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At least 811 records · Page 45Linked to original sources

PubMed2003

[Report of 2 cases of tuberculous retoropharygeal abscess in adults].

We report 2 cases of tuberculous retoropharyngeal abscess. Case 1 was a 21-year-old man with tuberculous cervical spondylitis and pulmonary tuberculosis and Case 2 was a 32-year-old woman with tuberculous lymph adenitis and military tuberculosis. Both reported sore throat and dysphagea. In case 1, throat examination showed a bulging abscess at the posterior wall of the pharynx. X-ray examination of the neck showed a massive soft tissue swelling on the lateral view. As soon as the diagnosis was established, prompt focal aspiration was done since the increasing danger of grave respiratory distress was expected. And moreover, surgical incision and drainage of retropharyngeal abscess were indicated. In case 2, intraoral midline incision through the posterior wall of the pharynx was administered because the abscess was small and limited. Though various tuberculous statics and antibiotics are available, tuberculous retropharyngeal abscess still occurs and should be considered to ensure rapid adequate attention to diagnosis and treatment.

Adult↗

PubMed2006

[Cat-scratch disease. Review of eight adult patients hospitalized for fever or adenopathy].

BACKGROUND: Cat-scratch disease is common among children. Among adults the disease is less often considered in the differential diagnosis of enlarged lymph nodes and fever. AIM: To report the clinical and laboratory features of eight patients with cat-scratch disease. MATERIAL AND METHODS: Review of the medical records of eight patients (aged 22 to 57 years, six males) with a serological diagnosis of cat-scratch disease (an IgG titer over 1:256, by immunofluorescence). RESULTS: Only five patients recalled having had contact with cats. Seven had fever and weight loss. Six had excessive sweating and five had chills. Seven had painfully enlarged lymph nodes mainly in submandibular and axillary regions. All had an increased C reactive protein and six had elevated erythrocyte sedimentation rate. Five had leukocytosis and four an elevated serum lactate dehydrogenase. The disease subsided in all, even in one patient that did not receive antimicrobials. CONCLUSIONS: Cat-scratch disease should be considered in the differential diagnosis of adult patients with lymph adenitis and fever.

Adult↗

PubMed1985

The Mazzotti reaction following treatment of onchocerciasis with diethylcarbamazine: clinical severity as a function of infection intensity.

To determine definitively whether or not the severity of the Mazzotti reaction was correlated with infection intensity, as determined by skin snip quantification, 21 infected Ghanian patients were evaluated during 7 days of treatment with 200 mg/day of diethylcarbamazine. Serial blood, urine and skin biopsy samples were collected during the progression of the Mazzotti reaction. Hypotension, fever, adenitis and pruritus were all correlated with infection intensity in these patients while arthralgia and tachycardia were not. Peripheral blood eosinopenia and neutrophilia also correlated with intensity of infection and appeared to reflect the accumulation of degranulating eosinophils around "mobilized" microfilariae that migrated from the dermis to the epidermis after diethylcarbamazine (DEC). Other mobilized microfilariae apparently were cleared by the liver and resulted in abnormal liver enzyme levels in the serum which, again, were directly correlated with the patients' microfilarial density. Though the severity of the Mazzotti reaction clearly correlated with intensity of infection, the different times of onset of symptoms, and cellular and serum chemistry changes indicate that there are probably multiple infection intensity-dependent mechanisms responsible for mediating this complex reaction.

Adolescent↗

PubMed2004

Intussusception in children seen at Muhimbili National Hospital, Dar es Salaam.

