OpenMed/multicare-articles huggingface dataset:
Case report: Experience and insights on the treatment of two cases of cryptococcal meningitis during the later stages of the COVID-19 pandemic
Authors: Yuli Zhou, Bingfeng Qiu, Jun Jiang, Tianwen Chen, Liqian Wang, Yunxing Yang, Senlin Ruan, Yanlei Chen, Huanli Fang, Juan Jin, Nan Yang
Journal: Front Immunol (2024)
Keywords: cerebrospinal fluid morphology, cryptococcal meningitis, laboratory examinations, novel coronavirus, opportunistic infections
MeSH terms: Antifungal Agents / therapeutic use, COVID-19 / complications, COVID-19 / epidemiology, Meningitis, Cryptococcal / diagnosis, Meningitis, Cryptococcal / drug therapy, SARS-CoV-2, Case Reports, Research Support, Non-U.S. Gov't, Adult, Coinfection, Cryptococcus neoformans / isolation & purification, Female, Humans, Male, Middle Aged, Treatment Outcome, Antifungal Agents

In the late stages of the COVID-19 pandemic, there's an increasing trend in opportunistic infections, including bacterial and fungal infections. This study discusses the treatment process of two cases of cryptococcal meningitis during the COVID-19 pandemic. It highlights the importance of laboratory testing for these co-infections and stresses the need for vigilance, early diagnosis, and proactive treatment to improve patient outcomes in the post-pandemic era.
Hydatid of Morgagni in Young Female: A Rare Case of Acute Abdomen-Case Report and Literature Review
Authors: Taisia Bollettini, Francesco Molinaro, Alice Benigna, Enrico Ciardini, Gabriele Centini, Natale Calomino, Giulia Fusi, Messina Mario, Rossella Angotti
Journal: Case Rep Obstet Gynecol (2024)
MeSH terms: Case Reports

Torsion of the hydatid of Morgagni is a rare condition which can cause acute abdominal pain in young female. We present a case report of a 13-year-old girl with acute abdominal pain and treated for torsion of the hydatid of Morgagni. Less than 20 cases of female younger than 18 years old with this condition are been described in the literature. Through our systematic review performed following the PRISMA statement, we want to emphasize the difficulty in diagnosis and the importance of considering this pathology in the differential diagnosis of acute abdomen in females with the aim of obtaining a timely surgical treatment to preserve fertility in these patients.
A Peculiar Cause of Shock: Analysing Two Clinical Cases
Authors: João Oliveira, Alberto Costa-Silva, Luís Vale, Daniel Costa, Rui Almeida-Pinto, Carlos Martins-Silva, Tiago Antunes-Lopes, João Silva
Journal: Case Rep Urol (2023)
MeSH terms: Case Reports

Introduction:
Pheochromocytoma is a rare neoplasia arising from the adrenal medulla that secretes catecholamines. Those afflicted by this condition can present a wide range of symptoms. One of the most common is paroxysmic hypertension. Interestingly, although rare, some patients present with shock. We describe two cases of pheochromocytoma in which the initial presentation was shock. Case 1. 49 year-old woman, with a history of resistant hypertension, presented to the emergency department with thoracic pain and fever. EKG, echocardiogram (ECC), and myocardial necrosis markers were compatible with Takotsubo syndrome (TS). CT demonstrated a staghorn calculus, hydronephrosis, and signs compatible with xanthogranulomatous pyelonephritis in the right kidney. Additionally, and incidentally, it revealed a 60 mm nodule on the right adrenal gland. Piperacillin/tazobactam was started immediately, and the patient was submitted to urgent upper urinary tract drainage. This procedure was complicated by a cardiorespiratory arrest that was treated with adrenaline administration. The patient was admitted to the ICU due to multifactorial shock and started alpha and, posteriorly, beta blockage. Biochemical adrenal incidentaloma endocrinologic study was negative (under hemodialysis). Multiorgan failure progressively improved. After 2 weeks, the patient was submitted to a laparoscopic transperitoneal right adrenalectomy. No complications were reported. Histological analysis revealed a pheochromocytoma. Case 2. 28-year-old woman presented to the emergency department with headaches and nausea. Vitals were compatible with shock. CT revealed an incidental 72 mm mass on the right adrenal. EKG, ECC, and myocardial necrosis markers were compatible with TS. The patient was started on alpha and, posteriorly, beta blockage. Adrenal incidentaloma endocrinological study demonstrated high urinary catecholamines. Right transperitoneal adrenalectomy was performed. No complications were noted. Histological analysis revealed a pheochromocytoma.
Conclusion:
Pheochromocytoma can present with complex, enigmatic, and rare clinical pictures. Clinicians should be wary of the possibility of this diagnosis when managing adrenal masses.
Case report: IKZF1-related early-onset CID is expected to be missed in TREC-based SCID screening but can be identified by determination of KREC levels
Authors: Christofer Äng, Rolf H Zetterström, Kim Ramme, Emma Axelsen, Per Marits, Mikael Sundin
Journal: Front Immunol (2023)
Keywords: cid, hct (hematopoietic cell transplant), ikzf1, ikaros, scid, newborn screening
MeSH terms: Severe Combined Immunodeficiency / diagnosis, Severe Combined Immunodeficiency / genetics, Severe Combined Immunodeficiency / therapy, Case Reports, Research Support, Non-U.S. Gov't, Humans, Ikaros Transcription Factor / genetics, Infant, Infant, Newborn, Neonatal Screening, Phenotype, IKZF1 protein, human, Ikaros Transcription Factor

