OpenMed/multicare-articles huggingface dataset:
Successful hepatic resection for invasive Klebsiella pneumoniae large multiloculated liver abscesses with percutaneous drainage failure: A case report
Authors: Hiroyuki Nojima, Hiroaki Shimizu, Takashi Murakami, Masato Yamazaki, Kazuto Yamazaki, Seiya Suzuki, Kiyohiko Shuto, Chihiro Kosugi, Akihiro Usui, Keiji Koda
Journal: Front Med (Lausanne) (2023)
Keywords: k pneumoniae, k1 serotype, klebsiella-associated multiloculated liver abscess, hyper mucus discharge, percutaneous drainage failure
MeSH terms: Case Reports

Background:
Invasive Klebsiella-associated liver abscesses can progress rapidly and cause severe metastatic infections such as meningitis and hydrocephalus, which are associated with high morbidity and mortality. In patients with large multiloculated liver abscesses after failure of percutaneous drainage, rapid diagnosis of the abscess followed by hepatic resection is necessary for early recovery and to prevent severe secondary metastatic complications.
Case presentation:
An 84-year-old woman with a large liver abscess and in septic shock was transferred to our hospital. Abdominal CT showed multiloculated liver abscesses 15 cm in diameter in the right lobe of the liver. We first performed percutaneous liver abscess drainage. The patient was managed in the intensive care unit, as well as treated with intravenous administration of meropenem followed by cefozopran according to the antibiogram. Klebsiella pneumoniae with invasive infection was confirmed by a string test in an isolated colony of K. pneumoniae; the K1 serotype with the rmpA and magA genes was determined by polymerase chain reaction and Sanger sequencing. Additional percutaneous liver abscess drainage was performed due to initial inadequate drainage. Although the abscess had shrunk to a diameter of 8 cm after drainage in 4 weeks, the patient recovered from sepsis, but still had low-grade fever (occasionally 38°C) and continued to have symptoms of chronic inflammation with persistent hyper mucus discharge from the liver abscess. Surgical resection was chosen to prevent prolonged hospitalization and ensure early recovery. A right posterior sectionectomy of the liver, including liver abscess, was performed. The post-operative course was uneventful, with no complications, and she was discharged after 18 days. There were no signs of abscess recurrence 1 year after surgery.
Conclusion:
We present a case of successful hepatic resection after percutaneous drainage failure in a patient with invasive K. pneumoniae multiloculated liver abscess.
Case Report: The Coronavirus Disease 2019 (COVID-19) Pneumonia With Multiple Thromboembolism
Authors: Tingting Cao, Guqin Zhang, Huabing Xie, Emily Pellegrini, Jin Li, Xiaoxing Chen, Huaqin Pan
Journal: Front Neurol (2021)
Keywords: covid-19, sars-cov-2 virus, anticoagulant treatment, multiple thromboembolism, pneumonia
MeSH terms: Case Reports

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) broke out in Wuhan, China, in late December 2019 and has since spread rapidly around the world. Severe coronavirus disease 2019 (COVID-19) pneumonia patients have abnormal blood coagulation function, but their thromboembolism prevalence is still unknown. We reported a case of a 49-year-old man infected with COVID-19, presenting with fever, chest pain, limb weakness, myalgia, and dyspnea. The patient was diagnosed with severe COVID-19 pneumonia, pulmonary thromboembolism (PTE), deep vein thrombosis (DVT), and cerebral infarction. He received supportive and empirical treatment including anticoagulant treatment, anti-inflammatory treatment, oxygen supply, and inhalation therapy. The patient's symptoms, CT images, and laboratory results improved after treatment, and a throat swab was reported to be negative for SARS-CoV-2 virus by polymerase chain reaction (PCR) test. However, on day 51 of illness onset, CT reexamination demonstrated hemorrhagic infarction. Anticoagulant therapy was discontinued temporarily. After the patient tested negative for SARS-CoV-2 virus by PCR test six more times, he was discharged and remained in home quarantine. This case highlights the importance of clinician attentiveness to the appearance of multiple thromboembolism, especially in patients with severe pulmonary damage. It also emphasizes the diagnostic value of early CT imaging and the need for effective treatment once thrombotic events occur.
Solitary coronary artery nourishing the entire heart
Authors: Bengi Yaymaci, Murat Ugurlucan, Murat Basaran, Ozer Selimoglu, Ali Kocailik, Senay Akyildiz, Orhan Coskun, Melih Us
Journal: Ann Saudi Med (2010)
MeSH terms: Coronary Angiography, Coronary Vessel Anomalies / diagnostic imaging, Case Reports, Aspirin / therapeutic use, Chest Pain, Coronary Vessel Anomalies / drug therapy, Coronary Vessel Anomalies / physiopathology, Dyspnea, Humans, Incidental Findings, Male, Middle Aged, Physical Exertion, Platelet Aggregation Inhibitors / therapeutic use, Smoking Cessation, Platelet Aggregation Inhibitors, Aspirin