OBJECTIVE: To review infants and children with intussusception and assess its magnitude of concern and any seasonal variation in our environment. DESIGN: A retrospective study. SETTING: Muhimbili National Hospital general paediatric and surgical wards from January 2000 to February 2004. METHODOLOGY: The charts of all infants and children up to the age of 10 years diagnosed to have intussusception were reviewed. Demographic factors evaluated included age, incidence in up to one-year olds, sex, month of presentation to assess seasonal variation, clinical features, methods of diagnosis and management, aetiology and any recurrence. RESULTS: Twenty eight children were diagnosed to have intussusception. Sixteen were males and 12 females (M:F=l .3:1). Of these, 21(75%) were infants (up to the age of one year), nine were boys and 12 were girls( M.F=l:1.3). Incidence rate in this age group was approximately 1: 7557. Most cases presented in January-March(39.3%) and July to September(39.3%). No case was seen in the month of April during the 4-year period. Except in 2002, there has been a male preponderance. The aetiology was mainly idiopathic (85.7%), there were three cases suspected to be due to mesenteric adenitis and one case of intraluminal haemangioma. There were two recurrent cases, one was within a week with no known aetiology. All patients presented with vomiting and abdominal pain/distension. Preceding gastro-enteritis was common. The majority of the cases, 17(60.7%) presented with the classic triad of vomiting, rectal bleeding and abdominal pain/distension. Abdominal mass was often difficult to palpate due to gross or tense abdomen and was only palpated in four cases(14.3%). Air or barium reduction is not done at our institution due to apart from lack of facilities, majority of the children present late, >48 hours from the onset of symptoms and diagnosis was mainly based on clinical symptoms and signs of intestinal obstruction and confirmed with presence of multiple fluid levels on a plain erect abdominal X-ray. All children were then managed by surgery, 11(39.3%) underwent bowel resection. Histopathology reports of those available did not show cause of intussusception. Seven patients died postoperatively, hospital mortality of 25%. CONCLUSION: The approximate incidence of intussusception in less than one-year olds is 1:7557 in Dar es Salaam. It is a concern in our environment causing considerable morbidity and mortality due to late presentation and efforts should be made to improve sanitation and hygiene, referring health facilities, socio-economic factors and probably look into ways of preventing the problem occurring. Seasonal variation was seen, most cases(78.6%) presenting in the dry season when there is shortage of water in the city.

Child↗

PubMed2004

[A 41 year-old female with abdominal pain and fever of 24 hours].

A 41 year-old female with intrauterine contraceptive device (ICD) from 8 year ago that complained fever and abdominal pain during 24 hours and leucocytosis. The radiology examination tests showed cegal, appendiceal, and right ovary enlargement with swollen of fat adjacent. In the differential diagnosis should be include: appendicitis, diverticulitis, chronic inflammatory digestive disease or mesenterical adenitis. In the differential diagnosis included: ovarian neoplasm, endometriosis, ectopic pregnancy, ovarian torsion and pelvic inflammatory diseases. From pelvic infections, it is import consider pelvic inflammatory disease, genital tuberculosis and pelvic actinomycosis. With the antecedent of ICD, the clinic and the radiological finding as abdominal mass with invasion of adjacent structures and absence of adenopathy; the first diagnosis is a abdominopelvic actinomycosis and the second is a genital tuberculosis.

Abdominal Pain↗

PubMed1985

Yersinia enterocolitica. Isolation from faeces of adults and children in Queensland.

Over a 22-month period, all 5075 faecal specimens received by the microbiology laboratory of the Mater Misericordiae Public Hospital, Brisbane, were screened for the presence of Yersinia enterocolitica by culturing on cefsulodinirgasan-novobiocin agar medium. Y. enterocolitica was isolated from 37 patients (0.7% of all specimens). Ten patients were 10 years of age or older, and presented predominantly with pain in the abdomen; of these, five underwent an appendicectomy. Mesenteric adenitis was diagnosed histologically in three patients and Y. enterocolitica was isolated from a lymph-node biopsy specimen in one of these. The other 27 patients were under 5 years of age, and presented predominantly with diarrhoea of 24 hours' to six weeks' duration. In seven cases, another recognized faecal pathogen was also isolated. The isolation rate of Y. enterocolitica was one-quarter that of Salmonella and seven times that of Shigella.

