OpenMed/multicare-articles huggingface dataset:
Amp-C Klebsiella-Induced Chorioamnionitis and Associated Abnormalities in Cardiotocography: A Case Report with a Narrative Review
Authors: Sufia Athar, Anvar P Vellamgot, Lolwa Mohammed Alansari
Journal: Case Rep Infect Dis (2022)
MeSH terms: Case Reports

Introduction:
Infections caused by multidrug-resistant organisms are on the rise in obstetric patients. Chorioamnionitis is associated with adverse pregnancy outcomes. If caused by multidrug-resistant organisms, chorioamnionitis is associated with high maternal and fetal morbidity. Due to the paucity of the literature and the challenges associated with their diagnosis, the diagnosis is usually delayed. This often leads to delays in management, and hence, adverse maternal and neonatal outcomes are noted. Important Clinical Findings. The patient presented with prelabour rupture of membranes for three days. She developed chorioamnionitis in labour, which was refractory to broad spectrum antibiotics. Persistent tachycardia with variable decelerations followed by prolonged fetal deceleration was observed in cardiotocography. Delivery of baby was done by cesarean section in the view of pathological findings in cardiotocography. The primary diagnoses, interventions, and outcomes. Based on the placental culture results, Amp-C Klebsiella-induced chorioamnionitis was diagnosed. Ertapenem was commenced after the sensitivity results. Good feto-maternal outcomes were observed. The neonate was admitted to the neonatal intensive care unit and discharged home in stable condition.
Conclusions:
Cases of multidrug-resistant organisms-induced chorioamnionitis are rarely reported, though they are associated with maternal morbidity and poor neonatal outcome. In cases of chorioamnionitis, caution should be taken in cases that are refractory to broad-spectrum antibiotics, and multidrug-resistant organisms should be suspected and managed to improve pregnancy outcome.
Stereotactic Body Radiotherapy for Localized Ureter Transitional Cell Carcinoma: Three Case Reports
Authors: Yoshiyasu Maehata, Kengo Kuriyama, Shinichi Aoki, Masayuki Araya, Kan Marino, Hiroshi Onishi
Journal: Case Rep Urol (2015)

The gold standard management for ureter transitional cell carcinoma (UTCC) is radical nephroureterectomy with excision of the bladder cuff. However, some patients cannot undergo this procedure for several reasons. In the case reports described herein, we performed stereotactic body radiotherapy (SBRT) on three patients with inoperable or surgery-rejected localized UTCC. Two out of the three patients did not develop local recurrence or distant metastasis during the observation period. However, recurrence was detected in the bladder of one patient 22 months after the treatment. No acute or late adverse events occurred in any of the three patients. SBRT may become one of the treatment options for inoperable or surgery-rejected UTCC patients.
Boerhaave's syndrome after pentazocine-induced vomiting in a 21-year-old male with asthma: a case report
Authors: Oyindamola Ibukun Awofisoye, Olaleye Emmanuel Olalekan, Ndubuisi Anumenechi, Frankilin Onwukpa
Journal: Pan Afr Med J (2021)
Keywords: boerhaave’s, case report, oesophageus, pneumomediastinum
MeSH terms: Esophageal Perforation / diagnostic imaging, Mediastinal Diseases / diagnostic imaging, Pentazocine / adverse effects, Vomiting / complications, Case Reports, Analgesics, Opioid / administration & dosage, Analgesics, Opioid / adverse effects, Anti-Bacterial Agents / administration & dosage, Asthma / physiopathology, Asthma / therapy, Chest Pain / etiology, Dyspnea / etiology, Esophageal Perforation / etiology, Esophageal Perforation / therapy, Humans, Male, Mediastinal Diseases / etiology, Mediastinal Diseases / therapy, Oxygen Inhalation Therapy, Pentazocine / administration & dosage, Tomography, X-Ray Computed, Vomiting / chemically induced, Young Adult, Analgesics, Opioid, Anti-Bacterial Agents, Pentazocine, Boerhaave syndrome

