OpenMed/multicare-articles huggingface dataset:
Nonalcoholic Wernicke's Encephalopathy Associated with Unintentional Weight Loss, Cholecystectomy, and Intractable Vomiting: The Role of Dual Thiamine and Corticosteroid Therapy
Authors: Vivek Verma, Chenell Donadee, Leslie Gomez, Marina Zaretskaya
Journal: Case Rep Neurol Med (2014)

A 23-year-old male with one month of intractable vomiting, subsequent cholecystitis status post cholecystectomy, and overall 40-pound weight loss over the last few months presented with altered mental status and seizures. MRI showed signal abnormalities involving the hypothalamus, periaqueductal gray matter, 4th ventricle, and bilateral thalami, indicative of Wernicke's encephalopathy. The patient was started on empiric IV thiamine and methylprednisolone; thiamine levels were subsequently found to be low. Infectious disease workup was negative. Within a few days of this therapy, the patient's neurological status steadily improved with increased responsiveness and communication. Repeat MRI 7 days after admission showed significant resolution of the signal abnormalities. Over the next several weeks the patient became fully conversational, cognitively intact, and increasingly ambulatory. Nonalcoholic Wernicke's encephalopathy is rare; there have been reports relating it separately to vomiting and invasive surgery. In this case report, we associate it with both recurrent vomiting and minimally invasive cholecystectomy. We also discuss combinatorial therapy of thiamine and corticosteroids, which is poorly defined in the literature. Though there is no consensus-based optimal treatment of Wernicke's encephalopathy, this adds to the discussion of using dual therapy and supports that the use of empiric corticosteroids does not harm the patient.
Case Report: Two Novel L1CAM Mutations in Two Unrelated Chinese Families With X-Linked Hydrocephalus
Authors: Hang Zhou, Qiuxia Yu, Yingsi Li, Fang Fu, Ru Li, Guilan Chen, Dan Wang, Yan Lu, Xin Yang, Dongzhi Li, Can Liao
Journal: Front Genet (2022)
Keywords: l1cam, case report, exome sequence, hydrocephalus, prenatal diagnosis
MeSH terms: Case Reports

L1 cell adhesion molecule is a type I transmembrane glycoprotein belonging to the immunoglobulin superfamily. Pathogenic mutations of L1CAM can cause L1 syndrome, referred to as a variety of disease spectrums characterized by hydrocephalus. In the present study, we reported two novel variants of L1CAM in two unrelated Chinese families with fetal hydrocephalus history. The woman of family 1, with three consecutive adverse birth histories of male fetuses with hydrocephalus, was identified by an exome sequence with a heterozygous mutation in the L1CAM gene, NM_000425.4: c.1696_1703 + 14del (p. S566Vfs*35), which was predicted to be pathogenic. It is predicted to disrupt RNA splicing and likely leads to an absent or disrupted protein product. In family 2, the mother, previously with once a voluntary termination of pregnancy owning to the fetus with hydrocephalus, was pregnant with a fetus with hydrocephalus in her second pregnancy. After fetal blood sampling, a pathogenic deletion of 1511bp in L1CAM, chromosome X: 153131395-153132905(hg19/GRCh37)/NM_000425.4: c.2043_2432-121del1511 leading to deletion of fibronectin type-III repeats I-II, was identified in the fetus with hydrocephalus inherited from the mother by an exome sequence. On her third pregnancy, a healthy female fetus was born without the L1CAM variant by preimplantation genetic testing for the monogenic disorder. This study emphasizes the importance of ultrasonic manifestation and family history of fetal hydrocephalus for L1CAM diagnosis. Our study expands the genotypes of L1CAM and aids the genetic counseling of fetal hydrocephalus and even preimplantation genetic testing for the monogenic disorder.
Case Report: Chronic Adaptive Deep Brain Stimulation Personalizing Therapy Based on Parkinsonian State
Authors: Asuka Nakajima, Yasushi Shimo, Atsuhito Fuse, Joji Tokugawa, Makoto Hishii, Hirokazu Iwamuro, Atsushi Umemura, Nobutaka Hattori
Journal: Front Hum Neurosci (2021)
Keywords: parkinson's disease, adaptive deep brain stimulation, beta oscillation, local field potential, physiological biomarker
MeSH terms: Case Reports

