OpenMed/multicare-articles huggingface dataset:
AngioJet thrombectomy with extracorporeal membrane oxygenation support for an acute large-scale pulmonary embolism with bilateral atrial thrombosis: a case report of catastrophic antiphospholipid syndrome
Authors: Jianyu Ji, Lei Jiang, Wei Wang, Xinyu Chi, Jinda Dong, Liqiu Lu, Minyan Huang, Xiutian Wei, Guangbao Pang, Jing Pang, Bin Xiong, Shulin Xiang
Journal: Front Cardiovasc Med (2024)
Keywords: angiojet thrombectomy, acute large-scale pulmonary embolism, bilateral atrial thrombosis, case report, catastrophic antiphospholipid syndrome, extracorporeal membrane oxygenation
MeSH terms: Case Reports

Background:
Catastrophic Antiphospholipid Syndrome (CAPS), a severe systemic autoimmune disorder, predominantly causes life-threatening multi-organ failure, with a high mortality rate. It primarily affects small vessels, seldom impacting large vessels. Notably, acute massive pulmonary embolism (PE) with bilateral atrial thrombosis is an exceptional occurrence in CAPS. Acute pulmonary embolism (PE) is a common cardiovascular disease that progresses rapidly and has a high mortality rate. Acute massive PE combined with bilateral atrial thrombosis has an even higher mortality rate. PE treatments primarily include pharmaceuticals, catheter interventions, and surgical measures, with integrated treatment strategies demonstrating promising outcomes in clinical practice. Extracorporeal membrane oxygenation (ECMO) can provide cardiopulmonary support for the treatment of high-risk PE patients and is a proven therapeutic measure.
Methods:
This report presents the case of a 52-year-old male admitted due to fever and sudden onset of impaired consciousness, with cardiac ultrasound and pulmonary artery CT angiography revealing an acute large-scale pulmonary embolism accompanied by bilateral atrial thrombosis, with the condition rapidly worsening and manifesting severe respiratory and circulatory failure. With ECMO support, the patient underwent a thrombectomy using an AngioJet intervention. The diagnosis of CAPS was confirmed through clinical presentation and laboratory examination, and treatment was adjusted accordingly.
Results:
The patient made a successful recovery and was subsequently discharged from the hospital.
Conclusion:
In CAPS patients, the rare instance of acute massive PE accompanied by bilateral atrial thrombosis significantly risks severe respiratory and circulatory failure, adversely affecting prognosis. Early initiation of ECMO therapy is crucial, offering a vital opportunity to address the root cause. In this case report the patient was successfully treated with an AngioJet thrombectomy supported by ECMO.
A 26-year-old man with multiple organ failure caused by Aeromonas dhakensis infection: a case report and literature review
Authors: Dan Luo, Liwan Dai
Journal: Front Med (Lausanne) (2024)
Keywords: aeromonas, community-acquired pneumonia, hemolytic uremic syndrome, hemoptysis, multiple organ dysfunction
MeSH terms: Case Reports

Background:
Infections in humans are mainly caused by Aeromonas hydrophila, Aeromonas caviae, and Aeromonas veronii. In recent years, Aeromonas dhakensis has been recognized as widely distributed in the environment, with strong virulence. However, this bacterial infection usually does not appear in patients with pneumonia as the first symptom.
Case report:
We report a 26-year-old man who was admitted to the hospital with community-acquired pneumonia as the first symptom and developed serious conditions such as hemolytic uremic syndrome, multiple organ dysfunction, and hemorrhagic shock within a short period. He died after 13 h of admission, and the subsequent metagenomic-next generation sequencing test confirmed the finally identified pathogen of infection as A. dhakensis.
Conclusion:

Aeromonas is a rare pathogen identified in the diagnosis of community-acquired pneumonia. Hence, doctors need to develop their experience in identifying the difference between infections caused by pathogenic microorganisms. Medical attention is essential during the occurrence of respiratory symptoms that could be controlled by empirical drugs, such as cephalosporins or quinolones. When patients with community-acquired pneumonia present hemoptysis and multiple organ dysfunction in clinical treatment, an unusual pathogen infection should be considered, and the underlying etiology should be clarified at the earliest for timely treatment.
Case report: Translational treatment of unresectable intrahepatic cholangiocarcinoma: Tislelizumab, Lenvatinib, and GEMOX in one case
Authors: He-Wei Zhang, Hai-Bo Yu
Journal: Front Oncol (2024)
Keywords: advanced intrahepatic cholangiocarcinoma, case report, chemotherapy, immunotherapy, targeted therapy
MeSH terms: Case Reports

