OpenMed/multicare-articles huggingface dataset:
Steroid-refractory ulcerative colitis treated with corticosteroids, metronidazole and vancomycin: a case report
Authors: Jonathan Miner, M Monem Gillan, Philip Alex, Michael Centola
Journal: BMC Gastroenterol (2005)
MeSH terms: Anti-Infective Agents / therapeutic use, Anti-Inflammatory Agents / therapeutic use, Clostridioides difficile, Clostridium Infections, Colitis, Ulcerative / diagnosis, Colitis, Ulcerative / microbiology, Prednisone / therapeutic use, Case Reports, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S., Adult, Anti-Bacterial Agents / therapeutic use, Anti-Inflammatory Agents / administration & dosage, Dose-Response Relationship, Drug, Drug Administration Schedule, Drug Resistance, Drug Therapy, Combination, Humans, Male, Metronidazole / therapeutic use, Prednisone / administration & dosage, Steroids / therapeutic use, Vancomycin / therapeutic use, Anti-Bacterial Agents, Anti-Infective Agents, Anti-Inflammatory Agents, Steroids, Metronidazole, Vancomycin, Prednisone

Background:
Increasing evidence elucidating the pathogenic mechanisms of ulcerative colitis (UC) has accumulated and the disease is widely assumed to be the consequence of genetic susceptibility and an abnormal immune response to commensal bacteria. However evidence regarding an infectious etiology in UC remains elusive.
Case presentation:
We report a provocative case of UC with profound rheumatologic involvement directly preceded by Clostridium difficile infection and accompanying fever, vomiting, bloody diarrhea, and arthritis. Colonic biopsy revealed a histopathology suggestive of UC. Antibiotic treatment eliminated detectable levels of enteric pathogens but did not abate symptoms. Resolution of symptoms was procurable with oral prednisone, but tapering of corticosteroids was only achievable in combination therapy with vancomycin and metronidazole.
Conclusions:
An infectious pathogen may have both precipitated and exacerbated autoimmune disease attributes in UC, symptoms of which could be resolved only with a combination of corticosteroids, vancomycin and metronidazole. This may warrant the need for more perceptive scrutiny of C. difficile and the like in patients with UC.
Unusual Vasospastic Angina: A Documented Asymptomatic Spasm with Normal ECG-A Case Report and a Review of the Literature
Authors: Ghassan Nakad, Hamid Bayeh
Journal: Case Rep Cardiol (2013)

We report the case of a 53-years-old patient, known to have coronary artery disease, presenting with typical angina at rest with normal ECG and laboratory findings. His angina is relieved by sublingual nitroglycerin. He had undergone a cardiac catheterisation two weeks prior to his presentation for the same complaints. It showed nonsignificant coronary lesions. Another catheterisation was performed during his current admission. He developed coronary spasm during the procedure, still with no ECG changes. The spasm was reversed by administration of 2 mg of intracoronary isosorbide dinitrate. Variant (Prinzmetal's) angina was diagnosed in the absence of electrical ECG changes during pain episodes.
Osteonevus of Nanta Presenting as Nodule over Left Eyebrow
Authors: Girish Kamat, Aneel Myageri, Ravikala Rao
Journal: Case Rep Dermatol Med (2012)
MeSH terms: Case Reports

Osteonevus of Nanta is a rare histopathological finding in which there is an ectopic bone formation in intradermal nevus. Very few cases have been reported so far in the literature. We present a case of osteonevus of Nanta, which occurred as a nodule over the left eyebrow in a 52-year-old female patient. Simple excision proved to be curative in the present case.
DKA with Severe Hypertriglyceridemia and Cerebral Edema in an Adolescent Boy: A Case Study and Review of the Literature
Authors: Tansit Saengkaew, Taninee Sahakitrungruang, Suttipong Wacharasindhu, Vichit Supornsilchai
Journal: Case Rep Endocrinol (2016)

A 13-year-old adolescent boy with type 1 diabetes mellitus (1b) presented with diabetic ketoacidosis (DKA) and cerebral edema. Grossly lipemic serum and lipemia retinals due to extremely high triglyceride (TG) level were observed without evidence of xanthoma or xanthelasma. Cerebral edema was treated by appropriate ventilation and mannitol administration. Normal saline was carefully given and regular insulin was titrated according to blood sugar levels. Triglyceride levels were reduced from 9,800 mg/dL to normal range within 9 days after conventional treatment was commenced without antilipid medication. Based on our review of the literature, this is the first reported case of confirmed pediatric DKA with severe hypertriglyceridemia and cerebral edema. In patients with DKA and hypertriglyceridemia, clinicians should be mindful of the possibility of associated acute pancreatitis and cerebral edema.
ST-Segment Elevation Myocardial Infarction from Septic Emboli Secondary to Infective Endocarditis by Abiotrophia Defectiva
Authors: Bashar Khiatah, Sam Jazayeri, John Wilde, Mathew Westfall, Thomas Q Kong Jr, Amanda Frugoli
Journal: Case Rep Cardiol (2020)
MeSH terms: Case Reports

