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PubMed1976

Clinical and laboratory aspects of Yersinia pseudotuberculosis infections, with a report of two cases.

Yersinia pseudotuberculosis infections in two bacteriologically confirmed cases are described. A child was found to have mesenteric adenitis and an adult had septicemia. Invariably simulating acute appendicitis, mesenteric adenitis most often occurs in male children and adolescents. Septicemia with this organism usually affects elderly, debilitated patients, who frequently have chronic hepatic disease. The infrequent diagnosis of infection with Yersinia pseudotuberculosis in the United States is probably due to failure to consider it a human pathogen. Currently classified with the Enterobacteriaceae, Yersinia pseudotuberculosis in a non-lactose-fermenting, Gram-negative coccobacillus. It is sensitive to a wide range of antibiotics, including tetracycline and streptomycin, but usually is resistant to ampicillin. Yersinia pseudotuberculosis has a worldwide distribution in wild and domestic mammals and birds. Infections in man may result from direct contact with infected animals or their excreta.

Aged↗

PubMed1992

Comparison of mycobacterial lymphadenitis among persons infected with human immunodeficiency virus and seronegative controls.

Lymphadenitis is a common extrapulmonary manifestation of mycobacterial disease in persons with human immunodeficiency virus (HIV) infection. We compared the clinical, mycobacterial, and diagnostic characteristics of mycobacterial adenitis in 11 HIV-seropositive and 29 HIV-seronegative patients. Ninety-three percent of the HIV-seronegative patients and 54% of the HIV-seropositive patients were foreign-born. In contrast to the HIV-seronegative patients, seropositive patients were more likely to be febrile and have negative purified protein derivative skin tests and abnormal chest roentgenograms. Sputum samples were rarely diagnostic in either group. Mycobacterium tuberculosis was the most commonly isolated organism in both groups, although United States-born patients with HIV infection were more likely to be infected with nontuberculous mycobacteria. In contrast to results for seronegative patients, fine-needle aspiration was usually diagnostic in the HIV-seropositive population, especially in those at risk for M. tuberculosis infection. Similarly, the rate at which smears were positive for acid-fast bacilli was significantly higher in the HIV-seropositive group, a circumstance suggesting a higher burden of organisms in this population. Finally, although preceding opportunistic infections were uncommon in the HIV-seropositive group, both tuberculous and nontuberculous adenitis were associated with advanced immunosuppression.

AIDS-Related Opportunistic Infections↗

PubMed2000

Chronic granulomatous disease. Report on a national registry of 368 patients.

A registry of United States residents with chronic granulomatous disease (CGD) was established in 1993 in order to estimate the minimum incidence of this uncommon primary immunodeficiency disease and characterize its epidemiologic and clinical features. To date, 368 patients have been registered; 259 have the X-linked recessive form of CGD, 81 have 1 of the autosomal recessive forms, and in 28 the mode of inheritance is unknown. The minimum estimate of birth rate is between 1/200,000 and 1/250,000 live births for the period 1980-1989. Pneumonia was the most prevalent infection (79% of patients; Aspergillus most prevalent cause), followed by suppurative adenitis (53% of patients; Staphylococcus most prevalent cause), subcutaneous abscess (42% of patients; Staphylococcus most prevalent cause), liver abscess (27% of patients; Staphylococcus most prevalent cause), osteomyelitis (25% of patients; Serratia most prevalent cause), and sepsis (18% of patients; Salmonella most prevalent cause). Fifteen percent of patients had gastric outlet obstruction, 10% urinary tract obstruction, and 17% colitis/enteritis. Ten percent of X-linked recessive kindreds and 3% of autosomal recessive kindreds had family members with lupus. Eighteen percent of patients either were deceased when registered or died after being registered. The most common causes of death were pneumonia and/or sepsis due to Aspergillus (23 patients) or Burkholderia cepacia (12 patients). Patients with the X-linked recessive form of the disease appear to have a more serious clinical phenotype than patients with the autosomal recessive forms of the disease, based on the fact that they are diagnosed significantly earlier (mean, 3.01 years of age versus 7.81 years of age, respectively), have a significantly higher prevalence of perirectal abscess (17% versus 7%), suppurative adenitis (59% versus 32%), bacteremia/fungemia (21% versus 10%), gastric obstruction (19% versus 5%), and urinary tract obstruction (11% versus 3%), and a higher mortality (21.2% versus 8.6%).

