OpenMed/multicare-articles huggingface dataset:
Case report: Persistence of residual antigen and RNA of the SARS-CoV-2 virus in tissues of two patients with long COVID
Authors: Denise Goh, Jeffrey Chun Tatt Lim, Sonia Bilbao Fernaíndez, Craig Ryan Joseph, Sara Gil Edwards, Zhen Wei Neo, Justina Nadia Lee, Sílvia Guerrero Caballero, Mai Chan Lau, Joe Poh Sheng Yeong
Journal: Front Immunol (2022)
Keywords: long covid, multiplex immunohistochemistry, post-acute covid-19 syndrome, residual sars-cov-2, viral persistence
MeSH terms: COVID-19 / complications, SARS-CoV-2, Case Reports, Research Support, Non-U.S. Gov't, Antibodies, Viral, Antigens, Viral, Humans, Nucleocapsid Proteins, Post-Acute COVID-19 Syndrome, RNA, Viral, Antibodies, Viral, Antigens, Viral, Nucleocapsid Proteins, RNA, Viral

The World Health Organization has defined long COVID-19 (LC) as a condition that occurs in individuals with a history of SARS-CoV-2 infection who exhibit persistent symptoms after its acute phase that last for at least two months and cannot be explained by an alternative diagnosis. Since we had previously reported residual viral antigens in tissues of convalescent patients, we aimed to assess the presence of such antigens in long COVID tissues. Here, we established the presence of the residual virus in the appendix, skin, and breast tissues of 2 patients who exhibited LC symptoms 163 and 426 days after symptom onset. With multiplex immunohistochemistry, we detected viral nucleocapsid protein in all three tissues. The nucleocapsid protein was further observed to colocalize with macrophage marker CD68, suggesting that immune cells were direct targets of SARS-CoV-2. Additionally, using RNAscope, the presence of viral RNA was also detected. Our positive finding in the breast tissue is corroborated by the recent reports of immunocompromised patients experiencing LC symptoms and persistent viral replication. Overall, our findings and emerging LC studies raise the possibility that the gastrointestinal tract may function as a reservoir for SARS-CoV-2.
Echocardiographic assessment and percutaneous closure of multiple atrial septal defects
Authors: Andrew R J Mitchell, Philip Roberts, Jonas Eichhöfer, Jonathan Timperley, Oliver J M Ormerod
Journal: Cardiovasc Ultrasound (2004)
MeSH terms: Balloon Occlusion / methods, Echocardiography / methods, Heart Septal Defects, Atrial / diagnostic imaging, Heart Septal Defects, Atrial / surgery, Ultrasonography, Interventional / methods, Case Reports, Adult, Balloon Occlusion / instrumentation, Cardiac Catheterization / instrumentation, Cardiac Catheterization / methods, Female, Humans, Prognosis, Treatment Outcome

Atrial septal defect closure is now routinely performed using a percutaneous approach under echocardiographic guidance. Centrally located, secundum defects are ideal for device closure but there is considerable morphological variation in size and location of the defects. A small proportion of atrial septal defects may have multiple fenestrations and these are often considered unsuitable for device closure. We report three cases of multiple atrial septal defects successfully closed with two Amplatzer septal occluders.
The Challenge of Melanocytic Lesions in Pediatric Patients: Clinical-Pathological Findings and the Diagnostic Value of PRAME
Authors: Giuseppina Rosaria Umano, Maria Elena Errico, Vittoria D'Onofrio, Giulia Delehaye, Letizia Trotta, Claudio Spinelli, Silvia Strambi, Renato Franco, Giuseppe D'Abbronzo, Andrea Ronchi, Alfonso Papparella
Journal: Front Oncol (2021)
Keywords: prame, atypical spitzoid tumor, children, immunohistochemistry, melanoma

