OpenMed/multicare-articles huggingface dataset:
Prolactinoma: A Massive Effect on Bone Mineral Density in a Young Patient
Authors: Scott Sperling, Harikrashna Bhatt
Journal: Case Rep Endocrinol (2016)

This case highlights a prolactinoma in a young male, and its impact on bone health. Osteoporosis has been noted to be an issue in postmenopausal women with prolactinomas. This case shows a similar impact on bone health in a young male resulting in low bone mineral density for age based on Z-score. This case report highlights the possible mechanisms for the bone loss in the setting of prolactinoma and the need for assessing bone health in such patients. Furthermore it highlights the need for a thorough evaluation in such patients.
Anesthetic management for cytoreductive surgery of pseudomyxoma peritonei with high intra-abdominal pressure: A case report
Authors: Yan-Jun Lin, Liang-Yuan Lu, De-Qiang Tao, Zhan-Min Yang
Journal: Front Surg (2023)
Keywords: anesthetic management, cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, intra-abdominal hypertension, pseudomyxoma peritonei
MeSH terms: Case Reports

Anesthetic management for patients of pseudomyxoma peritonei (PMP) is challenging. This case report describes a patient of PMP with high intra-abdominal pressure. Intubation was performed in lateral position; the intraabdominal pressure was relieved slowly to prevent significant hemodynamic changes. Additionally, positive pressure ventilation was performed to reduce the risk of re-expansion pulmonary edema. During the operation, transfusion and infusion therapy was performed with target-mediated fluid therapy according to stroke volume variation (SVV) and cardiac index (CI) and blood gas analysis.
Case Series: The Coexistence of Thrombocytopenia and Thromboembolism in COVID-19 Patients on ECMO: A Case Series and Literature Review
Authors: Can Jones, Kai Chen, Vijay Narendran
Journal: Front Med (Lausanne) (2021)
Keywords: covid-19, ecmo, anticoagulation, thrombocytopenia, thromboembolism
MeSH terms: Case Reports

Thrombocytopenia and thromboembolism are common complications in coronavirus disease 2019 (COVID-19) patients. The fact that COVID-19 patients develop both thrombocytopenia and thromboembolism has been observed, and multiple studies have investigated the underlying pathophysiology. Extracorporeal membrane oxygenation (ECMO) is reserved for COVID-19 patients who develop respiratory failure and not respond to conventional mechanical ventilation. ECMO induces thromboembolism and raises the incidence of developing thromboembolic events in COVID-19 patients. Here, we report the hospital courses and outcomes of three COVID-19 patients who were treated with ECMO, then developed both thrombocytopenia and thromboembolism. The coexistence of thrombocytopenia and thromboembolism challenges the clinical treatment strategy, including the decision of initiating anticoagulation. Based on current data, anticoagulation is recommended to all hospitalized COVID-19 patients unless there is active bleeding, previous bleeding history within 3 days, or platelet count is lower than 30,000 cells/μl. Further investigation into the mechanisms and implications of thrombocytopenia and thromboembolism in patients with COVID-19 pneumonia will lead to significantly improved outcomes and prognosis for the patients.
Giant myxoid liposarcoma of the stomach: Report of a case
Authors: Akari Sonoda, Hiroshi Sawayama, Nobutomo Miyanari, Takao Mizumoto, Tatsuo Kubota, Hideo Baba
Journal: Int J Surg Case Rep (2019)
Keywords: case report, myxoid liposarcoma, stomach, surgery

Introduction:
Liposarcoma is one of the most common soft tissue sarcomas in adults, but liposarcoma arising primarily from the stomach is very rare.
Presentation of case:
A 56-year-old man was referred to our hospital with abdominal distension and discomfort. A computed tomography scan showed a huge mass located between the stomach and transverse colon. The preliminary differential diagnoses were sarcoma with a mucinous component, gastrointestinal stromal tumor, lymphangioma, and mesenteric cyst. Upper and lower endoscopy was not performed because the patient declined. The patient underwent surgical resection, and the tumor was completely removed. Macroscopic examination revealed a 39-×26-×20-cm tumor weighing 13,000g. On histological examination, the tumor was diagnosed as a myxoid liposarcoma in the gastric submucosa. The patient was still doing well 2 years postoperatively.
Discussion:
Preoperative diagnosis of liposarcoma of the stomach is difficult. In the present case, the tumor was very large but was able to be resected completely.
Conclusion:
Even in patients with very large myxoid liposarcoma, curative resection can provide a good prognosis.
Case Report: A Huge Calabash Heart: A Rare Case of Supracardiac Total Anomalous Pulmonary Venous Return
Authors: Jianjun Tang, Zhihong Wu, Jia He, Qingdan Hu, Jun Yao, Lin Hu, Shenghua Zhou, Mingxian Chen
Journal: Front Cardiovasc Med (2022)
Keywords: congenital heart disease, enlargement, heart, structural heart disease, supracardiac total anomalous pulmonary venous return
MeSH terms: Case Reports

