OpenMed/multicare-articles huggingface dataset:
Gastric Siderosis and Ulceration from Intravenous Iron Supplementation Manifesting as Chronic Upper Gastrointestinal Bleeding: A Case Report and Review of the Literature
Authors: Donald Ewing, Ava Brozovich, Ethan Burns, Gonzalo Acosta, Courtney Hatcher, Pragnesh Patel, Rose Anton, Bincy Abraham, Leena Samuel
Journal: Case Rep Gastrointest Med (2019)
MeSH terms: Case Reports

Iron deficiency is the most common etiology of anemia worldwide and is often managed with varying methods of iron supplementation. Although rare, oral iron supplementation can perpetuate iron deficiency anemia by causing gastric ulceration and upper gastrointestinal bleeding in high-risk populations. However, this complication has not been previously described with intravenous iron supplementation. We present a case of a 63-year-old male with severe iron deficiency anemia on biweekly intravenous iron infusions and weekly packed red blood cell transfusions who presented with melena over several months. Upper endoscopy demonstrated a clean-based gastric body ulcer and nonbleeding gastric varices. Histology of the gastric ulcer was suggestive of iron-induced gastric mucosal injury. This case demonstrates that frequent utilization of intravenous iron and packed red blood cell transfusions may predispose certain patients to the development of iron-induced gastritis and ulceration.
Silent Bowels From a Silent Bite: A Rare Case of Paralytic Ileus Complicating Plasmodium falciparum Infection
Authors: Muhammad Ghallab, Mike Chung, Nicholas Zamora, Heng-Tien Aaron Lee, Natalie Balassiano, Salma Abdelmoteleb, Md Gulam Khan, Hazem Abosheaishaa, Kawser Ahmed
Journal: Cureus (2023)
MeSH terms: Case Reports

Malaria is a life-threatening, parasitic disease that continues to infect millions of people, especially in endemic regions. Despite advancements in malaria treatment, treating the disease remains challenging. One major challenge is identifying the disease from its unconventional manifestations. Therefore, recognizing its unusual clinical presentations is imperative in early detection and management with a better prognosis. This case report highlights the unique finding of paralytic ileus from a patient with confirmed malaria. Further investigation on the concurrence between paralytic ileus and malaria may aid in identifying the disease and subsequent improvement in treatment.
Delayed Adjacent Level Spondylodiscitis after Initial Surgery with Instrumented Spinal Fusion: A Report of Three Cases and Review of the Literature
Authors: Narihito Nagoshi, Masanobu Shioda, Etsuro Yorimitsu, Mitsuru Yagi
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

To date, 2 cases of adjacent level spondylodiscitis occurring a few months after initial spinal fusion were reported. However, the development of delayed adjacent level spondylodiscitis is very rare. The authors report 3 cases of spondylodiscitis that occurred at the proximal adjacent level of the fused spine more than 1 year after the initial surgery. Antibiotic treatment was initially chosen in all three cases. In two of the cases, progressive neurological deficit occurred at the level of the infection due to compression of neural elements and spinal instability. For these patients, additional spinal fusion was performed. In each of the three cases, the selected treatment resulted in successful bony fusion at the level of the spondylodiscitis. According to the National Nosocomial Infections Surveillance System, deep wound infection is defined as occurring within 1 year after surgery with instrumentation. The spondylodiscitis in the present cases occurred more than 1 year after the initial surgery, suggesting that these cases may be considered as adjacent segment disease rather than surgical site infection.
Blade of Grass as an Unusual Cause of Recurrent Facial Cutaneous Sinus Tract: A Clinical Case
Authors: Resmije Ademi-Abdyli, Feriall Perjuci, Teuta Bicaj, Yll Abdyli
Journal: Case Rep Dent (2016)

The presence of an embedded foreign body in the oral and maxillofacial region is not unusual, but the impaction of a foreign body with vegetative nature is rare. Prompt diagnosis and surgical removal of these foreign bodies will minimize their associated complications. This case report presents a patient with recurrent submandibular abscess and persistent facial cutaneous sinus tract caused by a retained blade of grass inside the facial soft tissue. The fact that the plain radiograph misdiagnosed the presence of a foreign body meant that the pathology persisted for about three months, and the patient underwent hospitalization, surgical procedures, and antibiotic regimens; however all of these failed until the foreign body was detected and removed. Conclusion. To avoid misdiagnosis of foreign body presence in the orofacial region, notably suspected foreign bodies with low radiopacity, the clinician must perform careful clinical examination and use the ultrasonography. Also, in the uncertain cases where the pathology persists, despite having undertaken surgical procedures and antibiotic regimens, the clinician should pay more attention to the patient's history which may suggest the presence of the foreign body.
Case report: Covered stent placement to treat delayed aneurysmal rupture after flow diverter-assisted coil embolization
Authors: Xiheng Chen, Siming Gui, Linggen Dong, Longhui Zhang, Huijian Ge, Peng Liu, Youxiang Li, Ming Lv
Journal: Front Neurol (2022)
Keywords: case report, delayed aneurysm rupture, flow diverter, intracranial aneurysm, subarachnoid hemorrhage
MeSH terms: Case Reports

