OpenMed/multicare-articles huggingface dataset:
A case of squamous cell carcinoma of conjunctiva as initial sign of systemic cancers
Authors: Hayato Mitamura, Toshiyuki Oshitari, Ryuta Kimoto, Jiro Yotsukura, Kaoru Asanagi, Takayuki Baba, Yoko Takahashi, Takashi Kishimoto, Shuichi Yamamoto
Journal: Case Rep Ophthalmol Med (2011)
MeSH terms: Case Reports

The purpose of this report is to present the findings in a case of squamous cell carcinoma (SCC) of the conjunctiva which was the initial sign of systemic cancers. A 94-year-old woman without known systemic diseases developed a mass in her right conjunctiva. She was referred to our hospital 5 months after the onset. She was diagnosed with conjunctival SCC by biopsy. Systemic CT before the surgery revealed multiple liver lesions, lung legions, and a large mass surrounding the appendix. The patient requested the surgery, and the main aim of the surgery was cosmesis. Histopathological examinations of the specimen led us to the final diagnosis as SCC. She did not receive any other therapy because of her age. As no other surgical procedures were undertaken, it is uncertain as to whether the conjunctival lesion was primary or secondary. Although, it is extremely rare that SCC of the conjunctiva is the initial sign of systemic cancers, careful systemic examinations to find other cancers should be made.
Chaos syndrome
Authors: Umesh Shriniwas Mudaliyar, Sneha Sreedhar
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

Congenital high airway obstruction syndrome (CHAOS) is the obstruction of the foetal upper airways, which may be partial or complete. It is usually incompatible with life. Prenatal recognition of the disease is quite important. We report here a case of CHAOS diagnosed on antenatal ultrasonography.
Two Cases of Retroperitoneal Liposarcoma Diagnosed Using Endoscopic Ultrasound-Guided Fine-Needle Aspiration (EUS-FNA)
Authors: Yuta Takahashi, Atsushi Irisawa, Manoop S Bhutani, Takuto Hikichi, Tadayuki Takagi, Goro Shibukawa, Takeru Wakatsuki, Hidemichi Imamura, Ai Sato, Masaki Sato, Tsunehiko Ikeda, Rei Suzuki, Katsutoshi Obara, Yuko Hashimoto, Kazuo Watanabe, Hiromasa Ohira
Journal: Diagn Ther Endosc (2009)
MeSH terms: Case Reports

This report describes our experience with two cases that were ultimately diagnosed as retroperitoneal liposarcoma using endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). Case 1 is that of a 54-year-old woman with chief complaints of nausea and abdominal distention. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a large (15 cm diameter) tumor, which was significantly compressing the stomach and apparently occupied the entire left abdominal cavity. Although advanced primary gastrointestinal stromal tumor (GIST) or retroperitoneal tumor was inferred as the differential diagnosis, a definitive diagnosis was difficult using imaging alone. After EUS-FNA was done, the tumor was diagnosed histopathologically as high-grade liposarcoma. Case 2 is that of a 73-year-old man. Abdominal ultrasonography and CT showed a 6 cm diameter tumor within the pelvic cavity. The tumor had high MRI signal-intensity on both T1 and T2 images. Endorectal EUS showed a hyperechoic mass. The images suggested lipoma or liposarcoma containing lipoma-like components. Myxoid liposarcoma was revealed by subsequent EUS-FNA. Performing EUS-FNA was clinically useful for determining the subsequent therapeutic strategy in these cases where a tumor of unknown origin existed in the retroperitoneum.
Hyperechoic Content of the Fetal Colon Is Not Always Cystinuria-Case Report
Authors: Antje Knapke, Guylhène Bourdat Michel, Isabelle Marey, Pauline Le Tanno
Journal: Front Pediatr (2022)
Keywords: hnf4a r76w, antenatal, congenital hyperinsulinism, cystinuria, renal fanconi disease
MeSH terms: Case Reports

Cystinuria is a recessively inherited genetic disease causing recurrent kidney stones with risk of kidney failure. The discovery of hyperechoic colonic content on an antenatal ultrasound is considered to be a pathognomic sign of cystinuria. Herein, we present a clinical case with antenatal diagnosis of cystinuria in an ultrasound finding, which eventually revealed a multisystem disease, characterized by the association of renal Fanconi syndrome, hyperinsulinemic hypoglycemia, and hepatic dysfunction. Genetic investigations evidenced the recurrent heterozygous missense HNF4A (p.Arg76Trp) variant. Our case report shows that antenatal hyperechoic colonic content can hide a complex proximal renal tubulopathy, and questions the genetic counseling provided to families in the antenatal period.
Coexistence of pulmonary tuberculosis with pulmonary sarcoidosis and skin sarcoidosis: a case report
Authors: Khalifa Abdulrahman Yusuf, Shadi Fayez Kanhosh, Abdulrahman Hasan Al-Madani
Journal: Egypt J Intern Med (2023)
Keywords: antimycobacterial treatment, corticosteroid therapy, sarcoidosis, tuberculosis
MeSH terms: Case Reports