Background:
Intrahepatic cholangiocellular carcinoma (ICC) is one of the most common invasive malignancies. Currently, ICC is treated with radical surgical resection. However, the majority of patients are diagnosed at an advanced stage, making surgery ineligible for them.
Case presentation:
We present a case of advanced ICC, which could not undergo radical surgery due to tumor invasion of liver blood vessels. The gemcitabine and oxaliplatin (GEMOX) regimen combined with Tislelizumab immunotherapy and Lenvatinib targeted therapy for 8 cycles resulted in significant tumor shrinkage significantly and the vascular invasion disappeared. CA19-9 levels were reduced to normal levels. Partial remission and successful tumor transformation were achieved. The patient underwent a successful radical surgical resection, including cholecystectomy, resection of liver segments IV, V, and VIII, as well as a regional lymphatic dissection procedure, resulting in complete pathological remission.
Conclusion:
Tumor-free surgical margins (R0) resection of patients with advanced ICC after combination of immune, targeted and chemotherapy is rare, and there are almost no cases of complete postoperative remission. The GEMOX regimen in combination with Tislelizumab and Lenvatinib has a good antitumor efficacy and safety profile, and may be a feasible and safe translational treatment option for advanced ICC.
Low-Grade Malignant Peripheral Nerve Sheath Tumor: A Case Report of Exceptional Parapatellar Location in the Knee
Authors: Mohammed Barrached, Achraf Tebbaa El Hassali
Journal: Cureus (2024)
Keywords: diagnosis, exceptional location, knee, malignant tumor of the peripheral nerve sheaths, nerve tumors
MeSH terms: Case Reports

Malignant tumors of the peripheral nerve sheaths are uncommon, constituting a small percentage, typically ranging from 2% to 5% of soft tissue sarcomas. Etiological diagnosis is often difficult but is guided by imaging and confirmed by histopathological and immunohistochemical examination. We report a case of a 46-year-old woman admitted for management of a mass in the medial parapatellar region of the right knee. Her medical history included a burn to the right leg five years ago and a previously undocumented resection of a medial parapatellar tissue mass in the right knee. Radiological examination showed a deep and superficial soft tissue mass in the medial soft tissue of the right knee opposite the patella, with no hemorrhagic components and heterogeneous enhancement after injection of gadolinium. Histopathology confirmed the diagnosis of a low-grade peripheral nerve sheath tumor, and a thoracic-abdominal-pelvic CT scan was performed, which was normal. Treatment consisted of a simple carcinological resection and local radiotherapy. No local recurrence was noted after one year of follow-up.
Severe colic in a newborn dairy calf caused by a large colostrum curd: a case report
Authors: Donald C Sockett, Andrea E Pohly, Kathleen M Deering, Ryan M Breuer
Journal: Front Vet Sci (2024)
Keywords: abdominal distension, abomasum, colostrum guidelines, esophageal feeder, newborn, postmortem evaluation
MeSH terms: Case Reports

A newborn female, Holstein calf weighing approximately 38.5 kg developed severe, persistent colic caused by a large colostrum curd located within the calf's abomasum. Based upon 10% body weight, the calf had been fed 4 liters (L) of first-milking colostrum approximately 30 min after birth and an additional 2 L of first-milking colostrum 6 h after the first feeding. Both the first and second feedings used an esophageal tube feeder to deliver the colostrum. Colic developed shortly after the second colostrum feeding. The affected calf did not respond to on-farm supportive medical therapy and was humanely euthanized by a penetrating captive bolt approximately 22 h after the onset of colic. This on-farm colostrum feeding protocol is routinely observed in the current dairy industry. This case demonstrates calves that are fed large volumes of colostrum during a relatively short window of time may develop a large, firm colostrum curd within the abomasum that causes abdominal distension, colic, and occasional death. There is an urgent need for prospective analytical studies that determine the optimal immunoglobulin mass (g/L) and the ideal volume of colostrum fed to newborn calves for both the first and second colostrum feedings within the most beneficial time frame. Guidelines should be developed that minimize complications that adversely affect calf health and well-being while ensuring the successful transfer of passive immunity.
V-A ECMO for neonatal coxsackievirus B fulminant myocarditis: a case report and literature review
Authors: Xingchao Li, Li Sun, Shibing Xi, Yaofei Hu, Zhongqin Yu, Hui Liu, Hui Sun, Weili Jing, Li Yuan, Hongyan Liu, Tao Li
Journal: Front Cardiovasc Med (2024)
Keywords: n-terminal pro-brain natriuretic peptide (nt-pro bnp), cardiac troponin i (ctni), coxsackievirus b (cvb), echocardiography, enterovirus, extracorporeal membrane oxygenation (ecmo), myocarditis, newborn
MeSH terms: Case Reports

