OpenMed/multicare-articles huggingface dataset:
Prophylactic Use of Uterine Artery Embolization to Decrease Bleeding in Laparoscopic Myomectomy: A Case Report
Authors: Swarnima Lunge Patil, Apoorva Dave, Kamlesh Chaudhari
Journal: Cureus (2024)
Keywords: hysterectomy, interventional radiologists, laparoscopic myomectomy, leiomyoma, uterine artery embolization
MeSH terms: Case Reports

Uterine fibroids, or leiomyomas, are the most frequent benign tumors affecting the female reproductive system, particularly during the reproductive years. The case report that follows presents the diagnosis and treatment of uterine fibroids in a female patient. The 33-year-old female patient in this instance arrived at the tertiary rural hospital with an abnormally large, bloated belly. Upon examination and imaging, it was discovered that the patient had multiple fibroids growing inside her uterus. Here, we present a successful management of uterine leiomyoma with laparoscopic myomectomy where we performed uterine artery embolization before surgical management in order to minimize blood loss during surgery. The case highlights the significance of collaboration between gynecologists, surgeons, and interventional radiologists. Thanks to their combined expertise, the patient was given a variety of treatment options, such as minimally invasive treatments, surgical interventions, and medication therapy. Decision considerations included the consequences of fibroids and the patient's age and desire to preserve fertility. The effect of fibroids on her life expectancy is taken into account. This case emphasizes how important it is to embolize the uterine arteries before having a myomectomy to cure large uterine leiomyomas successfully.
Treatment of multisegmental vertebral compression, burst fractures, and sandwich vertebra with severe osteoporosis using the PKP technique: a case report and literature review
Authors: Bo Han, Daming Pang, Yong Hai, Jincai Yang, Zhexuan Fan, Haifeng Gao, Peng Yin
Journal: Front Neurol (2023)
Keywords: burst fracture, multisegmental vertebral compression fracture, osteoporosis, percutaneous kyphoplasty, sandwich vertebra
MeSH terms: Case Reports

This study aimed to present a special case of treatment of a patient with multisegmental vertebral compression fracture, burst fracture, and sandwich vertebra and to review the literature on this condition. An 85 year-old female presented with severe low back pain but no radiating pain in the lower extremities. The patient was diagnosed with T12 and L5 vertebral compression fractures, fresh vertebral burst fractures in L2 and L3, and osteoporosis. The focus was on formulating a surgical treatment strategy. At the 12 month follow-up, no neurological deficits were observed, and the chosen surgical treatment approach yielded favorable clinical outcomes. A comprehensive literature review indicates that percutaneous kyphoplasty (PKP) can effectively alleviate pain and ensure safety in managing osteoporotic vertebral burst fractures. While complications remain a theoretical risk, they can be mitigated through meticulous assessment, careful surgical procedures, and appropriate preventive measures. PKP is an effective and safe treatment modality for osteoporotic vertebral burst fractures. Conservative management of sandwich vertebrae can yield positive clinical outcomes, but regular anti-osteoporosis treatment is necessary.
A post-transplant infection by Nocardia cyriacigeorgica
Authors: Nageswari Gandham, Sriram Kannuri, Aryan Gupta, Sahjid Mukhida, Nikunja Das, Shahzad Mirza
Journal: Access Microbiol (2023)
Keywords: nocardia cyriacigeorgica, nocardiosis, opportunistic infection, renal transplantation
MeSH terms: Case Reports

Nocardia are Gram-positive, acid-fast, filamentous bacteria that cause opportunistic infections in susceptible populations. We describe a case of post-transplant infection of pulmonary nocardiosis caused by the rare strain Nocardia cyriacigeorgica and the challenges faced in reaching a definitive diagnosis. This case report emphasizes on keeping nocardiosis as a differential diagnosis in transplant recipients, as this disease is largely underdiagnosed and underreported.
Dilemma of Thrombolysis in a patient with high-risk Pulmonary Embolism with severe Thrombocytopenia: A case report
Authors: Phool Iqbal, Mhd Baraa Habib, Ahmed Hatim, Mohammed Alkhatib, Muhammad Abu Bakar, Sunil Hassan Koya, Awni Alshurafa, Habib Ur Rehman
Journal: Qatar Med J (2024)
Keywords: high-risk pe, lymphoma, severe thrombocytopenia, thrombolysis
MeSH terms: Case Reports