Adolescent↗

PubMed1993

Evaluation of 242 consecutive parotidectomies performed for benign and malignant disease.

Between 1987 and 1992, one surgeon performed 242 parotidectomies in 229 patients. Among 97 patients with benign disease, pleomorphic adenoma (46) and sialo-adenitis (28) predominated, while metastatic melanoma (22) and squamous cell carcinoma (21) were the most common diagnoses among 132 patients with malignancy. The extent of parotidectomies were: 114 'appropriate' resections, 77 complete superficial parotidectomies, 35 near-total conservative and 14 radical total resections. The facial nerve was sacrificed in 19 operations and reconstructed in four. One hundred and five patients had a concomitant neck dissection and 45 patients had adjuvant radiotherapy. Postoperative facial nerve function was normal in 90% of patients with localized tumours and 55% of patients overall. Patients with sialo-adenitis or deep lobe tumours and those having a neck dissection were at greatest risk of facial weakness despite nerve preservation. At a median follow up of 34 months, 13 patients had developed tumour recurrence and attempts at salvage surgery have generally been disappointing.

Adolescent↗

PubMed1978

The prevalence of consolidated salivary deposits in the small ducts of human submandibular glands.

Deposits of apparently solid material were observed in the small salivary ducts in a series of non-diseased submandibular glands obtained from necropsies evenly divided by sex and adult age. The deposits were of granular or laminated structure. They were of mixed staining, the majority being predominantly eosinophilic. A small number of deposits were essentially wholly hematoxylinophilic and some of these were probably calcified. The prevalence of deposits, expressed as the number per unit sectional area, increased steadily with increasing age but was unrelated to sex. An apparently close correlation between intraductal salivary deposits and foci of obstructive adenitis in the same series of glands was shown to be mainly due to the common influence of age. The deposits probably form by precipitation of salivary glycoprotein, possibly because of parenchymal age changes. They may be related to early salivary lithogenesis but the statistical evidence of this study suggests that they are unlikely to be a major factor in the etiology of focal obstructive adenitis.

Adolescent↗

PubMed2006

PFAPA syndrome: new clinical aspects disclosed.

BACKGROUND: The recently described PFAPA (Periodic Fever, Aphthous stomatitis, Pharyngitis and Adenitis) syndrome is characterised by periodic fever, aphthous stomatitis, pharyngitis and adenitis. However, there are currently relatively few data on the natural history of this syndrome. OBJECTIVE: To describe the presentation, clinical course, doctors' awareness, therapeutic response and long-term follow-up of children with PFAPA syndrome. METHODS: Children with PFAPA syndrome referred over a 5-year period (from January 1999 to January 2004) were enrolled in the study. Data were gathered from medical records, parents' interviews, physical examination and telephone calls. RESULTS: 54 patients with PFAPA syndrome were evaluated. Our patients had a higher rate of abdominal pain (65%) and a lower rate of aphthous stomatitis (39%) than those in previous reports. Four different patterns of disease evolution were identified, including the relatively common (n = 14, 26%) and newly described course of alternating remissions and relapses. The remissions lasted 8.5 months on average (range 4-36 months). Diagnosis was established by primary paediatricians in 30 of 54 (56%) patients. However, a substantial delay in diagnosis was apparent (mean 15 months). Episodes were curtailed by a much lower dose of prednisone or equivalent corticosteroid (mean 0.6 mg/kg/day, range 0.15-1.5 mg/kg/day) than reported previously. Tonsillectomy was successful in the prevention of recurrence of further episodes in all six patients who underwent the procedure. CONCLUSIONS: We describe several new characteristics of PFAPA syndrome in children, contributing to our knowledge of this relatively unrecognised but troublesome syndrome. Early diagnosis and appropriate treatment can markedly improve the quality of life of both patients and families.

