OpenMed/multicare-articles huggingface dataset:
Evidence of SARS-CoV-2-Specific T-Cell-Mediated Myocarditis in a MIS-A Case
Authors: Kevin M Vannella, Cihan Oguz, Sydney R Stein, Stefania Pittaluga, Esra Dikoglu, Arjun Kanwal, Sabrina C Ramelli, Thomas Briese, Ling Su, Xiaolin Wu, Marcos J Ramos-Benitez, Luis J Perez-Valencia, Ashley Babyak, Nu Ri Cha, Joon-Yong Chung, Kris Ylaya, Ronson J Madathil, Kapil K Saharia, Thomas M Scalea, Quincy K Tran, Daniel L Herr, David E Kleiner, Stephen M Hewitt, Luigi D Notarangelo, Alison Grazioli, Daniel S Chertow
Journal: Front Immunol (2021)
Keywords: cdr3 sequences, mis-a, sars-cov-2, sars-cov-2 epitopes, t cell receptor (tcr), cd-hit, myocarditis
MeSH terms: COVID-19 / complications, Myocarditis / pathology, Myocarditis / virology, Systemic Inflammatory Response Syndrome / pathology, T-Lymphocytes / immunology, Case Reports, Research Support, N.I.H., Intramural, Adult, COVID-19 / immunology, COVID-19 / pathology, Humans, Male, Myocarditis / immunology, RNA, Viral / analysis, SARS-CoV-2, Systemic Inflammatory Response Syndrome / immunology, RNA, Viral, adult multisystem inflammatory disease, COVID-19 related

A 26-year-old otherwise healthy man died of fulminant myocarditis. Nasopharyngeal specimens collected premortem tested negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Histopathological evaluation of the heart showed myocardial necrosis surrounded by cytotoxic T-cells and tissue-repair macrophages. Myocardial T-cell receptor (TCR) sequencing revealed hyper-dominant clones with highly similar sequences to TCRs that are specific for SARS-CoV-2 epitopes. SARS-CoV-2 RNA was detected in the gut, supporting a diagnosis of multisystem inflammatory syndrome in adults (MIS-A). Molecular targets of MIS-associated inflammation are not known. Our data indicate that SARS-CoV-2 antigens selected high-frequency T-cell clones that mediated fatal myocarditis.
Embolic suppurative thyroiditis with concurrent carcinoma in pregnancy: lessons in management through a case report
Authors: Manish M George, Jay Goswamy, Susannah E Penney
Journal: Thyroid Res (2015)
Keywords: abscess, carcinoma, embolic, pregnancy, suppurative, thyroiditis
MeSH terms: Case Reports

Background:
The thyroid undergoes a variety of physiological changes during pregnancy. The relatively low iodine levels seen in pregnancy have been implicated in thyroid growth during this time. Management of thyroid cancer in pregnancy is not immediately apparent. Furthermore, acute suppurative thyroiditis is rare and this is attributed to the glands innate immunity. We thoroughly review the evidence regarding management of thyroid abscess and thyroid malignancy during pregnancy and illustrate it via an extremely rare case of an embolic thyroid abscess highlighting an underlying carcinoma in a pregnant woman.
Case:
A 29-year old female was found to have a thyroid mass during an antenatal assessment. Following a wound infection from Caesarian section she developed a rapidly progressive thyroid abscess. Incision and drainage of the abscess, and subsequent histology revealed papillary carcinoma. She subsequently underwent both total thyroidectomy with level 6 dissection and radio-iodine ablation post-natally.
Conclusion:
The literature is inconsistent regarding pregnancy as a risk factor for thyroid cancer, but overall it has been suggested as equally or slightly more frequent than in the non-pregnant population. Thyroid mass investigation should be as for the non-pregnant population. In the first trimester any endocrine surgery is associated with miscarriage, whereas these risks are reduced in second trimester. Importantly, there is no survival benefit in undergoing papillary carcinoma surgery in the third trimester versus early post partum and the risks of premature labour may outweigh any benefit gained by operating early. Most importantly, acute suppurative thyroiditis is rare entity and clinicians should have a low threshold for suspicion of underlying malignancy in these patients. This is especially true in the pregnant population who may be especially susceptible whilst undergoing hypertrophic thyroid changes.
Chronic multifocal non-bacterial osteomyelitis in hypophosphatasia mimicking malignancy
Authors: Hermann J Girschick, Etienne Mornet, Meinrad Beer, Monika Warmuth-Metz, Peter Schneider
Journal: BMC Pediatr (2007)
MeSH terms: Bone Neoplasms / diagnosis, Hypophosphatasia / diagnosis, Osteomyelitis / diagnosis, Case Reports, Research Support, Non-U.S. Gov't, Alkaline Phosphatase / blood, Biopsy, Needle, Blood Chemical Analysis, Calcification, Physiologic / physiology, Child, Chronic Disease, Diagnosis, Differential, Female, Follow-Up Studies, Humans, Hypophosphatasia / drug therapy, Magnetic Resonance Imaging, Naproxen / therapeutic use, Osteomyelitis / drug therapy, Osteomyelitis / microbiology, Prostaglandins / blood, Recurrence, Risk Assessment, Prostaglandins, Naproxen, Alkaline Phosphatase