Coronary artery anomalies are being more frequently diagnosed these days both because increasing numbers of patients are undergoing diagnostic studies and because advanced radiographic imaging methods are now commonly available. An isolated single coronary artery giving rise to the main coronary branches is a rare congenital anomaly. In this report we present a patient with a solitary coronary ostium, with both the left and right coronary artery systems arising from it, and then following their usual courses. This case was diagnosed incidentally during conventional angiography.
Ectopic Papillary Carcinoma in the Midline Neck Accompanied by a Benign Thyroid Gland
Authors: Lauran Evans, SeHoon Park, Christie Elliott, Courtney Garrett
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

Ectopic thyroid tissue can deposit anywhere in the body. There are several cases reporting papillary thyroid carcinoma (PTC) arising from ectopic tissues; however, these cases largely presented with primary PTC within the native thyroid gland as well. Alternatively, some cases report of PTC found solely in an ectopic thyroglossal duct cyst, but reports of isolated malignancy in other types of ectopic thyroid tissue with normal native tissue are sparse throughout the literature. Here, we present an unusual case of PTC in the midline anterior neck that does not appear to be consistent with a thyroglossal duct cyst, accompanied by a completely benign native thyroid gland, of which only few cases have been reported.
CAPN1 Variants as Cause of Hereditary Spastic Paraplegia Type 76
Authors: Jesus Eduardo Garcia-Berlanga, Mariana Moscovich, Isaac Jair Palacios, Alejandro Banegas-Lagos, Augusto Rojas-Martinez, Daniel Martinez-Ramirez
Journal: Case Rep Neurol Med (2019)
MeSH terms: Case Reports

Background:
Autosomal recessive hereditary spastic paraplegias (HSP) are a rare group of hereditary neurodegenerative disorders characterized by spasticity with or without other symptoms. SPG11 gene is the most common cause of autosomal recessive HSP. We report a case of autosomal recessive spastic paraplegia type 76 due to heterozygous variants of CAPN1 in an Argentinean subject.
Case presentation:
A 38-year-old Argentinean female presented with progressive gait problems and instability of 15-year duration. Oculomotor abnormalities, ataxia, bradykinesia, cervical dystonia, and lower limb pyramidal signs were observed. Brain MRI was unremarkable. Whole-exome sequencing analysis identified two heterozygous variants in CAPN1.
Conclusions:
Clinicians should screen for CAPN1 mutation in a young female patient without significant family history with a spastic paraplegia syndrome associated with other symptoms.
Cervical hibernoma and lipoblastomatosis
Authors: Carlos Eduardo Molinari Nardi, Leonardo Barreto, Leda Viegas de Carvalho, André Vicente Guimarães
Journal: Einstein (Sao Paulo) (2013)
MeSH terms: Head and Neck Neoplasms / pathology, Lipoblastoma / pathology, Lipoma / pathology, Case Reports, Adult, Biopsy, Fine-Needle, Diagnosis, Differential, Humans, Infant, Male

Lipoblastoma and lipoblastomatosis are rare benign soft-tissue tumoral lesions resembling fetal adipose tissue. A total of 16 cases of lipoblastoma of the neck were reported in the literature, and only 3 were described in the posterior side of the neck. Hibernoma is a rare benign adipose tumor composed of brown fat cells and only about ten cases occurring in the cervical area have been reported. We reported two rare cases of adipose tissue tumors. The first case was a male infant aged 12 months who had a cervical mass on the posterior side of the neck. He underwent a complete resection of the lesion and the pathologic study revealed lipoblastomatosis. The second case was a 36-year-old man with an anterior cervical mass, which moved with swallowing. A resection was made and the histological analysis showed hibernoma.
A fatal combination of disseminated strongyloidiasis with two bacterial infections in an immunocompromised host
Authors: Vineeta Vini, Sherly Antony, Teena Jacob, Archana Sasimohan, Aneeta Mary Jacob, Mercy John Idikula, Jacob Cherian
Journal: Access Microbiol (2021)
Keywords: aeromonas sobria, strongyloides stercoralis, disseminated strongyloidiasis, hyperinfection syndrome
MeSH terms: Case Reports