Background:
Managing a high-risk pulmonary embolism (PE) in a critically ill patient with severe thrombocytopenia can present a challenging dilemma. There is a high risk of fatal bleeding due to anticoagulation in high-risk PE with thrombocytopenia; therefore, risks and benefits are balanced while dealing with such a critical scenario.
Case report:
We present a case of a female patient with thrombocytopenia who was admitted for management of lymphoma. Her hospital course was complicated by high-risk PE, leading to acute respiratory failure and hypotension, necessitating urgent transfer to the medical intensive care unit. She was intubated and placed on mechanical ventilation. Multiple cardiac arrests occurred due to compromised cardiac output from a severely dilated right ventricle on bedside transthoracic echocardiography. As a last resort to save her life in this critical state and severe thrombocytopenia, she was given a half bolus dose of the recommended drug, i.e., 50mg IV of Alteplase. Subsequently, she stabilized and was extubated without any further complications.
Discussion:
High-risk PE needs prompt management with anticoagulation to avoid fatal outcomes. However, on the other hand, anticoagulation carries a high risk of bleeding, especially in patients with thrombocytopenia. These challenges prompt a modern perspective in situations where clear guidelines are absent.
Conclusion:
We aim to discuss our contemporary clinical practice in managing such a complex case and highlight the need for further studies.
Case Report: Mutation in TNNI3(c. 544G>A): a novel likely pathogenic mechanism of neonatal dilated cardiomyopathy
Authors: Xianhong Li, Liying Dai, Jian Zhang
Journal: Front Pediatr (2023)
Keywords: tnni3, dilated cardiomyopathy, neonate, novel mutation, pathogenic mechanism
MeSH terms: Case Reports

Background:
Dilated cardiomyopathy (DCM) is a rare disease that causes heart failure due to malfunction of the heart muscle characterized by left ventricular dilation and poor systolic function. Genetic screening leads to advantages in early diagnosis and prognostic assessment of patients with suspected inherited cardiomyopathies. Here, we report a case of neonatal dilated cardiomyopathy due to a mutation of the TNNI3 gene, which has not been published in neonatal dilated cardiomyopathy before.
Case presentation:
The patient was a 22-day-old newborn boy with poor ability to respond to stimuli, presenting with shortness of breath over 11 days. He presented with irregular fever, tachypnea, difficulty in ventilator withdrawal, and mild edema of both lower limbs, and III/6SM could be heard in the precardiac area. He presented repeated weaning difficulties during hospitalization with intractable low EF heart insufficiency. Doppler echocardiography showed refractory low ejection fraction, cardiac enlargement, cardiac insufficiency, mild pulmonary hypertension, and mitral and tricuspid insufficiency with mild valve regurgitation. Whole-exome sequencing showed a mutation in the TNNI3 gene, c. 544G>A (p.Glu182Lys). Thus, he was diagnosed with neonatal DCM. There was no mutation in the parents, the child died 2 weeks after discharge.
Conclusions:

TNNI3 mutation is a novel likely pathogenic mechanism of neonatal dilated cardiomyopathy. Therefore, systematic use of diagnostic tools, advanced risk models, and a deeper understanding of the mechanism are required to reduce morbidity and mortality in this disease.
MR-guided focused ultrasound thalamotomy for lithium-induced tremor: a case report and literature review
Authors: Kate Gelman, Joseph Melott, Vishal Thakur, Abdul R Tarabishy, Ana Brandt, Peter Konrad, Manish Ranjan, Adeel A Memon
Journal: Front Neurol (2024)
Keywords: mr-guided focused ultrasound (mrgfus), case report, high-intensity focused ultrasound (hifu), lithium, tremor
MeSH terms: Case Reports

Drug-induced tremor is a common side effect of lithium with an occurrence of approximately 25% of patients. Cessation of the offending drug can be difficult, and many medical treatments for drug-induced tremor are ineffective. Deep brain stimulation (DBS) has been shown in a limited number of case reports to effectively reduce drug-induced tremor, however, which remains an invasive therapeutic option. MR-guided focused ultrasound (MRgFUS) thalamotomy is an FDA-approved non-invasive treatment for essential tremor (ET). To the best of our knowledge, MRgFUS thalamotomy has never been reported to treat drug-induced tremor. Here, we present a case of a left-handed 55-year-old man with a progressive, medically refractory lithium-induced tremor of the bilateral upper extremities. The patient underwent MRgFUS thalamotomy targeting the right ventral intermediate nucleus (VIM) of the thalamus to treat the left hand. There was almost complete resolution of his left-hand tremor immediately following MRgFUS. There were no side effects. The patient continues to show excellent tremor control at 90-day follow-up and remains free from side effects. This case demonstrates MRgFUS thalamotomy as a possible novel treatment option to treat drug-induced tremor.
Case report: Heart transplant for persistent right heart failure after complete surgical repair and percutaneous closure of post-myocardial infarction ventricular septal rupture
Authors: Pankaj Garg, Amy Lykins, Mohammad Alomari, Peter Pollak, Parag Patel, Basar Sareyyupoglu
Journal: Front Cardiovasc Med (2023)
Keywords: acute myocardial infarction, cardiogenic shock, heart failure, heart transplant, mechanical circulatory support, right heart failure, structural heart disease, ventricular septal rupture
MeSH terms: Case Reports