Boerhaave's syndrome is an uncommon syndrome characterized by spontaneous rupture of the oesophagus with a high mortality rate. While excessive alcohol intake and binge-eating are the classic precipitants of this syndrome, medication-induced vomiting causing Booerhave's is quite uncommon. Traditionally managed operatively, conservative management is being increasingly reported in selected cases. We report the case of 21-year-old male with who developed sudden onset chest pain and dyspnoea after pentazocine induced vomiting. He was referred after lack of response to initial treatment for acute severe asthma. A chest CT scan showed pneumomediastinum, subcutaneous emphysema and oesophageal tear. He was managed conservatively with oxygen therapy, nil per mouth and antibiotics with improvement of symptoms and discharge after 8 days.
The aid of microsurgical instruments in nasolabial cyst enucleation. A report of two cases with critical review of the therapeutic approach
Authors: Ioannis Tilaveridis, Gregory Venetis, Dimitris Tatsis, Ioanna Kalaitsidou, Lambros Zouloumis
Journal: J Surg Case Rep (2023)
MeSH terms: Case Reports

Nasolabial cysts are rare non-odontogenic cysts related to epithelial remnants of the nasolacrimal duct, slowly enlarging and provoking extraoral swelling in the nasolabial fold with obstruction of the naris. Two patients of large unilateral nasolabial cysts are reported, appearing as cosmetically unappealing distention of the nasolabial fold. Diagnosis is based on clinical characteristics. Computed tomography imaging reveals the dimensions of the cyst, the correlation to the nasal cavity and might depict a depression on the labial surface of the maxilla. Intraoral surgical enucleation of the cystic wall or nasal marsupialization is the main treatment modalities. However, both procedures are related to a small percentage of recurrence. Microsurgical instruments were used to dissect the cystic wall from the nasal mucosa. The aim of this paper is to stress the implementation of microsurgical instruments to separate the cystic wall of the nasolabial cyst from the thin and friable nasal mucosa to avoid recurrence.
Case report: Challenges in immune reconstitution following hematopoietic stem cell transplantation for CTLA-4 insufficiency-like primary immune regulatory disorders
Authors: Adriana Margarit-Soler, Àngela Deyà-Martínez, Juan Torres Canizales, Alexandru Vlagea, Ana García-García, Júlia Marsal, Maria Trabazo Del Castillo, Sílvia Planas, Sílvia Simó, Ana Esteve-Sole, María Suárez-Lledó Grande, Isabel Badell, Montserrat Rovira Tarrats, Francesc Fernández-Avilés, Laia Alsina
Journal: Front Immunol (2022)
Keywords: ctla-4, abatacept, chimerism, hematopoietic stem cell transplantation, immune reconstitution, primary immunodeficiency
MeSH terms: Graft vs Host Disease / etiology, Hematopoietic Stem Cell Transplantation / adverse effects, Immune Reconstitution, Case Reports, Research Support, Non-U.S. Gov't, CTLA-4 Antigen / genetics, Humans, T-Lymphocytes, CTLA-4 Antigen