This article showcases a young patient who presented with STEMI secondary to septic emboli due to endocarditis with Abiotrophia Defectiva in the setting of a congenital bicuspid aortic valve. We aim to discuss current considerations for STEMI in young individuals including embolism due to IE, especially in patients with known or suspected congenital heart valve disease.
May-Thurner variant secondary to degenerative lumbar spondylolisthesis: a case report
Authors: David McKean, James Allman Sutcliffe, Hassan El Hassan, Nassim Parvizi, Anuj Wali, Dinuke Warakaulle, James Teh, Edward Seel, Stuart Blagg, Richard J Hughes
Journal: BJR Case Rep (2017)
MeSH terms: Case Reports

May-Thurner syndrome (MTS) is a rare condition in which patients develop iliofemoral deep venous thrombosis due to an anatomical variant in which the right common iliac artery overlies and compresses the left common iliac vein against the lumbar spine. We report a case of variant MTS, where vascular distortion secondary to spontaneous spinal arthrodesis of degenerative lumbar spondylolisthesis resulted in left common iliac vein compression and iliofemoral deep vein thrombosis. While the common complications of degenerative spondylolisthesis, such as spinal stenosis, are well described; the potential for pelvic vascular distortion secondary to anterior translation of the lumbar spine is not well recognized. The purpose in presenting this case is to describe the mechanism by which this variant of MTS occurs and highlight the need for vigilance for this unusual clinical entity.
A Rare Case of an Ectopic Liver Presenting as Right Atrial Mass
Authors: Adhirath Doshi, Dhaval Shah, Shradha Gupta, Deepika Panday, Arie Farji-Cisneros, Eddison Ramsaran, Robert Bojar
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Ectopic liver tissue is commonly observed in the abdominal cavity in adjacent organs. Extension of hepatic tissue into the intrathoracic cavity is rarely reported. We present the case of a 46-year-old woman with a 2.1 × 1.8 cm mass confirmed by transesophageal echocardiogram to be at the right atrial and inferior vena cava junction that was initially thought to be a myxoma which prompted surgical excision but subsequently identified as ectopic liver by histology.
Triple Jeopardy: Rapidly Progressive Glomerulonephritis Induced by Triple Seropositive Disease-A Rare Case
Authors: Apurva Vedire, Gautham Upadrasta, Ndausung Udongwo, Faseeha Rehman, Mohammad A Hossain
Journal: Case Rep Med (2022)
MeSH terms: Case Reports

The double-positive disease is the co-occurrence of antiglomerular basement membrane (anti-GBM) disease and antineutrophil cytoplasmic antibodies (ANCAs) and is an uncommon cause of renal failure. Our case of triple-positive disease is an even rarer cause of isolated renal failure, as it includes anti-GBM, antimyeloperoxidase (MPO), and antiproteinase 3 (PR3). We present a case of a 62-year-old Caucasian male with a history of multiple comorbidities, who presented to the emergency department (ED) with worsening dyspnea on exertion that started about one month prior to admission. He was found to be in renal failure secondary to triple-positive disease. We believe that the likely mechanism of our patient's triple-positive disease was a drug-induced ANCA vasculitis overlapping with Goodpasture's syndrome. We believe our case to be a valuable addition to the literature as it is a rare overlap syndrome without a previously established disease course or etiology.
Role of (18)F-FDG PET Scan in Rheumatoid Lung Nodule: Case Report and Review of the Literature
Authors: Christine L Chhakchhuak, Mehdi Khosravi, Kristine M Lohr
Journal: Case Rep Rheumatol (2013)

