OpenMed/multicare-articles huggingface dataset:
Pneumococcal meningitis in an adolescent with fever and foot ache
Authors: Catarina Dias, Cláudia Pedrosa, Jorge Romariz, Mafalda Santos, Lúcia Rodrigues
Journal: Case Rep Pediatr (2013)

Invasive pneumococcal disease predominantly affects younger children, elderly, and immunocompromised patients. Pneumococcal meningitis is a particularly important form of presentation, considering its high rate of morbimortality. We present the case of a previously healthy 12-year-old adolescent male who was hospitalized due to suspicion of osteoarticular infection in his left foot. A few hours later, he developed meningeal signs, exhibiting slight pleocytosis and Streptococcus pneumoniae isolates in both cerebrospinal fluid and blood. Imaging studies were inconclusive regarding the nature of the foot disorder. We considered the hypothesis of osteomyelitis of the navicular bone as the most likely, for which he completed six weeks of antibiotic therapy. There was a favorable clinical evolution, along with complete absence of osteoarticular or neurological sequelae. The relevance of this clinical case resides in the unusual presentation of invasive pneumococcal disease in this age group, as well as in the rare form of orthopedic involvement.
"A Dangerous Black Box:" Idiopathic Hemophagocytic Lymphohistiocytosis in Adult Patients-A Case Report and Review of the Literature
Authors: Nada Agbariah, Javier Sanz, Alicia Rovó
Journal: Case Rep Hematol (2022)
MeSH terms: Case Reports

Hemophagocytic lymphohistiocytosis (HLH) is a rare potentially life-threatening condition characterized by aberrant inflammation that can be related to genetic or sporadic forms. In both forms, triggering factors may be involved. Early detection of the underlying cause is crucial for therapeutic decision, while early intervention might be associated with better outcomes. The largest descriptions in the literature on HLH refer to pediatric cases. Adolescents and adults may also be affected, but there is scarce evidence regarding their diagnosis and management. We describe here the case of a 68-year-old Swiss woman with HLH, in whom an extensive search for underlying causes was performed, but neither trigger nor pathogenic variant was found. An early intervention first with dexamethasone and later with cyclosporine was performed. The patient showed a favorable response and did not require further hospitalization; however, one year after diagnosis, it was not possible to suspend cyclosporine due to recurrence of laboratory inflammation signs by drug tapering. The occurrence of HLH idiopathic forms represents a challenge; failure to identify the underlying triggering cause generates uncertainty, endless diagnostic investigations, and consequently additional delays in the treatment. This manuscript addresses the difficulties on this issue.
Case Report: A Case of Cystoid Macular Edema in Retinitis Pigmentosa With Central Retinal Vein Occlusion
Authors: Da-Hu Wang, Cao Gu, Yuan-Zhi Yuan
Journal: Front Med (Lausanne) (2022)
Keywords: anti-vegf (vascular endothelial growth factor), case report, central retinal vein occlusion (crvo), cystoid macular edema, retinitis pigmentosa (rp)
MeSH terms: Case Reports

Significance:
Cystoid macular edema (CME) is a common complication of retinitis pigmentosa (RP). However, CME in RP with central retinal vein occlusion (CRVO) is rare. Prompt administration of anti-vascular endothelial growth factor (anti-VEGF) medication can achieve a satisfactory prognosis.
Purpose:
This report describes a case of using anti-VEGF medication to treat CME secondary to RP with impending or mild CRVO.
Case report:
A 26-year-old female presented for blurred vision in both eyes. Best-corrected visual acuity (BCVA) was 20/50 in the right eye and finger-counting in the left eye. According to ophthalmic examinations, CME secondary to RP in the right eye and CME secondary to RP with impending or mild CRVO in her left eye can be diagnosed. Central macular thickness (CMT) was 554 μ m in the right eye and 831 μm in the left eye. Only the left eye was treated with a single intravitreal injection of anti-VEGF medication. One month later, BCVA increased to 20/200 and CMT decreased to 162 μm in the left eye. Interestingly, BCVA in the right eye also had an improvement (20/40) and intraretinal fluid decreased significantly. However, 3 months after injection, these improvements of both eyes were not maintained.
Conclusion:
This is the second case of RP with CRVO. Intravitreal injection of anti-VEGF medication for addressing CME secondary to RP with CRVO is an effective treatment, but it needs to be reinjected.
Case Report: SARS-CoV-2 Infection in a Child With Suprasellar Tumor and Hypothalamic-Pituitary Failure
Authors: Rossella Gaudino, Valentina Orlandi, Paolo Cavarzere, Matteo Chinello, Franco Antoniazzi, Simone Cesaro, Giorgio Piacentini
Journal: Front Endocrinol (Lausanne) (2021)
Keywords: covid-19, gns germ cell tumor, sars-cov2, diabetes insipidus, hypothalamic-pituitary failure, pediatric endocrinology
MeSH terms: COVID-19 / complications, Hypothalamo-Hypophyseal System / physiopathology, Neoplasms, Germ Cell and Embryonal / complications, Neoplasms, Germ Cell and Embryonal / therapy, Pituitary Neoplasms / complications, Pituitary Neoplasms / therapy, Case Reports, COVID-19 / physiopathology, COVID-19 / therapy, Child, Diabetes Insipidus / complications, Diabetes Insipidus / physiopathology, Female, Humans, Magnetic Resonance Imaging, Neoplasms, Germ Cell and Embryonal / physiopathology, Pituitary Neoplasms / physiopathology, Quarantine, Stem Cell Transplantation