We describe the case of a 51-year-old man with Parkinson's disease (PD) presenting with motor fluctuations, who received bilateral subthalamic deep brain stimulation (DBS) with an adaptive DBS (aDBS) device, Percept™ PC (Medtronic, Inc. , Minneapolis, MN). This device can deliver electrical stimulations based on fluctuations of neural oscillations of the local field potential (LFP) at the target structure. We observed that the LFP fluctuations were less evident inside the hospital than outside, while the stimulation successfully adapted to beta oscillation fluctuations during the aDBS phase without any stimulation-induced side effects. Thus, this new device facilitates condition-dependent stimulation; this new stimulation method is feasible and provides new insights into the pathophysiological mechanisms of PD.
Post-COVID-19 cavitary lung lesion due to Aspergillus flavus and Enterobacter cloacae in a patient suffering from COVID-19 pneumonia - a case report
Authors: Kamlesh Rajpal, Shailesh Kumar, Kumar Saurabh, Namrata Kumari, Rakesh Kumar, Randhir Kumar, Sweta Muni
Journal: Access Microbiol (2023)
Keywords: covid-19, coinfection, pulmonary cavitation
MeSH terms: Case Reports

The coronavirus disease 2019 (COVID-19) pandemic has manifested as a multifaceted paradigm but has primarily affected the respiratory system. Though a rare sequela after-COVID-19, we present a case of cavitary lung lesion in an adult patient, which manifested with common symptoms such as fever, cough and dyspnoea during the post-COVID-19 recovery period. Aspergillus flavus and Enterobacter cloacae were found to be the main causative organisms. Fungal and bacterial coinfection may be thought of in similar situations and appropriate treatment may be given to prevent further morbidity and mortality.
Case report: greater meningeal inflammation in lumbar than in ventricular region in human bacterial meningitis
Authors: Walid Naija, Joaquim Matéo, Laurent Raskine, Jean-François Timsit, Anne-Claire Lukascewicz, Bernard George, Didier Payen, Alexandre Mebazaa
Journal: Crit Care (2004)
MeSH terms: Cerebral Ventricles / pathology, Lumbosacral Region / pathology, Meningitis, Bacterial / cerebrospinal fluid, Meningitis, Bacterial / pathology, Neurosurgical Procedures / adverse effects, Pseudomonas Infections / cerebrospinal fluid, Pseudomonas Infections / pathology, Case Reports, Adult, Anti-Infective Agents / therapeutic use, Cerebral Ventricles / microbiology, Cerebrospinal Fluid Shunts, Chordoma / complications, Chordoma / surgery, Ciprofloxacin / therapeutic use, Humans, Lumbosacral Region / microbiology, Male, Meningitis, Bacterial / drug therapy, Meningitis, Bacterial / etiology, Neurosurgical Procedures / methods, Pharyngeal Neoplasms / complications, Pharyngeal Neoplasms / surgery, Pseudomonas Infections / drug therapy, Pseudomonas Infections / etiology, Pseudomonas aeruginosa / isolation & purification, Recurrence, Sphenoid Sinus / surgery, Spinal Puncture, Anti-Infective Agents, Ciprofloxacin

Differences in the composition of ventricular and lumbar cerebrospinal fluid (CSF) based on single pairs of samples have previously been described. We describe a patient that developed post-surgical recurrent meningitis monitored by daily biochemical and bacteriological CSF analysis, simultaneously withdrawn from lumbar space and ventricles. A 20-year-old Caucasian man was admitted to the ICU after a resection of a chordoma that extended from the sphenoidal sinus to the anterior face of C2. CSF was continuously leaking into the pharyngeal cavity after surgery, and three episodes of recurrent meningitis, all due to Pseudomonas aeruginosa O12, occurred. Our case showed permanent ventricular-to-lumbar CSF gradients of leukocytes, protein and glucose that were increased during the acute phase of meningitis, with the greatest amplitude being observed when bacteria were present in both ventricular and lumbar CSF. This might suggest a greater extent of meningeal inflammation in the lumbar than in the ventricular region. Our case also showed that the increase in intravenous antibiotics (cefepim from 8 to 12 g/day and ciprofloxacine from 1.2 to 2.4 g/day) led to an increase in concentration in plasma but not in CSF.
Medical Management of Pyometra in the Delayed Postoperative Period
Authors: Natalie A Vukmer, Heather Urrego, A Mitch Dizon
Journal: Case Rep Obstet Gynecol (2021)
MeSH terms: Case Reports