The incidence of post-acute myocardial infarction ventricular septal rupture (post-AMI VSR) has decreased; however, mortality after surgical repair of post-AMI VSR remains high. Patients who are not surgical candidates can be managed by heart transplant with a good outcome. A heart transplant in a patient after successful repair of VSR has never been reported. We report a patient who had persistent right heart failure after the successful repair of VSR and underwent a heart transplant with a good outcome.
Case report: One case of acute myeloid leukemia M3 with atypical morphology
Authors: Fa-Sheng Liu, Hua-Liang Huang
Journal: Front Oncol (2024)
Keywords: acute promyelocytic leukemia, atypical, chromosome analysis, diagnosis, flow cytometry
MeSH terms: Case Reports

Acute promyelocytic leukemia (APL) is a type of acute myeloid leukemia. About 2% of APL is characterized by atypical rearrangements. Here we reported one APL case with atypical manifestations and morphology. A 35-year-old woman patient, mainly due to fatigue, poor appetite for over 10 days and intermittent fever for 3 days. combined with the results of flow cytometry, fusion gene and chromosome, the patient was diagnosed as AML-M3 with atypical morphology. Double induction therapy with retinoic acid and arsenous acid was immediately administrated. Idarubicin was administrated on the 18th day. A re-examination was performed in the 5th week, both the blood routine test and myelogram showed normal results, and the fusion gene turned negative, indicating complete remission. When atypical morphology occurs, peripheral blood POX staining may be performed to check the abnormal cells. Flow cytometry, chromosome analysis, and fusion gene analysis are also required for further diagnosis.
Rapidly progressive locked-in syndrome secondary to atypical herpes simplex virus-1 rhombencephalitis in an immunocompromised individual
Authors: Jeffrey Xia, Rasha Ahmed
Journal: IDCases (2024)
Keywords: chronic lymphocytic leukemia, encephalitis, herpes simplex virus, infectious disease, locked-in, magnetic resonance imaging, neurology
MeSH terms: Case Reports

HSV-1 encephalitis (HSE) is the most common cause of fatal sporadic encephalitis in the United States. HSE in adults is most commonly due to the reactivation of HSV in the central nervous system (CNS) which results in CNS necrosis leading to neurological compromise. The most common symptoms include altered mentation, fever, seizures, and focal neurological deficits. HSE most commonly involves damage to the temporal lobes however can rarely involve other CNS structures such as the brainstem and cerebellum. Immunocompromised status may increase the risk of atypical HSE. HSE involvement of the brainstem, particularly the pons, most commonly cause neuro-ocular and neuro-bulbar deficits. Rarely can HSV brainstem encephalitis cause quadriplegia or locked-in syndrome. We present a case of HSV-1 rhombencephalitis complicated by locked-in syndrome in a patient with CLL.
Bilateral Subinternal Limiting Membrane Crystalline Deposits Secondary to Terson Syndrome
Authors: Anfisa Ayalon, Eran Greenbaum, Lily Okrent Smolar, Alexander Rubowitz
Journal: Case Rep Ophthalmol Med (2024)
MeSH terms: Case Reports

Background:
We report the case of bilateral, subinternal limiting membrane crystalline deposits in a patient with Terson syndrome, describe the possible pathogenesis, and highlight management. Case Presentation. A 24-year-old male with a history of traumatic massive parenchymal and subdural frontal hemorrhage presented to our clinic seven months after a motor vehicle accident, prolonged hospitalization, and rehabilitation, complaining of decreased vision in both eyes. The Snellen visual acuity was 1/60 in the right eye, and 6/60 in the left eye. Fundus examination showed an organized white vitreous hemorrhage in both eyes with almost no view of the retina. The anterior segments were normal. He underwent a 25-gauge pars plana vitrectomy in both eyes. During the surgery, golden crescent-shaped sediment consisting of small crystals was observed under the internal limiting membrane in both eyes: anterior to the inferior temporal vascular arcade in the right eye and posterior to it in the left eye. Internal limiting membrane (ILM) peeling after staining with ILM-blue dye was performed in the left eye, where the finding involved the macula. One year after the surgery, visual acuity significantly improved to 6/8.5 on the right and 6/6 on the left. Epiretinal membrane formation was observed in the right eye, where ILM peeling was not performed.
Conclusion:
Subinternal limiting membrane crystalline deposit finding is a rare condition. Consider performing internal limiting membrane peeling and sediment removal in cases with macular involvement. In cases where crystals are concentrated outside of the macula, follow-up may be considered.
Uterine Rupture Secondary to Pyomyoma, Leading to Intra-Abdominal Abscesses following an Uncomplicated Vaginal Delivery
Authors: Rachel Hartman, Olga Colón-Mercado, Valario Johnson, James Baron, Lauren Davis
Journal: Case Rep Obstet Gynecol (2023)
MeSH terms: Case Reports

