OpenMed/multicare-articles huggingface dataset:
A Case Series of Severe Dengue with Neurological Presentation in Children from a Colombian Hyperendemic Area
Authors: Jaime E Castellanos, Paula Esteban, Juanita Panqueba-Salgado, Daniela Benavides-Del-Castillo, Valentina Pastrana, Gladys Acosta, Doris Salgado, Carlos F Narvaez, Sigrid Camacho-Ortega, Eliana Calvo, Myriam L Velandia-Romero
Journal: Case Rep Med (2021)
MeSH terms: Case Reports

Dengue transmission is sustained in Colombia with increasing prevalence mainly in children. This work aimed to describe a case series of children diagnosed with dengue presenting neurological disease in Huila Province of Colombia. Eleven pediatric febrile patients confirmed for dengue disease and presenting neurological signs were studied in the University Hospital of Neiva, Huila Province. Clinical and laboratory findings, CSF cytochemical analysis, neurology images, and serology and molecular studies were performed. Viral RNA was detected in all patients' sera by RT-PCR. Nine out of 11 were primary infections. Tonic-clonic seizures (73%), consciousness alterations (27%), irritability (27%), and ataxia (18%) were the most frequent neurological signs. None of the patients had plasma leakage, hypovolemic shock, or liver disease, confirming the encephalitis diagnosis. Diagnostic images did not show abnormal findings, but neither bacterial nor fungal infections were detected in CSF analysis. All patients survived without sequelae except for one patient that presented ataxia for months. In conclusion, we described a group of children with neurological signs during severe dengue disease as the main finding, indicating the importance to including dengue as a differential diagnosis in neurological patients from endemic areas.
Cytokeratin 7-positive/cytokeratin 20-negative cecal adenocarcinoma metastatic to the uterine cervix: a case report
Authors: Masafumi Toyoshima, Yuta Momono, Hiromitsu Makino, Takako Kudo, Naomi Oka, Junko Sakurada, Hiroyoshi Suzuki, Hideaki Kodama, Kosuke Yoshinaga
Journal: World J Surg Oncol (2016)
MeSH terms: Adenocarcinoma / pathology, Cecal Neoplasms / pathology, Keratin-20 / metabolism, Keratin-7 / metabolism, Neoplasms, Second Primary / pathology, Uterine Cervical Neoplasms / secondary, Case Reports, Adenocarcinoma / metabolism, Adenocarcinoma / surgery, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Biomarkers, Tumor / metabolism, Cecal Neoplasms / metabolism, Cecal Neoplasms / surgery, Female, Humans, Immunoenzyme Techniques, Middle Aged, Neoplasm Staging, Neoplasms, Second Primary / drug therapy, Neoplasms, Second Primary / metabolism, Prognosis, Uterine Cervical Neoplasms / drug therapy, Uterine Cervical Neoplasms / metabolism, Biomarkers, Tumor, Keratin-20, Keratin-7

Background:
The vast majority of uterine cervical malignancies are primary carcinomas, and secondary neoplasms that metastasize to the uterine cervix from a distant organ are uncommon. Although relatively rare, metastases to the uterine cervix from a primary colon cancer have been reported. We report a rare case of metastatic carcinoma originating from a cecal adenocarcinoma with an unusual cytokeratin 7/cytokeratin 20 immunophenotype.
Case presentation:
A 74-year-old postmenopausal Japanese woman was referred to our hospital for the evaluation of a uterine tumor. She had a past medical history of cecal cancer and had undergone laparoscopically assisted right hemicolectomy at the age of 69 years. During follow-up, she was found to have elevated levels of the tumor markers carbohydrate antigen 19-9 (179.7 IU/mL) and carcinoembryonic antigen (26.9 μg/L). Positron emission tomography/computed tomography showed a focus of high 18F-fluorodeoxyglucose uptake in her uterus. Examination of a cervical biopsy found a poorly differentiated adenocarcinoma that was immunopositive for cytokeratin (CK)7 and caudal-related homeobox 2 (CDX2) expression and immunonegative for cytokeratin 20 expression. The patient underwent radical hysterectomy and bilateral salpingo-oophorectomy. Histopathological examination found invasive growth of irregular and atypical ductal hyperplasia. Immunohistochemical staining of the tumor specimen revealed the same immunophenotype as the biopsy specimen. The cecal cancer specimen from her previous surgery was also examined and found to have the same immunophenotype. The histopathological diagnosis was cecal adenocarcinoma metastatic to the uterine cervix. The patient is currently receiving adjuvant chemotherapy and to date is without evidence of recurrent disease.
Conclusions:
Our report illustrates the importance of immunohistochemistry for the correct diagnosis of the origin of a uterine cervical adenocarcinoma in a patient with a medical history of colorectal cancer. Re-examination of a previous oncological specimen is critical for cases with a uterine lesion that is difficult to identify as primary or metastatic cancer.
Very Rare Presentation of Cerebrovascular Accident in 20-Year-Old Man With Familial Mediterranean Fever-Case Report
Authors: Miramir Aghdashi, Seyed-Mostafa Seidmardani, Sara Vossoughian, Seyed Arman Seyed Mokhtari
Journal: Clin Med Insights Case Rep (2018)
Keywords: familial mediterranean fever, central nervous system, cerebrovascular accident
MeSH terms: Case Reports