A 46-year-old woman was admitted to the cardiovascular department because of a 3-month history of palpitations and exertional dyspnea. She had a history of a successful pregnancy at a very young age. The chest radiograph presented a "calabash" configuration. Echocardiogram discovered a large atrial septal defect with a suspected pulmonary vein abnormality. Cardiac CT revealed supracardiac total anomalous pulmonary venous return, whereby, all the pulmonary veins drain into a vertical vein and, finally, to the superior vena cava. Cardiac catheterization was consistent with anomalous pulmonary venous drainage without pulmonary hypertension. Finally, she underwent a successful surgical repair and appeared asymptomatic before her discharge.
Intraocular Silicone Oil Masquerading as Terson Syndrome
Authors: Navid Elmi Sadr, Bijan Samavat, Payam Mehrian, Alireza Hedayatfar
Journal: Case Rep Ophthalmol Med (2016)

Introduction. Terson syndrome is described as intraocular hemorrhage in association with any type of intracranial hemorrhage and is associated with higher mortality rate and vision loss. Intraocular hemorrhage in Terson syndrome may be diagnosed using computed tomography but there are false positive results. Silicone oil which is widely used for internal tamponade of complicated retinal detachments has high attenuation on computed tomography and hyperintensity on T1-weighted magnetic resonance imaging that can mimic intraocular hemorrhage. This report shows that silicone oil is another origin of false positive results in interpreting CT findings for detecting Terson syndrome. Case Report. A 71-year-old diabetic woman presented with loss of consciousness. Brain computed tomography revealed right cerebellar hemorrhage and ventricular hemorrhage and hyperdensity in vitreous cavity of the left eye that was initially interpreted as vitreous hemorrhage. Terson syndrome was the initial diagnosis but ophthalmoscopic examination and brain MRI showed that the left eye had silicone oil tamponade. Conclusion. Without knowing the history of previous vitreoretinal surgery, CT scan findings of intraocular silicone oil may be interpreted as vitreous hemorrhage. In patients with concomitant intracranial hemorrhage, it can masquerade as Terson syndrome.
Case report: Interstitial pneumonitis after initiation of lamotrigine
Authors: Victoria Watzal, Godber Mathis Godbersen, Ana Weidenauer, Matthäus Willeit, Valentin Popper, Michael Treiber, Maximilian Preiss, Dominik Ivkic, Ulrich Rabl, Gernot Fugger, Richard Frey, Christoph Kraus, Dan Rujescu, Lucie Bartova
Journal: Front Psychiatry (2023)
Keywords: adverse events, case report, interstitial pneumonitis, lamotrigine (ltg), pulmonary condition
MeSH terms: Case Reports

The second-generation anticonvulsant lamotrigine is widely used in the psychiatric field as a mood stabilizer or antidepressant augmentation therapy. Although particularly older anticonvulsants are known for their potential to cause hypersensitivity syndromes, newer antiepileptic drugs do hold a certain risk as well. Presenting a case of a 32-year-old male inpatient of African ethnicity suffering from a primary severe depressive episode in the course of a recurrent major depressive disorder, we report the occurrence of a rapid-onset drug-induced pneumonitis. Herewith, the interstitial pneumonitis occurred after the initiation of 25 mg lamotrigine as an augmentation therapy. Except for the clear temporal correlation between the administration of lamotrigine and the onset of pneumonitis, we did not reveal any further potentially causal diagnostic hints. Importantly, no relevant genetic variations of metabolizing enzymes or drug interactions resulting in lamotrigine overdosage as a potential cause of toxicity were identified. Our experience with a potentially life-threatening adverse drug reaction shortly after the initiation of the largely well-tolerated lamotrigine suggests a potential side effect under the second-generation anticonvulsant although similar adverse events are deemed to be very rare.
Iron-deficiency anemia as a rare cause of cerebral venous thrombosis and pulmonary embolism
Authors: Nicolas Nicastro, Armin Schnider, Béatrice Leemann
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Cerebral venous thrombosis (CVT) is a relatively rare cause of stroke and has a wide spectrum of unspecific symptoms, which may delay diagnosis. There are many etiologies, including hematological disorders, trauma, infection, and dehydration. Iron-deficiency anemia (IDA) has been reported as an extremely rare cause of CVT, especially in adults.
Culture-Negative Streptococcus suis Infection Diagnosed by Metagenomic Next-Generation Sequencing
Authors: Yuanyuan Dai, Li Chen, Wenjiao Chang, Huaiwei Lu, Peng Cui, Xiaoling Ma
Journal: Front Public Health (2019)
Keywords: streptococcus suis, bacteria, blood culture, metagenomic next-generation sequencing, streptococcal toxic shock syndrome
MeSH terms: Case Reports