Cytotoxic T-lymphocyte antigen-4 (CTLA-4) haploinsufficiency is a T-cell hyperactivation disorder that can manifest with both immunodeficiency and immune dysregulation. Approximately one-third of patients may present mild symptoms and remain stable under supportive care. The remaining patients may develop severe multiorgan autoimmunity requiring lifelong immunosuppressive treatment. Hematopoietic stem cell transplantation (HSCT) is potentially curable for patients with treatment-resistant immune dysregulation. Nevertheless, little experience is reported regarding the management of complications post-HSCT. We present case 1 (CTLA-4 haploinsufficiency) and case 2 (CTLA-4 insufficiency-like phenotype) manifesting with severe autoimmunity including cytopenia and involvement of the central nervous system (CNS), lung, and gut and variable impairment of humoral responses. Both patients underwent HSCT for which the main complications were persistent mixed chimerism, infections, and immune-mediated complications [graft-versus-host disease (GVHD) and nodular lung disease]. Detailed management and outcomes of therapeutic interventions post-HSCT are discussed. Concretely, post-HSCT abatacept and human leukocyte antigen (HLA)-matched sibling donor lymphocyte infusions may be used to increase T-cell donor chimerism with the aim of correcting the immune phenotype of CTLA-4 haploinsufficiency.
Trocar site hernia after laparoscopic colectomy: a case report and literature review
Authors: Delmonaco Pamela, Cirocchi Roberto, La Mura Francesco, Morelli Umberto, Migliaccio Carla, Napolitano Vincenzo, Trastulli Stefano, Farinella Eriberto, Giuliani Daniele, Desol Angelo, Milani Diego, Di Patrizi Micol Sole, Spizzirri Alessandro, Bravetti Maurizio, Sciannameo Vito, Avenia Nicola, Sciannameo Francesco
Journal: ISRN Surg (2011)
MeSH terms: Case Reports

Background. Trocar Site Hernia (TSH) is defined as an incisional hernia which occurs after minimally invasive surgery on the trocar incision site.In 2004 Tonouchi classified trocar site hernias into 3 types: Early onset type; Late onset type; Special type. Case Report. We report the case of a 76-year old woman that underwent an emergency explorative laparotomy on the 10th p.o. day after a laparoscopic left hemicolectomy. Surgery showed a small bowel herniation through the 12 mm trocar incision site; the intestinal loop appeared necrotic and had to be resected, and the hernia orifice was repaired. We carried out a review of literature about this topic. Discussion. The clinical onset of a trocar site hernia is usually early, occurring within the 30th post operative day and it is caused by the omentum or small bowel entrapment into the trocar orifice. The clinical presentation is insidious, with progression to an acute abdomen, and an emergency surgical approach is often required. Conclusions. TSH is a severe complication of operative laparoscopy especially with large-bore trocar ports. The incidence of TSH resulting from our review ranges from 0.007% to 22% with an average of 1.85%. Prevention of TSH appears to be more effective when trocar insertion through the abdominal wall is tangential, the closure of both the fascia and the peritoneum is performed if the incision is greater than 7 mm, the suture of extra umbilical port site is performed under laparoscopic vision.
Lateral orbital wall reconstruction after basal cell carcinoma penetration-Case report
Authors: Bruno Popić, Andrijana Kopić, Dubravka Holik, Kristijan Dinjar, Vlatko Kopić, Marko Matijević, Fran Popić
Journal: Front Surg (2022)
Keywords: basal cell carcinoma, lateral orbital wall, penetration, reconstruction, titanium mesh
MeSH terms: Case Reports

Advanced periorbital basal cell carcinomas may necessitate orbital exenteration and consequent vision loss, which significantly reduces patients' life quality. Orbital reconstruction is a demanding surgical procedure due to the complex orbital anatomy and vital structures located in the orbit. In this report, we presented an 83-year-old patient with advanced basal cell carcinoma that had expanded into the orbit. An orbitotomy was performed to remove the tumor completely while preserving the eye function. Orbital reconstruction was performed by a standard surgical method using a titanium mesh modeled according to a natural phantom skull. This maintained the eye function and achieved satisfactory facial esthetics.
Synchronous occurrence of papillary thyroid carcinoma and early esophageal squamous cell carcinoma in a 45-year-old female: a case report and review of the literature
Authors: Abdulfattah Altam, Ahmed Alsaaidi, Waleed Aljbri, Faisal Ahmed, Qasem Alyhari, Mohamed Badheeb
Journal: Pan Afr Med J (2022)
Keywords: esophagus, case report, papillary thyroid carcinoma, squamous cell carcinoma, synchronous neoplasm
MeSH terms: Carcinoma, Papillary / diagnosis, Carcinoma, Papillary / pathology, Carcinoma, Papillary / surgery, Esophageal Neoplasms / diagnosis, Esophageal Neoplasms / surgery, Esophageal Squamous Cell Carcinoma / diagnosis, Thyroid Neoplasms / diagnosis, Thyroid Neoplasms / epidemiology, Thyroid Neoplasms / surgery, Review, Case Reports, Female, Humans, Iodine Radioisotopes, Middle Aged, Thyroid Cancer, Papillary / pathology, Thyroidectomy, Iodine Radioisotopes