Background:
Necrotising granulomatous diseases of the lungs exhibit a narrow range of differential diagnoses. Tuberculosis accounts for most of these cases, while sarcoidosis is an uncommon entity in this group but both possess similar clinical and radiological similarities. One must consider a diagnosis of sarcoidosis once the standard anti-mycobacterial medications fail to achieve a clinical improvement. The case described highlights the coexistence of tuberculosis and sarcoidosis which is a rare entity in the medical literature.
Case presentation:
A 57-year-old male presented with respiratory symptoms and was diagnosed with tuberculosis (TB) demonstrating a polymerase chain reaction (PCR) test positive showing microbial DNA in bronchial washing. The patient started standard anti-TB treatment; however, he did not respond initially. Further investigations led us to diagnose pulmonary followed by skin sarcoidosis, based on histology. After confirmation of sarcoidosis, administered corticosteroids for 6 months simultaneously along with anti-TB treatment; however, anti-TB treatment was prolonged for a total of 9 months. The patient was found clinically symptomless after the completion of treatment during subsequent follow-ups.
Conclusion:
The use of corticosteroids as an adjunct with standard anti-TB treatment proves beneficial effects on the recovery of patients having a coexistence of pulmonary mycobacterium tuberculosis and sarcoidosis disease conditions.
Pneumocystis jirovecii Pneumonia in a HIV-Infected Patient with a CD4 Count Greater Than 400 Cells/ μ L and Atovaquone Prophylaxis
Authors: Abigayle Sullivan, Theresa Lanham, Ronald Krol, Shilla Zachariah
Journal: Case Rep Infect Dis (2020)
MeSH terms: Case Reports

We describe a rare case of Pneumocystis jirovecii pneumonia (PCP) in a heterosexual man with a pertinent medical history of well-controlled human immunodeficiency virus (HIV) on highly active antiretroviral therapy (HAART) and PCP prophylaxis with atovaquone. The patient presented with recurrent shortness of breath, worsening malaise, and fever, following treatment for hypersensitivity pneumonitis one month prior, including a twenty-four-day course of 40 milligrams daily glucocorticoid with taper. However, transbronchial biopsies, lavage, and cytology from prior admission were inconclusive. The patient refused video-assisted thoracic surgery (VATS) at that time. Upon readmission, bronchoscopy with right VATS and lung biopsy were performed. Grocott's methenamine silver stain of right lung biopsy was positive for Pneumocystis jirovecii. This case is a rare example of PCP in a patient with a normal CD4 count (>487 cells/μL) and a low viral load (<20 copies/mL) despite PCP prophylactic antibiotics in the setting of recent iatrogenic immunosuppression.
A Mobitz type II atrioventricular block in multicentric ischemic stroke
Authors: Utku Murat Kalafat, Canan Akman, Turker Karaboga, Tarik Ocak
Journal: Pan Afr Med J (2016)
Keywords: mobitz type ii av block, arrhytmia, cerebral ischemia
MeSH terms: Atrioventricular Block / complications, Brain Ischemia / etiology, Stroke / etiology, Case Reports, Brain Ischemia / pathology, Humans, Male, Middle Aged, Stroke / pathology

Cardiac and cerebrovascular illnesses are major causes of mortality and morbidity. Thromboembolisms, which are the result of cardiac arrhythmia, are important causes of ischemic stroke. In this study, we present a rare case of multicentric ischemic stroke induced by Mobitz type II atrioventricular block.
Hemobilia after laparoscopic cholecystectomy that was successfully treated conservatively: Case report
Authors: Ryosuke Arata, Senichiro Yanagawa, Yasushi Miyata, Tomokazu Ishitobi, Shinya Kodama, Kazuo Sumimoto
Journal: Int J Surg Case Rep (2020)
Keywords: case report, haemobilia, laparoscopic cholecystectomy, pseudoaneurysm
MeSH terms: Case Reports