Background:
Hypophosphatasia (HP) is characterized by a genetic defect in the tissue-nonspecific alkaline phosphatase (TNSALP) gene and predominantly an autosomal recessive trait. HP patients suffer from reduced bone mineralization. Biochemically, elevated concentrations of substrates of TNSALP, including pyridoxal-5'-phosphate and inorganic pyrophosphate occur in serum, tissues and urine. The latter has been associated with chronic inflammation and hyperprostaglandinism.
Case presentation:
We report on 2 affected children presenting with multifocal inflammatory bone lesions mimicking malignancy: A 6 years old girl with short stature had been treated with human growth hormone since 6 months. Then she started to complain about a painful swelling of her left cheek. MRI suggested a malignant bone lesion. Bone biopsy, however, revealed chronic inflammation. A bone scan showed a second rib lesion. Since biopsy was sterile, the descriptive diagnosis of chronic non-bacterial osteomyelitis (CNO) was established. The diagnostic tests related to growth failure were repeated and subsequent analyses demonstrated a molecular defect in the TNSALP gene. The second girl (10 years old) complained about back pain after she had fallen from her bike. X rays of her spine revealed compressions of 2 thoracic vertebrae. At first these were considered trauma related, however a bone scan did show an additional lesion in the right 4th rib. A biopsy of this rib revealed a sterile lympho- plasmocytoid osteomyelitis suggesting multifocal CNO. Further analyses did show a decreased TNSALP in leukocytes and elevated pyridoxal phosphate in plasma, suggesting a heterozygous carrier status of HP.
Conclusion:
Chronic bone oedema in adult HP and chronic hyper-prostaglandinism in childhood HP do suggest that in some HP patients bone inflammation is present in conjunction with the metabolic defect. Sterile multifocal osteomyelitis could be demonstrated. Non-steroidal anti-inflammatory treatment achieved complete remission. These cases illustrate chronic inflammation of the bone as a new feature of HP.
Elevated PSA level as a warning of mesh rejection risk after combined laparoscopic totally extraperitoneal hernia repair and transurethral resection of prostate: Case report
Authors: Adeodatus Yuda Handaya, Aditya Rifqi Fauzi, Victor Agastya Pramudya Werdana
Journal: Int J Surg Case Rep (2019)
Keywords: bilateral inguinal hernia, elevated psa levels, laparoscopy, prostate hypertrophy, rejected mesh

Background:
Prostate hypertrophy and inguinal hernia are common health issues in men aged more than 50 years. Recently, many studies showed that prostatectomy and laparoscopic inguinal hernia repair could be performed at the same time. This report depicts mesh rejection after concomitant repair of bilateral direct inguinal hernia with TEP and TURP.
Presentation of case:
A 66-year-old man presented with bilateral direct inguinal hernia and enlargement of the prostate. Prostate biopsy shows atypical adenomatous hyperplasia accompanied by chronic inflammatory cells. Surgery was performed with laparoscopic TEP by using mesh and TURP. The patient underwent a combination of laparoscopic TEP and TURP. A single preoperative and postoperative dose of levofloxacin was administered. The laparoscopic TEP and TURP procedures were completed with no difficulty. Hematoma at the right inguinal occurred three weeks after the procedure. Bilateral inguinal abscess and sepsis occurred at 3-month follow-up. We performed laparotomy mesh evacuation and debridement, and found no recurrence of the hernia.
Discussion:
Combined laparoscopic TEP hernia repair and TURP are feasible procedures. Bladder erosion caused by mesh might be the cause of mesh infection. However, the elevated PSA levels in this patient can be a warning sign of chronic infection in the prostate which can lead to complications of surgery.
Conclusions:
Elevated PSA levels can be a warning before doing a combination of TEP and TURP surgery because they can show signs of infection. However, further research is needed to ascertain the relationship between elevated PSA levels and complications of combination TEP and TURP surgery.
Natal teeth: report of two cases
Authors: Salma Aboulouidad, Zakaria Aziz, Mohammed El Bouihi, Saad Fawzi, Abdeljalil Abouchadi, Nadia Mansouri Hattab
Journal: Pan Afr Med J (2020)
Keywords: natal tooth, case report, extraction
MeSH terms: Natal Teeth / pathology, Natal Teeth / surgery, Case Reports, Breast Feeding, Crying / physiology, Female, Humans, Infant, Newborn, Mandible, Mothers, Tooth Extraction