Papillary thyroid cancer (PTC) coexistent with esophageal squamous cell carcinoma (SCC) is of rare occurrence. We report a 45-year-old female who presented with painless anterior neck swelling for the past year. Ultrasonography showed a left hypoechoic thyroid mass measured 20x13 mm without lymph node enlargement. The fine-needle aspiration cytology was suggestive of PTC. Consequently, total thyroidectomy with bilateral neck dissection was performed. Incidentally, a small mass measuring 4x2 cm arising from the esophageal wall was identified and resected. Postoperatively, the patient developed a small esophageal fistula which was treated conservatively. The histopathological examination confirmed the diagnosis of PTC and SCC of esophageal mass. The patient underwent radiotherapy, and radioactive iodine therapy, and had acceptable conditions within two years of follow-up. In conclusion, even though the coexistence of PTC and esophageal SCC is rare, the possibility of concurrence of both tumors should be considered if an incidental mass was identified intraoperatively.
Case report: Fulminant extraneural metastasis of glioblastoma through venous sinus
Authors: Yeong Jin Kim, Kang Hee Ahn, Kyung-Hwa Lee, Kyung-Sub Moon
Journal: Front Oncol (2022)
Keywords: extracranial, extraneural, glioblastoma, metastasis, venous sinus
MeSH terms: Case Reports

Background:
Extraneural metastasis (ENM) of glioblastoma are rare. However, as patient overall survival improves, the incidence of ENM has gradually increased. Although several risk factors have been proposed, venous sinus invasion was regarded as a very exceptional route for ENM.
Case description:
We report a 60-year-old man with glioblastoma in the temporal lobe, invading the transverse and sigmoid venous sinus. After gross total tumor resection, the patient received the standard chemoradiation therapy. Systemic evaluation for persistent shoulder and back pain revealed widespread metastasis to lymph nodes and multiple bones 9 months after surgery. Despite spine radiation therapy, the patient became paraplegic and died 1 year after surgery.
Conclusions:
Venous sinus invasion should be kept in mind by physicians, as a risk factor for glioblastoma ENM. Systemic evaluation of these patients with extracranial symptoms should be performed without hesitation.
Burkholderia cepacia meningitis in the Central African Republic
Authors: Thierry Frank, Alain Farra, Pierre-Alain Rubbo, Jean-Robert Mbecko, Hugues Sanke, Anne Le Flèche-Matéos, Jean-Pierre Lombart, Alain Berlioz-Arthaud
Journal: Pan Afr Med J (2019)
Keywords: burkholderia cepacia, central african republic, meningitis, antibiotics
MeSH terms: Anti-Bacterial Agents / pharmacology, Burkholderia Infections / diagnosis, Burkholderia cepacia / isolation & purification, Meningitis, Bacterial / diagnosis, Case Reports, Letter, Anti-Bacterial Agents / administration & dosage, Burkholderia Infections / drug therapy, Burkholderia Infections / microbiology, Central African Republic, Child, Preschool, Drug Resistance, Multiple, Bacterial, Humans, Male, Meningitis, Bacterial / drug therapy, Meningitis, Bacterial / microbiology, RNA, Ribosomal, 16S / genetics, Anti-Bacterial Agents, RNA, Ribosomal, 16S