Pyometra is a rare condition in which purulent material becomes entrapped within the uterine cavity. If unrecognized in a timely fashion, life-threatening complications can arise. The following is a case report of a 50-year-old female who presented to the emergency department with abdominal pain and heavy vaginal bleeding. She was diagnosed with a pyometra based on imaging and treated conservatively with antibiotics. The patient ultimately had an uncomplicated hysterectomy with resolution of normal female pelvic anatomy prior to surgery. Pyometra should be considered when women present with diffuse abdominal pain or peritonitis. As demonstrated in this report, early detection and conservative management may help prevent serious complications such as uterine perforation, lead to shorter hospital stays, and result in safer operative management.
Ruptured ileocolic artery pseudoaneurysm: case report
Authors: Carolina Vasconcellos Sant'Anna, Felipe Garcia Kuhl, Alane Miranda Leite, Selma Regina de Oliveira Raymundo, André Rodrigo Miquelin, Vitória Acar, Vitor Brumato Fachini, Matheus Rafael Canuti
Journal: J Vasc Bras (2022)
Keywords: endovascular procedure, pseudoaneurysm, superior mesenteric artery
MeSH terms: Case Reports

Visceral artery aneurysms (VAAs) and visceral artery pseudoaneurysms (VAPAs) are rare conditions and are potentially lethal when they rupture. They are usually found as incidental findings on computed tomography (CT) scans of asymptomatic patients. Although conventional open surgery is currently considered the gold standard treatment, the endovascular approach has gained prominence as a minimally invasive procedure with lower surgical risk. In this approach, use of coil embolization in saccular VAAs and VAPAs and implantation of flow-modulating stents constitute alternative treatments for fusiform aneurysms. We present the case of a 51-year-old female patient complaining of acute abdominal pain, tachycardia, and hypotension, with evidence of abdominal bleeding on CT angiography, who was diagnosed with a ruptured ileocolic artery (ICA) pseudoaneurysm. She underwent early endovascular treatment for ICA embolization, which was successful and achieved clinical improvement.
Guided Bone Regeneration of an Atrophic Maxilla Using Heterologous Cortical Lamina
Authors: Carlos Polis-Yanes, Carla Cadenas-Sebastián, Patricia Gual-Vaqués, Raúl Ayuso-Montero, Antoni Marí-Roig, José López-López
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Alloplastic dental implants are currently the best way to replace lost teeth. In order to achieve good function and prognosis of dental implants, having bone and soft tissue to support them is necessary. When the amount of bone left is not enough to ensure the outcome of the implant, techniques such as shorts implants, zygomatic implants, or guided bone regeneration have been used. Even though autologous bone is mostly the "gold standard," other biomaterials such as xenografts have led to the reduction of the morbidity of treatments and to the improvement of the regeneration technique outcomes. We present a clinical case of severe atrophy of the maxilla in which we used different types of biomaterials: heterologous cortical lamina, xenograft and autologous bone, and microscrews.
The value of forensic DNA leads in preventing crime and eliminating the innocent
Authors: Ray A Wickenheiser
Journal: Forensic Sci Int Synerg (2021)
Keywords: awaiting analysis backlog, backlog, comparison, cost-benefit, crime lab, elimination, forensic dna, forensic science, identification, investigative leads, preventable crime, prevention, sexual assault kits
MeSH terms: Editorial

The value of an investigative lead corresponds directly to the increase of the speed at which that lead is provided. A cost-benefit model using sexual assault cases demonstrates the preventative savings of quicker forensic DNA analytical response times by calculating the cost of additional crime committed while cases sit awaiting analysis to commence. Calculations are provided per analyst day and with estimated U.S. nationwide impacts. With the elimination of the awaiting analysis backlog, crimes could be prevented, as well as justice better served to those wrongfully suspected. A case study demonstrates the value of timely forensic DNA analysis for sexual assault cases. A wrongfully accused individual identified by eyewitness testimony was eliminated by forensic analysis, while a very similar appearing recidivist perpetrator was included in a subsequent DNA comparison.
Disseminated nocardiosis in an immunocompetent patient
Authors: M Ndlovu, P M Jeena, S A Thula, S A Singh, R Masekela
Journal: Afr J Thorac Crit Care Med (2019)
Keywords: acid-fast bacteria, actinomycetales, disseminated infection, slow growing bacteria
MeSH terms: Case Reports

Nocardiosis is a rare opportunistic bacterial infection. We describe an 8-year-old immunocompetent patient who presented with constitutional symptoms suggestive of probable tuberculosis (TB) in whom we confirmed a diagnosis of nocardiosis. Nocardia is a Gram-positive bacterium that is ubiquitous in soil and decaying vegetable matter. N. asteroides is the most common species. Despite the traditional description of nocardiosis as an opportunistic infection, case reports and case series of pulmonary nocardiosis have recently been reported in immunocompetent patients. Three clinical presentations of nocardiosis have been described; acute, subacute and chronic suppurative infections with episodes of exacerbations and remissions. We describe the presentation, diagnosis, management and prognosis of a rare case of disseminated nocardiosis managed initially as disseminated TB with no improvement.
Atypical cutaneous fibrous histiocytoma: an unusual and misleading variant of fibrous histiocytoma
Authors: Soumaya Ben Abdelkrim, Colondane Belajouza, Wafa Jomaa, Nadia Beizig, Zeineb Ben Said, Moncef Mokni, Rafia Nouira, Badreddine Sriha
Journal: Case Rep Pathol (2011)
MeSH terms: Case Reports