Familial Mediterranean fever (FMF) is characterized by recurrent episodes of fever accompanied by serosal, synovial, or cutaneous inflammation. The central nervous system (CNS) is rarely involved in FMF. The CNS involvement includes demyelinating lesions, posterior reversible encephalopathy syndrome, pseudotumor cerebri, optic neuritis, and cerebral vasculitis. Here, we present a 20-year-old man, a known case of FMF with abrupt left-sided hemiparesis. Brain magnetic resonance imaging revealed right periventricular infarction. Normal echocardiography ruled out cardioembolism, and thrombophilia workup was negative. Therefore, FMF-induced cerebrovascular accident was considered. Although rare, CNS involvement as a result of FMF disease should also be considered when encountering patients with FMF and CNS manifestations.
Extending the science fair project beyond the walls of the gymnasium with the Canadian Science Fair Journal
Authors: Rhiannon Ng, Kira Slivitzky, Richard Webster, Dayre McNally
Journal: Commun Biol (2019)
Keywords: authorship, education
MeSH terms: Periodicals as Topic, Scholarly Communication, Science / education, Adolescent, Canada, Child, Humans, Peer Review, Students

It is increasingly recognized that research is most impactful when disseminated to broad audiences within and beyond the scientific community. For children and youth, opportunities to share independent research beyond family and science fair attendees are limited by a lack of appropriate dissemination platforms. This lack of opportunity creates the 'science fair dilemma', where the engagement of students with the scientific community is curtailed once science fairs wrap up. Here we discuss this missed opportunity to encourage engagement and skill development of young scientists, and provide a case study of a student centric science journal aimed to tackle these challenges.
Case report: A quantitative and qualitative diffusion tensor imaging (DTI) study in varicella zoster-related brachial plexopathy
Authors: Manfredi Alberti, Federica Ginanneschi, Alessandro Rossi, Lucia Monti
Journal: Front Neuroimaging (2023)
Keywords: brachial plexus, diffusion tensor imaging (dti), electromyography, fractional anisotropy (fa), varicella-zoster virus (vzv)
MeSH terms: Case Reports

Diffusion tensor imaging (DTI) is considered feasible for the nerve plexuses' imaging and quantitative evaluation but its value in the clinical practice is still virtually unexplored. We present the DTI profile of a case of acute varicella-zoster virus (VZV)-related brachial plexopathy. A 72-year-old woman presented with left upper-limb segmental paresis involving the spinal metamers C6-C7, preceded by a painful dermatomal vesicular eruption in C5-T1 dermatomes. Clinical and electrophysiological findings and magnetic resonance imaging indicated a plexus involvement. DTI analysis showed decreased fractional anisotropy (FA) and an increase of all the other diffusivity indexes, i.e., mean, axial, and radial diffusivity. The mechanisms underlying DTI parameter differences between healthy and pathologic brachial plexus sides could be related to microstructural fiber damage. Water diffusion is affected within the nerve roots by increasing the diffusion distance, leading to increased diffusion perpendicular to the largest eigenvalue and therefore to decreased FA values The role of DTI in clinical practice has not been defined yet. Additional quantitative and qualitative DTI information could improve the assessment and follow-up of brachial plexopathy.
A Case of Idiopathic Non-Cirrhotic Portal Hypertension in a Patient With a Left Ventricular Assist Device
Authors: Shana Kothari, Michael Kalinowski, Natasha Shah, Hareth Raddawi
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: endoscopy, hepatic venous pressure gradient, left ventricular assist device, non-cirrhotic portal hypertension
MeSH terms: Heart-Assist Devices / adverse effects, Hypertension, Portal / etiology, Case Reports, Esophageal and Gastric Varices / etiology, Humans, Hypertension, Portal / diagnostic imaging, Hypertension, Portal / physiopathology, Liver / pathology, Male, Middle Aged, Pleural Effusion / diagnostic imaging, Pleural Effusion / etiology, Pleural Effusion / physiopathology, Portal Pressure, Tomography, X-Ray Computed, Ventricular Function, Right