This report illustrates a case that would have been missed in the most common screening algorithms used worldwide in newborn screening (NBS) for severe combined immunodeficiency (SCID). Our patient presented with a clinical picture that suggested a severe inborn error of immunity (IEI). The 6-month-old baby had normal T-cell receptor excision circle (TREC) levels but no measurable level of kappa-deleting recombination excision circles (KRECs) in the NBS sample. A de novo IKZF1-mutation (c.476A>G, p.Asn159Ser) was found. The clinical picture, immunologic workup, and genetic result were consistent with IKZF1-related combined immunodeficiency (CID). Our patient had symptomatic treatment and underwent allogeneic hematopoietic cell transplantation (HCT). IKZF1-related CID is a rare, serious, and early-onset disease; this case provides further insights into the phenotype, including KREC status.
Extracorporeal membrane oxygenation in acute respiratory distress syndrome caused by elderly tuberculous meningitis: a case report and review of the literature
Authors: Zhaokun Shi, Xue Zhu, Wenwei Gao, Shuhui Yu, Liying Zhan
Journal: Front Med (Lausanne) (2024)
Keywords: ards, anti-tuberculosis therapy, extracorporeal membrane oxygenation, meningitis, tuberculous
MeSH terms: Case Reports

Diagnosing and clinical management of tuberculous meningitis (TBM) are still challenging for clinicians. Analysis of cerebrospinal fluid (CSF) is an important diagnostic tool for patients with suspected central nervous system (CNS) diseases. Acute respiratory distress syndrome (ARDS), an inflammatory lung injury, can be treated by mechanical ventilation, fluid management, and even extracorporeal membrane oxygenation (ECMO). In addition, metagenomic next-generation sequencing (mNGS) can facilitate the detection of atypical, rare pathogens in clinical specimens. We report a case of a 65-year-old man with ARDS caused by TBM. He was admitted with a fever and shaking. Despite aggressive initial treatment, the patient progressed rapidly and developed ARDS. Without positive results of mNGS and culture, anti-tuberculosis (TB) treatment was started. In order to improve oxygenation levels, he was placed on veno-venous ECMO for 8 days. On day 47, the tracheotomy catheter was pulled out and sealed. The patient was conscious and could communicate with family members as normal.
Digital Laser-Sintered Expander in Adolescent Patient with Hyperdontia and Molar Impaction
Authors: Greta Roussanova Yordanova-Kostova, Emanuel Emiliyanov, Nikolay Yanev
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Supernumerary teeth can have normal or abnormal morphologic structure and characteristics, and their impacted form is diagnosed usually during X-ray examinations. In this case report, the presented patient is a 16-year-old female with anterior and right posterior open bite and bilateral posterior crossbite, upper right supernumerary paramolar, and impacted second and third molars. The paramolar development was the reason for the asymmetric growth of the alveolar bone in the upper jaw. The development of the bone is connected with the development of the teeth, and one additional tooth leads to extensive development in the maxilla. There is a risk of gingival recession occurrence when leveling the lower incisors due to the thin gingival biotype. A combined surgical-orthodontic treatment was done according to the following plan: extraction of supernumerary paramolar, germectomy of the upper right third molar (18) and at the same time periodontal graft in the lower anterior segment. A digitally three-dimensional (3D) printed appliance for rapid maxillary expansion was used for the transverse insufficiency of the upper jaw. The upper dental arch expander was designed with distal extension in the area of the upper right second molar (17). The extension was used as an anchorage during the orthodontic traction of the second molar. The treatment continued with a fixed orthodontic appliance-braces in the upper and lower jaw. With the extraction of the impacted and supernumerary teeth in the right maxillary segment, the eruption of 17 was stimulated and a change in the height of the alveolar bone was achieved. This favored the vertical changes and normalization of the occlusion. The maxillary expansion was also a significant factor in normalizing the occlusion. Observations on paramolar behavior showed that more often they develop in the bone and do not erupt. Each clinical case is highly individual, and patients seek orthodontic treatment at different stages of dentition development and corresponding development of the supernumerary teeth.
Partial Rhombencephalosynapsis Presenting in an Adult with Cerebello-Trigeminal-Dermal Dysplasia
Authors: Frances Tiffany Cava Morden, Bao Xin Liang, Linda Nguyen, Enrique Carrazana, Arash Ghaffari-Rafi, Kore Kai Liow
Journal: Epilepsy Behav Rep (2024)
Keywords: adult, cerebellar dysfunction, cerebello-trigeminal-dermal dysplasia, first-time onset seizures, gomez-lopez-hernandez syndrome, rhombencephalosynapsis
MeSH terms: Case Reports