Pediatric melanoma is a rare disease especially in children aged younger than 10 years old. Recent estimates report a rise of disease incidence in both adults and children. Diagnostic work-up is challenging in pediatric melanoma, as it displays a wide range of clinical presentations. Immunohistochemical biomarkers have been reported as predictors of malignancy in melanoma, however data specific to pediatric melanoma are poor. Our study aims to contribute to provide evidence of pediatric melanoma clinical features and differential diagnosis in this patient population. We describe our experience with a retrospective case series of pigmented skin lesions including malignant melanoma, atypical spitzoid tumor, and benign nevi in children and adolescents aged less than 16 years. We described the clinical and demographic characteristics of the cohort and evaluated the immunohistochemical expression of the PReferentially expressed Antigen in MElanoma (PRAME) for differential diagnosis of melanoma in children. The series displayed a similar distribution of melanoma between males and females, and the most common site of melanoma onset were the upper and lower limbs. In our cohort, PRAME was negative in most cases. Focal and slight positivity (from 1 to 5% of the neoplastic cells) was observed in four cases (two Spitz nevi and two atypical Spitz tumors). A moderate positivity in 25% of the neoplastic cells was observed in one case of atypical Spitz tumor. Immunohistochemical expression of PRAME might be useful in the differential diagnosis of malignant melanoma.
Traumatic Penetrating Neck Injury with Right Common Carotid Artery Dissection and Stenosis Effectively Managed with Stenting: A Case Report and Review of the Literature
Authors: Seidu A Richard, Chang Wei Zhang, Cong Wu, Wang Ting, Xie Xiaodong
Journal: Case Rep Vasc Med (2018)
MeSH terms: Case Reports

Introduction:
Penetrating neck injuries (PNI) are common and associated with arterial and other neuronal injuries. Although many authors have written on penetrating and blunt carotid artery injuries as a result of PNI or traumatic neck injuries, no one has reported a case or case series on PNI that resulted in blunt carotid dissection and stenosis.
Case presentation:
We present a case of 40-year-old building and construction male worker who slipped and fell on an iron rod that resulted in penetrating wound on the right side of the anterior neck a week prior to presenting at our facility. He pulled out the iron rod immediately. Computer tomography angiography (CTA) done revealed C2-C4 transverse process fractures on the right side and a fracture at the right lamina of C3 and right common carotid artery dissection with stenosis. He was successfully treated with stenting via endovascular approach.
Conclusions:
We adopt the view that patient should never pull out objects that result in PNI because of complex neurovascular architecture of the neck. The mortality rate of our patient will have doubled if the iron rode penetrated the common carotid artery. The gold standard treatment option for carotid artery dissection and stenosis is endovascular approaches.
The Clinical Course and Management of Severe Esophagitis Dissecans Superficialis: A Case Report
Authors: Isaac Jaben, Richard Schatz, Ira Willner
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: dysphagia, endoscopy, esophagus, odynophagia
MeSH terms: Esophagitis / diagnosis, Esophagitis / drug therapy, Esophagus / pathology, Steroids / administration & dosage, Case Reports, Aged, Deglutition Disorders / etiology, Esophagoscopy, Humans, Male, Methylprednisolone / administration & dosage, Prednisone / administration & dosage, Steroids, Prednisone, Methylprednisolone

Esophagitis dissecans superficialis is a rare clinical endoscopic finding with poorly understood pathogenesis and ill-defined management. A 71-year-old man is admitted with progressively worsening dysphagia and odynophagia with endoscopic features most consistent with severe esophagitis dissecans superficialis. Extensive workup did not reveal an etiology, and he was subsequently treated with steroids, resulting in rapid, almost complete clinical and endoscopic recovery.
Bacteremia and Urinary Tract Infection Caused by Chromobacterium violaceum: Case Reports from a Tertiary Care Hospital in Kathmandu, Nepal
Authors: Narayan Dutt Pant, Subhash Prasad Acharya, Raju Bhandari, Uday Narayan Yadav, Dil Bahadur Saru, Manisha Sharma
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

Chromobacterium violaceum is ubiquitous in the environment of tropical and subtropical regions but the infections caused by this organism are rare and the urinary tract infections caused by it are even rarer. Due to the propensity for hematogenous spread leading to fatal sepsis, the infections caused by Chromobacterium violaceum have high mortality rate (65-80%) with death occurring in as less as one week of acquiring infection. So, prompt proper treatment is necessary for successful treatment of the infections but, due to the rarity of the infections caused by the organism, there is limited awareness among the clinicians regarding the infections caused by this organism. Here, we reported a case of urinary tract infection caused by Chromobacterium violaceum in a 84-year-old male, who was a kidney patient, and another case of bacteremia caused by the same bacterium in a road traffic accident patient (22-year-old male), both of which were managed with the timely suitable treatment.
A Successful Treatment of Endoscopic Third Ventriculostomy with Choroid Plexus Cauterization for Hydrocephalus in Walker-Warburg Syndrome
Authors: Tomoko Tanaka, Catharine J Harris, Sarah S Barnett, N Scott Litofsky
Journal: Case Rep Neurol Med (2016)
MeSH terms: Case Reports