Flourine-18 fluoro-2-deoxy-glucose ((18)F-FDG) positron emission tomography combined with computed tomography (PET/CT) is a useful test for the management of malignant conditions. Inflammatory and infectious processes, however, can cause increased uptake on PET scanning, often causing diagnostic dilemmas. This knowledge is important to the rheumatologist not only because of the inflammatory conditions we treat but also because certain rheumatic diseases impose an increased risk of malignancy either due to the disease itself or as a consequence of medications used to treat the rheumatic diseases. There is an increasing body of evidence investigating the role of PET scans in inflammatory conditions. This paper describes a patient with rheumatoid arthritis who developed pulmonary nodules that showed increased uptake on PET/CT scan and reviews the use of PET scanning in the diagnosis and management of rheumatoid arthritis.
Concurrent aspergillosis and cystic pulmonary metastases in a patient with tongue squamous cell carcinoma
Authors: Hung-Chieh Su, Che-Chi Liao, Chieh-Lung Chen, Wei Chih Liao, Wen-Chien Cheng
Journal: Open Med (Wars) (2022)
Keywords: aspergillosis, cystic pulmonary metastasis, squamous cell carcinoma
MeSH terms: Case Reports

Pulmonary Aspergillus infection may have a variety of manifestations depending on the patients' immunity status and pre-existing lung conditions. Radiographically, aspergilloma, which is usually associated with noninvasive Aspergillus fumigatus conidia, may feature a characteristic mass in a cavity commonly located in the upper lobes of the lung. It is typically encountered upon pre-existing lung damage. Here we report Aspergillus growing in a pulmonary metastatic cavity in a 47-year-old male worker with a history of tongue cancer after a radical operation with neck dissection and concurrent chemotherapy in 2014. Chest radiography and computed tomography showed a cavitary lesion with a ball-in-hole lesion in the right upper lobe (RUL) and two cystic lesions within the bilateral upper lung field. Endobronchial ultrasound-guided transbronchial biopsy (EBUS-TBB) from the RUL anterior segmental bronchus (RB3) revealed the presence of Aspergillus conidia and squamous cell carcinoma. Wedge resection of the cystic lesion within the left upper lobe confirmed the diagnosis of metastatic squamous cell carcinoma. This is a rare case of aspergillosis within cavities of pulmonary metastases in a patient who was diagnosed with tongue squamous cell carcinoma. The conclusive distinction between neoplasm and fungal infection is difficult to achieve by radiography, and a pathological biopsy by EBUS-TBB is necessary to aid diagnosis. Clinicians should be aware of such an atypical presentation of metastases coexisting with Aspergillus infection.
A mass mimicking pancreatic adenocarcinoma, should hepatobiliary surgeons keep it in mind? a case report
Authors: Maria Sotiropoulou, Panagiotis Metaxas, Michail Vailas, Georgios Kyriakopoulos, Paraskevi Alexakou, Michail Psarologos, Charilaos Kyzeridis, Dimitrios Stergiou, Stamatina Koskolou, Stylianos Kapiris
Journal: Pan Afr Med J (2021)
Keywords: case report, lung cancer, metastasis, pancreas, surgery
MeSH terms: Adenocarcinoma / diagnosis, Carcinoma, Non-Small-Cell Lung / diagnosis, Lung Neoplasms / diagnosis, Pancreatic Neoplasms / diagnosis, Case Reports, Adenocarcinoma / pathology, Carcinoma, Non-Small-Cell Lung / pathology, Humans, Lung Neoplasms / pathology, Male, Middle Aged, Pancreatic Neoplasms / pathology, Pancreatic Neoplasms / secondary

Isolated metastasis to pancreas from lung cancer is an extremely rare entity, usually reported in case series and case reports in the medical literature; estimated to account for up to 3-5% of all pancreatic lesions. Herein, we describe a case of a male patient suffering from metachronous metastatic lesion to the tail of the pancreas secondary to non small cell lung carcinoma treated 4 years prior to his presentation. The patient underwent pancreatic resection due to high clinical suspicion for the malignant nature of the mass, which was proved to be secondary lesion from its prior primary tumor. To the best of our insight this is one of the few reported cases of such type of pancreatic metastasis that may be misleading for hepatobiliary surgeons during preoperative evaluation.
Multiseptate gallbladder in an asymptomatic child
Authors: Dylan Wanaguru, Ashish Jiwane, Andrew S Day, Susan Adams
Journal: Case Rep Gastrointest Med (2011)
MeSH terms: Case Reports

A one-year-old child being investigated for urinary tract infection was diagnosed with a multiseptate gallbladder. The patient remains asymptomatic, and investigations demonstrate no associated anomalies. Forty-three cases, including 13 cases in children were identified in the literature. Their presentation and management were reviewed.
Intravascular Large B-Cell Lymphoma: A Difficult Diagnostic Challenge
Authors: Maria S Khan, Mark McCubbin, Sucha Nand
Journal: J Investig Med High Impact Case Rep (2014)
Keywords: b cell, lymphoma