Background:
Neonatal (enteroviral) myocarditis (NM/NEM) is rare but unpredictable and devastating, with high mortality and morbidity. We report a case of neonatal coxsackievirus B (CVB) fulminant myocarditis successfully treated with veno-arterial extracorporeal membrane oxygenation (V-A ECMO).
Case presentation:
A previously healthy 7-day-old boy presented with fever for 4 days. Progressive cardiac dysfunction (weak heart sounds, hepatomegaly, pulmonary edema, ascites, and oliguria), decreased left ventricular ejection fraction (LVEF) and fractional shortening (FS), transient ventricular fibrillation, dramatically elevated creatine kinase-MB (405.8 U/L), cardiac troponin I (25.85 ng/ml), and N-terminal pro-brain natriuretic peptide (NT-proBNP > 35,000 ng/L), and positive blood CVB ribonucleic acid indicated neonatal CVB fulminating myocarditis. It was refractory to mechanical ventilation, fluid resuscitation, inotropes, corticosteroids, intravenous immunoglobulin, and diuretics during the first 4 days of hospitalization (DOH 1-4). The deterioration was suppressed by V-A ECMO in the next 5 days (DOH 5-9), despite the occurrence of bilateral grade III intraventricular hemorrhage on DOH 7. Within the first 4 days after ECMO decannulation (DOH 10-13), he continued to improve with withdrawal of mechanical ventilation, LVEF > 60%, and FS > 30%. In the subsequent 4 days (DOH 14-17), his LVEF and FS decreased to 52% and 25%, and further dropped to 37%-38% and 17% over the next 2 days (DOH 18-19), respectively. There was no other deterioration except for cardiomegaly and paroxysmal tachypnea. Through strengthening fluid restriction and diuresis, and improving cardiopulmonary function, he restabilized. Finally, notwithstanding NT-proBNP elevation (>35,000 ng/L), cardiomegaly, and low LVEF (40%-44%) and FS (18%-21%) levels, he was discharged on DOH 26 with oral medications discontinued within 3 weeks postdischarge. In nearly three years of follow-up, he was uneventful, with interventricular septum hyperechogenic foci and mild mitral/tricuspid regurgitation.
Conclusions:
Dynamic cardiac function monitoring via real-time echocardiography is useful for the diagnosis and treatment of NM/NEM. As a lifesaving therapy, ECMO may improve the survival rate of patients with NM/NEM. However, the "honeymoon period" after ECMO may cause the illusion of recovery. Regardless of whether the survivors of NM/NEM have undergone ECMO, close long-term follow-up is paramount to the prompt identification and intervention of abnormalities.
Neurological Spectrum of Epstein-Barr Virus Infection: A Rare Clinical Case
Authors: Dora Gomes, Rui André, Catarina Oliveira, Sofia Camões, Catarina R Silva, Miguel L Mendes
Journal: Cureus (2024)
Keywords: central nervous system infection, epstein-barr virus, intravenous immunoglobulin, nflammatory response, polyradiculoneuropathy
MeSH terms: Case Reports

The Epstein-Barr virus (EBV) is a DNA virus that has been infecting humans since ancient times, capable of causing a wide range of pathologies and affecting approximately 90% of the population. A 61-year-old male with no significant medical history presented with a 5-day history of imbalance and difficulty walking. Neurological examination revealed specific findings, including absent reflexes, bilateral asynergy, and gait abnormalities. Contrasting with Guillain-Barré Syndrome, lumbar puncture suggested a central nervous system infection. Serological testing confirmed Epstein-Barr virus (EBV) positivity, and intravenous immunoglobulin led to significant improvement. Electromyogram results suggested inflammatory/ipnfectious polyradiculopathy. Repeat EBV serology, showing strongly positive IgG and negative IgM, confirmed the diagnosis of Polyradiculoneuropathy secondary to EBV. This case underscores the rare neurological complications of EBV and the importance of considering viral infections in such presentations.
Coronary Artery Embolism and Myocardial Infarction, case report
Authors: Alejandro Narváez Orozco, Alberto Navarro Navajas, Carolina Cardona Buitrago, Juan M Senior-Sánchez, Juan Camilo Ortiz Uribe, Juan Andrés Delgado Restrepo
Journal: Arch Peru Cardiol Cir Cardiovasc (2024)
Keywords: acute coronary syndrome, atrial fibrillation, embolism, coronary artery, myocardial infarction
MeSH terms: Case Reports