In early 2020, a novel coronavirus leading to potentially death was discovered. Since then, the 2019 coronavirus disease (COVID-19) has spread to become a worldwide pandemic. Beyond the risks strictly related to the infection, concerns have been expressed for the endocrinological impact that COVID-19 may have, especially in vulnerable individuals with pre-existing endocrinological health conditions. To date new information is emerging regarding severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) in children but the literature is still scarce concerning this infection in patients with intracranial malignant neoplasms. We report a 9-year-old child infected with SARS-CoV-2 and recent diagnosis of suprasellar non-germinomatous germ cell tumor also suffering from diabetes insipidus and hypothalamic-pituitary failure (hypothyroidism, adrenal insufficiency, hypothalamic obesity and growth hormone deficiency) and its clinical course. The patient remained asymptomatic for the duration of the infection without requiring any change in the replacement therapeutic dosages taken before the infection. We then discuss the proposed approach to treat a pediatric patient with SARS-CoV-2 infection and hypothalamic-pituitary failure and we include a review of the literature. Our report suggests that SARS-CoV-2 infection is usually mild and self-limiting in children even those immunocompromised and with multiple endocrinological deficits. Patients are advised to keep any scheduled appointments unless informed otherwise.
Case Report: Chronic Pulmonary Aspergillosis-An Unusual Long-Term Complication of Lung Cancer Treatment
Authors: Katarzyna Guziejko, Katarzyna Klukowska, Urszula Budzińska, Robert Marek Mróz
Journal: Front Med (Lausanne) (2022)
Keywords: aspergillosis, cancer, itraconazole, lung, personalized treatment
MeSH terms: Case Reports

Background: Chronic pulmonary aspergillosis (CPA) is a rare complication of radiochemotherapy for lung cancer. It may develop months or years after radical treatment. The diagnosis of CPA is challenging and complex. Not only fungal infection but also cancer relapse always have to be taken under consideration. Antifungal therapy is the base treatment, especially in the case when a surgical procedure is not possible. Standard treatment for at least 6 months is recommended but the optimal duration of the antifungal therapy is unknown. We present the clinical case of CPA, in which we had to perform multidirectional diagnostic tests to confirm the diagnosis and modified treatment due to the recurrence of the disease. Case Presentation: We report a patient who developed CPA three and a half years after concurrent radiochemotherapy for locally advanced non-small-cell lung cancer. Non-specific symptoms were the cause of delayed diagnosis of fungal infection. Samples collected during bronchoscopy allowed to exclude the recurrence of lung cancer and establish the diagnosis of CPA. The patient was treated with itraconazole for 6 months. A few months later, controlled chest CT scans revealed the progression of CPA. Initially, retreatment with itraconazole was implemented. Due to the progression of fungal infection, voriconazole was used in the second line of treatment. Unfortunately, this therapy was complicated by the side effects and deterioration of the patient's condition. The reintroduction of itraconazole resulted in clinical and radiological improvement. Treatment is scheduled for at least 12 months. Conclusion: Chronic pulmonary aspergillosis (CPA) was the cause of clinical deterioration and radiological progression in a patient after the radical treatment of lung cancer. In the described case, the diagnosis of CPA was delayed because of the suspicion of the recurrence of lung cancer. As the surgery was not possible, antifungal therapy with itraconazole was implemented and the proper dosage and duration led to significant clinical improvement.
Pleural Fibroma; A meandering path to surgical removal
Authors: Shafqat Hassan, Syed Shirjeel Husain, Muhammad Amim Anwar, Saema Saeed
Journal: Pak J Med Sci (2015)
Keywords: counseling, lung mass, solitary fibrous tumor
MeSH terms: Case Reports

