OpenMed/multicare-articles huggingface dataset:
Case Report: Endovascular Treatment of a Giant Distal PICA Aneurysm in Association With a Cerebellar AVM: A Report on Treatment Considerations and a Literature Review
Authors: Hassan A Khayat, Christine M Hawkes, Almunder R Algird
Journal: Front Neurol (2020)
Keywords: arteriovenous malformation, coiling, parent vessel occlusion, posterior inferior cerebellar artery (pica), prenidal aneurysm
MeSH terms: Case Reports

Background: Distal posterior inferior cerebellar artery (PICA) aneurysms are uncommon intracranial vascular lesions. The coincidence of these aneurysms and Arteriovenous malformation (AVM) is even more rare. Since 1956, a total of 57 cases of distal PICA aneurysms associated with AVM have been reported with clear and adequate description. None of these reports describe a giant prenidal aneurysm at this particular location. The paucity of natural history data as well as lack of consensus about treatment strategies in such cases present a significant challenge that requires an individualized management approach. Case Description: A 68-year-old male presented with recurrent episodes of nausea and vomiting precipitated by physical exertion and change of head position. An MRI of the brain demonstrated a giant partially thrombosed right posterior inferior cerebellar artery (PICA) aneurysm with mass effect on the floor of the fourth ventricle. A conventional cerebral angiogram revealed a giant (3.1 x 3.1 x 2.8cm) distal right PICA pre-nidal aneurysm with two smaller distal PICA aneurysms. An AVM (Spetzler-Martin Grade 1) supplied by the right PICA as well as the right superior cerebellar artery (SCA) was also identified on cerebral angiography (not seen on an MRI). Endovascular coil embolization with parent vessel sacrifice was performed to occlude the giant aneurysm. Due to the asymptomatic nature, low risk of rupture, and the patient's age, AVM treatment was deferred. Conclusion: This paper presents the first case of a giant PICA aneurysm associated with cerebellar AVM. For PICA aneurysm-AVM complexes, meticulous evaluation of the morphology, associated anatomy, and comparative risk analysis for both lesions are key for treatment planning. Distal PICA aneurysms can be treated safely with parent vessel occlusion, particularly in the case of prenidal aneurysms.
Case Report: Secondary Hemophagocytic Lymphohistiocytosis (sHLH) and Candida auris Fungemia in Post-acute COVID-19 Syndrome: A Clinical Challenge
Authors: Sachin Gautam, Gaurav Sharma, Sumeet Singla, Sandeep Garg
Journal: Front Med (Lausanne) (2022)
Keywords: candida auris, cytokine storm syndrome (css), hyperferritinemia syndrome, intravenous immunoglobulin, macrophage activation syndrome (mas), multisystem inflammatory syndrome-adults (mis-a), post acute covid-19 syndrome (pacs), secondary hemophagocytic lymphohistiocytosis
MeSH terms: Case Reports