Presence of teeth at birth or within a month post-delivery is a rare condition. We report here 2 cases to highlight their clinical features and discuss their possible treatment. A 7- days old female newborn with two mandibular central incisors, noticed by the parents at birth, with complaint of continuous crying, inability to suck milk and causing discomfort to the mother. The left incisor was highly mobile justifying its extraction. The second case was a female newborn referred 2 hours after delivery, for a brownish highly mobile mandibular incisor noticed by the pediatrician. Extraction was immediately made to avoid the danger of aspiration. This phenomenon can lead to complications either local such as pain on suckling or general such as undernutrition or asphyxia by aspiration. The decision to maintain or remove these teeth should be assessed in each case independently, based on degree of mobility and interference with breastfeeding.
Case Report: Effect of Electroconvulsive Therapy on Obsessive-Compulsive Disorder Comorbid With Body Dysmorphic Disorder
Authors: Xiaoyan Ma, Ranli Li
Journal: Front Psychiatry (2021)
Keywords: body dysmorphic disorder, functional impairment, modified electroconvulsive therapy, morbidity, obsessive compulsive disorder
MeSH terms: Case Reports

Obsessive-compulsive disorder (OCD) is a chronic psychiatric condition that is associated with considerable morbidity, and ~90% of individuals with OCD have another psychiatric comorbidity. Patients with comorbid OCD and body dysmorphic disorder (BDD) have limited insight and poor psychosocial function, respond poorly to drug treatment, and have an increased risk of suicide. Modified electroconvulsive therapy (ECT) has been attempted to improve symptoms of OCD when drug treatment does not have a satisfactory effect. This report describes a patient who had OCD comorbid with BDD that was successfully treated with modified ECT. Although the mechanism of its effect is unclear, modified ECT may be an alternative treatment for patients with comorbid OCD and BDD. Its efficacy and mechanism of action require further investigation in a large sample of patients with these comorbid disorders.
A case of pulmonary tumor embolism syndrome with thrombus in transit
Authors: Alexandra Fuher, Esther de Boer, Peter Hountras
Journal: Respir Med Case Rep (2023)
Keywords: percutaneous aspiration thrombectomy, pulmonary tumor embolism syndrome, pulmonary vascular disease
MeSH terms: Case Reports

The incidence of pulmonary tumor embolism in patients with solid tumors is estimated to be between 3% and 26% yet is rarely diagnosed. In this case, a 74-year-old male with sarcomatoid variant of urothelial carcinoma and recently diagnosed left renal vein thrombus treated with low-molecular-weight-heparin, presented to the emergency department with acute syncope and dyspnea. He was found to have CT imaging of segmental and subsegmental arterial filling defects, a right atrial filling defect concerning for thrombus in transit and was diagnosed with pulmonary tumor embolism syndrome. The patient was treated with aspiration thrombectomy, with pathology demonstrating sarcomatoid urothelial carcinoma cells. He was initiated on a combination of gemcitabine plus carboplatin to decrease the tumor burden. While pulmonary tumor embolism syndrome is associated with a poor prognosis, prompt diagnosis and initiation of cancer-specific therapies can significantly improve survival.
Case report: Treatment with Pien-Tze-Huang for prolonged positive SARS-CoV-2 test results in COVID-19 patients: A report of five cases
Authors: Yujiao Zheng, Jinbo Cheng, Chengjuan Gu, Mingzhong Xiao, Zuoyu Shao, Linhua Zhao, Xiaolin Tong
Journal: Front Med (Lausanne) (2022)
Keywords: covid-19, chinese medicine, pien-tze-huang, rt-pcr, sars-cov-2
MeSH terms: Case Reports

