OpenMed/multicare-articles huggingface dataset:
Powassan meningoencephalitis, New York, New York, USA
Authors: Simon Sung, Alysse G Wurcel, Susan Whittier, Karen Kulas, Laura D Kramer, Robin Flam, James Kirkland Roberts, Simon Tsiouris
Journal: Emerg Infect Dis (2013)
Keywords: new york, powassan virus, arbovirus, encephalitis, flavivirius, meningitis, meningoencephalitis, tick-borne disease, vector-borne infections, viruses
MeSH terms: Encephalitis Viruses, Tick-Borne / classification, Encephalitis, Tick-Borne / diagnosis, Meningoencephalitis / diagnosis, Meningoencephalitis / virology, Case Reports, Adult, Encephalitis, Tick-Borne / drug therapy, Humans, Male, Meningoencephalitis / drug therapy, New York City, Serotyping, Treatment Outcome, Young Adult

Disease caused by Powassan virus (POWV), a tick-borne flavivirus, ranges from asymptomatic to severe neurologic compromise and death. Two cases of POWV meningoencephalitis in New York, USA, highlight diagnostic techniques, neurologic outcomes, and the effect of POWV on communities to which it is endemic.
Serological findings in a child with paroxysmal cold haemoglobinuria
Authors: Eduardo J Salido, Valentín Cabañas, Mercedes Berenguer, María I Macizo, Faustino García-Candel, Raúl Pérez-López, Jose M Moraleda
Journal: Case Rep Med (2014)

PCH is a rare autoimmune hemolytic anemia (AIHA) but is one of the most common causes of AIAH in children. For the diagnosis, it is important to perform the appropriate methods of serological investigation and show the typical biphasic reaction. This is a case report of a child who presented with features of haemolysis and was diagnosed with PCH of this way.
Fat Embolism Syndrome: A Case Report and Review Literature
Authors: Nattaphol Uransilp, Sombat Muengtaweepongsa, Nuttawut Chanalithichai, Nattapol Tammachote
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Fat embolism syndrome (FES) is a life-threatening complication in patients with orthopedic trauma, especially long bone fractures. The diagnosis of fat embolism is made by clinical features alone with no specific laboratory findings. FES has no specific treatment and requires supportive care, although it can be prevented by early fixation of bone fractures. Here, we report a case of FES in a patient with right femoral neck fracture, which was diagnosed initially by Gurd's criteria and subsequently confirmed by typical appearances on magnetic resonance imaging (MRI) of the brain. The patient received supportive management and a short course of intravenous methylprednisolone.
Simultaneous endovascular repair of an iatrogenic carotid-jugular fistula and a large iliocaval fistula presenting with multiorgan failure: a case report
Authors: Yuigi Yuminaga, Walid Mohabbat, Tam Nguyen, Andrew Michael Thompson, Charles Marshall Fisher
Journal: J Med Case Rep (2012)

Introduction:
Iliocaval fistulas can complicate an iliac artery aneurysm. The clinical presentation is classically a triad of hypotension, a pulsatile mass and heart failure. In this instance, following presentation with multiorgan failure, management included the immediate use of an endovascular stent graft on discovery of the fistula.
Case presentation:
A 62-year-old Caucasian man presented to our tertiary hospital for management of iatrogenic trauma due to the insertion of a central venous line into his right common carotid artery, causing transient ischemic attack. Our patient presented to a peripheral hospital with fever, nausea, vomiting, acute renal failure, acute hepatic dysfunction and congestive heart failure. A provisional diagnosis of sepsis of unknown origin was made. There was a 6.5 cm×6.5 cm right iliac artery aneurysm present on a non-contrast computed tomography scan. An unexpected intra-operative diagnosis of an iliocaval fistula was made following the successful angiographic removal of the central line to his right common carotid artery. Closure of the iliocaval fistula and repair of the iliac aneurysm using a three-piece endovascular aortic stent graft was then undertaken as part of the same procedure. This was an unexpected presentation of an iliocaval fistula.
Conclusion:
Our case demonstrates that endovascular repair of a large iliac artery aneurysm associated with a caval fistula is safe and effective and can be performed at the time of the diagnostic angiography. The presentation of an iliocaval fistula in this case was unusual which made the diagnosis difficult and unexpected at the time of surgery. The benefit of immediate repair, despite hemodynamic instability during anesthesia, is clear. Our patient had two coronary angiograms through his right femoral artery decades ago. Unusual iatrogenic causes of iliocaval fistulas secondary to previous coronary angiograms with wire and/or catheter manipulation should be considered in patients such as ours.
Salter-Harris Type III and Type IV Combined Fracture of the Distal Femoral Epiphysis: A Case Report
Authors: Ali Aydin, Murat Topal, Kutsi Tuncer, Eyüp Senocak
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Distal femoral physeal fractures are not common but have a high rate of complications. They generally follow one of the patterns described in the Salter-Harris classification. We present a case of combination of Salter-Harris type III and type IV injury. Our case was a 15-year-old boy who had a motor vehicle accident. There was swelling, ecchymosis, severe pain, and valgus deformity, because of medial proximal fracture fragment, on the left knee. We deemed that Salter-Harris type III and type IV combination fracture in our case has not been previously reported. We prepared this paper in consideration of its contribution to the literature.
Successful treatment of anterior tracheal necrosis after total thyroidectomy using vacuum-assisted closure therapy
Authors: Grégory Philippe, Nicolas Pichon, Justine Lerat, Jean Bernard Amiel, Marc Clavel, Muriel Mathonnet
Journal: Crit Care Res Pract (2012)
MeSH terms: Case Reports