Adolescent↗

PubMed1985

Yersinia enterocolitica infection in children.

The role of Yersinia enterocolitica as a human pathogen has been documented in publications from over 30 countries, and Y. enterocolitica has been recognized increasingly to cause gastrointestinal disease in children. In 1979, an Australian survey yielded only three isolates of Y. enterocolitica from 3298 faecal specimens obtained from adults. We screened all stool specimens received during a 22-month period for Yersinia by means of a recently developed selective agar medium. Y. enterocolitica was isolated from 32 of 4136 (0.7%) specimens. Most isolates were of serotype O:3, biotype 4. During the study, 154 Salmonella spp. (3.7%), 196 Campylobacter spp. (47%), seven Shigella spp. (0.2%) and 27 Aeromonas spp. (0.9% of 2779) were recovered. Children infected with Y. enterocolitica presented with acute diarrhoea associated with fever and pharyngitis; chronic or recurrent diarrhoea; or pain in the right iliac fossa associated with mesenteric adenitis. Gastrointestinal symptoms usually resolved spontaneously within two weeks. However, some children were treated successfully with cotrimoxazole.

Adolescent↗

PubMed1982

Nonmenstrual toxic shock syndrome: a review of 130 cases.

One hundred and thirty cases of toxic shock syndrome not associated with menstruation have been reported to the Centers for Disease Control, including 57 with onset in 1981 (12% of reported cases in 1981). These cases show that the syndrome occurs in a wide range of clinical settings and is associated with Staphylococcus aureus infections at a variety of sites: focal cutaneous and subcutaneous lesions, surgical-wound infections, postpartum infections, adenitis, bursitis, deep abscesses, and "primary" bacteremia. Although the clinical characteristics of nonmenstrual toxic shock syndrome are identical to those for menstrual toxic shock syndrome, the epidemiologic and demographic features are different. Of particular interest is the contrast in the racial distribution of the menstrual and nonmenstrual cases. Toxic shock syndrome can occur in persons of any age, race, or sex and must be considered in the differential diagnosis for any patient with a compatible illness.

Adolescent↗

PubMed2002

Color Doppler sonography in the evaluation of superficial lymphomatous lymph nodes.

OBJECTIVE: We performed a retrospective study to document the sonographic and color Doppler characteristics of lymphomatous superficial lymph nodes. METHODS: We selected 130 individuals who underwent sonography, color Doppler imaging, fine-needle aspiration biopsy, and surgical removal of the nodes with the final diagnosis of lymphoma (87) and chronic adenitis (43). During sonography, for each node we considered the longitudinal and axial diameters, long/short axis ratio, visibility of the hilum, and the internal echogenicity of the node. During the color and power Doppler examination, we classified the nodes into 3 patterns: type I, "hilar normal"; type II, "hilar activated"; and type III, "peripheral." RESULTS: Sonographic evidence was not significant. With color Doppler sonography, 97% of nodes affected by non-Hodgkin lymphoma, 94% of nodes affected by Hodgkin lymphoma, and 100% of non-neoplastic nodes showed hilar vascularity. Type I seemed more frequently associated with inflammation, and type II was more frequently associated with lymphoma. CONCLUSIONS: The presence of peripheric subcapsular vessels, which is typical of metastasis, is definitely rare in lymphoma (with the possible exception of the uncommon subtypes of high-grade lymphomas). The differential diagnosis between lymphoma and lymphadenitis is frequently impossible on the basis of sonographic and color Doppler patterns alone; therefore, clinical evaluation and biopsy are generally mandatory.

Adult↗

PubMed1999

[Doppler color in superficial adenopathies].