Introduction:
Hemobilia due to pseudoaneurysm rupture is a rare, life-threatening complication of laparoscopic cholecystectomy (LC) that can cause rapid hemodynamic instability. Therefore, symptoms of hemobilia must be assessed carefully.
Presentation of case:
An 88-year-old woman underwent LC in our hospital, and blood tests revealed elevation of hepatobiliary enzyme levels on postoperative day (POD) 12. Computed tomography (CT) showed a high absorption area in the common bile duct (CBD), and a diagnosis of hemobilia and a pseudoaneurysm without active bleeding into the abdominal cavity was made. There was no leakage of contrast medium outside the CBD during endoscopic retrograde cholangiography; thus, an endoscopic nasobiliary drainage (ENBD) tube was inserted on POD 12 and an endoscopic retrograde biliary drainage (ERBD) stent was placed in the CBD on POD 13. Thereafter, hepatobiliary enzyme levels gradually normalized and the ENBD tube and ERBD stent were removed on POD 27 and POD 54, respectively. The patient was discharged on POD 66.
Discussion:
Hemostasis establishment using surgery or intervention radiology is often required for the treatment of hemobilia due to pseudoaneurysms; however, conservative treatment was effective in our case and we were able to pursue a minimally invasive approach. Erosion due to clip penetration or incomplete clipping of the cystic artery or its branches during surgery may have caused the cystic artery pseudoaneurysm.
Conclusion:
Hemobilia could be life threatening and cause acute hemodynamic instability; therefore, prompt diagnosis is required. Although the frequency of complication is low, the possibility of hemobilia after LC should be considered.
Campylobacter fetus Bacteremia Revealed by Cellulitis without Gastrointestinal Symptoms in the Context of Acquired Hypogammaglobulinemia: A Report of Three Cases
Authors: Souleymane Brah, Laurent Chiche, Marion Brun, Nicolas Schleinitz, Jean-Robert Harle, Jean-Marc Durand
Journal: Case Rep Gastrointest Med (2011)
MeSH terms: Case Reports

Campylobacter fetus bacteremia is rare and occurs mainly in patients with immunosuppression. This infection, which often involves secondary localizations has already been reported in some primary humoral immune deficiencies. We describe three cases of severe infection due to C. fetus with cellulitis at presentation, but without any gastrointestinal symptoms, occurring in patients with acquired hypogammaglobulinemia.
Overcoming barriers for people with disabilities participating in income-generating activities: A proposed development framework
Authors: Nokuthula Tinta, Unathi Kolanisi
Journal: Afr J Disabil (2023)
Keywords: barriers, effective participation, framework, income-generating activities, intervention strategies, people with disabilities, sheltered workshop

Background:
People with disabilities in sheltered workshops are disempowered and face many barriers, adversely affecting their income-generating activities and weakening their competitiveness in the labour market. There is limited evidence on how to overcome these barriers.
Objectives:
This paper seeks to propose a framework to overcome the barriers experienced by people with disabilities participating in income-generating activities in a sheltered workshop.
Method:
The qualitative exploratory single case study was done with observations and semi-structured interviews as data collection methods. Purposive sampling was used to select 24 participants between ages 22 and 52 years, and content analysis was done of transcribed interviews. Community-based rehabilitation (CBR) guidelines were used to develop the framework.
Results:
A proposed framework was developed that outlined intervention strategies to address the barriers experienced by sheltered workshop participants to promote increased participation of people with disabilities in income-generation activities, thereby improving their quality of life.
Conclusion:
The participation of people with disabilities in income-generating activities is hindered by several barriers. However, the proposed framework overcomes the barriers to effective participation in income-generating activities.
Contribution:
People with disabilities will benefit from this framework as it will address their challenges and needs for empowerment. It would also inform stakeholders involved about these challenges and strategies.
Fatal Pneumococcus Sepsis after Treatment of Late Antibody-Mediated Kidney Graft Rejection
Authors: Gunilla Einecke, Jan Hinrich Bräsen, Nils Hanke, Hermann Haller, Anke Schwarz
Journal: Case Rep Nephrol (2018)
MeSH terms: Case Reports

