OpenMed/multicare-articles huggingface dataset:
Internal Jugular Vein Thrombosis After Microwave Ablation of Cervical Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Case Report
Authors: Ying Liu, Xi-Ju Wang, Jin-Ling Wang, Li-Hong Liu, Shuo-Ran Zhao, Shou-Jun Yu, Bei-Bei Yang, Qing-Ling Xu, Jin-Ke Li, Shu-Rong Wang
Journal: Front Endocrinol (Lausanne) (2022)
Keywords: cervical, internal jugular vein, lymph node, microwave ablation, papillary thyroid carcinoma, thrombosis
MeSH terms: Microwaves / adverse effects, Thyroid Neoplasms / pathology, Thyroid Neoplasms / surgery, Case Reports, Carcinoma, Papillary, Enoxaparin / analogs & derivatives, Humans, Jugular Veins / diagnostic imaging, Jugular Veins / pathology, Lymph Nodes / pathology, Lymphatic Metastasis, Retrospective Studies, Thyroid Cancer, Papillary / surgery, Treatment Outcome, Enoxaparin, enoxaparin sodium, Papillary Thyroid Microcarcinoma

In this study, two patients with papillary thyroid carcinoma and lymph node metastasis were treated by Dr. Shurong Wang's team and are reported. The two patients refused surgery and underwent microwave ablation (MWA) of the thyroid and lymph node lesions. Ultrasound review 2 days after MWA revealed internal jugular vein thrombosis. Patient #1 received low molecular weight heparin calcium injection, Xueshuantong injection, Xiangdan injection, and rivaroxaban. Patient #2 was treated with enoxaparin sodium injection, Xueshuantong injection, urokinase, and warfarin sodium tablet. The thrombus was successfully managed in each patient using anticoagulant treatment. Such complication of MWA has not been reported in many cases before. According to the relevant literature, thrombosis after thyroid cancer ablation might be related to subclinical hypothyroidism, increased heme oxidase 1 (HO-1) levels in the blood of patients with papillary thyroid cancer, and increased platelet content and mean platelet volume in patients with thyroid cancer. No specific cause of thrombosis was identified in the two cases reported here. No recurrence was observed after 1 (patient #1) and 4 (#2) years of follow-up. In conclusion, patients with papillary thyroid carcinoma and lymph node metastasis should undergo color Doppler ultrasound of the neck after MWA of thyroid lesions and neck metastasis.
Characteristics of multicystic biliary hamartoma: A case report
Authors: Jia Lian, Lixia Sun, Yankai Yang, Jun Li, Ye Zhang, Guiqiu Liu, Weijuan Hu
Journal: Front Surg (2023)
Keywords: cystic lesion, hamartoma, liver, multicystic biliary hamartoma, operation
MeSH terms: Case Reports

Introduction:
Multicystic biliary hamartoma (MCBH) is a very rare hepatic benign neoplasm that manifests as a localized cystic-solid mass. Only 17 cases have been described in the literature to date. MCBH diagnosis is currently dependent on imaging and pathology following surgical resection and no precise standards are in place.
Case presentation:
This case study involves a middle-aged male patient with a history of drinking but no other liver diseases. A routine ultrasound examination showed a 6.0 × 5.5 cm inhomogeneous echo mass in the right lobe of the liver. The patient experienced no discomfort or other symptoms, and blood tests were normal. Imaging revealed a localized cystic-solid neoplasm in segment 6 of the liver that did not have the features of a malignant tumor. Surgical resection was performed. Based on imaging, macroscopic examination, and histological results, a final diagnosis of MCBH was made.
Conclusion:
The imaging and pathological features of MCBH were summarized based on the published case reports to date. As a non-invasive examination, the imaging features will aid in the diagnosis of MCBH. Furthermore, these features, along with tumor size and patient symptoms, will facilitate clinicians in selecting surgical resection or follow-up for individual patients.
Executive Dysfunction and Language Deficits in a Pediatric Patient with OCD and MDD with Suicidality
Authors: Melissa Yuan
Journal: Case Rep Psychiatry (2019)
MeSH terms: Case Reports