INTRODUCTION: Superficial lymph nodes are frequently involved in different diseases. Their location makes them suitable for effective assessment with high-resolution US and color Doppler has been recently suggested as a tool for increasing sensitivity in lymph node studies. Thus, we investigated the main vascular patterns detectable in abnormal superficial lymph nodes. PATIENTS AND METHODS: We evaluated 260 nodes in 180 adult patients; the nodes were located in the cervicofacial ring (78, 30%), internal jugular stations (104, 40%), and supraclavicular (44, 17%), axillary (21, 8%), and inguinal (13, 5%) stations. Color Doppler was performed with 7.5-13 MHz linear transducers, with parameters adjusted for slow-flow detection (5-6 MHz frequency, 700-900 Hz PRF, 50 Hz band filter, high color persistence). Disease assessment required fine-needle biopsy (95 nodes in 95 patients) and clinical follow-up (165 nodes in 85 patients). RESULTS: Fifty-five nodes (21%) presented acute and 130 (50%) chronic inflammation: 75 nodes (29%) were metastatic. The following vascular patterns were detected: a single vascular pole (type I) was seen in chronic inflammation (72% sensitivity, 86% specificity, 57% positive and 92% negative predictive value); an enlarged single vascular pole, with 2-3 enlarged branches (type II) in acute adenitis (80% sensitivity, 81% specificity, 78% positive and 83% negative predictive value); multiple vascular poles with many deformed and displaced branches converging centrally (type III) in metastases (76% sensitivity, 100% specificity, 100% positive and 91% negative predictive value). CONCLUSIONS: We conclude that color and power Doppler are useful integrations to B-mode US because they can detect specific signs of malignancy such as peripheral vascular poles and intranodal displacement of vessels.

Humans↗

PubMed1997

[Biopsy of labial salivary glands and lacrimal glands in the diagnosis of Sjögren's syndrome].

OBJECTIVES: To determine the diagnostic value for Sjögren's syndrome (SS) by evaluating the presence of focal adenitis in labial salivary gland (LSG) and lacrimal gland (LG) biopsy specimens. METHODS: 109 suspected cases with SS underwent the biopsies. The diagnostic criteria of Fox et al. were followed. Both Chisholm-Manson's grading standard and Greenspan's focus score were used for the evaluation. RESULTS: Myoepithelial islands and severe lymphocyte infiltration with germinal centers were observed only in LG biopsy specimens. The lymphocytic foci scored of LG were significantly higher than that of LSG in 23 cases having both biopsy results. The evaluation of both kinds of specimen for such a patient was significantly more effective in diagnosing SS than using either one of them alone. CONCLUSION: We recommend that both LSG and LG biopsies be performed in patients suspected of having SS to reduce false negative results and improve diagnostic accuracy.

Adult↗

PubMedDate not supplied

Mycoplasma mycoides subsp. mycoides SC identification by PCR in sperm of seminal vesiculitis-affected bulls.

In this study, by using the polymerase chain reaction (PCR) diagnosis for the detection and identification of Mycoplasma, we investigated mycoplasmas contaminating the semen of yearling bulls affected by seminal vesiculitis. The bulls presented neither subclinical nor clinical contagious bovine pleuropneumonia signs and the complement fixation test for specific antibodies was negative. Furthermore, we have investigated mycoplasmas isolated from semen of healthy breeding bulls of several breeds and origins, which routinely underwent breeding soundness examinations and presented no clinical signs of seminal vesiculitis. We were able to demonstrate mycoplasma infection in all tested samples by i) growth on mycoplasma-specific media and ii) a PCR-based method using a mycoplasma-specific MGSO/GPO1 primer set to amplify the 16S fragment rDNA. In addition, the identification of Mycoplasma species was made by PCR using the MSC1/MSC2 primer set that specifically amplifies M. mycoides subsp. mycoides SC or the MM450/MM451 primer set followed by AsnI digestion analysis in order to identify M. mycoides subsp. mycoides LC. The data presented herein clearly show that M. mycoides subsp. mycoides SC infection was associated with seminal vesiculitis while M. mycoides subsp. mycoides LC was only found in bull semen from healthy control animals. Our findings confirm that the M. mycoides subsp. mycoides SC is shed in the sperm making the ejaculate a valuable biological sample for the isolation of these bacteria from serologically negative animals. Although the pathogenic role of M. bovigenitalium in bull seminal vesiculitis has been established, our clinical findings, semen characteristics, microbiological and bacterial genomic analysis strongly suggest that M. mycoides subsp. mycoides SC may contribute to induce vesicular adenitis in the bull.