Background: Streptococcus suis is a zoonotic pathogen that can cause severe infections such as meningitis and septicemia in both swine and humans. Rapid and accurate identification of the causative agent is very important for guiding clinical choices in administering countermeasures. Case Report: Here, we report a case of fatal S. suis infection in a patient who worked as a butcher in China. The 59-year-old man, who had previously undergone splenectomy, injured his finger while processing pork and developed severe sepsis. While blood cultures were negative following antibiotic treatment, S. suis was determined to be the causative agent by metagenomic next-generation sequencing (mNGS) and Sanger sequencing. Conclusion: Identification of etiological agents using techniques such as blood culture prior to antibiotic treatment is very important. mNGS may represent a useful method for diagnosis of infectious diseases, especially post-antibiotic treatment.
Rare case of low-grade fibromyxoid sarcoma of the thoracic wall with complete sternum reconstruction
Authors: João Nunes Pombo, Artur Nixon Martins, Catarina Paias Gouveia, Ágata Nawojowska, Samuel Mendes, Daniel Cabral, Francisco Félix, Bruno Rosa, Carlos Pinheiro, Miguel Andrade, Gaizka Saenz Ribeiro
Journal: Case Reports Plast Surg Hand Surg (2022)
Keywords: lgfms, low-grade fibromyxoid sarcoma, sternal reconstruction
MeSH terms: Case Reports

An 18-year-old boy presented with a giant midline mass with 9 years of evolution. The tumor was excised, and reconstruction made with a customized sternum implant and a free latissimus dorsi muscle flap with skin graft. Histological analysis was compatible with low-grade fibromyxoid sarcoma (LGFMS).
Neurasthenia at Mengo Hospital, Uganda: A case study in psychiatry and a diagnosis, 1906-50
Authors: Yolana Pringle
Journal: J Imp Commonw Hist (2016)
Keywords: psychiatry, uganda, detribalisation, empire, mission medicine, neurasthenia

This article uses a case-study approach to examine the complex and contradictory nature of diagnoses like neurasthenia in colonial Africa. Drawing on the case notes of European and African patients diagnosed with neurasthenia at the Church Missionary Society's Mengo Hospital, Uganda, it argues that in practice, and outside the colonial asylum in particular, ideas about race and mental illness were more nuanced than histories of psychiatry and empire might imply. At Mengo, the tales of pain and suffering recorded by the doctors remind us that there is more to the history of neurasthenia than colonial anxieties and socio-political control. This was a diagnosis that was negotiated in hospital examination rooms as much as in medical journals. Significantly, it was also a diagnosis that was not always reserved exclusively for white colonisers-at Mengo Hospital from the early 1900s neurasthenia was diagnosed in African patients too. It became part of a wider discussion about detribalisation, in which a person's social environment was as important as race.
Streptococcus intermedius: An Unusual Case of Purulent Pericarditis
Authors: Kara J Denby, Ryan D Byrne, Oscar G Gómez-Duarte
Journal: Case Rep Infect Dis (2017)
MeSH terms: Case Reports

Purulent pericarditis is a rare diagnosis with life-threatening implications due to the rapid accumulation of pericardial material, swiftly progressing to tamponade physiology. The nature of its quickly evolving and severe implications demands a low threshold for diagnostic consideration where appropriate. We present an unusual case of purulent pericarditis secondary to Streptococcus intermedius in a previously healthy male adolescent without traditional risk factors, which raises the question of whether emergent S. intermedius species may have acquired novel molecular mechanisms.
Success of Penile Replantation Using Combination of Cialis, Hyperbaric Oxygen, and SPY Technology
Authors: Karen B Lu, Kyle Sanneic, Jeffrey A Stone, Allen Morey, Bardia Amirlak
Journal: Eplasty (2019)
Keywords: cialis, hyperbaric oxygen, indocyanine green dye, penile amputation, penile replant
MeSH terms: Case Reports