The role of neuropsychiatric testing in psychiatric disorders is becoming more prominent. Neuropsychological measures that are similar across symptom domains and phenomena such as suicidality may help clinicians guide treatment and tailor therapies to the patient in the most effective way possible. We report the case of a 16-year-old girl who presented with bizarre, intrusive suicidal thoughts in the setting of OCD and MDD. This case is unusual in that we have accurate neuropsychological determination of our patient's language and executive function deficits, and we propose a link between them and her expression of suicidality in the context of OCD and MDD.
Case Report: Wiskott-Aldrich Syndrome Caused by Extremely Skewed X-Chromosome Inactivation in a Chinese Girl
Authors: Xuening Hou, Jie Sun, Chen Liu, Jihong Hao
Journal: Front Pediatr (2021)
Keywords: wiskott-aldrich syndrome, x-chromosome inactivation, female carrier, heterozygous mutation, microthrombocytopenia
MeSH terms: Case Reports

Wiskott-Aldrich syndrome (WAS) is a rare X-linked immunodeficiency disorder caused by abnormal expression of Wiskott-Aldrich syndrome protein due to WAS gene mutation, which is generally characterized by microthrombocytopenia, eczema, recurrent infections, and high risk of autoimmune complications and hematological malignancies. Although affected males with WAS usually manifest severe symptoms, female carriers have no significant clinical manifestations. Here, we describe a Chinese girl diagnosed with WAS carrying a heterozygous missense mutation in exon 2 of the WAS gene. The patient presented with persistent thrombocytopenia with small platelets and decreased WAS protein detected by flow cytometry and western blot analysis. The methylation analysis of the HUMARA gene displayed an extremely skewed X-chromosome inactivation (SXCI) pattern, where the X-chromosomes bearing normal WAS gene were predominantly inactivated, leaving the mutant gene active. Hence, our results suggest that completely inactivating the unaffected paternal X-chromosomes may be the reason for such phenotype in this female patient. SXCI has important implications for genetic counseling of female carriers with a family history of WAS.
Gallstone ileus with evident forchet sign:case report
Authors: Nazmi Özer
Journal: Int J Surg Case Rep (2019)
Keywords: computerized tomography (ct), enterolithotomy, forchet sign, gallstone ileus, rigler’s triad

Introduction:
Gallstone ileus (GSİ) is a rare complication of cholelithiasis (gallbladderstone), which may lead to obstruction of the small intestine. Particularly, computerized tomographic (CT) imaging method and special findings in these images help diagnosing of gallstone ileus. Treatment of this disease is surgery, surgery involves cholecystectomy + fistula repair + enterolitotomy, but it is controversial to perform cholecystectomy with enterolitotomy and fistula repair in the same session.
Presentation of case:
A 75-year-old male patient consulted to the emergency department with the complaints of nausea and vomiting. In the examinations of the patient, bilienteric fistula and gallstones that impacted in the jejunum leading to obstruction were observed in abdominal CT images of the patient who has ileus. The patient was evaluated as gallstone ileus. In addition, on tomographic images significant Forchet sign and Rigler's triad images were viewed which were pathognomonic for gallstone ileus and did not have images as clear as in our case in the literature search. Laparotomy was performed on the patient due to the fact that he was elderly and the duration of anesthesia was wanted to be kept short and stone was extracted by enterolitotomy. Cholecystectomy and fistula repair were left for another session because of gallbladder and surrounding tissues were edematous. The patient was discharged with full recovery on the 6th post-operative day.
Discussion-conclusion:
As well as this disease is a rare cause of mechanical bowel obstruction, it is mostly seen in elderly patients. The most sensitive and specific imaging method in diagnosis is contrast-enhanced abdominal computerized tomography. In the tomographic images, especially the Rigler's triad, Forchet sign and Petren sign are pathognomonic for gallstone ileus.
Time-Course Changes of Serum Keratin Concentrations after Liver Transplantation: Contrasting Results of Keratin-18 and Keratin-19 Fragments
Authors: Cristina Macía, Jose Loureiro, Isabel Campos-Varela, Ihab Abdulkader, Esteban Otero, Evaristo Varo, Santiago Tomé, Arturo Gonzalez-Quintela
Journal: Case Reports Hepatol (2020)
MeSH terms: Case Reports