Gomez-Lopez-Hernandez syndrome (GLHS), also known as cerebello-trigeminal-dermal dysplasia, is a neurocutaneous disorder typically presenting in childhood. GLHS is characterized by rhombencephalosynapsis (RES) and partial alopecia, with or without trigeminal anesthesia. We describe a rare case of GLHS in a paucisymptomatic adult who presented with new-onset seizure-like activity. Magnetic resonance imaging revealed partial midline fusion of the cerebellar hemispheres, incomplete development of vermis, and slight medialization of the dentate nuclei: all consistent with the diagnosis of RES. Radiographic evidence combined with partial alopecia, truncal ataxia, and muscular hypotonia are suggestive GLHS diagnosis. Our report not only highlights the importance of maintaining GLHS on the differential for new-onset seizure-like activity, but also demonstrates how patients with GLHS may be minimally symptomatic and diagnosed in adulthood.
Lay summary:
The Gomez-Lopez-Hernandez syndrome (GLHS), or cerebellotrigeminal-dermal dysplasia, is a rare condition that affects both the nervous system and the skin. It involves abnormal development of the brain, partial alopecia [thinning of hair], and loss of sensation in the face. One specific brain malformation, called rhombencephalosynapsis (RES), results from abnormal formation of the cerebellum and is seen in GHLS.Both RES and GLHS present early in childhood, and cases presenting later in life are exceptionally rare. Here we describe a young adult with RES and GLHS whose normal development and mild clumsiness eluded recognition by doctors until early adulthood when she presented with a single seizure.
Concurrence of dermatomyositis and psoriasis: a case report and literature review
Authors: Dan Chu, Wei Yang, Jun Niu
Journal: Front Immunol (2024)
Keywords: case report, corticosteroid, dermatomyositis, pathogenesis, psoriasis
MeSH terms: Dermatomyositis / complications, Dermatomyositis / diagnosis, Dermatomyositis / drug therapy, Neoplasms / complications, Psoriasis / complications, Skin Diseases / complications, Review, Case Reports, Research Support, Non-U.S. Gov't, Humans, Male, Skin / pathology

Dermatomyositis (DM) is a type of inflammatory myopathy with unknown causes. It is characterized by distinct skin lesions, weakness in the muscles close to the body, and the potential to affect multiple organs. Additionally, it may be associated with the presence of malignancies. The development of DM is influenced by genetic susceptibility, autoimmune response, and various external factors like cancer, drugs, and infectious agents. Psoriasis is a chronic, recurring, inflammatory, and systemic condition. Scaly erythema or plaque is the typical skin manifestation. The etiology of psoriasis involves genetic, immune, environmental and other factors. It is uncommon for a patient to have both of these diseases simultaneously, although individuals with DM may occasionally exhibit symptoms similar to those of psoriasis. Our patient was diagnosed with psoriasis in his 50s because of scalp squamous plaques, but he did not receive standard treatment. Ten years later, he developed symptoms of muscle pain and limb weakness. He was diagnosed with psoriasis complicated with dermatomyositis in our department and received corresponding treatment. Moreover, we reviewed the relevant literature to evaluate similarities and differences in clinical manifestation and treatment to other cases.
Hyperglycemia-Induced Complete Left-Sided Hemiballismus Due to Uncontrolled Diabetes in a 70-Year-Old Female: A Case Report
Authors: Taylor F Faust, Julee Reitzel, Aftab Khan, Garrett M Cail, Raphael Quansah
Journal: Cureus (2024)
Keywords: basal ganglia disease, diabete mellitus, diabetic ketoacidosis, non-ketotic hyperglycemia hemichorea-hemiballismus syndrome, putamen
MeSH terms: Case Reports