Adrenal Cortex Hormones↗

PubMed1998

Tuberculous inguinal and crural lymph nodes.

Non-respiratory forms of tuberculosis are frequently described in immigrants from endemic countries and in immunocompromised patients. Among the extrapulmonary forms of tuberculous disease, peripheral lymph node involvements, generally cervical, are the most common. Interestingly, only a few cases of tuberculous inguinal adenitis have been reported in the literature during the last 15 years. We report 2 cases of isolated inguinal inflammatory lymph-adenitis observed in immigrant immunocompetent women. The diagnosis of tuberculosis was confirmed by culture obtained by needle aspiration of a lymph node. The lesions completely healed after standard antituberculous therapy.

Adult↗

PubMed2004

Management of isolated extrapulmonary tuberculosis in a pregnant patient.

The worldwide incidence of tuberculosis is increasing, largely as a consequence of both the increasing prevalence of human immunodeficiency virus and the emergence of drug-resistant strains. The pulmonary system is typically the primary site of involvement by this infectious disease; however, extrapulmonary disease does occasionally occur. Although uncommon, neck involvement can occur. The usual presentation is bilateral adenopathy from pulmonary dissemination. Tuberculous cervical adenitis in the absence of pulmonary findings is rare. A concurrent diagnosis of pregnancy complicates the treatment of the infected patient. We present a case of isolated, unilateral tuberculous cervical adenitis in a pregnant patient and discuss the multidisciplinary approach necessary for the appropriate management of this unique situation.

Adult↗

PubMed2003

Determination of aetiology of superficial enlarged lymph nodes using fine needle aspiration cytology.

OBJECTIVE: To asses the causes and patterns of enlarged superficial lymph nodes. DESIGN: Cross sectional survey. SETTING: Jimma Teaching Hospital, Pathology Department, Jimma University, Southwest Ethiopia for a study conducted between September 1999 and August 2001. PARTICIPANTS: Eight hundred and eight patients presenting with enlarged superficial lymph nodes in cervical, axillary, inguinal etc. regions were included (456 males and 352 females) whereas non lymph node samples and deep-seated lymphoid lesions were excluded from the study. MAIN OUTCOME MEASURES: Fine needle aspiration cytology (FNAC) technique and Wright's staining procedure were utilized to diagnose the causes of enlarged lymph nodes. RESULTS: Of the 1693 patients attended to at the cytologic diagnostic service, 808(47.7%) had lymph node disorders with benign and malignant causes of lymph node enlargements comprising of 93.2% and 6.8% respectively. The most frequent cause of benign enlargement was tuberculous lymph adenities (66.3%), followed by reactive lymph node hyperplasia (19.2%). Among malignant ones, non-Hodgkin's lymphomas (2.7%) and metastatic carcinomas (2.2%) were most frequently diagnosed. The cervical region was the most frequent site for enlarged lymph node disorders accounting for more than three quarters of all cases. CONCLUSION: This study revealed a huge burden of benign lymph node enlargements in general, and tuberculous lymph adenities in particular. The latter was responsible for about two-third of lymph node enlargements in South Western parts of this country. It is recommended that health providers undertake intensive public health education and screening activities in order to help salvage our community from these potentially preventable and treatable causes of enlarged lymph node disorders.

Adolescent↗

PubMed1962

Surprises in operations on the inguinal area in young children.

In surgical operations in the inguinal area in infants and children many unusual pathologic states were observed that were at first thought to be simple hernia. Among the conditions observed, in addition to complicated hernias and other anomalies of the processus vaginalis, were male pseudo-hermaphroditism, ectopic spleen, ectopic adrenal with neuroblastoma, diverticulum of the bladder, inguinal adenitis and suppurative iliac adenitis. In light of the sometimes surprising contents of the hernia sac, good exposure and careful identification of all anatomic structures is mandatory.