A 52 Year old male was admitted with respiratory distress. Radiological examination revealed a large mass in patient's right hemi thorax with mediastinal shift and partial lung collapse. Biopsies previously done conferred the diagnosis of solitary fibrous tumor; however, in order to avoid a surgical resection, patient didn't follow the adviced procedure. After thorough counseling, surgical resection was done with few post operative complications and patient recovered well with ability to perform his daily activities with partial support. The histopathology results showed solitary fibrous tumor. Apart from pneumonia and local wound infection, patient status was well for the next six week follow-up.
Pemphigus Foliaceus-Repeated Treatment With Rituximab 7 Years After Initial Response: A Case Report
Authors: Magdalena Kraft, Margitta Worm
Journal: Front Med (Lausanne) (2018)
Keywords: anti-cd20, autoimmune blistering diseases, b-cell depletion, pemphigus foliaceus, rituximab
MeSH terms: Case Reports

Pemphigus foliaceus is an autoimmune skin disease mediated by autoantibodies directed against desmoglein-1 located in the upper epidermal layer. Rituximab, a monoclonal anit-CD20 antibody depleting b-cells, offers an effective treatment possibility for therapy-resistant pemphigus foliaceus. Here, we present the case of 55-year-old man who did not respond sufficiently to conventional treatment with prednisolone, azathioprine, and cyclophosphamide, but underwent almost complete remission after rituximab treatment. The patient relapsed 7 years later, and a repeated course of rituximab infusions led to a partial remission.
Case Report: Novel Monitoring for Anaerobic Conditions Detected by Respiratory Quotient in a Critically Ill Pediatric Patient
Authors: Kenichiro Hayashi, Hikoro Matsui
Journal: Front Pediatr (2022)
Keywords: vco2, vo2, anaerobic metabolism, indirect calorimetry, respiratory quotient
MeSH terms: Case Reports

Background:
Hyperlactemia after cardiopulmonary bypass is associated with adverse events during the early postoperative period in children. Serum lactate levels, a standard marker of anaerobic metabolism, are determined by the production, conversion and clearance of lactate, and may lag behind the anaerobic response. Here, we report a neonatal case under anaerobic conditions after cardiac surgery, whose expired gas parameters dramatically changed before a rise in blood lactate.
Case presentation:
A 23-day-old girl with tetralogy of Fallot was admitted to the pediatric intensive care unit after modified Blalock-Taussig shunt operation. As hemoconcentration increased and pleural fluid and ascites accumulated, we performed partial exchange transfusion to prevent shunt occlusion. Ten minutes after partial exchange transfusion, oxygen uptake and carbon dioxide production measured by indirect calorimetry suddenly dropped, while the respiratory quotient began to rise steeply before hyperlactatemia developed a few hours later.
Conclusion:
Analysis of expired gas in critically ill children can detect the transition from aerobic to anaerobic conditions before hyperlactatemia.
Contrast-Enhanced Mammography in the Diagnosis of Breast Angiosarcoma
Authors: Maya Grisaru Kacen, Nikhil Sangle, Anat Kornecki
Journal: Case Rep Radiol (2021)
MeSH terms: Case Reports

A 60-year-old female presented for further assessment of a new right breast lump (November 2020). She had a history of a stage I (T1bN0M0) right breast invasive mammary carcinoma, grade 2 (score 7/9) with receptors ER/PR-negative, HER2/neu-positive, diagnosed four years prior to her current presentation. At that time, she was treated with a right breast lumpectomy and local radiation. Breast assessment with contrast-enhanced mammography showed new skin thickening with associated enhancement within the palpable region. Histology of subsequent ultrasound-guided biopsy found radiation-induced breast angiosarcoma. Breast angiosarcoma is a rare entity that represents less than 1% of all breast cancers. To our knowledge, this is the first case describing the imaging findings of breast angiosarcoma on contrast-enhanced mammography.
A case report: Upper limb recovery from stroke related to SARS-CoV-2 infection during an intervention with a brain-computer interface
Authors: Ruben I Carino-Escobar, Martín E Rodríguez-García, Ana G Ramirez-Nava, Jimena Quinzaños-Fresnedo, Emmanuel Ortega-Robles, Oscar Arias-Carrion, Raquel Valdés-Cristerna, Jessica Cantillo-Negrete
Journal: Front Neurol (2022)
Keywords: bci - brain computer interface, covid-19, case report, hemiparesis, stroke
MeSH terms: Case Reports