Introduction:
Flow diverter (FD) placement is widely accepted as a treatment for large saccular intracranial aneurysms. Delayed aneurysmal rupture (DAR) after FD placement is potentially catastrophic and difficult to treat. To our knowledge, using a Willis covered stent (WCS) to treat DAR after placement of a Pipeline Flex embolization device (PFED) combined with coiling has not been previously reported.
Case presentation:
A 49-year-old woman with an incidental asymptomatic large right supraclinoid internal carotid artery aneurysm was treated with PFED placement and adjunctive coiling. DAR causing subarachnoid hemorrhage occurred 11 hours after the procedure. Treatment using a WCS was successful and resulted in a favorable clinical outcome (modified Rankin scale score 2).
Conclusion:
DAR after FD implantation requires isolation of the aneurysm from the cerebral circulation as soon as possible. WCS placement can achieve this immediately and occlude the aneurysm. We hope our case could provide new idea for similar cases in the future.
Septic arthritis following femoral neck fracture: A case report
Authors: Chulin Chewakidakarn, Anuchit Nawatthakul, Methasit Suksintharanon, Varah Yuenyongviwat
Journal: Int J Surg Case Rep (2019)
Keywords: case report, femoral neck fracture, septic arthritis, total hip replacement

Introduction:
Femoral neck fracture is common in the elderly, especially in the era of aging populations. Septic arthritis of the hip after femoral neck fracture is a rare complication. There are limited reports on this complication especially in patients without a severe medical condition and there is no consensus on the method of treatment of this complication.
Case presentation:
A 75-year-old male had right hip pain for two weeks after falling on his right hip. The patient was diagnosed as pathological fracture with hematologic malignancy. He was scheduled for bipolar hemiarthroplasty. However, an intraoperative finding found that the hip joint was filled with pus. The treatment was successful with a two-stage procedure. The first stage was implantation of an antibiotic cement spacer and the second stage was total hip replacement.
Conclusion:
Septic arthritis following femoral neck fracture is a complication which requires special attention for the diagnosis and treatment. Increasing hip pain or the developing signs of infection in patients awaiting surgery may indicate infection in the hip. The two-stage procedure is the treatment of choice in this condition.
The role of anterior segment optical coherence tomography in the management of an intra-corneal foreign body
Authors: Ali Riza Cenk Celebi, Ayse Ebru Kilavuzoglu, Ugur Emrah Altiparmak, C Banu Cosar, Abdullah Ozkiris
Journal: Springerplus (2016)
Keywords: anterior segment, cirrus sd-oct, cornea, foreign body removal, spectral domain optical coherence tomography

Introduction:
Corneal foreign bodies are reported to be the second most common type of ocular injury. Anterior segment optical coherence tomography (AS-OCT) is a valuable tool for the early diagnosis and monitoring the progress of treatment in cases of ocular trauma. Herein we aimed to report on a patient with an intra-corneal foreign body and the role of AS-OCT in management.
Case presentation:
A 34-year-old male presented with foreign body sensation in his left eye. Slit-lamp biomicroscopic examination revealed a peripherally located intrastromally embedded foreign body with a free anterior edge extending outwards from the cornea. It was not possible to visualize the foreign body's entire route through the cornea because of localized corneal edema. AS-OCT showed shadowing of the corneal layers corresponding to the location of the corneal foreign body. A hyper-reflective lesion was observed close to the inside edge of the foreign body in the cornea, indicating that the foreign body had not completely penetrated the cornea. The foreign body was removed via the external route, as it had not completely penetrated the cornea. During the postoperative period the patient was asymptomatic, although the left eye's cornea healed with scar tissue.
Discussion and evaluation:
AS-OCT facilitates non-invasive rapid imaging of ocular tissue at va rious depths, thereby providing accurate assessment of foreign body characteristics.The location of an intracorneal foreign body and the status of the surrounding ocular structure dictate the optimal surgical technique to be employed.
Conclusions:
AS-OCT in the present case facilitated localization and determination of the size of a corneal foreign body. In addition, AS-OCT findings assisted in selection of the appropriate surgical intervention.
Spondylodiscitis occurring after diagnostic lumbar puncture: a case report
Authors: Mehmet Sabri Gürbüz, Mehmet Zafer Berkman
Journal: Case Rep Infect Dis (2013)