Abdominal Cavity↗

PubMed2001

Breast cancer in south-east Republic of Yemen.

A retrospective study of breast cancer was carried out using the treatment registry of Aden Health Office and archives of Al-Gamhoria Teaching Hospital from January 1989 to December 1996 and the records of patients registered at Aden Cancer Centre from January 1997 to December 1998. The data analysed included age, sex, residence, breast affected and type of cancer. There were 227 patients with breast cancer registered between January 1989 and December 1998; 225 were female and 2 were male. Most of the patients (81.5%) had infiltrating ductal carcinoma. About 90% of the patients had lymph node involvement. The age groups most affected were 30-39 years and 40-49 years.

Adult↗

PubMedDate not supplied

[Detection of Aedes (Stegomyia) Aegypti L. mosquitoes in Sochi city].

Few Aedes aegypti females were found when collecting the mosquitoes attacking human beings in the Central District of Sochi in August to September 2001-2004. Ae. aegypti, a vector of dangerous causative agents of diseases, such as yellow and Aden fevers, appeared on the Black Sea coast of the Caucasus is recorded after its long absence. By taking into account the potential epidemic value of Ae. aegypti, it is necessary to make a monitoring in the cities, towns, and settlements to establish the spread, number, and the breading sites of mosquitoes in the given area and to prevent their mass reproduction. The effectiveness of Ae. albopictus as a vector of Aden fever has been established in different regions of the world. Entomological surveys for Ae. albopictus should be made in the areas of Russia where Ae. aegypti mosquitoes were distributed early in the past century, particularly in the southern port towns and settlements of Russia. Ae. albopictus is potentially able to spread to the north further than is Ae. aegypti.

Aedes↗

PubMed2007

Pattern of rheumatic heart disease in Southern Yemen.

OBJECTIVE: To determine the pattern of rheumatic heart disease in Aden city and surrounding areas by assessing its frequency distribution, severity and complications. METHODS: We conducted this research in a sole regional echocardiographic department for Southern Yemen governorates at a referral hospital located in Aden city, from January 1999 to December 2003. It was a retrospective study focused on echocardiographic findings in 805 patients affected by rheumatic heart disease. RESULTS: Out of 805 patients, 383 (47.6%) were male and 422 (52.4%) were female (age range, 4-70 years; mean age, 28.6 +/- 14.5). Heart valve damage was distributed among patients as follow: mitral 459 (57.1%), aorta 70 (8.7%) and both valves 276 (34.2%); isolated lesions 55.2% and multiple 44.8%; mitral regurgitation 464 (57.6%), mitral stenosis 405 (50.3%), aortic regurgitation 327 (40.6%) and aortic stenosis 54 (6.7%). All children aged less than 10 years had regurgitation. Stenosis and multiple valve lesions predominated in adolescents and young adults. Complications were detected in 20.8% of cases. Pulmonary hypertension was the most common complication (80.4%). Lesions with moderate and severe degree were detected in 51% cases. Only 34.8% of patients at severe stage were operated. CONCLUSION: Rheumatic heart disease takes an aggressive course in Southern Yemen. Children, adolescents and young adults of both gender are the victims. Complications appear early with scanty opportunity to reach advanced age. There is a little chance for palliative treatment.

Adolescent↗

PubMed1990

[Histological study of the oral mucosa of PSS].

Histological examination was performed on the oral mucosa of 25 patients with PSS which consisted of 16 cases of Acrosclerotic type (A type) and 9 cases of Diffuse type (D type). Results obtained were as follows: (A) Sclerotic change of connective tissue were found in the submucosal area (a type) and in the salivary peri-glandular++ area (b type) and also in the both areas (c type). (1) In A type of PSS, sclerotic changes was found in 14 out of 16 cases (87.5%) and (2) In D type, 9 out of 9 cases (100%). (3) In D type, sclerotic changes were marked and, moreover, found in the earlier stage of disease more than in A type. (B) Inflammatory change of salivary gland based on the criteria of Chisholm and Mason. (1) Moderate and marked salivary gland adenitis were found in 6 out of 16 cases of A type (37.5%) and 2 out of 9 cases of D type (22%). (2) Adenitis were found more frequently in the early stage of disease in both types. From above described findings, it is concluded that 1) as to sclerotic change, the early and marked changes were found in D type and 2) as to inflammation of salivary gland, no significant difference was found between both types.