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes a disease (COVID-19) with multisystem involvement. The world is now entering a phase of post-COVID-19 manifestations in this pandemic. Secondary hemophagocytic lymphohistiocytosis (sHLH) is a life-threatening hyperinflammatory event triggered by viral infections, including SARS-CoV-2. Both Multisystem Inflammatory Syndrome-Adults (MIS-A) and Cytokine Storm Syndrome (CSS) are considered close differentials of sHLH and add to the spectrum of Post-acute COVID-19 syndrome (PACS). In this report, we presented the case of a middle-aged Asian man who was initially discharged upon recovery from severe COVID-19 infection after 17 days of hospitalization to a private institute and later came to our hospital 13 days post-discharge. Here, he was diagnosed with sHLH, occurring as an extension of CSS, with delayed presentation falling within the spectrum of PACS. The diagnosis of sHLH was made holistically with the HLH-2004 criteria. Our patient initially responded to intravenous immunoglobulin (IVIG) and dexamethasone, later complicated by disseminated Candida auris infection and had a fatal outcome. Though many cases of HLH during active COVID-19 and a few cases post COVID-19 recovery have been reported, based on H-score, which has limitations as a diagnostic tool. We report the first case report of post-COVID-19 sHLH using the HLH-2004 criteria, complicated by disseminated Candidemia, emphasizing that the care of patients with COVID-19 does not conclude at the time of hospital discharge. We highlight the importance of surveillance in the post-COVID phase for early detection of sHLH which may predispose to fatal opportunistic infections (OIs).
Fatal antiphospholipid syndrome following endoscopic transnasal-transsphenoidal surgery for a pituitary tumor: A case report
Authors: Chiao-Zhu Li, Chiao-Ching Li, Chih-Chuan Hsieh, Meng-Chi Lin, Dueng-Yuan Hueng, Feng-Chen Liu, Yuan-Hao Chen
Journal: Medicine (Baltimore) (2017)
MeSH terms: Anticoagulants / administration & dosage, Brain Infarction / blood, Brain Infarction / diagnostic imaging, Brain Infarction / etiology, Glucocorticoids / administration & dosage, Hypophysectomy / adverse effects, Hypophysectomy / methods, Pituitary Neoplasms / surgery, Postoperative Complications / blood, Postoperative Complications / diagnosis, Postoperative Complications / physiopathology, Case Reports, Adult, Antiphospholipid Syndrome / blood, Antiphospholipid Syndrome / diagnosis, Antiphospholipid Syndrome / etiology, Antiphospholipid Syndrome / physiopathology, Fatal Outcome, Female, Humans, Magnetic Resonance Imaging, Natural Orifice Endoscopic Surgery / methods, Pituitary Neoplasms / pathology, Plasma Exchange / methods, Thrombocytopenia / blood, Thrombocytopenia / diagnosis, Thrombocytopenia / etiology, Thrombocytopenia / physiopathology, Anticoagulants, Glucocorticoids

Introduction:
The fatal type of antiphospholipid syndrome is a rare but life-threating condition. It may be triggered by surgery or infection. Endoscopic transnasal-transsphenoidal surgery is a common procedure for pituitary tumor. We report a catastrophic case of a young woman died of fatal antiphospholipid syndrome following endoscopic transnasal-transsphenoidal surgery.
Methods and result:
A 31-year-old woman of a history of stroke received endoscopic transnasal-transsphenoidal surgery for a pituitary tumor. The whole procedure was smooth. However, the patient suffered from acute delirium on postoperative day 4. Then, her consciousness became comatose state rapidly with dilatation of pupils. Urgent magnetic resonance imaging of brain demonstrated multiple acute lacunar infarcts. The positive antiphosphoipid antibody and severe thrombocytopenia were also noted. Fatal antiphospholipid syndrome was diagnosed. Plasma exchange, corticosteroids, anticoagulant agent were prescribed. The hemodynamic condition was gradually stable. However, the consciousness was still in deep coma. The patient died of organ donation 2 months later.
Conclusion:
If patients have a history of cerebral stroke in their early life, such as a young stroke, the APS and higher risk of developing fatal APS after major surgery should be considered. The optimal management of APS remains controversial. The best treatment strategies are only early diagnosis and aggressive therapies combing of anticoagulant, corticosteroid, and plasma exchange. The intravenous immunoglobulin is prescribed for patients with refractory APS.
Cloxacillin: A New Cause of Pill-Induced Esophagitis
Authors: Petros Zezos, Ziv Harel, Fred Saibil
Journal: Can J Gastroenterol Hepatol (2016)
MeSH terms: Anti-Bacterial Agents / adverse effects, Cloxacillin / adverse effects, Esophagitis / chemically induced, Case Reports, Aged, Chest Pain / chemically induced, Humans, Male, Anti-Bacterial Agents, Cloxacillin