Objective:
Under normal conditions, adult hepatocytes express only keratin-8 (K8) and keratin-18 (K18), whereas cholangiocytes also express K19. In this study, we delineate the pattern of normal time-course changes in serum K19 and K18 levels after liver transplantation. Patients and Methods. Serum levels of the K19 fragment CYFRA 21-1 and the K18 fragments tissue polypeptide specific antigen (TPS) and M30 (a neoepitope that is generated after caspase cleavage during apoptosis) were measured at baseline and at regular intervals (up to 6 months) after liver transplantation in 11 adult patients.
Results:
There was a gradual decrease in serum K19 concentrations from baseline values after transplantation, following a time-course pattern similar to that of serum bilirubin. In contrast, serum concentrations of K18 fragments increased markedly shortly after transplantation and gradually decreased thereafter, following a time-course pattern similar to that of serum transaminases. The increase in TPS tended to occur earlier than that in M30, suggesting an initial predominance of hepatocyte necrosis followed by a predominance of apoptosis in the first days after transplantation. Five patients presented posttransplant complications (acute rejection in three cases and HCV recurrence in two cases). An early increase in serum K19 concentrations was observed in all cases. An increase in serum concentrations of K18 fragments (M30 and TPS) was observed in the two cases with HCV recurrence and was more variable in the three cases with acute rejection.
Conclusions:
Serum concentrations of K19 and K18 fragments follow a dissimilar pattern of time-course changes after liver transplantation. The diagnostic value of variations in these normal patterns should be addressed in future studies.
A Case Report and Literature Review of Clostridium difficile Negative Antibiotic Associated Hemorrhagic Colitis Caused by Klebsiella oxytoca
Authors: Aaron Fisher, Alexandra Halalau
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Klebsiella oxytoca hemorrhagic colitis is a rare form of antibiotic associated hemorrhagic colitis that is Clostridium difficile negative. Klebsiella oxytoca colitis has been shown to be triggered by penicillin administration, yet other antibiotics have been implicated as well. It can mimic the appearance of ischemic colitis on endoscopy; however it will generally be found in young, otherwise healthy patients without risk factors. We present a case of a 33-year-old Caucasian female who presented to the emergency room with profuse, bloody diarrhea for 5 days, after a one-week course of ampicillin. Colonoscopy was notable for ulcerated mucosa with erythema and easy friability and the biopsy was suggestive of ischemic colitis. Stool culture was positive for many Klebsiella oxytoca. The patient was discharged home with resolution of symptoms after three days in the hospital. She was instructed to avoid penicillin antibiotics and minimize nonsteroidal anti-inflammatory drug use.
Meckel's diverticulum: an exceptional cause of vesicoenteric fistula: case report and literature review
Authors: Mahdi Bouassida, Mohamed Mongi Mighri, Khaled Trigui, Mohamed Fadhel Chtourou, Selim Sassi, Bilel Feidi, Fathi Chebbi, Khaled Bouzaidi, Hassen Touinsi, Sadok Sassi
Journal: Pan Afr Med J (2013)
Keywords: meckel's diverticulum, surgery, vesicoenteric fistula
MeSH terms: Intestinal Fistula / etiology, Meckel Diverticulum / complications, Urinary Bladder Fistula / etiology, Case Reports, Review, Aged, Female, Humans, Intestinal Fistula / pathology, Laparotomy, Meckel Diverticulum / surgery, Urinary Bladder Fistula / pathology

Meckel's diverticulum is the most common congenital malformation of the gastrointestinal tract. It can cause complications in the form of ulceration, hemorrhage, intussusception, intestinal obstruction, perforation and, very rarely, vesicodiverticular fistulae as noted in six previously reported cases. 66-year-old woman was presented with an enterovesical fistula. Exploratory laparotomy revealed a vesico-diverticular fistula resulting from a perforated Meckel's diverticulum. Pathologic examination revealed that the diverticulum did not contain ectopic gastric or pancreatic tissue. The patient underwent a diverticulectomy and had an uneventful postoperative course. Unlike four of the six previously reported cases, our patient had no coexisting bowel or bladder disease occurring with her vesico-diverticular fistula.
Conclusion:
This is only the third reported case of a vesico-diverticular fistula resulting from a perforated Meckel's diverticulum that did not contain ectopic tissue.
Percutaneous curettage and continuous irrigation for MRSA lumbar spondylodiscitis: a report of three cases
Authors: Yoshiki Yamagami, Sei Shibuya, Satoshi Komatsubara, Tetsuji Yamamoto, Nobuo Arima
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