Burkholderia cepacia causes frequent infections in immunocompromised and hospitalized patients, with a significant mortality rate. This bacterial species has also been associated with epidemic outbreaks due to contamination of antiseptic solutions and parenteral and nebulized medications. In 2016, in the town of Bongonon in the north of the Central African Republic (CAR), a three-year-old boy with febrile meningeal syndrome (fever, neck stiffness and altered general condition) was admitted for a medical consultation provided by the nongovernmental organization MSF-Spain. On 20 March 2016, a sample of the boy's cerebrospinal fluid was sent to the Bacteriology Laboratory of the Pasteur Institute of Bangui for analysis. Conventional bacteriology showed that the isolate was a Gram-negative bacillus, which was identified as B. cepacia by using API 20 NE, with 99.9%confidence. In addition, the strain presented an acquired resistance to ticarcillin-clavulanate, ceftazidime and imipenem but remained susceptible to cotrimoxazole. As B. cepacia had never previously been isolated from cerebrospinal fluid in Africa, we chose to identify the strain by 16S rRNA gene sequencing. The molecular data showed that the isolate belonged to B. cepacia group. This is the first report of a case of meningitis caused by B. cepacia in CAR and developing countries.
Role of donepezil in autism: its conduciveness in psychopharmacotherapy
Authors: Rohit Kant Srivastava, Medhavi Agarwal, Ashish Pundhir
Journal: Case Rep Psychiatry (2011)
MeSH terms: Case Reports

A woman consulted psychiatric Out-Patient Department (OPD) for her 5-year and 2-month-old son presenting with typical autistic symptoms like social, behavioural, and communicational ineptitudeness. Subsequent treatment with Donepezil resulted in marked improvement in the aforementioned symptomatology. Recent studies in autistic child have shown diminished acetylcholine and nicotinic receptor activity, thus an acetylcholinergic enhancer, Donepezil, likely accounts for improvement in autistic symptoms. Evidently, the case report consolidates Donepezil role as a potentially useful agent in the treatment of cognitive and behavioural symptoms observed in this disorder.
Diabetes Insipidus Complicating Management in a Child with COVID-19 and Multiorgan System Failure: A Novel Use for Furosemide
Authors: Sara D Gungor, Robert P Woroniecki, Erin Hulfish, Katherine V Biagas
Journal: Case Rep Crit Care (2021)
MeSH terms: Case Reports

Judicious balance of fluids is needed for optimal management of acute respiratory distress syndrome (ARDS). Achieving optimal fluid balance is difficult in patients with disorders of fluid homeostasis such as diabetes insipidus (DI). There is little data on the use of Furosemide to aid in balancing fluid and electrolytes in patients with DI. Here, we present a critically ill 11-year-old female with developmental delay, septo-optic dysplasia, central DI, and respiratory failure secondary to COVID-19 ARDS. She required careful titration of a Vasopressin infusion in addition to IV Furosemide for successful management of fluid and electrolyte derangements. On admission, she demonstrated high-volume urine output with mild hypernatremia (serum sodium 156 mmol/L). Despite her maximum Vasopressin infusion rate of 8 mU/kg/hr, by day two of admission, she voided a total of 4 L resulting in severe hypernatremia (serum sodium 171 mmol/L). With continually high Vasopressin infusion rates, her overall fluid balance became increasingly net positive, although her hypernatremia persisted. Her ARDS continued to worsen. After 48 hours of the addition of intermittent Furosemide, successful diuresis along with resolution of hypernatremia was achieved. The combination of IV Furosemide with Vasopressin infusion resulted in tailored diuresis and more controlled titration of serum sodium levels than adjustment in Vasopressin and fluids alone. These results are in contradistinction to the published literature, which focuses on the use of thiazide diuretics in managing DI. This experience highlights the potential for loop diuretics to aid in establishing a desired fluid and electrolyte status in managing patients with both DI and ARDS.
BNT162b2 COVID-19 Vaccine Induced Immune Thrombocytopenic Purpura
Authors: A K Ghosh, S Bhushan, L D R Lopez, D Sampat, Z Salah, C A Hatoum
Journal: Case Rep Med (2022)
MeSH terms: Case Reports