Total thyroidectomy involving the adjacent structures of the trachea can cause tracheal damage such as early tracheal necrosis. The authors describe the first case of anterior tracheal necrosis following total thyroidectomy treated using vacuum-assisted closure device. After two weeks of VAC therapy, there was no evidence of ongoing infection and the trachea was partially closed around a tracheotomy cannula, removed after 3 months. The use of a VAC therapy to reduce and close the tracheal rent and to create a rapid granulation tissue over tracheal structure appeared as a good opportunity after anterior tracheal necrosis.
Successful treatment of severe immune checkpoint inhibitor associated autoimmune hepatitis with basiliximab: a case report
Authors: Maiah Zarrabi, Camille Hamilton, Samuel W French, Noah Federman, Theodore S Nowicki
Journal: Front Immunol (2023)
Keywords: case report, immune evasion, immunohistochemistry, immunotherapy, programmed cell death
MeSH terms: Hepatitis, Autoimmune / diagnosis, Hepatitis, Autoimmune / drug therapy, Hepatitis, Autoimmune / etiology, Immune Checkpoint Inhibitors / adverse effects, Case Reports, Antibodies, Monoclonal / adverse effects, Basiliximab, Female, Humans, Nivolumab / adverse effects, Immune Checkpoint Inhibitors, Basiliximab, Nivolumab, Antibodies, Monoclonal

Immune checkpoint inhibitors (ICIs) targeting programmed cell death-1 (PD-1) and its corresponding ligand PD-L1 are being increasingly used for a wide variety of cancers, including refractory sarcomas. Autoimmune hepatitis is a known side effect of ICIs, and is typically managed with broad, non-specific immunosuppression. Here, we report a case of severe autoimmune hepatitis occurring after anti-PD-1 therapy with nivolumab in a patient with osteosarcoma. Following prolonged unsuccessful treatment with intravenous immunoglobulin, steroids, everolimus, tacrolimus, mycophenolate, and anti-thymoglobulin, the patient was eventually treated with the anti-CD25 monoclonal antibody basiliximab. This resulted in prompt, sustained resolution of her hepatitis without significant side effects. Our case demonstrates that basiliximab may be an effective therapy for steroid-refractory severe ICI-associated hepatitis.
Clinical and molecular characteristics of a novel rare de novo variant in PPP2CA in a patient with a developmental disorder, autism, and epilepsy
Authors: Iris Verbinnen, Sara S Procknow, Lisa Lenaerts, Sara Reynhout, Aujan Mehregan, Chris Ulens, Veerle Janssens, Katherine A King
Journal: Front Cell Dev Biol (2022)
Keywords: pp2a-related neurodevelopmental disorders, ppp2ca, autism (asd), case report, de novo mutation, developmental delay, epilepsy