Atypical fibrous histiocytoma is a distinctive variant of cutaneous fibrous histiocytoma, which is often mistaken histologically for sarcoma and which have a tendency to recur locally and a capacity to metastasize, although very rarely. We report a new case of atypical cutaneous fibrous histiocytoma in a 31-year-old man who presented with a recurrent polypoid nodule on the abdominal wall. The diagnosis was made on the basis of morphological and immunohistochemical findings. We discuss through this case and a review of the literature pathological and evolutive features and diagnostic difficulties of this entity.
Malignant Eccrine Spiradenoma of the External Auditory Canal: A Case Report and Literature Review
Authors: Dong You, Zhao Ma, Jing Liu, Xiao Song, Wei Dong
Journal: Front Oncol (2021)
Keywords: case report, external auditory canal, malignant eccrine spiradenoma, review, sweat gland tumor
MeSH terms: Case Reports

Spiradenocarcinoma, or malignant eccrine spiradenoma (MES), is a rare sweat gland tumor originating from eccrine sweat glands. To the best of our knowledge, only two cases of MES of the external auditory canal have been reported to date. Here, we report a third case of MES located in the external auditory canal.
Resection of a giant thoracic solitary fibrous tumor treated with preoperative arterial coiling followed by a double-level thoracotomy
Authors: Jessica Cox, Haley Leesley, Abe DeAnda, Diana Palacio Uran, Scott Lick
Journal: J Surg Case Rep (2023)
MeSH terms: Case Reports

Solitary fibrous tumor (SFT) are rare pleura neoplasms often localized to middle or inferior hemithorax. A middle-aged woman presents to the emergency department following a motor vehicle accident, the computed tomography scan revealed a giant tumor occupying the entire left pleural cavity with a complete collapse of the left lung and substantial right deviation of heart and mediastinum. Using preoperative arterial coiling followed by a double-level thoracotomy we successfully resected the giant tumor. The SFT weighed ~10 lbs. At 2-month follow-up visit patient reports mild discomfort during strenuous movement/heavy lifting but denies any shortness of breath.
Possible complications of ureteroscopy in modern endourological era: two-point or "scabbard" avulsion
Authors: Andrius Gaizauskas, Marius Markevicius, Sergejus Gaizauskas, Arunas Zelvys
Journal: Case Rep Urol (2014)

Indication has led ureteroscopy to be a worldwide technique, with the expected appearance of multiple types of complications. Severe complications are possible including ureteral perforation or avulsion. Ureteral avulsion has been described as an upper urinary tract injury related to the action of blunt trauma, especially from traffic accidents, being the mechanism of injury, the result of an acute deceleration/acceleration movement. With the advent of endourology, that term is also applied to the extensive degloving injury resulting from a mechanism of stretching of the ureter that eventually breaks at the most weakened site, or ureteral avulsion is referred to as a discontinuation of the full thickness of the ureter. The paper presents a case report and literature review of the two-point or "scabbard" avulsion. The loss of long segment of the upper ureter, when end-to-end anastomosis is not technically feasible, presents a challenge to the urological surgeon. In the era of small calibre ureteroscopes these complications, due to growing incidence of renal stones will become more and more actual. Our message to other urologists is to know such a complication, to know the ways of treatment, and to analyse ureteroscopic signs, when to stop or pay attention.
EBV-Negative Monomorphic B-Cell Posttransplant Lymphoproliferative Disorder with Marked Morphologic Pleomorphism and Pathogenic Mutations in ASXL1, BCOR, CDKN2A, NF1, and TP53
Authors: Agata M Bogusz
Journal: Case Rep Hematol (2017)
MeSH terms: Case Reports