Objective: There are very few studies reporting the techniques utilized in penile replantation. Of those in literature, many agree that the use of microvascular technique results in better outcomes. The most common complications are skin necrosis and venous congestion, which are even higher in replants without arterial supply. Methods: This study describes a case of self-inflicted penile amputation treated with microsurgical replantation and managed postoperatively with hyperbaric oxygen therapy and Cialis (tadalafil), and SPY angiography. The penile replant had extensive skin necrosis, which prevented a sufficient clinical evaluation of the replanted penis. Serial SPY angiography was performed to assess tissue viability, following hyperbaric oxygen therapy and Cialis treatment. Results: SPY angiography was critical to the decision making of the operating team in the management of this case of penile replantation. Conclusions: The use of SPY angiography prevented the patient from undergoing revision amputation and allowed for a safe and successful penile replantation.
Endophthalmitis after tooth extraction in a patient with previous perforating eye injury
Authors: Tevfik Ogurel, Zafer Onaran, Reyhan Ogurel, Kemal Örnek
Journal: Pan Afr Med J (2015)
Keywords: endophthalmitis, perforating injury, tooth extraction
MeSH terms: Endophthalmitis / etiology, Eye Injuries / pathology, Pain / etiology, Tooth Extraction / adverse effects, Case Reports, Humans, Male, Middle Aged, Visual Acuity

The aim of this stuty is to describe a case of endophthalmitis after tooth extraction in a patient with previous perforating eye injury. 50 years old male patient attempted to our clinic with complaints of sudden severe pain, reduced vision, light sensitivity and redness in the right eye. The patient stated that severe pain in his eye began approximately 12 hours following tooth extraction. The patient's ocular examination revealed a visual acuity of hand motion in the right eye. Anterior segment examination of the right eye showed intense conjunctival hyperemia, chemosis, a fine keraticprespitat and corneal edema. Dental procedures of the patients who had recently underwent ocular surgery or trauma should be done in a more controlled manner under anti -infective therapy or should be postponed in elective procedures.
Non O1 Vibrio cholerae as a cause of bacteremic lower limb cellulitis: A case report
Authors: Tarig Ahmed Abdelhafiz, Amani Mansour Alnimr, Abdulrahman Mohammed Alabduljabbar, Hussain Salman AlMuqallad, Abdullah Abdulmonem Alzarra, Hassan Nasser Alrashed, Moudhi Mufarej Aladwani, Amani Mohammed Hakami
Journal: Int J Surg Case Rep (2019)
Keywords: cellulitis, diabetic foot, non-o1, non-o139 vibrio cholerae

Introduction:
Self-limiting gastroenteritis and wound infections in immunocompetent patients are most of the cases involved with Non-O1, non-O139 Vibrio cholerae which its microorganism occasionally accountable for intestinal and extra-intestinal infections. Cellulitis is an infection of the skin and underlying soft tissue mostly affected by bacteria. Diabetic foot ulcer is the most costly and devastating complication of diabetes mellitus.
Case presentation:
This following case describes a bacteremic soft tissue infection in a diabetic patient who is 54-year-old male with 6 years of type 2 diabetes mellitus. The patient was treated with surgical debridement of the foot ulcer, calf fasciotomy and medical therapy then he discharged. The next day readmitted with deteriorating of his condition the whole right leg to the level of the knee became ischemic and black with evidence of wet gangrene. A Guillotine above knee amputation was done.
Discussion:
Upon review of literature, we only found few cases have been reported of cellulitis due to V. cholerae. A degree of hepatic impairment or immunocompromised state like Diabetes Mellitus, chronic infections, malignancies, and peripheral vascular disease are seen in the majority of non-gastrointestinal V. cholerae infections which suggests that it should be included in the differential diagnosis of bacteremic skin and soft tissue infections in patients with underlying illnesses.
Conclusion:
Cholerae should be included in the differential diagnosis of any bacteremic skin and soft tissue infections especially in elderly, comorbid and immune-compromised patients. Well-timed, proper antibiotic and surgical treatments are important in management of the infection to decrease morbidity and mortality.
Characteristics and Unexpected COVID-19 Diagnoses in Resuscitation Room Patients during the COVID-19 Outbreak-A Retrospective Case Series
Authors: Sebastian Bergrath, Olaf Aretz, Hendrik Haake, Adrian Ringelstein, Ingo Greiffendorf, Ullrich Graeven, Jochen Windfuhr
Journal: Biomed Res Int (2020)
MeSH terms: Betacoronavirus, Clinical Laboratory Techniques / methods, Coronavirus Infections / diagnosis, Pneumonia, Viral / diagnosis, Case Reports, Aged, Aged, 80 and over, COVID-19, COVID-19 Testing, COVID-19 Vaccines, Coronavirus Infections / diagnostic imaging, Coronavirus Infections / epidemiology, Critical Illness, Diagnosis, Differential, Disease Outbreaks, Emergency Service, Hospital, False Negative Reactions, Female, Germany / epidemiology, Humans, Male, Middle Aged, Pandemics, Pneumonia, Viral / diagnostic imaging, Pneumonia, Viral / epidemiology, RNA, Viral / genetics, RNA, Viral / isolation & purification, Real-Time Polymerase Chain Reaction, Resuscitation, Retrospective Studies, SARS-CoV-2, Tomography, X-Ray Computed, Triage, COVID-19 Vaccines, Covid-19 aAPC vaccine, RNA, Viral