A large variety of medications can cause pill-induced esophagitis. Herein we present a case of cloxacillin-induced esophagitis. A 66-year-old male presented with an acute onset of epigastric and retrosternal pain on the 5th day of a course of oral cloxacillin prescribed for erysipelas. Initial clinical and imaging assessment was negative and he was sent home. A few days later, he returned with persistent severe retrosternal pain; endoscopy at the same day revealed a normal upper esophagus, several small stellate erosions in the midesophagus, and a normal squamocolumnar junction with a small hiatus hernia. Treatment with esomeprazole 40 mg bid and Mucaine(R) suspension resulted in complete resolution of his symptoms. Pill-induced esophagitis may be underreported by patients, when symptoms are mild and unrecognized and/or underdiagnosed by the clinicians as a cause of retrosternal pain, odynophagia, or dysphagia. Failure of early recognition may result in unnecessary diagnostic investigations and prolongation of the patient's discomfort. This case signifies the importance of enhancing clinician awareness for drug-associated esophageal injury when assessing patients with retrosternal pain, as well as the value of prophylaxis against this unpleasant condition by universally recommending drinking enough water in an upright position during ingestion of any oral medication.
Back-table procedure and auto-lung transplantation for locally advanced lung cancer: a case report
Authors: Yoko Karube, Masayuki Chida, Morimichi Nishihira, Takashi Inoue, Osamu Araki, Satoru Kobayashi, Tetsu Sado
Journal: J Cardiothorac Surg (2016)
MeSH terms: Adenocarcinoma / surgery, Lung Neoplasms / surgery, Lung Transplantation / methods, Pneumonectomy / methods, Case Reports, Adenocarcinoma / pathology, Adenocarcinoma of Lung, Female, Humans, Lung Neoplasms / pathology, Middle Aged

Background:
To avoid a pneumonectomy and preserve the lung parenchyma, a bronchovascular double-sleeve plasty including an extended sleeve lobectomy is a good choice for locally advanced lung cancer.
Case presentation:
We describe a case with lung adenocarcinoma enrolled in our new protocol for ex situ auto-lung transplantation following an en bloc pneumonectomy and back table procedure for central lung cancer. Following completion of the pneumonectomy, the excised lung was irrigated with a cold extracellular phosphate-buffered solution to protect the lung graft from ischemia-reperfusion injury during preparation of the graft of a right basal segment as a back-table procedure.
Conclusion:
Although auto-lung transplantation is a complicated procedure, an en bloc pneumonectomy following a back table procedure makes preparation of the graft easy, while simultaneous mediastinal lymph node dissection by another surgeon shortens operation time.
Scleral buckle extrusion associated with phthisis
Authors: Tural Galbinur, Itay Chowers
Journal: Case Rep Ophthalmol Med (2011)
MeSH terms: Case Reports

Exposure of implanted episcleral element is a rare complication of buckling procedures. We describe a 40-year-old man who presented to our clinic complaining of foreign body sensation and irritation in his left eye which lasted several months. The patient history was positive for bilateral rhegmatogenous retinal detachment which was treated with sclera buckling. Upon presentation the left eye demonstrated phthisis and an exposed and infected sclera buckle and explant in the lower quadrants. The explant was removed, and the patient was treated with antibiotics. This case suggests that wide encircling sclera element might erode through the conjunctiva of eyes undergoing phthisis. Integrity of the conjunctiva overlying episcleral implant should be evaluated during routine follow-up exams to exclude exposure of the implant particularly in eyes undergoing phthisis.
Malrotation Induced Small Intestine Ischemia in an Adolescent
Authors: Karadeniz Erdem, Atamanalp Selçuk Sabri
Journal: Case Rep Surg (2017)
MeSH terms: Case Reports