COVID-19 may increase the risk of acute ischemic stroke that can cause a loss of upper limb function, even in patients with low risk factors. However, only individual cases have been reported assessing different degrees of hospitalization outcomes. Therefore, outpatient recovery profiles during rehabilitation interventions are needed to better understand neuroplasticity mechanisms required for upper limb motor recovery. Here, we report the progression of physiological and clinical outcomes during upper limb rehabilitation of a 41-year-old patient, without any stroke risk factors, which presented a stroke on the same day as being diagnosed with COVID-19. The patient, who presented hemiparesis with incomplete motor recovery after conventional treatment, participated in a clinical trial consisting of an experimental brain-computer interface (BCI) therapy focused on upper limb rehabilitation during the chronic stage of stroke. Clinical and physiological features were measured throughout the intervention, including the Fugl-Meyer Assessment for the Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), the Modified Ashworth Scale (MAS), corticospinal excitability using transcranial magnetic stimulation, cortical activity with electroencephalography, and upper limb strength. After the intervention, the patient gained 8 points and 24 points of FMA-UE and ARAT, respectively, along with a reduction of one point of MAS. In addition, grip and pinch strength doubled. Corticospinal excitability of the affected hemisphere increased while it decreased in the unaffected hemisphere. Moreover, cortical activity became more pronounced in the affected hemisphere during movement intention of the paralyzed hand. Recovery was higher compared to that reported in other BCI interventions in stroke and was due to a reengagement of the primary motor cortex of the affected hemisphere during hand motor control. This suggests that patients with stroke related to COVID-19 may benefit from a BCI intervention and highlights the possibility of a significant recovery in these patients, even in the chronic stage of stroke.
A novel technique of laparoscopic reduction of incarcerated internal supravesical hernia via peritoneal incision: A case report
Authors: Yugo Matsui, Teppei Murakami, Kenta Horita, Satoshi Ishida, Shotaro Matsuda, Aoi Tayama, Ryutaro Sakata
Journal: Int J Surg Case Rep (2020)
Keywords: internal supravesical hernia, laparoscopic reduction, laparoscopy, peritoneal incision technique, small bowel obstruction
MeSH terms: Case Reports

Introduction:
Laparoscopic reduction techniques for internal supravesical hernia have not been discussed much in literature.
Case presentation:
A 90-year old woman was admitted for symptoms of intestinal obstruction. She was diagnosed with small bowel strangulation by CT scan and laparoscopy was performed. Laparoscopy revealed a mass medial to the medial inguinal fold with tightly incarcerated small bowel. The bowel could not be reduced by traction or external compression, and required incision of the hernia ring. The tight incarceration posed a risk of bowel injury and so we performed peritoneal incision in a similar manner to the TAPP approach for loosening and precise incision of the hernia ring. The bowel was successfully reduced and the hernia was repaired by partial sac resection.
Discussion:
Surgical methods as well as reduction technique were reviewed from previous literature. Procedures with open laparotomy, laparoscopy and anterior approach have been described, but details of reduction were not seen in many of these reports. Various methods have been described for bowel reduction in other hernias, but none involving peritoneal incision. This is the first report describing bowel reduction via the peritoneal incision technique.
Conclusion:
Internal supravesical hernia may pose difficulty in bowel reduction, but the peritoneal incision technique allows safe incision of the hernia ring under laparoscopic situations.
Repair of total penile skin loss after ritual circumcision using a scrotal flap: a case report
Authors: Sultan Qaid, Faisal Ahmed, Ebrahim Al-Shami, Qasem Alyhari, Saif Ghabisha, Mohammad Reza Askarpour, Zakaria Al-Mekhlafy, Essam Hadwan
Journal: Pan Afr Med J (2022)
Keywords: skin loss, case report, ritual circumcision, scrotal flap
MeSH terms: Circumcision, Male / adverse effects, Plastic Surgery Procedures / methods, Case Reports, Ceremonial Behavior, Humans, Infant, Newborn, Male, Penis / surgery, Scrotum / surgery