Coronavirus disease 2019 (COVID-19) has rapidly spread around the world since December 2019, becoming a global pandemic. Atypical cases of COVID-19, manifesting as prolonged positive SARS-CoV-2 test results during the convalescence period, have been encountered. These cases increase the difficulty of COVID-19 prevention and treatment. Here, we report five cases of COVID-19 patients who demonstrated prolonged positive SARS-CoV-2 tests after regular traditional Chinese medicine and western medicine treatments. After administration of Pien-Tze-Huang and cessation of previous treatments, SARS-CoV-2 tests results of the patients turned and remained negative. We believe the finding will contribute to a better understanding of atypical COVID-19 cases and hope to offer a potential therapy. Since this is a preliminary case series, larger-scale clinical trials are warranted.
A large seminoma occurring 20 years after diagnosis of complete androgen insensitivity syndrome: A case report
Authors: Hiroshi Tsubamoto, Yuri Yada, Kazuko Sakata, Nobuyuki Kondoh, Hideaki Sawai
Journal: Gynecol Oncol Case Rep (2013)
Keywords: androgen insensitivity syndrome, counseling, neoadjuvant chemotherapy, seminoma

•A seminoma developed in a patient with androgen insensitivity syndrome.•The patient had a de novo androgen receptor mutation.•Proper management of AIS, including appropriate genetic counseling, is necessary.
Pneumococcal Meningitis Complicated by Cerebral Vasculitis, Abscess, Hydrocephalus, and Hearing Loss
Authors: Abdul Razzakh Poil, Adila Shaukat, Devendra Kumar
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Intracranial abscesses, postinfectious vasculitis, and hydrocephalus are rare complications of Streptococcus pneumoniae (S. pneumoniae) meningitis, and to our knowledge, there have been no case reports where all these 3 complications occurred in a single patient with Streptococcus pneumoniae meningitis. Here, we report a case of a 48-year-old male who developed postinfectious vasculitis, abscess, hydrocephalus, and hearing loss after S. pneumoniae meningitis. Clinicians ought to be aware of the possible adverse outcomes of S. pneumoniae meningitis and the limitations of current treatment options.
Hypopyon after Primary Cryopreserved Amniotic Membrane Transplantation for Sterile Corneal Ulceration: A Case Report and Review of the Literature
Authors: Kostas G Boboridis, Dimitrios G Mikropoulos, Nick S Georgiadis
Journal: Case Rep Ophthalmol Med (2021)
MeSH terms: Case Reports

Purpose. To report the acute development of hypopyon after primary cryopreserved amniotic membrane transplantation (AMT) for persistent corneal epithelial defect and sterile ulceration. Case Presentation. A selected case report of a 71-year-old male who underwent primary cryopreserved AMT for the management of long-standing corneal epithelial defects and stroma thinning. The patient developed 2 mm sterile hypopyon within 48 hours after AMT for corneal surface reconstruction. He responded well to the intensified routine postoperative topical treatment of steroid and antibiotic eye drops with the hypopyon resolving completely one week later. Five weeks after surgery, the corneal surface was smooth and epithelialized with no anterior chamber reaction or recurrence of hypopyon. Discussion. Hypopyon may develop as a rare complication of primary cryopreserved AMT for sterile corneal defects. It may be attributed to immunologic or hypersensitivity reaction and should be differentiated from active ocular infection as it resolves spontaneously with the routine postoperative topical treatment of steroid and antibiotic drops.
Dent Disease Type 2 as a Cause of Focal Segmental Glomerulosclerosis in a 6-Year-Old Boy: A Case Report
Authors: Martin Bezdíčka, Jan Langer, Jaromír Háček, Jakub Zieg
Journal: Front Pediatr (2020)
Keywords: dent disease, ocrl gene, case report, focal segmental glomerulo sclerosis, nephrotic syndrome
MeSH terms: Case Reports

Dent disease is an X-linked recessive renal tubular disorder characterized by proximal tubule dysfunction. Typical features include low molecular weight proteinuria, hypercalciuria, nephrocalcinosis, nephrolithiasis, rickets, and chronic renal failure. We present a case of a 6-year-old boy with nephrotic proteinuria without hypoalbuminemia or edema. His renal biopsy revealed focal segmental glomerulosclerosis (FSGS), some of the glomeruli were globally sclerotic. Hypercalciuria was present intermittently and urine protein electrophoresis showed low molecular weight protein fraction of 50%. The next generation sequencing identified pathogenic variant in OCRL gene causing Dent disease type 2. We report an uncommon histologic finding of FSGS in Dent disease type 2 and highlight the importance of protein content examination and genetic analysis for the proper diagnosis in these complicated cases.
Giant Baker's Cyst Associated with Rheumatoid Arthritis
Authors: Levent Adiyeke, Emre Bılgın, Tahir Mutlu Duymus, İsmail Emre Ketencı, Meriç Ugurlar
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