PP2A-related (neuro) developmental disorders are a family of genetic diseases caused by a heterozygous alteration in one of several genes encoding a subunit of type 2A protein phosphatases. Reported affected genes, so far, are PPP2R5D, encoding the PP2A regulatory B56δ subunit; PPP2R1A, encoding the scaffolding Aα subunit; and PPP2CA, encoding the catalytic Cα subunit-in that order of frequency. Patients with a pathogenic de novo mutation in one of these genes, in part, present with overlapping features, such as generalized hypotonia, intellectual and developmental delay, facial dysmorphologies, seizures, and autistic features, and, in part, with opposite features, e.g., smaller versus larger head sizes or normal versus absent corpus callosum. Molecular variant characterization has been consistent so far with loss-of-function or dominant-negative disease mechanisms for all three affected genes. Here, we present a case report of another PPP2CA-affected individual with a novel de novo missense variant, resulting in a one-amino acid substitution in the Cα subunit: p.Cys196Arg. Biochemical characterization of the variant revealed its pathogenicity, as it appeared severely catalytically impaired, showed mildly affected A subunit binding, and moderately decreased binding to B/B55, B"/PR72, and all B56 subunits, except B56γ1. Carboxy-terminal methylation appeared unaffected, as was binding to B"'/STRN3-all being consistent with a partial loss of function. Clinically, the girl presented with mild-to-moderate developmental delay, a full-scale IQ of 83, mild dysmorphic facial features, tonic-clonic seizures, and autistic behaviors. Brain MRI appeared normal. We conclude that this individual falls within the milder end of the clinical and molecular spectrum of previously reported PPP2CA cases.
Retinal hemangioblastoma in a patient with Von Hippel-Lindau disease: A case report and literature review
Authors: Yikeng Huang, Weiwen Hu, Xionggao Huang
Journal: Front Oncol (2022)
Keywords: von hippel-lindau disease (vhl), case report, clinical management, retinal hemangioblastoma (rh), vitreoretinal surgery
MeSH terms: Case Reports

Background:
Retinal hemangioblastoma (RH) is a rare benign tumor and a considerable number of which are caused by Von Hippel-Lindau disease (VHL). Herein, we described a case of VHL-associated RH with retinal detachment who underwent both laser photocoagulation and vitreoretinal surgery and received satisfactory visual recovery. In addition, we reviewed the current diagnosis, genotype-phenotype association, and treatment of VHL-associated RH.
Case description:
A 34-year-old woman presented with vision loss in the right eye at our hospital. Fundus photography and angiography showed retinal detachment and multiple large hemangiomas in the right eye. The visual acuity improved significantly after laser photocoagulation and vitreoretinal surgery. Genetic analyses showed a p.Asn78Ser (c.233A>G) heterozygous missense mutation in the VHL gene.
Conclusion:
We described a rare case of VHL-associated RH and may provide a new perspective towards diagnosis and treatment of this disease. RH is one of the most common manifestations of VHL and poses a serious threat to vision. Ophthalmic examination methods include fundus examination and fundus photography, etc. The management of the disease emphasizes timely follow-up, early detection of the lesion, and the decision of treatment options according to the size, location and complications of the lesion, including ablation therapy and vitreoretinal surgery. Clinicians should strengthen the understanding of this rare disease for early detection and treatment.
An atypical case of intracerebral schwannoma
Authors: Abdulrahman Abdullah AlBatly, Reem Seraj Zakzouk, Ali Khalaf Alhaidey
Journal: Pan Afr Med J (2014)
Keywords: intracerebral schwannoma, glioblastoma multiforme, immunohistochemically
MeSH terms: Brain Neoplasms / pathology, Neurilemmoma / pathology, Case Reports, Brain Neoplasms / diagnosis, Female, Humans, Magnetic Resonance Imaging, Middle Aged, Neurilemmoma / diagnosis, Tomography, X-Ray Computed

We report a case of intracerebral cystic schwannoma in the temporal fossa manifested as a gradually worsening headache in a 49-years-old woman. Computed Tomography (CT) and magnetic resonance imaging (MRI) showed a left temporal partly cystic, partly solid mass. The preoperative diagnosis was astrocytoma or glioblastoma multiforme (GBM), but microscopic examination of the mass showed the characteristic pattern with cellular Antony A component. Immunohistochemically, the tumor was positive for S-100 protein. These findings are consistent with a schwannoma. Intracerebral schwannomas not related to cranial nerves are rare and most reported cases involved young patients.
Look Upstream: Measurement for Innovation on the Upper Rio Negro of the Amazon Basin
Authors: Kurt Shaw, Rita de Cácia Oenning da Silva
Journal: Front Pediatr (2021)
Keywords: amazonia (brazil), early childhood development, indigenous children and families, multilingualism, video coaching