Antibody-mediated rejection (ABMR) is a major cause of late renal allograft dysfunction and graft loss. Risks and benefits of treatment of late ABMR have not been evaluated in randomized clinical trials. We report on a 35-year-old patient with deterioration in renal function and progressive proteinuria 15 years after transplantation. Recurrent infections after a splenectomy following traumatic splenic rupture 3 years earlier had led to reduction of immunosuppression. Renal transplant biopsy showed glomerular double contours, 40% fibrosis/tubular atrophy, peritubular capillaritis, and positive C4d staining indicating chronic-active ABMR. ABMR treatment was initiated with steroids, plasmapheresis, and rituximab. Fourteen days later, she presented to the emergency department with fever, diarrhea, vomiting, and hypotension. Despite antibiotic treatment she deteriorated with progressive hypotension, capillary leak with pleural effusion, peripheral edema, and progressive respiratory insufficiency. She died due to septic shock five days after admission. Blood cultures showed Streptococcus pneumoniae, consistent with a diagnosis of overwhelming postsplenectomy infection syndrome, despite protective pneumococcus vaccination titers. We assume that the infection was caused by one of the strains not covered by the Pneumovax 23 vaccination. The increased immunosuppression with B cell depletion may have contributed to the overwhelming course of this infection.
Single-hair follicular unit transplant for stable vitiligo
Authors: Muthuvel Kumaresan
Journal: J Cutan Aesthet Surg (2011)
Keywords: follicular unit transplant, leukotrichia, stable vitiligo
MeSH terms: Case Reports

Follicular unit transplant (FUT) is one of the surgical procedures which has been recently used to repigment a stable vitiligo patch. Single-hair FUT was done for a 30-year-old male with stable vitiligo patch on the upper lip. Repigmentation was noted in 4 weeks and complete pigmentation seen at 8 weeks. No recurrence was noted at the end of 6-month follow-up with excellent colour match. This case is presented to highlight the effectiveness of FUT in focal vitligo patch with leukotrichia.
Clinical Features and Visual Acuity Outcomes in Culture-Positive Endogenous Fungal Endophthalmitis in Southern China
Authors: Fang Duan, Yao Yang, Zhaohui Yuan, Yongxin Zheng, Zhixing Cheng, Xiaofeng Lin
Journal: J Ophthalmol (2017)

Purpose:
To report the causative organisms, management strategies, and visual outcomes of culture-proven endogenous fungal endophthalmitis in a case series from southern China.
Methods:
We reviewed the microbiological and medical records of patients with culture-positive endogenous fungal endophthalmitis visiting the Zhongshan Ophthalmic Center, Guangzhou, China, between January 1, 2006, and March 31, 2016.
Results:
The inclusion criteria were met in 32 eyes of 29 patients. Molds were a common causative organism in 15 patients (51.7%), while yeasts appeared in 14 patients (48.3%). Initial visual acuity (VA) at the level of finger counting or better was significantly related to a good visual outcome (P = 0.002). Molds as a causative agent were significantly associated with worse visual outcome than yeasts (P = 0.020).
Conclusion:
Molds were a common cause of culture-proven fungal endophthalmitis. Endogenous fungal endophthalmitis is generally associated with poor VA outcomes, especially if caused by molds and if the patient's initial VA is too low to permit finger counting.
Successful Use of Tissue Plasminogen Activator in an Adolescent Male with Pyogenic Liver Abscess
Authors: Janine Zee-Cheng, Thomas Fox, Sonal Patel, Samer Abu-Sultaneh
Journal: Case Rep Crit Care (2019)
MeSH terms: Case Reports

Large pyogenic liver abscess is a rare and difficult to treat entity in pediatric patients. Percutaneous drainage rather than open surgical drainage has become more common in recent years, even for large abscesses. Percutaneous drainage can be complicated by catheter obstruction. We present the case of a 16-year-old male presenting with abdominal pain, fever, and chills. He was diagnosed with a 9-centimeter liver abscess. A CT-guided percutaneous drainage was placed. The catheter initially drained well, but then became occluded. Tissue plasminogen activator was instilled into the catheter every 6 hours for a total of five doses, resulting in increased drainage and improved clinical state of the patient. To our knowledge, this is the first reported use of tissue plasminogen activator in pyogenic liver abscess in the pediatric population.
A Case Report of Takayasu's Arteritis and Ulcerative Colitis in a Pediatric Patient with Chronic Recurrent Multifocal Osteomyelitis Successfully Treated with Infliximab: Diagnostic Clues in Disease Associations and Immune Dysregulation
Authors: Viveka Clare De Guerra, Humaira Hashmi, Bree Kramer, Rula Balluz, Mary Beth Son, Deborah Stein, Alicia Lieberman, Mahmoud Zahra, Rabheh Abdul-Aziz
Journal: Case Rep Rheumatol (2019)
MeSH terms: Case Reports