We report a rare case of a "giant Baker's cyst-related rheumatoid arthritis (RA)" with 95 × 26 mm dimensions originating from the semimembranosus tendon. The patient presented with chronic pain and a palpable mass behind his left calf located between the posteriosuperior aspect of the popliteal fossa and the distal third of the calf. In MRI cystic lesion which was located in soft tissue at the posterior of gastrocnemius, extensive synovial pannus inside and degeneration of medial meniscus posterior horn were observed. Arthroscopic joint debridement and partial excision of the cyst via biomechanical valve excision were performed. The patient continued his follow-up visits at Rheumatology Department and there was no recurrence of cyst-related symptoms in 1-year follow-up. Similar cases were reported in the literature previously. However, as far as we know, a giant Baker's cyst-related RA, which was treated as described, has not yet been presented.
Pituitary Apoplexy Presenting as Ophthalmoplegia and Altered Level of Consciousness without Headache
Authors: Nooshin Salehi, Anthony Firek, Iqbal Munir
Journal: Case Rep Endocrinol (2018)
MeSH terms: Case Reports

Background. Pituitary apoplexy (PA) is a clinical syndrome caused by acute ischemic infarction or hemorrhage of the pituitary gland. The typical clinical presentation of PA includes acute onset of severe headache, visual disturbance, cranial nerve palsy, and altered level of consciousness. Case Report. A 78-year-old man presented to the emergency department with one-day history of ptosis and diplopia and an acute-onset episode of altered level of consciousness which was resolving. He denied having headache, nausea, or vomiting. Physical examination revealed third-cranial nerve palsy and fourth-cranial nerve palsy both on the right side. Noncontrast computed tomography (CT) scan of the head was unremarkable. Brain magnetic resonance imaging (MRI) showed a pituitary mass with hemorrhage (apoplexy) and extension to the right cavernous sinus. The patient developed another episode of altered level of consciousness in the hospital. Transsphenoidal resection of the tumor was done which resulted in complete recovery of the ophthalmoplegia and mental status. Conclusion. Pituitary apoplexy can present with ophthalmoplegia and altered level of consciousness without having headache, nausea, or vomiting. A CT scan of the head could be negative for hemorrhage. A high index of suspicion is needed for early diagnosis and timely management of pituitary apoplexy.
Preventing long term relapsing tinea unguium with topical anti-fungal cream: a case report
Authors: Bruce Arroll, Amanda Oakley
Journal: Cases J (2009)

Background:
The patient was aged 34 when he consulted a dermatologist in Vancouver BC with onychomycosis affecting the right great toenail.
Case presentation:
Trichophyton rubrum was cultured from nail clippings. Griseofulvin was taken for 6 months, resulting in clinical and mycological cure. Over the next 27 years there were multiple relapses. Each course of treatment with oral terbinafine (for up to 18 months) or itraconazole resulted in clinical and mycological cure. A dermatological colleague suggested the reason for relapse was likely to be self re-infection.
Conclusion:
No clinical relapse has occurred with once-weekly miconazole cream applied to the toenail and webspaces of the right foot over the last four years.
3D-printed guides for cervical pedicle screw placement in primary spine tumor: Case report and technical description
Authors: Nicola Marengo, Giuseppe Di Perna, Bianca Maria Baldassarre, Fabio Cofano, Raffaele De Marco, Pietro Zeppa, Salvatore Petrone, Marco Ajello, Diego Garbossa, Francesco Zenga
Journal: Front Surg (2022)
Keywords: 3d-printed guides, case report, cervical pedicle screw (cps), chordoma, craniovertebral junction (cvj), spine tumor
MeSH terms: Case Reports

Introduction:
For spine surgeons, dealing with unstable cervical spine has been usually challenging, and this becomes more difficult when facing a primary craniovertebral junction tumor. Primary spine tumor surgery should always include column reconstruction in order to guarantee biomechanical stability of the spine, but surgeons should always be aware that instrumentations could create interferences with postoperative radiations. However, although carbon fiber instrumentations have started to be used in thoracolumbar oncology for few years, these options are still not available for cervical spine. In the reported case, the adopted strategy to obtain adequate column reconstruction was based on the idea of reducing the amount of titanium needed for posterior fixation and maximizing the distance between the radiation target and titanium rods.
Case report and aim:
We present the case of a 53-year-old woman harboring a craniovertebral junction chordoma. A short occipito-C3 construct was selected. Specifically, titanium cervical pedicle screws were placed by using a new technology consisting in patient-tailored and customized 3D-printed guides. The aim of this case report is to determine the feasibility and safety of 3D-printed guides for cervical pedicle screw (CPS) positioning, even in the case of cervical spine tumor.
Conclusion:
CPS could represent a good solution by providing strong biomechanical purchase and tailored 3D-printed guides could increase the safety and the accuracy of this challenging screw placement, even in oncological patients.