This report details the presentation of a 72-year-old female with left-sided continuous non-rhythmic involuntary movements persisting for two months. The movements affected the left side of her face, arm, and leg. The patient had a history of multiple hyperglycemic episodes and diabetic ketoacidosis. This report investigates the basal ganglia's involvement in hemiballismus, a movement disorder possibly linked to the patient's hyperglycemia. It discusses the complex management of hyperglycemia-induced hemiballismus and the need for more research to understand the underlying mechanism and optimal treatment strategies.
Case report: Cyclophosphamide pulse therapy for chronic recalcitrant erythema nodosum leprosum
Authors: Gustavo U Machado, Thiago Amparo, Flávia Bulhões, Paulo R L Machado
Journal: Front Med (Lausanne) (2023)
Keywords: cyclophosphamide, erythema nodosum leprosum (enl), leprosy, pulse therapy, type 2 reaction
MeSH terms: Case Reports

Chronic recalcitrant erythema nodosum leprosum (ENL) or type 2 reaction (T2R) is a severe condition found in approximately 50% of multibacillary leprosy subjects. T2R is associated with important morbidities and may lead to several disabilities, not only due to nerve damage but also due to the prolonged use of corticosteroids, thalidomide, or immunosuppressors. We describe here four leprosy patients with chronic recalcitrant ENL treated with cyclophosphamide pulse therapy. All subjects had been on prednisone and thalidomide therapy for at least 30 months but showed inflammatory activity when doses were reduced. Pulse therapy with 1.0 g of cyclophosphamide was used every 4-6 weeks for a minimum of three applications. After pulse therapy, all cases presented total or partial regression of symptoms, and we were able to taper thalidomide and prednisone doses, with better control of ENL, avoiding further hospital admissions and disabilities. No side effects were observed during or after infusion therapy. Cyclophosphamide pulse therapy may be useful and safe to control chronic recalcitrant ENL.
Effectiveness of Neurorehabilitation in Improving the Functional Recovery and Quality of Life of Patients With Parkinson's Disease: A Case Report
Authors: Pinky D Israni, Vaishnavi Yadav, Anam R Sasun
Journal: Cureus (2024)
Keywords: case report, exergames, neurorehabilitation, outcome measures, parkinson's disease, physical therapy, physiotherapy, virtual reality, voluntary movements
MeSH terms: Case Reports

Parkinson's disease (PD) is a degenerative neurological illness characterized by various motor and non-motor symptoms that can lead to varying degrees of functional impairment. Key neuropathological findings include Lewy bodies containing synuclein and the loss of dopaminergic neurons in the substantia nigra, reducing the facilitation of voluntary movements. The disease is marked by bradykinesia, rigidity, and tremors. Here, we present the case of a 56-year-old man who sought neurorehabilitation due to tremors, slowness of movements, and weakness. The rehabilitation plan was carefully devised with weekly goals. The rehabilitation spanned six weeks, during which the individual showed positive improvement in all measured outcomes. Virtual reality and exergame technologies have emerged as prominent tools for enhancing balance and gait in PD. Our study utilized outcome measures such as the Unified Parkinson's Disease Rating Scale, the World Health Organization Quality-of-Life Scale, and the Barthel Index. Neurophysiotherapy plays a significant role in enhancing a patient's functional rehabilitation.
Metastatic mucinous adenocarcinoma from breast mimicking a pyogenic granuloma in the gingiva: a case report
Authors: Rudra Prasad Chatterjee, Sangeeta Sinha, Debdita Banerjee, Lamia Parveen, Sanchita Kundu
Journal: Pan Afr Med J (2024)
Keywords: adenocarcinoma, case report, metastatic, mucinous, pyogenic granuloma
MeSH terms: Adenocarcinoma, Mucinous / diagnosis, Adenocarcinoma, Mucinous / pathology, Gingival Neoplasms / diagnosis, Gingival Neoplasms / pathology, Gingival Neoplasms / secondary, Granuloma, Pyogenic / diagnosis, Mouth Neoplasms, Case Reports, Female, Gingiva / pathology, Humans, Middle Aged