There has been a recent increase in pyogenic spondylitis caused by methicillin-resistant Staphylococcus aureus (MRSA) associated with an increasing number of compromised patients. As long as serious paralysis is absent, we recommend percutaneous curettage and continuous irrigation as an effective treatment for MRSA lumbar spondylodiscitis. Under local anesthesia, the affected lumbar discs were curetted using percutaneous nucleotomy, and tubes were placed for continuous irrigation. The period of continuous irrigation was generally 2 weeks. Infection was controlled after one procedure in two cases and after two procedures in one case. Postoperative radiography and magnetic resonance imaging (MRI) showed callus formation, normalized signal intensity in vertebral bodies, and regression of abscesses. Open surgery under general anesthesia has been considered risky in patients with poor performance status or old age. The present method, which is an application of needle biopsy, can be performed under local anesthesia and is minimally invasive.
Immune Checkpoint Inhibitor-Related Myositis Overlapping With Myocarditis: An Institutional Case Series and a Systematic Review of Literature
Authors: Yuki Nakagomi, Kazuko Tajiri, Saori Shimada, Siqi Li, Keiko Inoue, Yoshiko Murakata, Momoko Murata, Shunsuke Sakai, Kimi Sato, Masaki Ieda
Journal: Front Pharmacol (2022)
Keywords: cardio-oncology, creatine kinase, immune-related adverse event, irae, onco-cardiology, troponin

Background: Immune checkpoint inhibitor (ICI)-related myositis with myocarditis is a rare but potentially fatal immune-related adverse event. However, its clinical features, response to immunosuppressive treatment, and prognosis remain poorly understood. Here, we describe the clinical course of patients with ICI-related myositis overlapping with myocarditis treated at our institution and a systematic review focusing on the response to immunosuppressive therapy. Methods: We identified patients who developed ICI-induced myositis with myocarditis and were treated at our hospital using a retrospective chart review of electronic medical records. For the systematic review, studies reporting ICI-induced myositis with myocarditis were identified using the Cochrane Library and PubMed databases. Results: Of the 625 patients treated with ICIs, four developed myositis with concurrent myocarditis. All the patients received immunosuppressive therapy. We assessed the activity of myocarditis and myositis based on temporal changes in troponin and creatine kinase (CK) levels. In all patients, peak troponin values appeared later than the peak CK values (median, 17 days). The median time from the start of ICI therapy to the peak of troponin and CK levels was 42.5 and 28 days, respectively. In all patients, CK levels decreased rapidly and steadily after the initiation of immunosuppressants. However, troponin levels were unstable and increased. In all patients, CK levels normalized within one month (range, 12-27 days), but troponin levels took several months to normalize (range, 84-161 days). Fourteen cases of ICI-related myositis with myocarditis were included in the systematic review. Of the 14 cases, 12 (86%) had their CK level decreased after the initial steroid treatment, but the troponin level increased and was higher than that before the start of treatment. In addition, the peak troponin values appeared later than the peak CK values (a median of 6.5 days). Eight (89%) of 9 long-term follow-up patients had troponin levels above the normal range even after CK normalization. Conclusion: In most cases of ICI-related myositis with myocarditis, troponin levels increased after the initial steroid treatment despite decreased CK levels, and exceeded pre-steroid levels. In addition, troponin remained elevated for several months after CK normalized.
Hydatid cyst of the calf presenting as painless mass: A case report
Authors: Ayad Ahmad Mohammed, Sardar Hassan Arif
Journal: Int J Surg Case Rep (2019)
Keywords: case report, echinococcosis, echinococcus granulosus, hydatid disease, musculoskeletal system, tape worm

Background:
Hydatid disease is a zoonotic disease that is transmitted to the human by ingesting the eggs of the parasite Echinococcus granulosus, it most commonly affects the liver but every organ could be affected, musculoskeletal system involvement occurs in 0.5-4% of patients. Most patients present as soft tissue mass in the affected muscle. Preoperative diagnosis usually done radiologically by ultrasound or MRI examination.
Case presentation:
We present a 60-year-old lady presented with painless mass in the right calf for 2 years. The mass was soft, non-tender, mobile from side to side. Ultrasound of the mass showed cystic lesion that contained multiple small cysts inside, and the diagnosis of hydatid disease was made before surgery. During surgery and after opening the mass the lesion appeared to be hydatid cyst containing innumerable daughter cysts. Complete evacuation of the all the daughter cysts done. The patient discharged next day with no postoperative complications. The patient received postoperative albendazole therapy for 2 months and follow up done 6 months after surgery with no complications.
Conclusion:
Hydatid disease should be thought when patients present with mass lesion in any part of the body especially in endemic areas. The most important step in the diagnosis is to exclude the presence of other cysts in other parts of the body.
Unexplained Portal Gas in a Patient with an Esophageal Ulcer
Authors: Samiksha Gupta, Balaram Krishna Surapaneni, Rakesh Vinayek, Sudhir K Dutta
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Emphysematous gastritis is the infection of gastric mucosa by gas producing microorganisms. It is a rare infection with less than 100 cases reported in the literature. The association of portal venous gas along with emphysematous gastritis is a rare entity. The concomitant portal venous gas worsens the outcome and warrant for surgical treatment. Our case has portal venous gas on CT scan along with suspicion of emphysematous gastritis and an esophageal ulcer on upper GI endoscopy. Medical treatment was given in our case of portal venous gas with the esophageal ulcer. Our case is unique because our patient responded to the conservative management. The patient presented with past history of polysubstance abuse and chronic kidney disease presented with symptoms of acute abdomen. CT scan revealed portal venous gas and suspicion of gastric emphysema. In addition, few foci of gas are seen along the vessels traversing between the stomach and liver. Endoscopy with gastric mucosa biopsy showed Candida albicans. Subsequently, antifungals were started. There was improvement in clinical condition of the patient. We, hereby, also summarize all the reported cases of emphysematous gastritis with treatment and outcome in each case. There has been change in trend from surgical to medical treatment.
Large graft tectonic penetrating keratoplasty in a case of severe aspergillus keratitis
Authors: Albert John Bromeo, Elenor Reina Aquino-Alegre, Ruben Lim Bon Siong
Journal: GMS Ophthalmol Cases (2020)
MeSH terms: Case Reports