Idiopathic non-cirrhotic portal hypertension is a rare diagnosis caused by an unknown etiology with elevated intrahepatic portal pressures in the absence of underlying liver disease. We present a unique case of a 57-year-old male with a left ventricular assist device and preserved right ventricular function that was found to have an elevated hepatic venous pressure gradient and sequelae of portal hypertension without underlying liver disease. There is limited treatment available as management is primarily aimed toward preventing complications of the disease. This case highlights the need for further investigative research of this disease entity and its pathogenesis.
A Large Dentigerous Cyst in a Child as a Complication of Deciduous Molar Endodontic Treatment: An Interesting Case Report with Short Literature Review
Authors: Naida Hadziabdic, Amila Balic, Emina Cengic, Elma Katana, Damir Duratbegovic, Edina Lazovic Salcin
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

This study presents a case report of an inflammatory dentigerous cyst of tooth #35, associated with its previously endodontically treated deciduous predecessor. Cystic lesion growth caused impaction of the second premolar, displacing it closer to the lower border of the mandible. The lesion represents a typical dentigerous cyst that possibly arises in association with periapical inflammation of a deciduous molar involving the follicle of the premolars. This report highlights the inflammatory etiology of dentigerous cysts, which mainly occur in mixed dentition. A 12-year-old patient was referred to Oral Surgery Department regarding a sizeable radiolucent lesion in the unerupted mandibular second premolar region, detected on an Orthopantomagram (OPG) X-ray. A non-vital primary predecessor had been endodontically treated at least one year before an examination, with a control OPG X-ray showing no signs of pathology at the time. The patient did not report any symptoms. Clinical examination revealed an egg-like tumefaction of the alveolar bone in the left premolar region of the mandible. Cone-beam computed tomography analysis showed a sizeable translucent lesion surrounding the crown of the impacted tooth. The lesion was enucleated in its entirety, along with the impacted premolar, under local anesthesia. Clinical findings combined with radiographic and microscopic examinations confirmed the diagnosis of an inflammatory dentigerous cyst. The seventeen month follow-up revealed good bone healing. This case presented a rare complication of endodontic treatment of deciduous teeth and informed on possible complications of endodontic therapy in deciduous teeth, emphasizing the importance of early diagnosis of cysts in preventing extraction of permanent teeth.
Case Report: Three's a crowd: a case report examining the diagnostic and pharmacokinetic challenges in HIV-tuberculous meningitis-malaria co-infection
Authors: Jayne Ellis, Prosperity C Eneh, Kenneth Ssebambulidde, Morris K Rutakingirwa, Mohammed Lamorde, Joshua Rhein, Fiona V Cresswell, David R Boulware, Melanie R Nicol
Journal: Wellcome Open Res (2019)
Keywords: hiv/aids, case report, drug-drug interactions, pharmacokinetics, tuberculosis, malaria, tuberculous meningitis