Walker-Warburg syndrome (WWS) is a rare autosomal recessive congenital muscular dystrophy with brain malformations and ocular abnormalities that falls under the wider phenotypic spectrum of the dystroglycanopathies. Mutations in a number of genes including POMT1, POMT2, POMGNT1, POMGNT2, FKTN, FKRP, LARGE, and ISPD are known to cause alpha dystroglycan-related muscular dystrophy. Mutations in these genes result in a broad phenotypic spectrum ranging from the severe WWS to a mild congenital muscular dystrophy with no brain involvement. WWS is fatal to most patients early in life with mean survival of 9 months. The most common brain finding is cobblestone lissencephaly with the vast majority of patients (97%) also having ventricular dilation with or without hydrocephalus. Surgical treatment has not been frequently detailed. This report describes our successful treatment of a patient with WWS and hydrocephalus with Endoscopic Third Ventriculostomy (ETV) with choroid plexus cauterization (CPC). Fourteen months following treatment, a follow-up MRI CSF flow study demonstrated robust CSF flow through floor of third ventricle from interpeduncular cistern to lateral ventricle.
Massive Thrombosis of the Right Atrium Extended to the Superior Vena Cava at the Diagnosis of Acute Myeloid Leukemia
Authors: Bienvenu Houssou, Gnon Gourou Orou-Guiwa, Rachida Habbal, Meryem Qachouh, Asmaa Quessar
Journal: Case Rep Cardiol (2016)

Introduction. Venous thromboembolic disease is a common complication found in 8% of patients with acute myeloid leukemia. The location at the right atrium is exceptional. These last fifty years, only 6 cases of thrombosis of the atrium in the diagnosis of acute myeloid leukemia were published on PubMed search engine. Case Presentation. 35-year-old farmer, who had been admitted by emergency department for superior vena cava syndrome and had a hyperleukocytic AML with complex karyotype associated with a significant thrombosis of the right atrium, extended all along the superior vena cava. He has been treated by the 2011 AML protocol using low molecular weight heparin and died from respiratory distress. Conclusions. If thrombosis is common in AML, the location in right atrium is rare. Its management requires surgery that is sometimes difficult to achieve.
Chorea and retinal vessel occlusion in a patient with systemic lupus erythematosus
Authors: Vahid-Reza Ostovan, Askar Ghorbani
Journal: Iran J Neurol (2013)
Keywords: antiphospholipid syndrome, chorea, retinal vessel occlusion, systemic lupus erythematosus
MeSH terms: Case Reports

Various neurological complications occur in primary or secondary antiphospholipid syndrome (APS) consisting of cerebrovascular attacks, ocular events, dementia, seizure, chorea, and transverse myelopathy that are all related to the titer of antiphospholipid antibodies (aPL). We report a patient with chorea and retinal vessel occlusion as manifestations of systemic lupus erythematosus (SLE) and APS. A 27-year-old man presented with progressive visual field defect and decreases visual acuity of right eye (OD) as well as involuntary movements in both hands and slurred speech. Investigations led to the diagnosis of SLE and APS. Anticoagulant and immunosuppressant was started for him. As his condition improved, the prednisolone was gradually tapered. This is the first case report of concomitant retinal vessel occlusion and chorea in SLE and APS.
Helium Hand - High Pressure Injection Injury
Authors: Brandon Funk, Francis Flaherty, Edward Gillis
Journal: J Belg Soc Radiol (2023)
Keywords: compartment syndrome, hand injury, helium, high pressure injection, subcutaneous emphysema
MeSH terms: Case Reports

Teaching Point: High-pressure injection injuries are clinically significant injuries which may be underappreciated on initial physical exam and which require a high index of suspicion and early clinical intervention to avoid negative outcomes.
Acute thrombosis in mitralic mechanical prosthesis: a case report
Authors: Enrico Vizzardi, Antonio D'Aloia, Gregoriana Zanini, Elena Antonioli, Ermanna Chiari, Livio Dei Cas
Journal: Cases J (2009)