Introduction:

Strongyloides stercoralis is an intestinal nematode that is endemic in tropical countries. It can have a variable presentation ranging from asymptomatic eosinophilia in immunocompetent hosts to disseminated disease with sepsis in immunocompromised hosts.
Case report:
We report a case of chronic diarrhoea and decreased appetite in a 53-year-old man. He was a chronic alcoholic with diabetes, hypertension and dyslipidaemia and had earlier been treated for pulmonary tuberculosis. He was treated symptomatically for loose stools at a primary health care facility without relief. Following referral to our tertiary care centre, microscopic examination of the stool showed numerous larvae and a few eggs of Strongyloides stercoralis. Additionally, Aeromonas sobria was isolated from stool culture. The patient was discharged following improvement with a combination therapy of ivermectin, albendazole and ciprofloxacin. However, within 3 days, he was readmitted and succumbed to Escherichia coli sepsis.
Conclusion:
Strongyloidiasis can be diagnosed easily using a very simple but often neglected investigation, namely stool microscopy. This provides an early diagnosis, based on which prompt treatment with the appropriate antihelminthics can be started, thereby reducing the probability of disseminated infection. Disseminated strongyloidiasis is a medical emergency with a poor prognosis, especially in an immunocompromised state. Such patients should be treated aggressively with antihelminthics. They must be monitored for sufficient duration in the hospital for early signs of complication. Their discharge from hospital should be planned based on a negative stool microscopy report in addition to clinical improvement, so as to decrease the mortality reported for both untreated and treated individuals.
Prosopagnosia as a Type of Conversion Disorder
Authors: Clodagh Power, Oisin Hannigan, Robert Coen, Irene Bruce, Matthew Gibb, Marie McCarthy, David Robinson, Brian A Lawlor
Journal: Case Rep Psychiatry (2018)
MeSH terms: Case Reports

Background:
Conversion disorder is a common and debilitating condition that remains poorly understood. We present a previously undescribed form of conversion disorder to highlight the complexity of the condition and consider the interplay of factors that produce conversion symptoms.
Case:
A 50-year-old male presented with acquired prosopagnosia and language impairment. Neuropsychological testing indicated right temporal lobe dysfunction. Extensive work-up outruled an organic aetiology. Reactivation of childhood trauma coincided with the onset of his symptoms. Childhood trauma is known to have adverse effects on the developing brain which may affect an individual's emotional behaviour and coping style. Functional neuroimaging techniques suggest that conversion symptoms may be linked to the disruption of higher order neural circuitry involved in the integration of emotional processing and cortical functioning.
Conclusions:
We propose that our patient's adverse childhood experiences led to the development of a particular personality and coping style that "primed" him for a later abnormal emotional and behavioural response when confronted with reminders of his traumatic background. Further interdisciplinary studies are required to further elucidate the neurobiological basis for this condition.
Case Report: Is Surgical Treatment Beneficial for Intracranial Basal Ganglia Cunninghamellamycosis Following Haematopoietic Stem Cell Transplantation?
Authors: Bixin Xi, Aiguo Liu, Xin Zhao, Yicheng Zhang, Na Wang
Journal: Front Pediatr (2022)
Keywords: hsct, benefits, cunninghamellamycosis, intracranial basal ganglia, surgical treatment
MeSH terms: Case Reports

Cunninghamellamycosis is an unusual but often highly fatal mucormycosis caused by Cunninghamella bertholletiae, which belongs to the basal lineage order Mucorales. It is especially fatal when the central nervous system is involved. So far, there are few reported cases of surgical treatment for intracranial mucormycosis in children after allogeneic haematopoietic stem cell transplantation (HSCT). The surgical management of deep-seated basal ganglia fungal lesions remains controversial, and its clinical benefits are not yet well established. Herein, we present a rare case of disseminated mucormycosis caused by C. bertholletiae involving the lung and intracranial basal ganglia after homologous leucocytic antigen-matched sibling donor HSCT. The patient was successfully treated for intracranial cunninghamellamycosis with neuroendoscopic surgery and systemic wide-spectrum antifungal treatment and achieved pulmonary recovery without recurrent C. bertholletiae infection or neurologic sequelae. Over the follow-up period of 13 months, there were no adverse events associated with the intracranial surgical debridement, and the patient remained in good health.
Prone Positioning and Intravenous Zanamivir may Represent Effective Alternatives for Patients with Severe ARDS Virus A (H1N1) Related Pneumonia in Hospitals with no Access to ECMO
Authors: Giuseppe Gristina, Giuseppe Nardi, Daniela Orazi, Francesco Nicola Lauria, Maria Beatrice Valli, Eleonora Lalle, Stefano Menzo, Luigi Riccioni, Maria Pia Camporiondo
Journal: Crit Care Res Pract (2010)
MeSH terms: Case Reports