Ritual circumcision is associated with a high rate of complications, mainly if performed by an untrained practitioner. Furthermore, excessive skin removal is a rare complication of this procedure that results in penis "trapping" underneath the skin and future sexual dysfunction. Here, we presented a 45-day-old Yemeni newborn with a trapped penis due to total loss of penile skin during a ritual circumcision performed by a traditional untrained practitioner using the guillotine technique one month ago. The patient underwent surgical exploration, and the penis was deliberated, released, and the skin defect was repaired with a single-step scrotal flap advancement over the penile shaft. At the six-month follow-up, the outcome was both functional and cosmetically satisfying. In conclusion, we recommend that the circumcision procedure be performed at the very least by an educated and skilled health professional. Additionally, a scrotal advancement flap is still an option in significant penile skin loss cases.
Branchial cleft cyst arising in posterior mediastinum: A case report
Authors: Lin-Jie Li, Zhi-Feng Han, Sheng-Tao Shang
Journal: Front Surg (2023)
Keywords: branchial cleft cysts, diagnosis, mediastinal cysts, posterior mediastinum, treatment
MeSH terms: Case Reports

Branchial cleft cysts are congenital diseases of the neck caused by abnormal embryonic development of the first to fourth branchial clefts. Most branchial cleft cysts are found in the head and neck, but branchial cleft cysts arising in posterior mediastinum are rarely reported. We report a 44-year-old Chinese man who was found to have a right-posterior mediastinal mass on chest computed tomography (CT) during a physical examination. The size of the mass was about 30.6 mm * 25.1 mm and enhanced CT of the chest showed an occupying lesion in the right parietal esophagus of the upper-posterior mediastinum with no significant enhancement. The patient was considered to have a neurogenic tumor with cystic change and underwent posterior mediastinal tumor resection. Postoperatively, pathological examination confirmed the final diagnosis of bronchial cleft cyst. The patient was discharged on the 7th day after surgery. One year postsurgery, no obvious recurrence was found in reexamination.
Suicidal ideation induced by episodic cannabis use
Authors: Michele Raja, Antonella Azzoni
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

The report describes a patient who presented suicidal ideation only in two different occasions, immediately after acute cannabis intoxication. He used cannabis only in these two circumstances. Although a definite association between cannabis use and suicidal ideation or behavior has been already reported in the literature, the described case presents two original clinical aspects that deserve consideration. First, episodic assumption of cannabis induced suicidal ideation abruptly. Second, suicidal ideation appeared independent of mood depression, stressors, or life events, suggesting that suicidality may be not a direct consequence of depression and appears to be a relatively independent psychopathological dimension. There seems to be no linear relation between the severity of depression and the risk of suicide.
The Usefulness of Percutaneous Endoscopic Technique in Multifocal Lumbar Pathology
Authors: Chul-Woo Lee, Kang-Jun Yoon
Journal: Biomed Res Int (2019)
MeSH terms: Endoscopy / methods, Lumbar Vertebrae / pathology, Lumbar Vertebrae / surgery, Case Reports, Aged, Female, Humans, Intervertebral Disc Degeneration / pathology, Intervertebral Disc Degeneration / surgery, Intervertebral Disc Displacement / pathology, Intervertebral Disc Displacement / surgery, Middle Aged, Spinal Canal / pathology, Spinal Canal / surgery, Intervertebral disc disease

Introduction. The multifocal lumbar pathology including disc herniation and stenosis in the spinal canal or foramen has been considered the most difficult to approach surgically. It often requires mandatory dual approaches and/or fusion techniques. Traditional percutaneous endoscopic lumbar transforaminal and interlaminar approach has been focused on unifocal disc herniation. However, the development of endoscopic spinal instruments and surgical technique has broadened surgical indication and therapeutic boundary in endoscopic spine surgery. Cases Presentation. The authors present outcomes of four patients with multilumbar pathology including highly inferior migrated disc combined with lateral recess stenosis, multifocal disc herniation, bilateral disc herniations in spinal canal and foraminal disc herniation combined with central canal stenosis. They were successfully treated by percutaneous uniportal full endoscopic approach with single incision. Conclusion. Percutaneous endoscopic spine surgery is a safe and effective tool to figure out multilumbar pathology in a minimal invasive way.