Introduction:
Emergency department (ED) triage regarding infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is challenging. During the coronavirus disease 2019 (COVID-19) outbreak in Germany, the diagnostic outcomes of critically ill patients admitted to the resuscitation room in the ED of our academic 754-bed hospital should be analyzed.
Methods:
All resuscitation room patients between March 1st and April 15th 2020 were included in this retrospective study. Every patient with suspicion of SARS-CoV-2 infection received a pharyngeal swab for real-time polymerase chain reaction (rt-PCR), divided in the clinical subgroups of "highly suspicious for COVID-19" and "COVID-19 as differential diagnosis." All respiratory and infectious symptoms were included as at least "differential diagnosis" as an expanded suspicion strategy.
Results:
Ninety-five patients were included (trauma n = 14, critically ill n = 81). Of 3 highly suspicious patients, 2 had rt-PCR positive pharyngeal swabs. In 39 patients, COVID-19 was defined as differential diagnosis, and 3 were positive for SARS-CoV-2. Of them, pharyngeal swabs were positive in 1 case, while in 2 cases, only tracheal fluid was rt-PCR positive while the pharyngeal swabs were negative. In one of these 2 cases, chest computed tomography (CT) was also negative for ground-glass opacities but showed a pulmonary abscess and pulmonary embolism.
Conclusion:
We recommend an expanded suspicion strategy for COVID-19 due to unexpected diagnostic outcomes. Personal protective equipment should be used in every resuscitation room operation due to unexpected cases and initial knowledge gaps. Furthermore, tracheal fluid should be tested for SARS-CoV-2 in every intubated patient due to cases with negative pharyngeal swabs and negative chest CT.
Bihemispheric posterior inferior cerebellar artery occurring with an azygos anterior cerebral artery: case study
Authors: Jamie Toms, Rishi Wadhwa, Sudheer Ambekar, Hugo Cuellar
Journal: Case Rep Radiol (2014)

Variations in intracranial vasculature are well known. We report a rare anatomic variation in a patient who underwent cerebral angiography for suspected intracranial aneurysm. Digital subtraction angiography revealed a bihemispheric posterior inferior cerebellar artery (PICA) and an azygous anterior cerebral artery (ACA). There was no evidence of any aneurysm or vascular abnormality. To our knowledge, this is the first reported case of a patient with a common PICA supplying both the cerebellar hemispheres and a common ACA supplying ACA territory bilaterally. It is important for the physician to be aware of these anatomical variations in order to differentiate a normal variant from a pathological condition.
Erysipelas on surgical scar: a case report
Authors: Asma Korbi, Ahmed Hajji, Hela Dahmani, Farouk Ennaceur, Haifa Bergaoui, Awatef Hajjaji, Raja Faleh
Journal: Pan Afr Med J (2020)
Keywords: case report, erysipelas, patey scar, post-operative
MeSH terms: Cicatrix / microbiology, Erysipelas / diagnosis, Surgical Wound Infection / diagnosis, Case Reports, Adenocarcinoma, Mucinous / surgery, Breast Neoplasms / surgery, Cicatrix / pathology, Erysipelas / etiology, Female, Humans, Mastectomy, Modified Radical / adverse effects, Middle Aged, Surgical Wound Infection / microbiology

Erysipelas is a non-necrotizing acute dermal hypodermatitis most often of streptococcal origin. It most often affects the lower limbs. Erysipelas on surgical scar has been rarely reported in the literature. Few cases have been published since the first descriptions of this pathological entity by Baddour et al in 1982. We report the case of a 47-year-old patient. Operated for right breast mucinous carcinoma, she had neo-adjuvant chemotherapy followed by a surgical treatment (Patey) which occured without incident. The evolution was marked by the appearance after 11 months of the intervention of an Erysipelas on Patey scar. The patient was put on cefazol for 7 days intravenously injectable. The evolution was marked by the complete disappearance of the rash and the edema.