Background:
Takayasu's arteritis with comorbid chronic recurrent multifocal osteomyelitis and ulcerative colitis is rare in the pediatric population. Treatment with anti-TNF alpha agents such as infliximab has been a successful treatment strategy in adults and can be used effectively in the pediatric population.
Case presentation:
We present the case of a 15-year-old Caucasian girl with a history of chronic recurrent multifocal osteomyelitis and ulcerative colitis presenting with hypertensive emergency secondary to Takayasu's arteritis with middle aortic syndrome. She was treated with corticosteroids and methotrexate and ultimately required infliximab infusions of 15 mg/kg every 4 weeks to successfully control her symptoms and normalize her inflammatory markers.
Conclusions:
In this case, we discuss the use of infliximab in an adolescent patient with chronic recurrent multifocal osteomyelitis, ulcerative colitis, and Takayasu's arteritis. The significance of this case is determined by the unique occurrence of all three conditions in a pediatric patient, the important consideration of vasculitis in the differential of a pediatric patient presenting with hypertensive emergency, the need for vigilance for detecting diagnostic clues, signs, and symptoms, knowledge of disease associations when evaluating a patient with a predisposition for autoinflammatory conditions, and the use of increasing doses of infliximab to control symptoms.
Primary Cutaneous Secretory Carcinoma: A Case Report and Literature Review
Authors: Karthik Pittala, Shannon Hall, Mallorie L Huff, Hina Sheikh, Sean J Wallace
Journal: Cureus (2023)
Keywords: cutaneous secretory carcinoma, mammary analog secretory carcinoma, secretory breast carcinoma, secretory carcinoma, secretory carcinoma of the skin
MeSH terms: Case Reports

Cutaneous secretory carcinomas (CSCs) are primary neoplasms of the skin that have been just recently described in the literature through case reports and series. In this case, a cutaneous lesion was found on the left temporal region of an 83-year-old male. He was referred to plastic surgery for complete excision, with negative margins confirmed by pathology. Histology, immunostaining, and genetic testing showed characteristics confirming the diagnosis of CSC and were supported by the information present in the current literature. Our patient showed no evidence of nodal disease or recurrence during regular follow-ups. Given the rarity of CSCs, we aim to present our experience regarding the diagnosis, pathological analysis, and management of our patient as well as summarize the present literature to further open avenues of research.
Collision tumour of large-cell neuroendocrine carcinoma and adenocarcinoma in the stomach: A case report
Authors: Eduardo Payet, Pau I Pilco, Jaime Montes, Alejandra Cordero-Morales, Maria Jose Savitzky, Karoline Stenning-Persivale
Journal: Ecancermedicalscience (2016)
Keywords: adenocarcinoma, carcinoma, collision tumour, neuroendocrine
MeSH terms: Case Reports

Concurrence of adenocarcinoma and large-cell neuroendocrine carcinoma of the stomach is a rare condition. Here, we report a case of gastric collision tumour with large-cell neuroendocrine carcinoma and adenocarcinoma. A 71-year-old Peruvian man presented with nausea, epigastric pain, and weight loss for seven months. An Endoscopic evaluation revealed a huge ulcerative and infiltrative mass in the upper and middle third of the stomach. The patient underwent a D2 total gastrectomy. Microscopically, two separated and attached ulcerative lesions were recognised. The proximal to the cardial lesion showed neuroendocrine morphology and immunoreactivity for synaptophysin, and the other a moderated tubular adenocarcinoma Borrmann type III. Both lesions invaded serosa and lymph nodes metastases were found in 17 of 41 lymph nodes retrieved (one lymph node with neuroendocrine metastatic deposits).
Dystrophic epidermolysis bullosa in pregnancy: a case report of the autosomal dominant subtype and review of the literature
Authors: Nicole Colgrove, Rayan Elkattah, Howard Herrell
Journal: Case Rep Med (2014)

Epidermolysis bullosa (EB) is a group of inherited blistering skin diseases that vary widely in their pathogenesis and severity. There are three main categories of EB: simplex, junctional, and dystrophic. This classification is based on the level of tissue separation within the basement membrane zone and this is attributed to abnormalities of individual or several anchoring proteins that form the interlocking network spanning from the epidermis to the dermis underneath. Dystrophic EB results from mutations in COL7A1 gene coding for type VII collagen leading to blister formation within the dermis. Diagnosis ultimately depends on the patient's specific genetic mutation, but initial diagnosis can be made from careful examination and history taking. We present a pregnant patient known to have autosomal dominant dystrophic EB and discuss the obstetrical and neonatal outcome. The paper also reviews the current English literature on this rare skin disorder.