Coronary embolism (CE) is a rare cause of non-atherosclerotic acute coronary syndrome (ACS). The clinical presentation is similar to ACS, and the diagnosis is supported by Shibata criteria. Atrial fibrillation is the main reported etiology in CE cases. Management includes percutaneous intervention with thromboaspiration and anticoagulation. The following case is a description of a patient with acute chest pain and recently diagnosed atrial fibrillation (AF) with a rapid ventricular response, is described. A thrombotic lesion in the distal right coronary artery (RCA) of embolic origin, was documented. Successful mechanical thromboaspiration was performed; intravascular ultrasound (IVUS) showed no thrombus, dissection, or atherosclerotic plaque. CE is an underdiagnosed cause of ACS; diagnosis relies on Shibata criteria, and patients experience worse outcomes in follow-up.
Percutaneous Closure Based on Physiological Assessment of an Arteriovenous Fistula in a Patient With Chronic Limb Threatening Ischaemia
Authors: Keisuke Shoji, Michitaka Kitamura, Shiori Yoshida, Kenshi Ono, Naotoshi Wada, Tetsuya Nomura, Natsuya Keira, Tetsuya Tatsumi
Journal: EJVES Vasc Forum (2023)
Keywords: arteriovenous fistula, chronic limb threatening ischaemia, laser doppler flowmetry
MeSH terms: Case Reports

Introduction:
An arteriovenous fistula (AVF) is a potential complication of endovascular therapy (EVT). Arteriovenous fistula steal syndrome sometimes leads to severe limb ischaemia; however, assessment of peripheral perfusion in AVF has not yet been established.
Report:
A 90 year old woman diagnosed with chronic limb threatening ischaemia underwent EVT. However, subintimal angioplasty of infrapopliteal lesions resulted in AVF formation in the posterior tibial artery (PTA). Revascularisation of the anterior tibial artery and PTA was performed, but severe AVF steal syndrome persisted and wound healing was delayed. An attempt to physiologically assess the effects of AVF closure and perform an AVF closing manoeuvre, if necessary, was performed. The physiological assessment was performed by laser Doppler flowmetry (LDF) and blood flow was temporarily blocked via the AVF at the distal PTA using a 6 F guiding extension catheter. A significant increase in blood flow was observed in the perfused area of the plantar artery. Coil embolisation and covered stent implantation in the PTA completely closed the AVF. During the procedure, peripheral perfusion with LDF gradually increased in the heel and fifth toe. After AVF closure, the skin perfusion pressure values increased significantly, wound healing was accelerated, and complete healing was achieved.
Discussion:
Laser Doppler flowmetry measurements under simulated AVF closure using a guiding extension catheter may be useful for the physiological assessment of peripheral perfusion before percutaneous AVF closure.
Clinical phenotype of the 16p.13.11 microdeletion: a case report with a mini review of the literature
Authors: Roberto Palumbi, Emanuela Ponzi, Stefania Micella, Mara Pascali, Roberta Bucci, Mattia Gentile, Lucia Margari, Marta Simone
Journal: Front Genet (2024)
Keywords: autism spectrum disorder, case report, chromosome 16p1311 microdeletion, copy number variations, neurodevelopment
MeSH terms: Case Reports