In 2016, 10.4 million cases of tuberculosis (TB) were reported globally. Malaria also continues to be a global public health threat. Due to marked epidemiological overlap in the global burden of TB and malaria, co-infection does occur. An HIV-infected, 32-year-old male presented with a two-week history of headache with fevers to Mulago National Referral Hospital, Uganda. Five months prior, he was diagnosed with pulmonary TB. He endorsed poor adherence to anti-tuberculous medications. Mycobacterium tuberculosis in CSF was confirmed on Xpert MTB/RIF Ultra. On day 2, he was initiated on dexamethasone at 0.4mg/kg/day and induction TB-medications were re-commenced (rifampicin, isoniazid, ethambutol, pyrazinamide) for TBM. He continued to spike high-grade fevers, a peripheral blood smear showed P. falciparum parasites despite a negative malaria rapid diagnostic test (RDT). He received three doses of IV artesunate and then completed 3 days of oral artemether/lumefantrine. To our knowledge this is the first published case of HIV-TBM-malaria co-infection. TBM/malaria co-infection poses a number of management challenges. Due to potential overlap in symptoms between TBM and malaria, it is important to remain vigilant for co-infection. Access to accurate parasitological diagnostics is essential, as RDT use continues to expand, it is essential that clinicians are aware of the potential for false negative results. Anti-malarial therapeutic options are limited due to important drug-drug interactions (DDIs). Rifampicin is a potent enzyme inducer of several hepatic cytochrome P450 enzymes, this induction results in reduced plasma concentrations of several anti-malarial medications. Despite recognition of potential DDIs between rifampicin and artemisinin compounds, and rifampicin and quinine, no treatment guidelines currently exist for managing patients with co-infection. There is both an urgent need for the development of new anti-malarial drugs which do not interact with rifampicin and for pharmacokinetic studies to guide dose modification of existing anti-malarial drugs to inform clinical practice guidelines.
A Case Report of Normal Pressure Hydrocephalus Developing After COVID-19 Infection
Authors: Faraz Badar, Muhammad Azaz I Cheema, Asma Iftikhar
Journal: Cureus (2023)
Keywords: covid 19, external ventricular drain (evd), normal-pressure hydrocephalus, shunt, ventriculoperitoneal shunts
MeSH terms: Case Reports

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus) has been reported to cause significant injury to the central nervous system (CNS). Herein, we describe the case of a 48-year-old male with a past medical history of attention-deficit/hyperactivity disorder (ADHD), hypertension, and hyperlipidemia who developed typical symptomatology of normal pressure hydrocephalus (NPH) with cognitive impairment, gait dysfunction, and urinary incontinence after a mild coronavirus disease (COVID-19) infection. The diagnosis was confirmed by imaging and lumbar puncture (LP). The patient was treated with a ventriculoperitoneal (VP) shunt placed by neurosurgery and had a complete recovery. Despite increasing reports of neurological manifestations of COVID-19 infection, the mechanism of such pathology is still not well understood. Hypotheses include viral invasion of the CNS either through the nasopharynx and olfactory epithelium or directly through the blood brain barrier.
Height augmentation in 11β-hydroxylase deficiency congenital adrenal hyperplasia
Authors: Munier A Nour, Danièle Pacaud
Journal: Int J Pediatr Endocrinol (2015)
Keywords: aromatase inhibitor, congenital adrenal hyperplasia, growth, growth hormone, steroid 11-beta-hydroxylase
MeSH terms: Case Reports

Context:
11β-hydroxylase deficiency is the second most common form of congenital adrenal hyperplasia. Untreated, this enzyme deficiency leads to virilization, hypertension, and significant height impairment.
Patient:
We describe a patient from abroad who first presented to us at age 7 years for follow-up of ambiguous genitalia. He had been investigated and treated in Pakistan at 3-years-of-age following presentation for bilateral cryptorchidism. He was found to have 46, XX karyotype, elevated 17-OH progesterone and was diagnosed with congenital adrenal hyperplasia. In Pakistan, the patient had abdominal hysterectomy, bilateral salpingoophrectomy, and was started on corticosteroid replacement. At 7 years, shortly after immigrating to Canada, height was 138 cm and BMI 19.3 kg/m(2) (+2.9 SDS and +1.7 SDS, respectively, male growth chart) and blood pressure was greater than the 99th percentile for age and height. The patient had Prader stage III - IV genital anatomy. Bone age was significantly advanced, yielding a severely compromised predicted final adult height. Biochemical evaluation was consistent with 11β-hydroxylase deficiency congenital adrenal hyperplasia.
Intervention and outcome:
In an attempt to improve final height, in addition to glucocorticoid replacement, this patient was treated with recombinant growth hormone and a third generation aromatase inhibitor (Letrozole) with an improvement in final height attained as compared with predicted height.
Conclusions:
This case of a 46,XX patient raised as male with congenital adrenal hyperplasia due to 11β-hydroxylase deficiency highlights a number of unique and difficult treatment challenges; specifically, the role of new therapeutic options for optimization of growth in the context of prior suboptimal disease management.
Sclerema Neonatorum Treated Successfully with Parenteral Steroids: An Experience from a Resource Poor Country
Authors: Sandeep Shrestha, Nagendra Chaudhary, Sujit Koirala, Ruchi Gupta
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Sclerema neonatorum is a form of panniculitides characterized by diffuse hardening of subcutaneous tissue with minimal inflammation. It usually affects ill and preterm neonates. Prognosis is usually poor in many cases despite aggressive management. Various treatment modalities (antibiotics, intravenous immunoglobulin, steroids, and exchange transfusion) have been explained in literature. Steroids due to its easy availability and low cost can prove to be lifesaving in such cases, especially in resource poor countries. Here, we report a case of sclerema neonatorum in a one-week preterm baby treated successfully with parenteral steroids and antibiotics.
Serotonin syndrome after sertraline overdose in a child: a case report
Authors: Joana Grenha, Ana Garrido, Hernani Brito, Maria José Oliveira, Fátima Santos
Journal: Case Rep Pediatr (2013)