Spondylodiscitis is a rare disease which is generally seen after long-term epidural catheterization. However, spondylidiscitis developing after diagnostic lumbar puncture is very rare. Early diagnosis has a crucial role in the management of the disease and inclines the morbidity rates. However, the diagnosis is often delayed due to the rarity and insidious onset of the disease usually presenting with low back pain which has a high frequency in the society. If it is diagnosed early before development of an abscess requiring surgery or neurological deficit, it responds to antimicrobial therapy quite well. We report 66-year-old male case of spondylodiscitis developing after diagnostic lumbar puncture. The patient was treated with antimicrobial therapy. After antimicrobial therapy, findings of spondylodiscitis were completely resolved and no recurrence was seen in the period of 9-month followup.
Membranous nephropathy with solitary polyclonal IgA deposition: A case report and literature review
Authors: Masato Sawamura, Atsushi Komatsuda, Hajime Kaga, Ayano Saito, Tadashi Yasuda, Hideki Wakui, Kensuke Joh, Naoto Takahashi
Journal: Clin Nephrol Case Stud (2019)
Keywords: membranous nephropathy, rare disease, solitary polyclonal iga deposition

A 60-year-old man presented with nephrotic syndrome (NS). Light microscopy of renal biopsy specimens showed minor glomerular abnormalities, while immunofluorescence microscopy revealed solitary polyclonal granular IgA deposition along the glomerular capillary walls. Electron microscopy showed small amounts of electron-dense deposits in the subepithelial area, but not in the mesangial area. In this patient, apparent underlying disease was not found during the 3-year follow-up, and low-dose prednisolone was effective in the treatment of NS. To our knowledge, there is only one case report of membranous nephropathy with clinicopathological features similar to our case.
Double Bolus Alteplase Therapy during Cardiopulmonary Resuscitation for Cardiac Arrest due to Massive Pulmonary Embolism Guided by Focused Bedside Echocardiography
Authors: Hafiz B Mahboob, Bruce W Denney
Journal: Case Rep Crit Care (2018)
MeSH terms: Case Reports

Massive pulmonary embolism (PE) frequently leads to cardiac arrest (CA) which carries an extremely high mortality rate. Although available, randomized trials have not shown survival benefits from thrombolytic use. Thrombolytics however have been used successfully during resuscitation in clinical practice in multiple case reports and in retrospective studies. Recent resuscitation guidelines recommend using alteplase for PE related CA; however they do not offer a standardized treatment regimen. The most consistently applied approach is an intravenous bolus of 50 mg tissue plasminogen activator (t-PA) early during cardiopulmonary resuscitation (CPR). There is no consensus on the subsequent dosing. We present a case in which two 50 mg boluses of t-PA were administered 20 minutes apart during CPR due to persistent hemodynamic compromise guided by bedside echocardiogram. The patient had an excellent outcome with normalization of cardiac function and no neurologic sequela. This case demonstrates the benefit of utilizing bedside echocardiography to guide administration of a second bolus of alteplase when there is persistent hemodynamic compromise despite achieving return of spontaneous circulation after the initial bolus, and there is evidence of persistent right ventricle dysfunction. Future trials are warranted to help establish guidelines for thrombolytic use in cardiac arrest to maximize safety and efficacy.
Case Report: First Case of Cefotaxime-Sulbactam-Induced Acute Intravascular Hemolysis in a Newborn With ABO Blood Type Incompatibility by the Mechanism of Non-Immunologic Protein Adsorption
Authors: Yuanjun Wu, Yong Wu, Yong Yang, Baochan Chen, Jianqun Li, Ganping Guo, Fu Xiong
Journal: Front Immunol (2021)
Keywords: acute intravascular hemolysis, cefotaxime, drug-induced immune hemolytic anemia (diiha), hemolytic disease of newborn (hdn), non-immunologic protein adsorption (nipa), sulbactam
MeSH terms: ABO Blood-Group System / immunology, Anemia, Hemolytic / chemically induced, Blood Group Incompatibility / complications, Cefotaxime / adverse effects, Erythroblastosis, Fetal / etiology, Hemolysis, Immunoglobulin G / immunology, Isoantibodies / immunology, Sulbactam / adverse effects, Case Reports, Research Support, Non-U.S. Gov't, Acute Disease, Adsorption, Anemia, Hemolytic / blood, Antigen-Antibody Reactions, Blood Group Incompatibility / blood, Cefotaxime / administration & dosage, Complement Activation, Coombs Test, Erythroblastosis, Fetal / blood, Erythrocyte Membrane / chemistry, Erythrocyte Membrane / immunology, Fatal Outcome, Female, Humans, Infant, Newborn, Male, Maternal-Fetal Exchange, Pregnancy, Sulbactam / administration & dosage, Young Adult, ABO Blood-Group System, Immunoglobulin G, Isoantibodies, Cefotaxime, Sulbactam