Posttransplant lymphoproliferative disorders (PTLDs) are a diverse group of lymphoid or plasmacytic proliferations frequently driven by Epstein-Barr virus (EBV). EBV-negative PTLDs appear to represent a distinct entity. This report describes an unusual case of a 33-year-old woman that developed a monomorphic EBV-negative PTLD consistent with diffuse large B-cell lymphoma (DLBCL) 13 years after heart-lung transplant. Histological examination revealed marked pleomorphism of the malignant cells including nodular areas reminiscent of classical Hodgkin lymphoma (cHL) with abundant large, bizarre Hodgkin-like cells. By immunostaining, the malignant cells were immunoreactive for CD45, CD20, CD79a, PAX5, BCL6, MUM1, and p53 and negative for CD15, CD30, latent membrane protein 1 (LMP1), and EBV-encoded RNA (EBER). Flow cytometry demonstrated lambda light chain restricted CD5 and CD10 negative B-cells. Fluorescence in situ hybridization studies (FISH) were negative for cMYC, BCL2, and BCL6 rearrangements but showed deletion of TP53 and monosomy of chromosome 17. Next-generation sequencing studies (NGS) revealed numerous genetic alterations including 6 pathogenic mutations in ASXL1, BCOR, CDKN2A, NF1, and TP53(x2) genes and 30 variants of unknown significance (VOUS) in ABL1, ASXL1, ATM, BCOR, BCORL1, BRNIP3, CDH2, CDKN2A, DNMT3A, ETV6, EZH2, FBXW7, KIT, NF1, RUNX1, SETPB1, SF1, SMC1A, STAG2, TET2, TP53, and U2AF2.
A Fatal and Extremely Rare Obstetric Complication: Neglected Shoulder Presentation at Term Pregnancy
Authors: Orkun Cetin, Halise Yolli, Numan Cim, Recep Yıldızhan, Hanım Guler Sahin
Journal: Case Rep Obstet Gynecol (2015)

Stillbirth is still an important problem for parents and healthcare providers worldwide. Nowadays, the neglected shoulder presentation is usually observed in developing countries and is associated with increased risk of fetomaternal morbidity and mortality. In recent years, there were limited reports about obstetric management of this serious complication in the literature. In this case report, we aimed at describing the neglected shoulder presentation at term pregnancy that caused fetal death and discussing management options for this rare obstetric complication during labor.
A Rare Case of Triple Positive Metachronous Breast Cancer
Authors: Hardik S Chhatrala, John Khuu, Lara Zuberi
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: her-2 positive, brain metastasis, breast cancer, metachronous, pathologic complete remission, triple positive
MeSH terms: Brain Neoplasms / secondary, Breast Neoplasms / pathology, Neoplasms, Second Primary / pathology, Case Reports, Adult, Breast / pathology, Breast Neoplasms / diagnosis, Female, Hospice Care, Humans, Neoplasms, Second Primary / diagnosis, Receptor, ErbB-2 / blood, Receptors, Estrogen / blood, Receptors, Progesterone / blood, Risk Factors, Receptors, Estrogen, Receptors, Progesterone, ERBB2 protein, human, Receptor, ErbB-2

Metachronous contralateral breast cancer (MCBC) is defined as contralateral breast cancer (BC) diagnosed more than 1 year after previous BC diagnosis. More BC survivors are at risk of MCBC given improved life expectancy with the availability of advanced cancer care. Estrogen receptor/progesterone receptor negative and HER-2-positive status of first BC are independent risk factors for the development of MCBC. We present a rare case of triple positive (estrogen receptor, progesterone receptor, HER-2 positive) MCBC patient who eventually developed brain metastasis within 15 months despite a near complete pathologic response of primary tumor. This case highlights that even in this era of antiestrogen and anti-HER-2 therapies, triple positive MCBC can have an aggressive clinical course, especially with brain metastasis as the first sign of metastasis.
Unusual Manifestations of Acute Cytomegalovirus Infection in Solid Organ Transplant Hosts: A Report of Two Cases
Authors: Alfredo Mena Lora, Justin Khine, Nadia Khosrodad, Vijay Yeldandi
Journal: Case Rep Transplant (2017)
MeSH terms: Case Reports

Cytomegalovirus (CMV) infection is a common cause of morbidity and mortality in immunocompromised hosts. Tissue-invasive CMV disease causing ulcerative skin disease or esophageal necrosis is rare. We herein describe two cases: a 47-year-old renal and pancreas transplant recipient who presented with skin ulcerations on his elbow and a 50-year-old renal transplant recipient who presented with acute esophageal necrosis. In both, tissue biopsy revealed CMV inclusion bodies by immunohistochemical staining of infected endothelial and mucosal cells. Ganciclovir was given to both cases and full remission occurred. Due to the varying presentations of acute CMV infection in immunosuppressed hosts, high suspicion and early tissue biopsy are vital for proper diagnosis and treatment when any suspicious cutaneous or mucosal manifestations are present.