Background:
Pyomyomas are an infrequent complication of uterine fibroids and, in extremely rare cases, the cause of spontaneous uterine rupture. A few documented cases were managed conservatively with oral antibiotics and CT-guided drainage or myomectomy with fertility preserved. However, treatment more frequently involves IV antibiotics and a hysterectomy. Case Description. A 31-year-old G2P0111 PPD 7 presented with intra-abdominal abscesses of unknown source. She was treated with broad-spectrum antibiotics, image-guided percutaneous (IR) drainage of the largest abscess, and surgical exploration with debridement. During surgery, she was diagnosed with spontaneous uterine rupture. The uterine defect was successfully repaired, and she was able to be successfully managed with fertility-sparing treatment. The patient ultimately did not require a hysterectomy. The final pathology was consistent with pyomyoma.
Conclusion:
In a majority of cases, pyomyoma treatment requires a hysterectomy, and fertility is unable to be preserved. However, conservative management with IV antibiotics, IR drainage, and surgical debridement could be a fertility-preserving approach to the treatment of pyomyomas.
Intrapelvic Cup Migration Following Revision Total Hip Arthroplasty: A Case Report and Review of the Literature
Authors: Spyridon Papagiannis, George Sinos, Christiana Kotsia, Irini Tatani, Panagiotis Megas
Journal: Cureus (2024)
Keywords: complication, cup protrusion, intrapelvic migration, revision, total hip arthroplasty, total hip arthroplasty revision
MeSH terms: Case Reports

Intrapelvic acetabular cup migration is a rare but serious complication that can occur following either primary or revision total hip arthroplasty. Medial acetabular wall weakening is considered the main predisposing factor for acetabular protrusion. A thorough preoperative plan is essential to advocate proper pelvic anatomy reconstruction, including osteosynthesis of the pelvis, if necessary, preservation of muscle and bone stock, and selection of the right prosthetic components without damaging adjacent anatomical structures. We present a rare case of an 84-year-old woman with a hip dislocation and complete intrapelvic migration of the acetabular component, nine years after her second revision surgery of a hip prosthesis placed 60 years ago due to congenital hip dysplasia. The protruded acetabulum was not removed since preoperative CT and digital subtraction angiography (DSA) revealed no vascular compromise. A non-cemented, tantalum acetabular cup, reinforced by a short flange titanium acetabular cage, was placed with a cemented, polyethylene-bearing surface, which was revised to a cemented, constrained acetabular insert three months postoperatively due to dislocation after mobilization on the bed. We conducted a literature review to elucidate the causes, proper diagnostic tools, and preoperative planning of this rare occurrence while trying to evaluate a potential treatment protocol.
A case of left atrial intimal sarcoma with rhabdomyosarcoma differentiation: a case report and literature review
Authors: Hongyun Shu, Duan Xiao, Sisi Han, Yongkang Du, Jinduan Lin, Qiaowen Li
Journal: Front Oncol (2024)
Keywords: diagnosis, intimal sarcoma, primary cardiac tumors, rhabdomyosarcoma, treatment
MeSH terms: Case Reports

Primary cardiac malignancies are rare, with cardiac sarcomas being the main type. Among these, intimal sarcomas are the most common. However, they tend to occur in the great vessels and are rare in the heart, with only a few isolated cases reported. We report a challenging case of a patient with left atrial intimal sarcoma with rhabdomyosarcoma differentiation. The patient was admitted after a physical examination detected left heart occupancy, and initial imaging suspected a left atrial thrombus. The patient then underwent extracorporeal circulation-assisted open cardiac surgery with resection of an atrial mass. The postoperative pathological findings were suggestive of an arterial intimal sarcoma, which included areas of rhabdomyosarcoma differentiation within the tumor tissue. Unfortunately, the patient's tumor recurred 4 months later, and she died due to treatment failure. This case highlights the rarity and risk of misdiagnosis of cardiac intimal sarcoma. Additionally, we aim to improve the understanding of intimal sarcoma through a review of immunohistochemistry and gene amplification techniques.
Dyskinesia-hyperpyrexia syndrome in Parkinson's disease triggered by overdose of levodopa - a case report and literature review
Authors: Xiangnan Du, Xuemei Wang, Xiaokun Geng
Journal: Front Neurol (2024)
Keywords: parkinson's disease, acute hyperpyrexia syndrome, dyskinesia, hyperpyrexia, treatment
MeSH terms: Case Reports