Adult↗

PubMed1989

[Yersinia enterocolitica infections and thalassemia major in children].

We report two cases of severe Yersinia enterocolitica infection in children with homozygous thalassemia. One patient had septicemia and the other had mesenteric adenitis. Two factors can enhance the infectivity of Yersinia enterocolitica in children with thalassemia: iron overload and deferoxamine therapy. Laparotomy and cefotaxime-netilmicin therapy were successful in the patient with mesenteric adenitis. In the patient with septicemia, cefotaxime-netilmicin, then doxycycline-netilmicin failed, and recovery was finally achieved under rifampicin-netilmicin. Because of the possibility of septicemic dissemination secondary to digestive Yersinia enterocolitica infection in children with thalassemia, we advocate immediate discontinuation of deferoxamine and prescription of oral antimicrobial therapy (trimethoprim-sulfamethoxazole for instance) in every thalassemic patient with febrile diarrhea.

Adolescent↗

PubMed1988

Streptococcal infections and their sequelae in the upper respiratory tract.

Local sequelae of group A beta-hemolytic streptococci (GABHS) are common and can vary from otitis media, sinusitis, cervical adenitis associated with generalized adenopathy, peritonsillitis and persisting symptoms in spite of therapy, GABHS is one of the pathogens isolated in acute or chronic otitis media and in acute maxillary sinusitis. In cervical adenitis associated with generalized adenopathy GABHS is, along with S. aureus, the most commonly recovered bacteria. In peritonsillitis, GABHS can be recovered alone or in combination with anaerobes in 50% of the cases. These sequelae are usually associated with a slow clinical response to therapy and a high percentage of relapses, reinfections, and chronic infections in the presence of a penicillin-sensitive GABHS. One of the possible causes of these so-called failures is the interference that beta-lactamase producing bacteria can have on the activity of penicillin and similar compounds. When to select a beta-lactamase-resistant antibiotic for the treatment of an apparent penicillin-sensitive infection remains an important area for further research.

Adolescent↗

PubMed1987

Cervical tuberculosis. Differential diagnosis and CT imaging.

This paper shows some typical CT-scan patterns of tuberculous cervical adenitis. Two cases are presented which suggested to be a cyst of the first and second branchial cleft according to their appearance and location on CT-scan, but which turned out to be cervical tuberculous adenitis after further investigation. It is meant to stress the importance of tuberculosis in the differential diagnosis of cystic lesions of the neck on CT imaging.

Adult↗

PubMed1977

[9-(Adenylyl)alkylcobalamins as inhibitors of adenosylcobalamin-dependent glycerol dehydratase from Aerobacter aerogenes].

The behavior of two coenzyme analogs, [(5-aden-9-yl)methoxyethyl] cob (III) alamin and [(5-aden-9-yl)pentyl] cob (III) alamin modified at the nucleoside ligand sugar moiety was studied in the system of adenosyl-cobalamin-dependent glycerol dehydratase from Aerobacter aerogenes. It was shown that neither of the analogs possesses coenzyme properties and that both are strong competitive inhibitors for adenosylcobalamin (AdoCbl). The affinity of the two analogs for the apoenzyme is higher than that of AdoCbl. The data obtained are indicative of the essential role of the ribofuranoside fragment of AdoCbl in the manifestation of the coenzyme activity. The apoenzyme interaction with the analogs under study is discussed in terms of the Dreiding stereomodels for AdoCbl and its analogs.

Apoenzymes↗