We describe a case of a man, 42 years old, submitted to successful fibrinolitic strategy with rTPA in acute mitralic prosthesis valve thrombosis and ipomobility of one emidisk. There aren't a consensus agreement in therapeutic strategy but we may support the approach of some authors that employ fibrinolisis in patients without absolute or relative controindications and if thrombus dimension is less than 1 cm otherwise they make use of heparin therapy in non obstructive thrombosis with successive transesophageal echocardiography evaluation for the efficacy and the later indication for thrombolisis or surgery treatment.
Hemolytic uremic syndrome and Clostridium difficile colitis
Authors: Maryam Keshtkar-Jahromi, Mahsa Mohebtash
Journal: J Community Hosp Intern Med Perspect (2012)
Keywords: clostridium difficile, colitis, hemolytic uremic syndrome
MeSH terms: Case Reports

Hemolytic uremic syndrome (HUS) can be associated with different infectious etiologies, but the relationship between pseudomembranous colitis and HUS was first described in the 1970s in some childhood patients. There is very limited published literature on Clostridium difficile-associated HUS. We report a case of C. difficile-related HUS in an adult patient and provide a review of the literature.
Warm autoimmune haemolytic anaemia complicated by simultaneous arterial and venous thromboses: a case report
Authors: Ela Ćurčić, Ozrenka Zlopaša, Sara Šundalić, Mia Rora, Radovan Radonić, Ana Vujaklija Brajković
Journal: Pan Afr Med J (2022)
Keywords: warm autoimmune haemolytic anaemia, anticoagulation, case report, thrombosis
MeSH terms: Anemia, Hemolytic, Autoimmune / complications, Anemia, Hemolytic, Autoimmune / diagnosis, Thrombosis, Venous Thromboembolism, Venous Thrombosis / complications, Venous Thrombosis / etiology, Case Reports, Adult, Anticoagulants / therapeutic use, Humans, Male, Anticoagulants

The novelty described in this case report is the simultaneous development of arterial and venous thrombosis in a previously healthy Caucasian 37-year-old male with newly diagnosed warm autoimmune haemolytic anaemia (WA-AIHA). Clinical presentation included sensorimotor dysphasia, right arm paresis, abdominal pain, and swelling of the left leg. Computed tomography angiography showed partial occlusion of the left middle cerebral artery and multiple infarcts of the kidneys and spleen, while Doppler ultrasound revealed thrombosis of the left popliteal vein. A therapeutic dose of low-molecular-weight-heparin was instituted together with rituximab, leading to the complete serological and haematological remission. The exact thrombotic risk factors in WA-AIHA are still not completely identified and no generally accepted guidelines on thromboprophylaxis exist. The severe onset of the WA-AIHA might point towards a close association between haemolysis itself and thrombosis, raising the question of the necessity of prophylactic anticoagulation.
A Guttate Psoriasis That Tends to Spare Three Tattoos: A Macrophage Liaison
Authors: Panagiota Spyridonos, Vasiliki Zampeli, Sophia-Nefeli Rapti, Ioannis D Bassukas
Journal: Case Rep Dermatol Med (2021)
MeSH terms: Case Reports

Induction of new psoriasis sites was reported in only a small amount of psoriasis patients undergoing tattooing, despite the intuitive belief that tattoo trauma might awaken the disease due to the isomorphic phenomenon of Koebner. In this case report, we discuss a patient who presented with a remarkable sparing of his three tattoo sites during a guttate psoriasis flare-up that was unrelated to tattooing. The spatial concordance of tattoo and psoriasis lesions was analyzed on clinical pictures of tattoo sites taken during the psoriasis episode. For the quantification of the spatial distribution of the psoriasis lesions, Voronoi diagrams were generated, and coefficients of variation and the two-sample t-test were employed to compare the distributions of Voronoi patch sizes in different settings. Compared to skin areas without tattoos, a tattoo introduced a higher variation in the sizes of the Voronoi patches centered around psoriasis lesions. Based on our findings, we would like to discuss the possible role of macrophages as the key cellular link in the complex pathophysiologic relationship between tattooing/tattoo and psoriasis. Taking into account the relationship of autophagy and psoriasis lesions, we propose the hypothesis that tattoos represent a "psoriasis-hostile" tissue environment pertained by a population of LAP active M2-polarized macrophages. Further clinical studies of the relationship of psoriasis lesions to the tattooed skin are needed and may provide important insights into the role of macrophages in the pathogenesis of psoriasis.
Case Report: Wernicke's encephalopathy after gastric surgery presenting as lactic acidosis and refractory thrombocytopenia
Authors: Qi Lin, Guanghua Li, Zhixiong Wang, Yu Zhang
Journal: Front Surg (2023)
Keywords: wernicke's encephalopathy, gastric cancer, lactate, postoperative management, thrombocytopenias
MeSH terms: Case Reports