Background:
ABO blood type incompatibility hemolytic disease of newborn (ABO-HDN) and drug-induced immune hemolytic anemia (DIIHA) due to non-immunologic protein adsorption (NIPA) mainly cause extravascular hemolysis. All the reported severe DIIHA were caused by drug-induced antibodies, and rare report of acute intravascular hemolysis was caused by the NIPA mechanism or ABO-HDN.
Case presentation:
We report the first case of acute intravascular hemolysis induced by cefotaxime sodium - sulbactam sodium (CTX - SBT) in a case of ABO-HDN which resulted in death at 55 h after birth. The mother's blood type was O and RhD-positive, and the newborn's blood type was B and RhD-positive. No irregular red blood cell (RBC) antibodies or drug-dependent antibodies related to CTX or SBT was detected in the mother's plasma and the plasma or the RBC acid eluent of the newborn. Before the newborn received CTX - SBT treatment, the result of direct antiglobulin test (DAT) was negative while anti-B was positive (2 +) in both plasma and acid eluent. After the newborn received CTX - SBT treatment, the results of DAT for anti-IgG and anti-C3d were both positive, while anti-B was not detected in plasma, but stronger anti-B (3 +) was detected in acid eluent. In vitro experiments confirmed that NIPA of SBT promoted the specific binding of maternal-derived IgG anti-B to B antigen on RBCs of the newborn, thereby inducing acute intravascular hemolysis.
Conclusion:
The NIPA effect of SBT promoted the specific binding of mother-derived IgG anti-B in newborn's plasma to the newborn's RBC B antigens and formed an immune complex, and then activated complement, which led to acute intravascular hemolysis. Drugs such as SBT with NIPA effect should not be used for newborns with HDN.
Solitary Osteochondroma of the Ventral Scapula Associated with Large Bursa Formation and Pseudowinging of the Scapula: A Case Report and Literature Review
Authors: Kiyohisa Ogawa, Wataru Inokuchi
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Osteochondroma (OC) is the most common benign bone tumor and may occur on any bone in which endochondral ossification develops. Although scapular OC accounts for less than 5% of the cases of solitary OC, OC is the most common lesion among the tumors and tumor-like lesions of the scapula. OC that develops near the medial scapular border easily causes friction with the ribcage; hence, almost half the number of cases of OC associated with marked bursa formation develops in the ventral scapula. We report a case of a 27-year-old female with a painful OC of the ventral scapular surface associated with large bursa formation and pseudowinging of the scapula. After l2 years of follow-up with magnetic resonance imaging, we confirm that the accompanied bursa left at surgery disappears.
The challenging diagnosis of food protein-induced enterocolitis syndrome: A case report series
Authors: Caiyan Zhao, Ling Chen, Jinzhi Gao
Journal: Front Pediatr (2022)
Keywords: ige, atypical, cow’s milk protein allergy (cmpa), food protein-induced enterocolitis syndrome (fpies), neonate
MeSH terms: Case Reports

Food protein-induced enterocolitis syndrome (FPIES) is a type of non-immunoglobulin E (IgE)-mediated food allergy. However, in addition to vomiting and diarrhea, IgE-mediated skin or respiratory symptoms may be comorbidities in some patients with FPIES. We described four unusual cases of neonates with FPIES, whose clinical presentations were variable and misleading. All patients experienced vomiting, diarrhea or other gastrointestinal symptoms, and three of them developed IgE-mediated food allergy. Case 1 was admitted to the hospital with convulsions and then developed severe sepsis and necrotizing enterocolitis (NEC)-like appearance. Case 2 was wrongly diagnosed with Stevens-Johnson syndrome due to a severe extravasation rash of the skin and mucous membranes and a systemic inflammatory response. There was unexplained cholestasis in case 3, which might be attributed to food allergy. Asymptomatic elevation of C-reactive protein was the only hint at early-stage FPIES in case 4. Moreover, there were increased serum food-specific IgG values in three of the above cases. After eliminating the offending food, all of the above clinical manifestations rapidly improved in the four cases; thus, we believe that the most correct diagnosis in the described four cases was FPIES. This case report series should further draw clinicians' attention to FPIES with variable and atypical symptoms. The usefulness of IgG levels in identifying the presence of FPIES is uncertain.
Mucocele of the glands of Blandin-Nuhn: a case report
Authors: Nathalia Garcia Leon, Gilberto E Marrugo Pardo
Journal: Colomb Med (Cali) (2013)
Keywords: blandin nuhn glands, mucocele