Mucin-producing adenocarcinomas (MAC) are an extremely rare, indistinct group of neoplasm having either a salivary gland origin or with prominent glandular component. The diagnosis is chiefly based on the histological aspect conjoined with immunohistochemical evaluation as clinico-radiographical features are non-specific. It can arise as a primary metastasis to soft tissues, most commonly from either lung, breast, kidney, or colon. This paper reports a 51-year-old woman with buccolingual gingival swelling having a final diagnosis of metastatic mucinous adenocarcinoma from the breast. A tissue biopsy was performed followed by immunohistochemistry that confirmed the diagnosis. They are extremely rare, making the diagnosis challenging as it may mimic a benign neoplasm. It accounts for approximately 1% of all oral malignant neoplasms having gingival propensity. The clinician should therefore take into account every diagnostic aspect while encountering such oral lesions to achieve proper patient welfare.
Sternoclavicular Septic Arthritis and Surgical Intervention: A Case Report
Authors: Abdullah Alnasser, Zeyad S Alamari, Taif M Almutairi, Hamid T Aljohani, Ahmed M Almulla
Journal: Cureus (2024)
Keywords: conservative and surgical treatment, empirical antibiotic therapy, medial clavicle resection, shoulder range of motion, sternoclavicular joint (scj) septic arthritis
MeSH terms: Case Reports

Management of septic arthritis is an area of controversy, especially in rare locations like the sternoclavicular joints. In this case report, we present a case of septic sternoclavicular joint, which was resistant to medical treatment and deteriorated during the treatment course. Although medical treatment has proven effective based on previous literature, some cases will still not benefit from it. In this case, our patient responded significantly to surgical treatment regarding upper limb function, faster infection eradication and rehabilitation, and shorter hospitalization and antibiotics duration.
Endobronchial Infection and Bacterial Lymphadenitis by Gemella morbillorum Leading to Airway Perforation and a Bronchopleural Fistula
Authors: Kaitlin N DePrez, John Ferguson
Journal: Case Rep Pulmonol (2024)
MeSH terms: Case Reports

Introduction: Necrotizing bronchial infection with severe infectious lymphadenitis is infrequently encountered and most commonly ascribed to Aspergillus, Histoplasma, and Mycobacterium species. We present a unique cause of severe airway destruction with lymphadenitis and bronchopleural fistula formation by the bacterium Gemella morbillorum. Case: A 24-year-old man presented with acute symptoms of vomiting, fever, and shoulder pain. A CT of the chest demonstrated a large subcarinal mass encasing the central bronchi. The workup for malignant, fungal, and granulomatous etiologies was unrevealing, while blood cultures identified G. morbillorum. Fiberoptic bronchoscopy revealed a perforation of the right middle lobar bronchus and the formation of a bronchopleural fistula, resulting in a large hydropneumothorax with empyema. Despite antibiotic therapy, surgical intervention to repair the fistula, and ventilatory support, the progression of the bronchopleural fistula led to fatal respiratory failure. Conclusion: In cases of severe mediastinal adenopathy in a young patient, bacterial lymphadenitis should be considered in the differential diagnosis with lymphoma, germ cell tumor, granulomatosis with polyangiitis, sarcoidosis, histoplasmosis, and inflammatory myofibroblastic tumor.
Case Report: Stretching the limits-late valvuloplasty for THV dysfunction following redo mitral valve-in-valve implantation
Authors: David Meier, Georgios Tzimas, Mariama Akodad, Ali Husain, James Dundas, Julius Jelisejevas, Anson Cheung, Stephanie L Sellers, Jonathon A Leipsic, Philipp Blanke, David A Wood, Janarthanan Sathananthan, John G Webb
Journal: Front Cardiovasc Med (2023)
Keywords: balloon dilatation, late valvuloplasty, mitral valve in valve, over-expansion, redo mitral valve in valve
MeSH terms: Case Reports

Late balloon valvuloplasty can be used to treat under-expansion-related transcatheter heart valve (THV) dysfunction. Whether this can be performed following redo-THV implantation is unknown. Herein, we report a case of a 72-year-old male presenting with symptomatic gradient elevation following redo mitral valve-in-valve implantation. The patient was successfully treated with late balloon valvuloplasty with gradient improvement. In conclusion, late valvuloplasty is effective even with several layers of valves. However, larger studies are required to clarify the role of this approach further.