentation, diagnosis, and management of this child.
Bilobed Flap for Reconstruction of a Large Keratoacanthoma of the Thumb
Authors: Özgür Agdoğan, Rahşan Karaçal
Journal: Case Reports Plast Surg Hand Surg (2019)
Keywords: thumb, bilobed flap, large keratoacanthoma
MeSH terms: Case Reports

We present the bilobed flap principle which can be used to reconstruct of large defects located on the dorsum of the thumb. The flap provides similar texture, colour and thickness as adjacent hand skin. The final results were excellent both functionally and cosmetically.
Surgical excision of peripheral giant cell granuloma of the maxilla: a case report
Authors: Narjiss Akerzoul, Babacar Touré
Journal: Pan Afr Med J (2023)
Keywords: peripheral giant cell granuloma, case report, granuloma, maxilla, traumatic extractions
MeSH terms: Granuloma, Giant Cell / diagnosis, Granuloma, Giant Cell / etiology, Granuloma, Giant Cell / surgery, Case Reports, Gingiva / pathology, Humans, Liver / pathology, Mandible / pathology, Maxilla / pathology, Maxilla / surgery

Peripheral giant cell granuloma (PGCG) is described as an elevated lesion that is located mostly on the gingival mucosa and alveolar crest, consecutive to irritative factors and trauma. It predominantly occurs more in the mandible than the maxilla, and it is usually seen in the 4th to the 6th decades. The clinical appearance of this lesion is red-bluish in color, presenting a similar tissue to the one observed in the liver, usually measuring less than 2 cm. The treatment of the PGCG is the surgical excision. The recurrence of this lesion is rarely described in the literature. The present case highlights the importance of considering the traumatic extractions as one of the main uncommon etiologic factors, leading to the development of peripheral giant cell granuloma. It precisely describes the diagnosis, the treatment of a peripheral giant cell granuloma located in maxillary canine-premolar region, occurred consecutively after ancient traumatic extractions of the 13 and 14 since 1 year. This paper also reports a maxillary location of giant cell granuloma, while the literature reports more commonly the mandibular location. This lesion was excised surgically, and healed uneventually, and in which the follow-up didn´t show any sign of recurrence.
Anomalous Origin of a Right Coronary Artery from Pulmonary Artery
Authors: Muhammad Shabbir Rawala, S Tahira Shah Naqvi, Kinaan Farhan, Muhammad Yasin, Syed Bilal Rizvi
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Congenital defects of the coronary arteries are noted in 0.2-1.4% of the general population. The first case of an anomalous origin of right coronary artery from pulmonary artery (ARCAPA) was described by Brooks in 1885. ARCAPA has an overall incidence of 0.002% in the general population. Most of the cases are asymptomatic; however, it can lead to serious complications such as heart failure, ischemia, and sudden death. A 57-year-old man presented to the cardiologist's office with complaints of shortness of breath and fatigue. The patient also had a previous history of coronary stents and heart failure. Initially, he was evaluated with a stress test which was reported as abnormal. The patient then underwent an invasive coronary angiography that revealed anomalous origin of the right coronary artery (RCA) and multivessel disease. Cardiothoracic surgery evaluated the patient and coronary artery bypass graft was performed. During the surgery, the anomalous origin of RCA from the pulmonary artery was identified and was successfully corrected by reimplanting the RCA into the ascending aorta. The anomalous origin of RCA is a rare yet life-threatening condition. The RCA due to its location of origin from the pulmonary artery tends to be a low-pressure vessel with a very thin and fragile wall. It also serves as a retrograde venous conduit from the left coronary circulation into the pulmonary artery. This connection results in a left-to-right shunt that explains the increase in oxygen saturation in the pulmonary artery and the high cardiac output which is normally seen in these cases. The clinical presentation can vary from coronary ischemia to heart failure or sudden death. Therefore, surgical correction is recommended even in asymptomatic patients. We present a case of an anomalous origin of RCA from the pulmonary artery which, unlike the origin of left coronary from pulmonary artery, is very rare. Patients with this condition should have early correction even if they are asymptomatic in order to prevent long-term complications.
De Novo Postinfectious Glomerulonephritis Secondary to Nephritogenic Streptococci as the Cause of Transplant Acute Kidney Injury: A Case Report and Review of the Literature
Authors: Alexander Bullen, Mita M Shah
Journal: Case Rep Transplant (2018)
MeSH terms: Case Reports