Dyskinesia-hyperpyrexia syndrome, a rare medical emergency in Parkinson's disease, is first described in 2010. It is characterized by severe continuous dyskinesia associated with rhabdomyolysis, hyperthermia and subsequent alteration of the mental state. Gradual reduction of dopaminergic dose or DBS is recommended treatment. The prognosis is usually good, but sometimes fatal. But so far, this potentially fatal complication is not widely recognized by clinicians. In emergency, if clinicians fail to make prompt diagnosis and treatment, patients' conditions may get worse, and their lives may be threatened in serious cases.
Anesthetic Challenges Associated With Posterior Reversible Encephalopathy Syndrome in a Pregnant Woman Scheduled for a Caesarean Section
Authors: Vivek Chakole, Jui A Jadhav, Shrilekh Mankhair, Sambit Dash
Journal: Cureus (2024)
Keywords: eclampsia, lscs, posterior reversible encephalopathy syndrome, spinal anesthesia, sub arachnoid blockage
MeSH terms: Case Reports

Recently, there has been a rise in reports of posterior reversible encephalopathy syndrome (PRES), which is an uncommon neurologic illness. The precise cause of PRES syndrome is yet unknown, but there are certain illnesses that have been associated with it. Furthermore, because of advances in imaging methods and growing awareness, the connection between PRES and pre-eclampsia/eclampsia is becoming increasingly recognised. Pre-eclampsia/eclampsia by itself poses distinct perioperative difficulties; in addition, PRES makes anesthesia administration more difficult. Regretfully, there is a lack of knowledge regarding the anesthetic treatment provided to the extremely sick and medically complex patients, and it is uncertain whether the chosen anesthetic might exacerbate neurologic problems. Here, we discuss the implications for the anesthetic management of PRES presentations.
Life-Threatening Anaphylaxis due to Cerebrolysin®
Authors: Helmut Trimmel, Wolfgang Tauber, Martin Zikeli
Journal: Case Rep Neurol Med (2024)
MeSH terms: Case Reports

In this case report, we describe a well-documented, severe anaphylactic reaction after intravenous administration of cerebrolysin, a neurotrophic agent derived from highly purified porcine brain tissue, consisting of peptides and free amino acids. Cerebrolysin has been in use for decades, in various neurological diseases, but especially stroke and traumatic brain injury, with the aim of enhancing cognitive performance. After administration of cerebrolysin to an 85-year-old male patient suffering from subacute stroke, he developed a fulminant anaphylactic reaction. Following institutional standards, vital functions were quickly restored. The anaphylactic reaction was clearly confirmed by laboratory tests. To date, only rare cases of anaphylaxis due to cerebrolysin have been published in the literature. The current report is intended to raise awareness for the possibility of such a reaction, given the widespread use of cerebrolysin in several indications in mostly critical patients. The case shows how a completely unexpected life-threatening situation can be successfully treated by targeted measures, if the situation is recognized quickly. In light of this event, we consider pathophysiology of allergic reactions and treatment guidelines.
Lanthanum Gastropathy in Gastrectomy Specimen: A Case Report
Authors: Erika M Dorff, Sarah Y Liu, Wasef Abu-Jaish, Amer K Abu Alfa
Journal: Gastro Hep Adv (2024)
Keywords: end-stage renal disease, gastropathy, histiocyte, lanthanum carbonate
MeSH terms: Case Reports

Lanthanum carbonate (LC) is a phosphate binder used in end-stage renal disease (ESRD) with few adverse effects due to poor systemic absorption. Gastrointestinal deposition is likely due to alterations in epithelial permeability from inflammation in ESRD. It is challenging to detect in cases with minimal deposition and may be missed on endoscopy and biopsy. A 36-year-old with ESRD who was evaluated for gastrectomy was found to have LC deposition histologically. Years later, the excised portion had similar findings. This case allows for evaluation of LC gastropathy in a resection specimen, providing the opportunity to showcase its unique pathology features.