Serotonin syndrome is a potentially life-threatening drug effect. It may be misdiagnosed because it has mostly been reported in adults. Case Report. An 8-year-old girl with behavioral problems and medicated with risperidone and sertraline was admitted in the emergency department after she had taken voluntarily 1500 mg of sertraline (50 mg/kg). At admission, she had marked agitation, visual hallucinations, diaphoresis, flushing, and tremor. She had fever and periods of hypertension. She also showed generalized rigidity and involuntary movements. She was treated with fluids and iv diazepam, midazolam, clemastine, and biperiden. As the patient presented a severe insomnia and a progressive rhabdomyolysis, she was transferred to pediatric intensive care unit (ICU), where she was under treatment with cyproheptadine, mechanical ventilation, and muscular paralysis for 11 days. She was discharged from hospital a few days later with no neurological sequelae. Conclusions. Serotonin syndrome is still not well recognized by physicians. In our patient, the diagnosis was made early due to the history of overdose with serotonin reuptake inhibitors and the triad of mental, neurological, and autonomic signs. Parents must be educated to prevent children from having free access to drugs, avoiding self-medication or overdose.
Severe Respiratory and Hemodynamic Failures following Successful Spontaneous Pneumothorax Drainage
Authors: Nicolas Mayeur, Samuel Groyer, Sylvie Vimeux, Jérôme Roustan
Journal: Case Rep Emerg Med (2021)
MeSH terms: Case Reports

Spontaneous pneumothorax is a frequent situation in respiratory medicine, and its treatment is based on conservative treatment or pleural drainage. Reexpansion pulmonary edema (REPE) is often a mild complication following pneumothorax drainage. We report here a severe case of unilateral REPE following spontaneous pneumothorax drainage associated with major pulmonary plasmatic leakage. The clinical presentation was severe and sudden with respiratory and circulatory failures. Initial resuscitation was mostly based on prone and head-down positioning in association to fluid expansion and mechanical ventilation. On the basis of this clinical case report, we strongly suggest to think about severe pulmonary reexpansion edema when respiratory and hemodynamic failures occur few hours after pneumothorax-related efficient pleural tube drainage.
A Recurrent Misdiagnosed and Maltreated Case of Keratosis Obturans
Authors: Hamoud Alarouj, Faisal AlObaid, Abdulmohsen K AlBader, Mahmoud A K Ebrahim
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

Keratosis obturans is an obscure entity characterized by accumulation of desquamated keratinous material in the bony portion of the external auditory canal. Patients with this condition typically present with severe otalgia, conductive hearing loss, and global widening of the external auditory canal. We present a case of keratosis obturans that was misdiagnosed as impacted wax. The case was diagnosed and managed by microscope-guided examination with the patient under general anesthesia.
Solitary fibrous tumor of the kidney: a case report
Authors: Abdullah Demirtaş, Volkan Sabur, Hülya Akgün, Emre Can Akınsal, Deniz Demirci
Journal: Case Rep Urol (2013)

Solitary fibrous tumor is a spindle cell neoplasm mostly originating from pleura; however, it has also recently been reported to be extrapleural. A 57-year-old man presented with left lumbal pain. Ultrasonography and computed tomography showed a cystic lesion of 14 × 11 cm with solid areas and septations in middle and lower poles of the left kidney. Radical nephrectomy was performed. Immunohistochemical studies showed strong reactions with CD34 and CD99. A nuclear positivity with Ki-67 was observed in less than 1% of cells. Despite repeated stainings with vimentin, no clear tumor evaluation could be made due to artifacts. The tumor was negative with Bcl-2, desmin, HMB-45, S100, FVIII, and CD31. Histopathological and molecular studies made the diagnosis of a solitary fibrous tumor. The patient is now currently free of disease at the 26th month of followup.