Penetrating keratoplasty is indicated for cases of severe microbial keratitis, particularly if associated with impending corneal perforation. The case report details a 45-year-old male farmer who consulted for blurring of vision in the left eye after an incident wherein mud was flung onto his eye during farming. He noted eye redness and a growing opacity on his left eye. He was initially treated with topical antimicrobial and corticosteroid medication which did not resolve his symptoms. He presented with a visual acuity of hand movement on the affected eye. Slit lamp examination showed a large protruding mound-like plaque, occupying almost the entire corneal surface of the left eye, with associated scleritis. The ocular ultrasound was unremarkable. The patient was diagnosed with fungal keratitis, which culture from corneal scraping showed to be from an infection with Aspergillus. A tectonic penetrating keratoplasty with 360-degree iridectomy, lens extraction, and anterior vitrectomy was immediately done, and a regimen consisting of topical natamycin was started. Despite the severe presentation of the fungal corneal infection, the eye was fortunately salvaged.
Case Report: Drug-Induced Immune Haemolytic Anaemia Caused by Cefoperazone-Tazobactam/ Sulbactam Combination Therapy
Authors: Yuanjun Wu, Yong Wu, Yanli Ji, Jiajie Liang, Ziyi He, Yanhui Liu, Li Tang, Ganping Guo
Journal: Front Med (Lausanne) (2021)
Keywords: cefoperazone, cefoperazone-dependent antibodies, direct antiglobulin test (dat), druginduced immune hemolytic anaemia (diiha), nonimmunologic protein adsorption (nipa), sulbactam, tazobactam
MeSH terms: Case Reports

There has previously been a report of a patient developing haemolytic anaemia following exposure to cefoperazone. Another case has been reported involving the detection of cefoperazone-dependent antibodies in the absence of immune haemolytic anaemia. To date, no serological evidence has been reported to suggest that cefoperazone can lead to drug-induced immune haemolytic anaemia (DIIHA). This report aims to fill these gaps in knowledge by describing a case of DIIHA caused by cefoperazone-dependent antibodies. A 59-year-old man developed fatal haemolytic anaemia while receiving cefoperazone-tazobactam or cefoperazone-sulbactam for the treatment of a lung infection that occurred after craniocerebral surgery. This eventually led to renal function impairment. Prior to the discontinuation of cefoperazone treatment, the patient showed strong positive (4+) results for both anti-IgG and anti-C3d direct antiglobulin test (DAT), while cefoperazone-dependent IgM and IgG antibodies were detected. The patient's plasma and O-type RBCs were incubated with tazobactam or sulbactam solution at 37°C for 3 h, the results of DAT for anti-IgG and anti-C3d were both positive. Forty-three days after the discontinuation of cefoperazone, the results of DAT for anti-IgG and anti-C3d were negative. Meanwhile incubation of the patient's fresh serum and his own RBCs with cefoperazone at 37°C, gave rise to mild haemolysis, and the results of DAT for both anti-IgG and anti-C3d were positive. It is suggested that cefoperazone-dependent antibodies can activate complement, and the non-immunologic protein adsorption effect of tazobactam or sulbactam can enhance IgG and complement binding to RBCs. This may promote the formation of immunocomplexes and complement activation, thereby aggravating haemolysis.