Background:
Chromosome 16p13.11 microdeletion is a very rare copy number variant (CNV), associated with a clinical syndrome characterized by global development delay, neuropsychiatric conditions, facial dysmorphisms, microcephaly, gastroesophageal reflux disease, and congenital heart defects. The 16p13.11 locus is a very unstable genomic region, rich in low-copy number repeats, characterized by many homologous DNA sequences. Usually, the most common CNV of this region include microduplications/duplications, while the microdeletions are rare, and their clinical features are heterogeneous and poorly described so far.
Case report:
In this paper, we report the genetic and the clinical features of a patient diagnosed with chromosome 16p13.11 microdeletion, and a short review of the literature on this topic. Our patient was characterized by several facial dysmorphic features, autistic symptoms and language development delay. The genetic evaluation revealed and interstitial deletion of the long arm of the chromosome 16, approximately of 1.5 Mb.
Conclusion:
Interestingly, compared to previous cases, this patient was characterized by autistic symptoms, severe language and motor coordination disorder, without cognitive and cerebral malformations, frequently associated with this microdeletion syndrome.
Case report: Ghost cell odontogenic carcinoma in a dog: diagnostics and surgical outcome
Authors: Chun-Geun Kim, Ga-Won Lee, Hyun Sil Kim, Seung-Yong Han, Dawool Han, Hee-Myung Park
Journal: Front Vet Sci (2023)
Keywords: dog, ghost cell, ghost cell odontogenic carcinoma (gcoc), odontogenic carcinoma, oral tumor

A 6 year-old spayed female Poodle presented with a mandibular mass. Radiographic examination revealed osteolysis from the right mandibular canine to the fourth premolar, along with horizontal bone loss and dorsal displacement of the right mandibular first and second premolars. Skull cone beam computed tomography revealed osteolysis at the level of the right mandibular canine and fourth premolar. A destructive bone lesion was observed in the apical area of the right mandibular canine, with mass invasion of the interradicular bone of the right mandibular first molar near the mandibular canal. Consequently, unilateral total mandibulectomy and skin flap surgery were performed. Histopathological examination revealed poorly demarcated and infiltrative neoplastic epithelial cells that formed small islands and trabeculae. Neoplastic cells exhibited the malignant features of cytological atypia and high mitotic activity. Furthermore, the neoplastic epithelial cells frequently showed ghost cell changes and were diagnosed as ghost cell odontogenic carcinoma (GCOC). The dog was followed up for 1 year, during which no severe complications or local recurrence was observed, except for slight mandibular drift, tongue protrusion, and drooling. This case report describes the clinical features, diagnostic imaging, and histologic features of an unreported GCOC in a dog and the favorable outcome following surgical resection.
Statin-Induced Necrotizing Autoimmune Myopathy: Case Report of a Patient under Chronic Treatment
Authors: Ilaria Anna Bellofatto, Marta Sessarego, Amedeo Tirandi, Chiara Olivero, Cosimo Sgura, Elia Maioli, Aurora Gavoci, Elisa Schiavetta, Federica Frè, Benedetta Saccomanno, Federico Zaottini, Riccardo Picasso, Chiara Fiorillo, Luca Liberale, Luciano Carlo Ottonello, Nicholas Bardi, Fabrizio Montecucco
Journal: Case Rep Med (2023)
MeSH terms: Case Reports

Introduction:
3-Hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) inhibitors are widely used worldwide to treat dyslipidaemia and prevent cardiovascular events. Statins can cause a wide variety of muscle injuries ranging from myalgia to severe rhabdomyolysis. In most cases, these symptoms are mild and self-limiting and do not require specific treatment besides drug withdrawal. Statin-induced autoimmune necrotizing myopathy (SINAM) is a rare but potentially fatal complication, characterized by the subacute onset of progressive proximal muscle weakness and considerably high creatine phosphokinase (CK) levels in patients exposed to statins. The diagnosis is supported by the presence of antibodies HMGCR, which allows the differentiation from other forms of necrotizing autoimmune myopathies. Symptoms usually progress even after statin discontinuation and can determine severe muscle damage. Summary. We describe the case of a 77-year-old man who developed SINAM after 5 years of statin use. He suffered from muscle functional impairment mainly involving proximal lower limb muscles which progressed to the point that he almost became bedridden. Initial treatment with prednisone alone was not effective, and he required a combination therapy with steroids, methotrexate, and intravenous immunoglobulins. After 5 months of therapy and rehabilitation, he showed complete laboratory response and muscle strength recovery.
Conclusion:
Recognizing SINAM is paramount in order to promptly start treatment and avoid permanent muscle damage. Using a combination therapy from the beginning could contribute to a better outcome. Prompt statin cessation, categorization of the muscle disease by autoantibody testing, imaging, and histology, exclusion of malignancy, and anti-inflammatory therapy with corticosteroids, antimetabolites, immunoglobulins, and in some cases rituximab are currently accepted approaches to this entity.