Acute kidney injury is common among kidney transplant recipients. Postinfectious glomerulonephritis secondary to nephritogenic streptococci is one of the oldest known etiologies of acute kidney injury in native kidneys but rarely reported among kidney transplant recipients. This report is of a biopsy-proven case of acute kidney injury in a renal allograft recipient caused by de novo poststreptococcal glomerulonephritis.
Case Report: Early Transplant Rejection of a Methanol-Intoxicated Donor Heart in a Young Female Patient. A Diagnostic Approach With CMR, Cardiac Biopsy, and Genetic Risk Assessment
Authors: Lukas Stoiber, Felix Schoenrath, Christoph Knosalla, Hendrik Milting, Karin Klingel, Carsten Tschöpe, Radu Tanacli, Rolf Gebker, Alexander Berger, Burkert Pieske, Sebastian Kelle
Journal: Front Immunol (2021)
Keywords: cardiac magnetic resonance imaging (cmr), cardiomyopathy, gene sequence, heart transplantation, mapping - magnetic resonance imaging
MeSH terms: Alcoholic Intoxication / complications, Cardiomyopathy, Dilated / surgery, Graft Rejection / diagnosis, Heart Failure / surgery, Heart Transplantation / adverse effects, Magnetic Resonance Imaging, Methanol / poisoning, Molecular Diagnostic Techniques, Tissue Donors, Case Reports, Alcoholic Intoxication / diagnosis, Biopsy, Cardiomyopathy, Dilated / diagnosis, Cardiomyopathy, Dilated / physiopathology, Diagnosis, Differential, Donor Selection, Female, Genetic Predisposition to Disease, Graft Rejection / etiology, Graft Rejection / genetics, Graft Rejection / therapy, Heart Failure / diagnosis, Heart Failure / physiopathology, Humans, Middle Aged, Predictive Value of Tests, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Young Adult, Methanol

This case report describes the contributions of multimodality imaging, cardiac biopsy, and genetic sequencing to the diagnosis and management of heart transplant rejection in a 23-year old patient with dilated cardiomyopathy.
Malakoplakia of the Pancreas with Simultaneous Colon Involvement: Case Report and Review of the Literature
Authors: Surya Guha, Haiyan Liu
Journal: Case Rep Pathol (2015)

Although malakoplakia has been reported to occur at various body sites, pancreatic malakoplakia with simultaneous colonic involvement is very rare. Lesions of malakoplakia can masquerade as tumor masses leading to unwanted resections. Nevertheless, malakoplakia can occur in association with frank carcinomas, especially in the colon. By reporting a case of pancreatic malakoplakia diagnosed by fine needle aspiration cytology, this paper aims to describe cytologic features of malakoplakia and to further review findings from previous reported cases of pancreatic malakoplakia in the literature. With advances in minimally invasive, image-guided aspiration technologies, cytomorphological analyses can diagnose lesions of malakoplakia. This may help avoid surgeries that would have otherwise been carried out due to a misleading impression of tumor. However challenges remain as to the further management of patients diagnosed with this condition. More studies are necessary to determine the probability of malignancies arising in association with malakoplakia, in order to devise appropriate treatment protocols.
Herpes Simplex Virus Pneumonia: Importance of Aspiration Etiology
Authors: Kentaro Odani, Mitsuhiro Tachibana, Rintaro Tamashima, Yutaka Tsutsumi
Journal: Case Rep Pathol (2019)
MeSH terms: Case Reports

Herpes simplex virus (HSV) pneumonia caused by aspiration from the oropharyngeal exudates is described. An 89-year-old Japanese male in a poor performance state complained of appetite loss followed by difficulty in swallowing, and bilateral pulmonary infiltrates with interstitial reactions were radiologically pointed out. Antibiotics administration was ineffective, and he died on the 6th day of hospitalization. At autopsy, HSV-induced multiple mucosal erosions were observed on the tongue, pharynx, epiglottis, and trachea. In bilateral lower lobes of the lung, HSV infected bronchiolar and type-II alveolar cells in association with acute interstitial reactions. The infected cells with intranuclear inclusion bodies were immunoreactive with HSV antiserum. HSV-1 infection was confirmed by immunostaining with monospecific monoclonal antibodies and by type-specific real-time polymerase chain reaction. It is very likely that HSV pneumonia was provoked by aspiration of infected exudates from the upper airway (namely, sequential infection from the tongue, epiglottis, and trachea to lung). Oropharyngeal herpes might cause anorexia and difficulty in swallowing, probably accelerating aspiration. The medical staff did not recognize the oropharyngeal lesions of this aged patient. We must realize again the importance of oral care for hospitalized patients to avoid aspiration pneumonia, including herpetic pneumonia.
Trapped Esophageal Stent in a Child: An Unusual Complication
Authors: Mustafa Okumuş
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Background:
Migration is the most frequent and well-known complication of self-expandable metal stents (SEMS). Most of the time, migrated stents are still in the esophagus and can be relocated or removed successfully through endoscopy. However, what can be done if the stent is stuck between two esophageal strictures? Herein, we present a child with a trapped esophageal stent.
Method:
A 2-year-old male patient with an esophageal stent which migrated and became stuck between two esophageal strictures was reported.
Results:
Proximal stricture was excised, and the stent was removed via a right thoracotomy. Balloon dilatation was applied to the distal stricture. The patient was discharged on the 17th postoperative day without any problem.
Conclusions:
Pediatric patients with an esophageal stent should be closely followed up during this period. Early detection of complications makes treatment easier. Otherwise, there may be no option other than surgical treatment, as in the patient presented here.