Intestinal malrotation occurs if midgut does not complete or partially completes its 270° counter-clockwise rotation around the superior mesenteric artery during embryologic life. In general, it frequently manifests with vomiting due to duodenal obstruction and volvulus in the initial months of life, and it is very rare to manifest in the adulthood. A 20-year-old male patient who had severe abdominal pain, nausea, vomiting, and distention for one day was evaluated at the emergency department. On abdominal tomography "swirling appearance of structures around the superior mesenteric artery" was reported. CT appearance was considered compatible with a rotational anomaly. Emergency surgery was planned for the patient. In laparotomy, it was observed that an approximately 100 cm long small intestine segment was rotated around a band (Ladd) and ischemia was developed in this segment due to rotation of its mesentery. The rotation of the small intestinal mesentery was corrected by opening the bands. After the warm application to the intestinal mesenteric ischemia for a while, the color and the peristalsis of the intestines became normal. The patient was discharged on postoperative day 2 with suggestions.
Significantly elevated serum lipase in pregnancy with nausea and vomiting: acute pancreatitis or hyperemesis gravidarum?
Authors: Amanda Johnson, Bethany Cluskey, Nina Hooshvar, Daphne Tice, Courtney Devin, Elaine Kao, Suhalia Nawabi, Steven Jones, Lihua Zhang, Chi Dola
Journal: Case Rep Obstet Gynecol (2015)

Hyperemesis gravidarum is a severe manifestation of nausea and vomiting of pregnancy and it is associated with weight loss and metabolic abnormalities. It is known that abnormal laboratory values, including mildly elevated serum lipase level, could be associated with hyperemesis gravidarum. However, in this case report details of two women with hyperemesis gravidarum but with significantly elevated serum lipase levels were discussed. These patients presented with severe nausea and vomiting but without abdominal pain. They were found to have severely elevated lipase levels over 1,000 units/liter. In the absence of other findings of pancreatitis, they were treated with conservative measures for hyperemesis gravidarum, with eventual resolution to normal lipase levels. Although significantly elevated lipase level in pregnant patients with nausea and vomiting is a concern for acute pancreatitis, these two cases of significantly elevated serum lipase without other clinical findings of pancreatitis led to this report that serum lipase could be quite elevated in hyperemesis gravidarum and that it might not be an accurate biochemical marker for acute pancreatitis. Imaging studies are thus necessary to establish the diagnosis of acute pancreatitis.
Next-generation sequencing-based detection in a breast MMPMN patient with EGFR T790M mutation: a rare case report and literature review
Authors: Huiyun Lv, Aijuan Tian, Shanshan Zhao, Jinbo Zhao, Chen Song
Journal: Front Oncol (2023)
Keywords: egfr t790m mutation, breast cancer, multiple primary malignant neoplasms, next-generation sequencing, osimertinib
MeSH terms: Case Reports

Multiple primary malignant neoplasms (MPMNs) are difficult to identify from the metastasis or recurrence of malignant tumors. Additionally, the genetic mutations in each primary tumor vary from each other; therefore, it is critical to explore potential abnormal genes. Next-generation sequencing (NGS) technology has emerged as a reliable approach for detecting mutated genes in primary tumors and can provide several targeted therapeutic options for patients with MPMNs. Here, we report a case of metachronous multiple primary malignant neoplasm (MMPMN) patient with primary ovarian and breast cancer. Targeted NGS genetic profiling revealed a rare EGFR T790M mutation in this patient's primary breast tumor tissue, which has only been reported previously in breast cancer (BC). Based on the NGS results, osimertinib was recommended for this patient. Although this patient did not receive osimertinib because of gastrointestinal hemorrhage, this case highlights the significance of NGS technology in the diagnosis and treatment of MPMNs.
Case Report: Suspected Solitary Osseous Plasmacytoma in a Cat: Use of Magnetic Resonance Imaging to Diagnose and Confirm Resolution of Disease Following Chemotherapy
Authors: Talisha M Moore, Stephanie A Thomovsky, Craig A Thompson, Hock Gan Heng, R Timothy Bentley
Journal: Front Vet Sci (2021)
Keywords: feline, hyperglobulinemia, magnetic resonace imaging, monoclonal gammaopathy, vertebral tumor
MeSH terms: Case Reports