The first patient with influenza A/H1N1-related pneumonia was admitted to an Italian ICU at the end of August 2009. Until then, despite the international alarm, the level of awareness was low and very few Italian hospitals were equipped with ECMOs. Moreover the PCR test for A H1N1 virus was sporadically available and the emergency departments of even the largest institutions could rely only on the rapid test for the urgent screening of patients with pneumonia and respiratory failure. On September 5th, a young and "apparently" previously healthy man, was admitted to our ICU because of a severe ARDS caused by influenza A H1N1 virus. As there was no ECMO available, he was treated with prolonged cycles of prone positioning ventilation. Antiviral treatment was started with Oseltamivir, but as enteral absorption was impaired by paralytic ileus and tube feeding intolerance, Oseltamivir had to be discontinued. Intravenous Zanamivir 1200 mg/day for ten days was therefore prescribed as "off label" antiviral therapy. A bone marrow biopsy allowed the diagnosis of an initial stage of "hairy cells leukaemia." ARDS related to A/H1N1 influenza was the first sign of the disease in our patient. He did well with complete clearance of the infection from the BAL after 10 days of Zanamivir, although the nasopharyngeal swabs remained positive for ten more days. Prone positioning ventilation may be a life-saver strategy in patients with severe ARDS when ECMO is not immediately available. However, prone positioning ventilation is often associated with severe impairment of the absorption of drugs that require enteral administration via the nasogastric tube. In these cases, intravenous Zanamivir may be an effective alternative strategy.
One lung ventilation management in a patient with Reinke's edema
Authors: Marco Rispoli, Moana Rossella Nespoli, Dario Maria Mattiacci, Carlo Curcio, Dino Casazza, Dario Amore
Journal: Int J Surg Case Rep (2020)
Keywords: reinke’s edema, vivasight slt, vivasight-endoblocher™
MeSH terms: Case Reports

Introduction:
Reinke's edema (RE) is a benign laryngeal disease. We describe the case of a patient with history of bilateral RE requiring surgical treatment, that came to our attention for a lung lobectomy due to adenocarcinoma. In consideration of the possible complications at the time of extubation and of the probable difficult control of the airways, the patient underwent intervention of microflap surgery for the RE at the same time of lobectomy. We opted for Bronchial Blocker (BB) using a Viva-sight™ Single Lumen Tube (SLT) Internal Diameter (ID) 7.0 mm (Ambu A/S, Baltorpbakken 13, DK-2750 Ballerup, Denmark) with integrated high-resolution camera.
Presentation of case:
The patient (female, 67 years old, BMI 28) was a candidate for lung lobectomy. She reported a RE requiring surgical treatment. An armoured Endo Tracheal Tube (ETT) ID 5.0 mm was positioned and microflap surgery was performed. Once this surgery ended, the armoured ETT was removed after placing an airway guide wire exchanger and a SLT ID 7.0 mm was placed. ​VivaSight-endoblocher™ (EB) was positioned in the right bronchus.
Discussion:
We opted for double intervention, the risk that could result from the delay persuaded the patient to perform surgery for the RE. Postponing the lobectomy was dangerous for the oncological situation. The Viva-Sight SLT represented the right compromise.
Conclusion:
Even after the microflap, the space available for the ETT was reduced and, in order not to traumatize a tissue already stressed by surgery and to facilitate the tracheal intubation, we opted for BB using a Viva-sight™.
A Rare Case of Colonic Sarcoidosis Presenting as a Mass
Authors: Haozhe Sun, Jasbir Makker, Harish Patel, Nikhitha Mantri, Ali N Hussain, Naeem Abbas
Journal: Case Rep Gastrointest Med (2020)
MeSH terms: Case Reports