Case Presentation. A 69-year-old Hispanic male, with a past history of diabetes and coronary disease, was admitted for fever, diarrhea, and confusion of 4 weeks duration. Physical examination showed a disoriented patient with multiple ecchymoses, possible ascites, and bilateral scrotal swelling. Hemoglobin was 6.7, prothrombin time (PT) 21.4 seconds with international normalized ratio 2.1, partial thromboplastin time (PTT) 55.6 seconds, fibrin split 10 µg/L, and lactate dehydrogenase (LDH) 1231 IU/L. Except for a positive DNA test for Epstein-Barr virus (EBV) infection, extensive diagnostic workup for infections, malignancy, or a neurological cause was negative. Mixing studies revealed a nonspecific inhibitor of PT and PTT but Factor VIII levels were normal. The patient was empirically treated with antibiotics but developed hypotension and died on day 27 of admission. At autopsy, patient was found to have intravascular diffuse large B-cell lymphoma involving skin, testes, lung, and muscles. The malignant cells were positive for CD20, CD791, Mum-1, and Pax-5 and negative for CD3, CD5, CD10, CD30, and Bcl-6. The malignant cells were 100% positive for Ki-67. Discussion. Intravascular large cell B-cell lymphoma (IVLBCL) is rare form of diffuse large B-cell lymphoma and tends to proliferate within small blood vessels, particularly capillaries and postcapillary venules. The cause of its affinity for vascular bed remains unknown. In many reports, IVLBCL was associated with HIV, HHV8, and EBV infections. The fact that our case showed evidence of EBV infection lends support to the association of this diagnosis to viral illness. The available literature on this subject is scant, and in many cases, the diagnosis was made only at autopsy. The typical presentation of this disorder is with B symptoms, progressive neurologic deficits, and skin findings. Bone marrow, spleen, and liver are involved in a minority of patients. Nearly all patients have elevated LDH, and about 65% are anemic. About 20% have hepatic and renal dysfunction. The treatment consists of systemic chemotherapy with cyclophosphamide, doxorubicin, vincristine, prednisone plus rituximab (CHOP-R) and central nervous system prophylaxis. Retrospective data suggests that, with treatment, 51% to 82% of the patients achieve a complete remission and 27% to 56% are alive at 2-year follow-up. Conclusion. IVLBCL is a difficult diagnosis to make as the disease remains confined to the vascular lumen. It may be associated with certain viral illnesses, and this association needs to be explored further. It is important to consider this diagnosis in the appropriate settings because patients may achieve durable remissions with therapy.
A rare cause of proximal intestinal obstruction in adults - annular pancreas: a case report
Authors: Bouassida Mahdi, Sassi Selim, Touinsi Hassen, Mighri Mohamed Mongi, Chtourou Mohamed Fadhel, Chebbi Fathi, Sassi Sadok
Journal: Pan Afr Med J (2011)
Keywords: annular pancreas, bypass, duodenal stenosis
MeSH terms: Gastroenterostomy / methods, Intestinal Obstruction / etiology, Pancreatic Diseases / complications, Case Reports, Abdominal Pain / etiology, Female, Follow-Up Studies, Humans, Intestinal Obstruction / diagnosis, Intestinal Obstruction / surgery, Nausea / etiology, Pancreas / abnormalities, Pancreatic Diseases / diagnosis, Vomiting / etiology, Young Adult, Annular pancreas

Annular pancreas is a rare congenital anomaly characterized by the presence of ectopic pancreatic tissue surrounding the descending part of the duodenum. It is one of the few congenital anomalies of the gastrointestinal tract which can produce symptoms late in life. In adults, the factors initiating symptoms are recurrent pancreatitis, duodenal stenosis at the site of the annulus, or duodenal or gastric ulceration. We report a new case involving a 24-year-old woman hospitalised for epigastric pain, nausea and vomiting. Radiological examination was consisted with an annular pancreas. At operation a complete obstruction of the second part of the duodenum was found, caused by an annular pancreas, no other congenital anomaly of the intra-abdominal organs was noted. A gastroenterostomy was performed.
One-stage laparoscopic surgery for inspissated bile syndrome: case report and review of surgical techniques
Authors: Steffen Berger, Susanne Schibli, Enno Stranzinger, Dietmar Cholewa
Journal: Springerplus (2013)