A 9-year-old female spayed Domestic Shorthair cat presented for pain, reluctance to jump, and hyporexia of 14 days duration. Neurologic examination was consistent with C6-T2 myelopathy. Magnetic resonance imaging (MRI) revealed a solitary, contrast-enhancing lesion within the T2 vertebral body. Solitary osseous plasmacytoma was diagnosed based on neurologic examination, advanced imaging, and clinicopathologic findings. Melphalan and prednisolone therapy were initiated. Complete resolution of clinical signs and the vertebral lesion were documented at a 2-year follow up examination with neurologic examination and repeat spinal MRI, respectively. Solitary osseous plasmacytoma are rare neoplasms in humans and domestic animals. As such, there is a paucity of published information regarding diagnostic criteria, MRI findings, treatment modalities, progression, and remission of disease in the feline patient. Most data are extrapolated from human medicine. The purpose of this report is to document neurologic exam and MR findings at the time of diagnosis and complete resolution of a solitary osseous vertebral plasmacytoma following melphalan and prednisolone therapy.
Uveitic crystalline maculopathy
Authors: Chris Or, Andrew W Kirker, Farzin Forooghian
Journal: J Ophthalmic Inflamm Infect (2015)
Keywords: blood-retinal barrier, crystalline maculopathy, uveitic crystalline maculopathy, uveitis

Background:
The purpose of this case report is to present a novel cause of crystalline maculopathy.
Findings:
A 52-year-old Japanese female presented with a 4-month history of decreased vision in the left eye. Best corrected visual acuity in the left eye was 20/40. Dilated fundus examination of the right eye was unremarkable, but that of the left eye demonstrated foveal yellow-green intraretinal crystals and mild vitritis. Optical coherence tomography of the left eye revealed small intraretinal fluid cysts and intraretinal crystals. Ultra-widefield fluorescein angiography was normal in the right eye, but that of the left eye demonstrated features of intermediate uveitis. There was no history or findings to suggest any cause for the crystals other than the uveitis.
Conclusions:
We propose that this may represent a novel category of crystalline retinopathy, termed uveitic crystalline maculopathy. We hypothesize that breakdown of the blood-retinal barrier as seen in uveitis may contribute to the deposition of crystals in the macula, although the precise composition of the crystals is unknown.
Profuse coarse pulmonary nodules in a patient with lymphangioleiomyomatosis: thirty-three years of follow-up
Authors: Daniel B Rasmussen, Saher B Shaker, Niels Seersholm, Sara Colella, Paul F Clementsen
Journal: Eur Clin Respir J (2014)
Keywords: lymphangioleiomyomatosis, cysts, neoplasm, nodules
MeSH terms: Case Reports

Lymphangioleiomyomatosis (LAM) is a rare disease characterized by progressive cystic destruction of the lungs. We present an unusual radiological presentation of lymphangioleiomyomatosis in a patient followed for 33 years with profuse coarse lung nodules in addition to the classical cystic lesions. We believe that this report might support the case for considering LAM a low-malignant neoplasm.
Severe Hypernatremia in a Significantly Underweight Female Child
Authors: Megan B Coriell, Prasanthi Gandham, Kupper Wintergerst, Bradly Thrasher
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

In this study, we present the case of a 5-year-old female who presented for evaluation of dehydration with labs that revealed significant hypernatremia concerning for diabetes insipidus (DI). Further evaluation revealed that she had underlying chronic malnutrition. Her diagnostic work up for DI produced some evidence consistent with DI while other data indicated otherwise, bringing up the possibility of partial DI. She was ultimately diagnosed with sporadic vasopressin release secondary to her chronic malnutrition. This case illustrates another effect chronic malnutrition can have on pediatric patients along with the importance of a broad differential for patients with severe hypernatremia.
Chromosome 20p Partial De Novo Duplication Identified in a Female Paediatric Patient with Characteristic Facial Dysmorphism and Behavioural Anomalies
Authors: Shahzaib Khattak, Meryam Jan, Sara Warsi, Sohail Khattak
Journal: Case Rep Genet (2020)
MeSH terms: Case Reports