Mucoceles arising from the Blandin Nuhn glands are uncommon benign lesions of the oral cavity, which by their clinical presentation may be confused with more serious diseases such as vascular lesions, pyogenic granulomas, polyps, or squamous papillomas; thereby, it is convenient to be aware of the characteristics of this entity to guide the accurate and timely diagnosis and treatment. Herein, we present a case of a 10-year-old patient with a recurrent lesion of this type, which required surgical excision and marsupialization of the same, with no evidence of recurrence during follow-up.
Case Report: Combined Intravenous Infusion and Local Injection of CAR-T Cells Induced Remission in a Relapsed Diffuse Large B-Cell Lymphoma Patient
Authors: Linhui Hu, Fan Wu, Huiping Wang, Weiwei Zhu, Juan Wang, Fengxiang Yu, Zhimin Zhai
Journal: Front Immunol (2021)
Keywords: case report, chimeric antigen receptor t cell therapy, diffuse large b-cell lymphoma, extranodal disease, local injection
MeSH terms: Immunotherapy, Adoptive / methods, Lymphoma, Large B-Cell, Diffuse / therapy, Receptors, Chimeric Antigen / administration & dosage, Receptors, Chimeric Antigen / immunology, Case Reports, Research Support, Non-U.S. Gov't, Female, Humans, Infusions, Intravenous, Lymphoma, Large B-Cell, Diffuse / pathology, Middle Aged, Remission Induction, Treatment Outcome, Receptors, Chimeric Antigen

Relapsed diffuse large B-cell lymphoma (DLBCL) is a disease with a poor prognosis. Recent clinical trials results showed chimeric antigen receptor (CAR) T cell therapy has a promising role in treating relapsed DLBCL. Unfortunately, patients with extranodal lesions respond poorly to CAR-T cells administered intravenously. Herein, we evaluated the efficacy and safety of a new treatment strategy of CAR-T cells, combining intravenous infusion with local injection of CAR-T cells, in a relapsed DLBCL patient with extranodal lesions. The patient achieved durable remission and without severe adverse effects after CAR-T cells treatment. During the follow-up period of one year, the patient remained in good condition. In conclusion, combining intravenous injection with a local injection for CAR-T cell is a feasible strategy for relapsed DLBCL patients with extranodal lesions.
Intraoperative Complications of Cataract Surgery Using Intracameral Illumination in the Elderly over 75 Years
Authors: Yu Jeong Kim, Su Jin Park, Jong Yeon Lee, Dae Yeong Lee, Dong Heun Nam
Journal: J Ophthalmol (2019)

Purpose:
To evaluate intraoperative complications and utilization of adjunctive devices between microscope and intracameral illuminations during cataract surgery in the elderly over 75 years.
Design:
A retrospective, consecutive, interventional case series Participants. Two hundred eighty-six eyes of 184 patients older than 75 years who underwent cataract surgery using microscope and intracameral illuminations.
Methods:
A chart review was performed on an advanced cataract surgery group of 141 consecutive cases in which the intracameral illumination was used and on a standard cataract surgery group of 145 consecutive cases in which the intracameral illumination was not used.
Main outcome measures:
Intraoperative complications (posterior capsule rupture, radial tear of the anterior capsule, dropped nucleus, or sulcus-implanted/sclera-fixated IOL) and utilization of adjunctive devices (pupil expansion device or anterior capsule staining).
Results:
The frequency of use of the pupil expansion device was lower in the advanced cataract surgery group than that in the standard cataract surgery group (0.7% vs 6.9%; p=0.007). Furthermore, the rates of a posterior capsule rupture and at least one intraoperative complication were lower in the advanced cataract surgery group than those in the standard cataract surgery group (0.7% vs 4.8%; p=0.067) (0.7% vs 7.6%; p=0.004).
Conclusions:
In the current cohort of patients over 75 years, the rate of intraoperative complications was lower when using the intracameral illumination than that when using the conventional method. Cataract surgery using intracameral illumination would be good option for elderly people.