Introduction:
Sarcoidosis is a common multisystem chronic inflammatory disease of an unidentified inciting etiology. The most common initial manifestations of this disease involve the pulmonary system, and involvement of the gastrointestinal tract is rare. Sarcoidosis of the gastrointestinal tract occurs in an oral-anal gradient, with the esophagus and stomach being the most commonly involved sites, while colonic involvement remains extremely rare. Case Presentation. We present a case of a 24-year-old African American man who was evaluated for persistent abdominal pain, chronic diarrhea, and weight loss. Workup for infectious etiologies and celiac disease was unrevealing. An inflammatory mass in the hepatic flexure was found during colonoscopy, and a computed tomography (CT) scan of the abdomen was significant for circumferential thickening of the cecum and ascending colon, along with nodular thickening of the peritoneum without enhancement. Malignancy and inflammatory bowel disease were the initial differentials. A peritoneal biopsy was also performed. Pathology of the colon and peritoneal biopsy was significant for the presence of noncaseating granulomas and confluent granulomatous inflammation. The patient was diagnosed with colonic sarcoidosis, and treatment with corticosteroids was initiated. Symptoms resolved with treatment, and a follow-up colonoscopy five months later showed interval healing.
Conclusion:
Although rare, colonic sarcoidosis should be considered as one of the differential diagnoses when evaluating a patient with chronic diarrhea and a mass on colonoscopy. Histopathology is the key to diagnosis as it distinguishes malignancy from sarcoidosis. Corticosteroids remain as an option for treating colonic sarcoidosis.
DIEP flap salvage by cannula venesection of the superficial inferior epigastric vein
Authors: Puttan Wongtriratanachai, Abbe Michelle Martin, Kongkrit Chaiyasate
Journal: Eur J Plast Surg (2016)
Keywords: cannula, diep flap, siev, venesection, venous congestion

The deep inferior epigastric perforator (DIEP) flap is a technique of autologous breast reconstruction that is gaining popularity. The main advantage of the DIEP flap over the traditional transverse rectus abdominis myocutaneous (TRAM) flap is that there is a lower incidence of abdominal wall donor-site morbidity with the DIEP flap. However, venous congestion is the most dreaded complication of DIEP flap surgery which requires prompt intervention. In this case report, we present a simple but effective procedure to salvage the congested DIEP flap. A 55-year-old female underwent left breast reconstruction with DIEP flap and developed venous congestion during surgery. Cannula venesection of the superficial inferior epigastric vein (SIEV) was performed intraoperatively followed by intermittent aspiration of blood for 3 days. A satisfactory aesthetic result was achieved with no evidence of fat necrosis. This procedure eliminated the need for performing an additional microvascular anastomosis, required less operative time, and allowed augmentation of the venous drainage of the congested flap.
Level of evidence:
Level V, therapeutic study.
Diagnostics and Treatment of Volkmann Ischemic Contracture in a Seven-Year-Old Child
Authors: Annekatrin Schulze, Jurek Schultz, Adrian Dragu, Guido Fitze
Journal: European J Pediatr Surg Rep (2022)
Keywords: volkmann ischemic contracture, children, compartment syndrome, supracondylar fracture, tenotomy
MeSH terms: Case Reports

A 7-year-old boy presented 6 weeks after open reduction and crossed Kirschner wire (K-wire) fixation of a supracondylar humerus fracture. Previous treatments had restored skeletal anatomy without documented complications. However, the patient would not move the entire arm, including his forearm and hand. Any passive movement led to anxious adverse reactions, and there was partial numbness of all fingers. After intensive physio- and occupational therapy supported by nerve stimulation and psychological counseling, anxiety-related functional deficits of the shoulder and elbow resolved to reveal the severe Volkmann contracture of the right hand developed fully. Electroneurography, X-ray, magnetic resonance imaging of the forearm, and ultrasonography showed nonfunctional ulnar and a partially disturbed radial motor nerve distal to the elbow along with damaged flexor muscles of the forearm after compartment syndrome. In addition, damage to the median nerve at the elbow level was diagnosed. After intense conservative therapy, we partially resected fibrotic fascia of the superficial flexor compartment, freed ulnar and median nerves, and performed staircase-like releases of tendons and tenotomies. We achieved a full range of motion of all fingers and markedly improved the range of motion of the wrist. The Disabilities of the Arm, Shoulder and Hand scores for function improved from 80 to 16 at the 2-year follow-up postoperatively, but some impairments of fine motor function persisted. Subtle symptoms of a developing compartment syndrome need to be recognized. Overlooked and untreated, a consecutive Volkmann contracture can turn the extremity nonfunctional. Intensive physical, psychological, and surgical therapy in a specialized center can restore function but requires endurance and perseverance throughout the lengthy recovery.