The growth of the randomized controlled trial (RCT) as the "gold standard" for evaluation has justly been praised as an advance in the professionalization of social programs and projects, an "adoption of science" - in the words of the Lancet. None the less, the emphasis on the RCT biases funding for projects that distribute private goods and which focus on "low hanging fruit" in health, nutrition, and sanitation, simply because those areas lend themselves to the sort of measurement that works with RCTs. As a result, many project developers in the government and NGO sectors lament that a hegemonic focus on RCTs impedes creativity or new models that challenge traditional paradigms. This case study of CanalCanoa, a community video coaching project for indigenous parents of young children in the Rio Negro region of the Amazon Basin, offers techniques to measure for innovation. Instead of developing a new RCT for an extremely diverse population (27 ethnic groups) where traditional childcare methods are in historical flux because of urbanization, CanalCanoa measured variables shown by previous RCTs to be causally connected with positive development results. By researching the impact of the intervention on nutrition, language (multilingualism, use of traditional songs and stories), and social network expansion, CanalCanoa measured upstream indicators, thus mixing scientific rigor with an opportunity for innovation and providing important insight and reform of a theory of change.
Giant epidermal inclusion cyst of the thyroid: a rare occurrence
Authors: Swagatika Samal, Mukund Sable, Pradeep Pradhan
Journal: Autops Case Rep (2021)
Keywords: epidermal cyst, rare diseases, thyroid gland, thyroidectomy
MeSH terms: Case Reports

Epidermal inclusion cyst (EIC) of the thyroid is extremely rare in the clinical practice. A handful of cases have been documented in the past in the world literature. A giant EIC of the thyroid is hitherto unreported. This lesion may arise from the squamous metaplasia of the thyroid follicular cells. Though non-neoplastic, giant forms can cause compression of the vital structures of the neck. In the present case, we have described a giant epidermal inclusion cyst successfully managed with surgical management.
False-Negative Platelet Factor 4 Antibodies and Serotonin Release Assay and the Utility of Repeat Testing in the Diagnosis of Heparin-Induced Thrombocytopenia and Thrombosis
Authors: Tarig Omer, Naresh Mullaguri, Pravin George, Christopher R Newey
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

Objective:
To report a case of false-negative serological tests in the diagnosis of heparin-induced thrombocytopenia (HIT) followed by a brief review of the literature on this topic.
Case presentation:
A 75-year-old Caucasian female patient was admitted with a traumatic right ankle fracture that required open reduction and internal fixation. Despite postoperative subcutaneous heparin chemoprophylaxis, she developed deep vein thrombosis (DVT) and pulmonary embolism (PE) on day 4 and subsequently started on continuous heparin infusion. On day 5, she suffered a stroke from a complete occlusion of the right common carotid artery with tandem occlusion of the right middle cerebral artery. She underwent successful thrombectomy of both arteries. The proposed stroke mechanism was paradoxical embolism through a patent foramen ovale. Over the next few days, thrombocytopenia was noted, the heparin drip was stopped, and HIT antibodies (antibodies targeting the complex of platelet factor 4 and heparin; PF4-H AB) and serotonin release assay (SRA) tests were sent. Because of the suspicion for HIT, she was started on bivalirudin with subsequent improvement in platelet count. Initial PF4-H AB and SRA tests were negative, bivalirudin was stopped, and heparin was restarted. Subsequently, her platelets trended down, again raising clinical suspicion of HIT. Repeat PF4-H AB and SRA testing resulted positive.
Conclusions:
A positive SRA in the appropriate context is considered for the diagnosis of heparin-induced thrombocytopenia. This case report highlights that false-negative serological evaluation is possible early in the course of the disease. Repeat testing is recommended in patients with high clinical suspicion.
An Unusual Pediatric Case of Allen Key Penetrating Trauma in Maxillofacial Region
Authors: Feride Fatma Görgülü, Orhan Görgülü, Ayşe Selcan Koç, Fatma Yasemin Öksüzler
Journal: Case Rep Radiol (2018)
MeSH terms: Case Reports

Paranasal sinus (PNS) foreign bodies are not common. They are usually due to penetrating trauma and iatrogenic events. On imaging, radiopaque foreign bodies can easily be detected by X-ray views of PNS. CT scan may be necessary to evaluate the exact location of foreign body in some cases. Foreign body in the PNS should be removed as early as possible. Approach and technique of its removal depend upon its size, shape, and location. Nasal endoscopic examination can be helpful for these cases. We present a pediatric girl case of penetrating FB injury inserted into the maxillary sinus towards nasopharynx in a suddenly braking car.
Severe Progressive Multifocal Leukoencephalopathy (PML) and Spontaneous Immune Reconstitution Inflammatory Syndrome (IRIS) in an Immunocompetent Patient
Authors: Lea Krey, Peter Raab, Romilda Sherzay, Georg Berding, Matthias Stoll, Martin Stangel, Florian Wegner
Journal: Front Immunol (2019)
Keywords: jc-virus, corticosteroid, immunocompetence, progressive multifocal leukoencephalopathy (pml), spontaneous immune reconstitution inflammatory syndrome (iris)
MeSH terms: Immune Reconstitution Inflammatory Syndrome / diagnosis, Immunocompromised Host, Leukoencephalopathy, Progressive Multifocal / diagnosis, Case Reports, Aged, Brain / diagnostic imaging, Brain / pathology, Humans, Immune Reconstitution Inflammatory Syndrome / etiology, Immune Reconstitution Inflammatory Syndrome / therapy, JC Virus / genetics, Leukoencephalopathy, Progressive Multifocal / etiology, Leukoencephalopathy, Progressive Multifocal / therapy, Magnetic Resonance Imaging, Male, Polymerase Chain Reaction, Positron-Emission Tomography, Serologic Tests