Inspissated bile syndrome in a 6 week old boy was unresponsive to oral ursodesoxycholic acid. Intraoperative cholangiography revealed complete obstruction of the common bile duct. Therefore, the gallbladder fundus was pulled out through a laparoscopy port site and sutured to the fascia. A catheter was positioned into the infundibulum for irrigation with ursodesoxycholic acid. At day 8 complete resolution of the plug and free passage of contrast medium into the duodenum was documented radiologically. The catheter was removed, skin closed spontaneously without a second surgery for closure of the gall bladder.
Case Report: Central retinal artery occlusion following sildenafil intake
Authors: Anis Mahmoud, Fatma Abid, Molka Khairallah, Fatma Sakji, Hassen Ibn Hadj Amor, Hala Attia, Sameh Mbarek, Riadh Messaoud
Journal: F1000Res (2022)
Keywords: central retinal artery occlusion, sildenafil, systemic drug retinal toxicity, phosphodiesterase v inhibitor
MeSH terms: Acetazolamide, Retinal Artery Occlusion / chemically induced, Retinal Artery Occlusion / complications, Retinal Artery Occlusion / diagnosis, Case Reports, Humans, Isosorbide Dinitrate, Male, Middle Aged, Sildenafil Citrate / adverse effects, Visual Acuity, Sildenafil Citrate, Isosorbide Dinitrate, Acetazolamide

Purpose: To report a case of central retinal artery occlusion associated with sildenafil intake and briefly discuss its causative pathogenesis. Methods: A 50-year-old man with no premorbidities presented with symptoms of sudden severe visual field constriction in the left eye (LE). Best-corrected visual acuity in the LE was 20/25. Fundus examination and fluorescein angiography of the LE were suggestive of central retinal artery occlusion (CRAO) with cilioretinal artery sparing. Further investigation revealed that 100 mg of sildenafil had been taken for the first time three hours before the onset of symptoms. Results: The patient was treated promptly with intravenous acetazolamide, sublingual isosorbide dinitrate and ocular massage, but without visual recovery. No other associated systemic or local risk factors were found, and the case was classified as a potential complication of sildenafil. Conclusion: Although no direct link could be established, the aim of this report is to highlight the incidence and to consider this issue when evaluating any case of central retinal artery occlusion.
Case report: Reconstruction of the left renal vein with resected autologous right renal vein interposition after excision of an inferior vena cava leiomyosarcoma
Authors: Xiaohang Li, Baifeng Li, Na Zhang, Fengshan Wang, Chengshuo Zhang, Ning Sun, Jialin Zhang
Journal: Front Surg (2022)
Keywords: inferior vena cava, interposition vascular graft, leiomyosarcoma, reconstruction, renal vein
MeSH terms: Case Reports

Background:
Leiomyosarcoma of the inferior vena cava (IVC) was a rather rare disease with the characteristics of invading the adjacent viscera. Surgical resection is the only potential curative treatment, and radiation therapy and chemotherapy for leiomyosarcoma are not definite. There is few literature reporting the leiomyosarcoma of the IVC.
Case presentation:
A previously healthy 64-year-old female was admitted to the First Affiliated Hospital of China Medical University with the complaint of right lower quadrant abdominal pain for almost three years and worsening with a radiating ache in the waist recently. Contrast-enhanced computed tomography(CT) scans revealed a large (7.8 cm*5.5 cm*5.0 cm) irregular hypodense retroperitoneal mass with heterogeneous enhancement and invasion of the IVC, and the right ureter was compressed with proximal ureteral dilatation and hydrops. Three-dimensional CT of the IVC revealed that the IVC was encircled by the tumor with moderate invasion. During the operation, the tumor was resected en bloc with the IVC (from the suprarenal to infrarenal segment), the right kidney with ureter, and the duodenum seromuscular layer. As the left renal vein was involved, it was also partly resected. IVC reconstruction was performed with the interposition of a 20 mm diameter polytetrafluoroethylene (PTFE) prosthesis, and the right renal vein was anastomosed between the left renal vein and the reconstructed IVC to guarantee the left renal vein reflux. The patient had an uneventful recovery process with normal renal function after the operation. However, follow-up CT indicated that the left renal vein was blocked two weeks after the surgery. The patient was discharged two weeks after the operation. She continues well and has no evidence of disease fourteen months after the surgery.
Conclusions:
Wide excision of the tumor en bloc with the IVC is the main treatment for leiomyosarcoma of the IVC. IVC reconstruction with prosthetic PTFE grafts is recommended. When the left renal vein is partly resected due to involvement of the tumor, reconstruction of left renal vein should also be performed to avoid renal impairment. If the right renal vein does not show tumor involvement, the resected right renal vein can be used to reconstruct the left renal vein.