Copy number variations (CNVs) involving the JAG1 gene are rare and infrequently reported in the scientific literature. Recently, a generally healthy young patient presenting with a history of behavioural concerns was referred to us. Herein, we discuss the patient, a 7-year-old female possessing a 0.797 Mb microduplication within the short arm of chromosome 20 at band 12.2. The patient generates considerable curiosity due to the rarity of her case, which includes a de novo partial duplication involving the JAG1 gene. The patient exhibits a wide range of symptoms including facial dysmorphism (dolichocephaly, round face, tented philtrum, anteverted nares, and micrognathia), clinodactyly, and an inborn congenital heart defect. She presented with behavioural concerns including ADHD-I, SPD, motor clumsiness, and poor self-regulation. Deletions in JAG1 are often linked to Alagille Syndrome; however, complete duplications have not been specifically identified as disease-causing. JAG1 mutations are reported alongside various clinical features including facial dysmorphology, heart defects, vertebral abnormalities, and ocular dysmorphic features (strabismus, epicanthal folds, and slanted palpebral fissures). This particular microduplication is rare, and thus, limited data exist regarding its significance. To our knowledge, most reported duplications are larger than 0.797 Mb. This may define a critical region causing phenotypical changes in some patient cases.
A novel treatment of pediatric bilateral condylar fractures with lateral dislocation of the temporomandibular joint (TMJ) using transfacial pinning
Authors: Kerry A Morrison, Roberto L Flores
Journal: Case Reports Plast Surg Hand Surg (2023)
Keywords: pediatric facial trauma, craniofacial surgery, pediatric condylar fractures, pediatric mandibular fractures, pediatric symphyseal fractures, transfacial pinning
MeSH terms: Case Reports

A 3-year-old patient sustained a tripartite mandibular fracture, including bilateral condylar fractures with lateral dislocation of the left condyle and symphyseal fracture. Staged lower jaw reconstruction with closed reduction of the laterally dislocated condyle, transfacial pinning between the mandibular angles, MMF using circummandibular wiring and intermaxillary fixation screws was performed.
Spontaneous bilateral tubal ectopic pregnancy: a case report
Authors: Michael Nyakura, Felix Godwin Mhlanga, Mugove Madziyire, Sitshengiso Matshalaga
Journal: Pan Afr Med J (2021)
Keywords: spontaneous, bilateral, case report, ectopic pregnancy, ruptured
MeSH terms: Laparotomy / methods, Pregnancy, Tubal / diagnostic imaging, Salpingectomy / methods, Case Reports, Adult, Delayed Diagnosis, Female, Humans, Pregnancy, Pregnancy, Tubal / surgery, Shock, Hemorrhagic / diagnosis, Shock, Hemorrhagic / etiology, Ultrasonography

Bilateral tubal ectopic pregnancy is a very rare form of extra-uterine pregnancy with high maternal morbidity and mortality if intervention is delayed. We report the case of a 27-year-old para 2 gravida 3 patient who presented in haemorrhagic shock after delayed diagnosis of ectopic pregnancy. An ultrasound scan noted a right tubal ectopic pregnancy. At laparotomy, bilateral ruptured tubal ectopic pregnancy was encountered and bilateral salpingectomy was done as both tubes were not salvageable. She recovered completely postoperatively and histology confirmed bilateral tubal ectopic pregnancies. Bilateral tubal ectopic pregnancy may not be easily diagnosed on a scan; hence vigilance at surgery is critical to prevent maternal mortality.