Immune thrombocytopenic purpura (ITP) has been reported following vaccinations such as MMR as well as after viral infections such as hepatitis C and HIV. Few case reports have been reported of ITP after COVID-19 infections and COVID-19 vaccines. Herein, we present a patient who presented with severe ITP with a platelet count of 0 after receiving the second dose of the BNT162b2 mRNA COVID-19 vaccine (also known as the Pfizer BioNTech). She subsequently recovered with a prolonged treatment course.
A case of aspergillus endophthalmitis in an immuncompetent woman: intra-ocular penetration of oral voriconazole: a case report
Authors: Sa Logan, Ms Rajan, E Graham, Em Johnson, Jl Klein
Journal: Cases J (2010)

Background:
There are very few reports of Aspergillus fumigatus causing endogenous endophthalmitis (EAE) in immunocompetent individuals although it is well recognised in the immunocompromised. Treatment can be with intravitreal, intravenous and oral antifungal agents. The benefit of an oral agent is clear however the concentration of voriconazole in the inflamed eye after oral administration has not previously been documented.
Case presentation:
We present a case of EAE in an immunocompetent 78-year-old Caucasian female who was subsequently managed with oral voriconazole. Using a bioassay, we show an appropriate voriconazole concentration in serum and vitreous samples.
Conclusion:
This case adds to the limited literature on the prevalence of endogenous endophthalmitis in immunocompetent patients and supports the use of voriconazole in such cases.
Pediatric plastic bronchitis: case report and retrospective comparative analysis of epidemiology and pathology
Authors: Rebecca Kunder, Christian Kunder, Heather Y Sun, Gerald Berry, Anna Messner, Jennifer Frankovich, Stephen Roth, John Mark
Journal: Case Rep Pulmonol (2013)

Plastic bronchitis (PB) is a pathologic condition in which airway casts develop in the tracheobronchial tree causing airway obstruction. There is no standard treatment strategy for this uncommon condition. We report an index patient treated using an emerging multimodal strategy of directly instilled and inhaled tissue plasminogen activator (t-PA) as well as 13 other cases of PB at our institution between 2000 and 2012. The majority of cases (n = 8) occurred in patients with congenital heart disease. Clinical presentations, treatments used, histopathology of the casts, and patient outcomes are reviewed. Further discussion is focused on the epidemiology of plastic bronchitis and a systematic approach to the histologic classification of casts. Comorbid conditions identified in this study included congenital heart disease (8), pneumonia (3), and asthma (2). Our institutional prevalence rate was 6.8 per 100,000 patients, and our case fatality rate was 7%.
American Canine Hepatozoonosis Causes Multifocal Periosteal Proliferation on CT: A Case Report of 4 Dogs
Authors: Cambridge L Coy, Jeremy B Evans, Alison M Lee, Danielle R Dugat, Jonathan M Levine, John F Griffin 4th
Journal: Front Vet Sci (2022)
Keywords: canis, case report, gulf coast, neutrophilia, periosteum, pseudocortex, tick
MeSH terms: Case Reports

American canine hepatozoonosis (ACH) represents an important but relatively uncommon differential diagnosis in a dog with fever, muscle wasting, profound leukocytosis, and/or musculoskeletal pain. Despite this, obtaining a definitive diagnosis can prove difficult. Peripheral blood smears and whole-blood polymerase chain reaction (PCR) rely on rare parasitemia, and the gold standard diagnostic test (skeletal muscle biopsy) is uncommonly pursued due to its invasive and costly nature. Demonstration of characteristic periosteal proliferative lesions aids diagnosis. The lesions typically involve the more proximal long bones of the appendicular skeleton. The periosteal proliferation is of currently unknown pathogenesis, but its distribution is characteristic of this disease with few differential diagnoses. This case series describes the findings on computed tomography (CT) in 4 dogs with PCR- or cytologically-confirmed Hepatozoon americanum. All dogs had multifocal, bilaterally asymmetric, irregularly marginated, non-destructive, non-articular, periosteal proliferative lesions. Recognition of this unusual CT finding and awareness of this disease could assist in the diagnosis and subsequent treatment of dogs with ACH and may offer an additional indication for CT in cases of fever, muscle wasting, and myalgia.