Background: Progressive multifocal leukoencephalopathy (PML) is an opportunistic infection with JC-virus (JCV), a papova-virus, affecting mostly oligodendrocytes and the white matter of the central nervous system. Progressive Multifocal Leukoencephalopathy (PML) almost exclusively occurs in immunocompromised patients based on different underlying conditions of severe cellular immunodeficiency such as HIV/AIDS, secondary to neoplastic and autoimmune diseases, or during immunosuppressive therapy. Case presentation: We present the case of an otherwise healthy and immunocompetent patient without immunosuppressive therapy who was admitted with hemianopsia to the right side, sensory aphasia and changes of behavior. Magnet resonance imaging (MRI) and laboratory testing confirmed the diagnosis of PML, although functional tests did not show any evidence for cellular immunodeficiency. Extensive immunological tests did not reveal an apparent immunodeficiency. During symptomatic therapy the patient developed seizures which were assumed to be caused by a spontaneous immune reconstitution inflammatory syndrome (IRIS) demonstrated by MRI. We added a high dose of intravenous corticosteroids to the antiepileptic treatment and seizures ended shortly thereafter. However, the impairments of vision, behavior and language persisted. Conclusions: Our case report highlights that an apparently immunocompetent patient can develop PML and IRIS spontaneously. Therefore, MRI should be applied immediately whenever a rapid progression of PML symptoms occurs as treatment of IRIS with corticosteroids can result in a marked clinical improvement.
Klippel-trénaunay syndrome with intracranial arteriovenous malformation: a rare presentation
Authors: Mahniya F Sadiq, Waqas Shuaib, Muhammad H Tiwana, Jamlik-Omari Johnson, Faisal Khosa
Journal: Case Rep Radiol (2014)

Klippel-Trénaunay syndrome (KTS) is a rare vascular congenital anomaly affecting less than 200,000 people in the United States. Vascular malformations associated with KTS tend to affect slow flow systems: venous, capillary, and lymphatic systems. The nature of the syndrome leads to a higher risk for the development of arteriovenous malformations. Our case presentation describes a patient with KTS and an associated rare presentation of intraventricular arteriovenous malformation (AVM).
Evaluation of Tumor Viability for Primary and Bone Metastases in Metastatic Castration-Resistant Prostate Cancer Using Whole-Body Magnetic Resonance Imaging
Authors: Hiromichi Iwamura, Yasuhiro Kaiho, Jun Ito, Go Anan, Nozomi Satani, Tomonori Matsuura, Ryo Tamura, Kazuhiro Murakami, Kaneki Koyama, Makoto Sato
Journal: Case Rep Urol (2018)
MeSH terms: Case Reports

In contrast to bone scan and computed tomography (CT), which depend on osteoblastic response to detect bone metastasis, whole-body magnetic resonance imaging (WB-MRI) may be able to directly detect viable tumors. A 75-year-old male who had progressive metastatic prostate cancer during primary androgen deprivation therapy was referred to our hospital. Although bone scan and CT showed multiple bone metastases, WB-MRI suggested nonviable bone metastasis and viable tumor of the primary lesion. Prostate needle biopsy demonstrated viable prostate cancer cells from 10 of 12 cores. In contrast, CT-guided needle biopsy from bone metastasis of the lumbar vertebra revealed no malignant cells. Based on these findings, we reasoned that viable tumor cells inducing disease progression may primarily exist in the primary lesions and not in the metastatic lesions, and combined prostate radiotherapy and systemic hormonal therapy resulted in successful clinical response and disease control. The use of WB-MRI to detect viable disease lesions may enable us to design optimal treatment strategies for patients with metastatic castration-resistant prostate cancer.