Wernicke's encephalopathy (WE) is a severe neuropsychiatric disorder, mainly resulting from a nutritional deficiency of thiamine. WE is hard to detect at an early stage. Less than 20% of WE can be diagnosed during a patient's lifetime, and WE tends to occur in patients with chronic alcoholism. Therefore, a large proportion of non-alcoholic WE patients are misdiagnosed. Lactate is an important by-product of anaerobic metabolism when the aerobic metabolism is blocked without thiamine, which can potentially serve as an alerting index for WE. Here, we report a case of a patient with WE who suffered gastric outlet obstruction following postoperative fasting, accompanied by lactic acidosis and refractory thrombocytopenia. A 67-year-old non-alcoholic woman who suffered hyperemesis for 2 months was diagnosed with gastric outlet obstruction (GOO). Gastric biopsies with endoscopy revealed gastric cancer, and total gastrectomy, together with D2 nodal dissection, was performed. She developed a coma with refractory thrombocytopenia rapidly after the surgical procedures were performed. The above conditions were treated not by the administration of antibiotics but by that of thiamine. We also found before the start of the procedures that she had a high level of blood lactate for a long period of time. Early diagnosis of WE is important because permanent injury can be caused to the central nervous system. Even today, the diagnosis of WE mainly depends on clinical symptoms, but occasionally, a typical triad occurs among WE patients. Therefore, a sensitive index for early diagnosis is critical for WE. Rising levels of blood lactate as a result of thiamine deficiency can serve as a warning for WE. In addition, we noted that this patient had a non-typical thiamine-sensitive refractory thrombocytopenia.
Case report: Spinal drop metastasis of IDH-mutant, 1p/19q-codeleted oligodendroglioma
Authors: Ahmet Kursat Karaman, Bora Korkmazer, Nil Urganci, Gülçin Baş, Serdar Arslan, Nil Comunoglu, Mehmet Murat Hanci, Osman Kızılkılıç
Journal: Front Neurol (2022)
Keywords: 1p/19q-codeletion, idh1 (r132h) mutation, drop metastases, oligodendroglioma, spinal metastasis
MeSH terms: Case Reports

Background:
Symptomatic spinal metastases of oligodendroglioma are rare. Moreover, none of the previously published cases demonstrated the typical IDH mutation and 1p/19q-codeletion for this glial tumor. This case presents an IDH mutant, 1p/19q-codeleted oligodendroglioma with multiple spinal drop metastases.
Case description:
We report a case of a 55-year-old woman with left frontal grade 3 oligodendroglioma diagnosed 3 years ago. No tumor recurrence was observed in post-operative follow-up MRI examinations. However, she was admitted to our institution again with severe low back pain. Gadolinium enhanced MRI of the spine revealed an intradural, extramedullary metastatic lesion between T11-L1 levels and multiple enhancing metastatic tumor deposits around cauda equine roots between L4-S1. T11-T12 midline laminectomy was performed and gross total resection of metastatic lesions was achieved. Final histological diagnosis of the spinal lesions was WHO Grade 3 Oligodendroglioma, IDH-mutant, 1p/19q-codeleted.
Conclusion:
This case is the first molecularly-defined spinal metastatic oligodendroglioma. The possibility of drop metastasis should be kept in mind in oligodendroglioma patients with spinal cord-related symptoms. There is no standard approach for the diagnosis and treatment of spinal metastases of this type of glial tumor.
Bilateral acute zonal occult outer retinopathy (AZOOR) in a young adult Indian male
Authors: Pukhraj Rishi, Ekta Rishi
Journal: GMS Ophthalmol Cases (2019)
Keywords: acute zonal occult outer retinopathy, eye, macula, maculopathy
MeSH terms: Case Reports

A 31-year-old male presented with central scotoma of 9 months duration in the right eye and a similar complaint in the left eye, since a week. Best corrected visual acuity (BCVA) was 20/60 in the right eye and 20/30 in the left eye. Clinical features and supportive investigations were consistent with the diagnosis of acute zonal occult outer retinopathy (AZOOR). The patient was treated with systemic steroids. At 3-month follow-up visit, BCVA improved to 20/40 in the right eye and remained at 20/30 in the left eye. Humphrey's visual field showed a slight reduction of scotoma in both eyes.