Animals↗

PubMedDate not supplied

Nontuberculous mycobacterial infection of the head and neck in immunocompetent children: CT and MR findings.

BACKGROUND AND PURPOSE: Infections caused by nontuberculous mycobacteria (NTM) commonly manifest as cervicofacial adenitis in otherwise healthy children. The aim of this study was to characterize the imaging findings of NTM infection of the head and neck in immunocompetent children. METHODS: The medical records and imaging examinations (CT in 10, MR in two) were reviewed in 12 immunocompetent children with NTM infection of the head and neck. RESULTS: The usual presentation (n = 9) was of an enlarging, non-tender mass with violaceous skin discoloration, unresponsive to conventional antibiotics. The duration of symptoms was 6 days to 5 months. Imaging revealed asymmetric adenopathy with contiguous low-density ring-enhancing masses in all patients. There was cutaneous extension in 10 patients. Inflammatory stranding of the subcutaneous fat was minimal (n = 9) or absent (n = 2) in 11 patients. The masses involved the submandibular space (n = 3), the parotid space (n = 2), the cheek (n = 1), the anterior triangle of the neck (n = 2), the submandibular and parotid spaces (n = 2), the parotid space and neck (n = 1), and the neck and retropharyngeal space (n = 1). Surgical management included incision and drainage only (n = 2), incision and drainage with curettage (n = 2), excisional biopsy after incision and drainage (n = 1), excisional biopsy only (n = 5), superficial parotidectomy only (n = 1), and superficial parotidectomy with contralateral excisional biopsy (n = 1). All patients improved in response to surgery and long-term antimycobacterial antibiotics. CONCLUSION: NTM infection of the head and neck has a characteristic clinical presentation and imaging appearance. Recognition of this disease is important; appropriate treatment is excision and, in selected cases, antimycobacterial therapy.

Child↗

PubMed1999

Whipple's disease: benefit of the fine-needle aspiration cytology from lymph nodes.

We report a case of Whipple's disease with predominant neurological symptoms and without any clinical digestive sign. The diagnosis was suspected by fine-needle aspiration from an axillary lymph node and confirmed by the duodenal biopsy and ultrastructural results. Whipple's disease is a rare, chronic, systemic infectious disease. Electron microscopy and PCR on paraffin blocks are very helpful when histologic findings are not discriminant. On cytologic examination, the major differential diagnosis is mycobacterial adenitis. Here we highlight the possibility of diagnosis Whipple's disease on mere cytological material.

Biopsy, Needle↗

PubMed2000

[Endoscopic approach to pulmonary diseases: Transbronchial needle aspiration].

Transbronchial needle aspiration (TBNA) is a bronchoscopic technique to obtain cytologic and histologic specimen from deep site of bronchial wall. We investigated the utility and safety of TBNA in 200 patients who had mass lesions in the lung or in the mediastinum. 101 patients had submucosal or peribronchial malignant lesions (central malignancy) and TBNA was the only diagnostic method in 28 patients (28%). 39 patients had peripheral malignant lesions (peripheral malignancy) and TBNA was the only diagnostic method in 12 patients (31%). The other 60 patients had benign lesions and TBNA was diagnostic in only 5 patients (8%); bronchogenic cyst in 2, tuberculous lymph adenitis in 1, parathyroid adenoma in 1 and lung abscess in 1. In central malignancy, the yield of TBNA as exclusive means of diagnosis was higher for mediastinal tumor than for lung cancer. In peripheral malignancy it was higher for metastatic lung tumor than for primary lung tumor. In order to stage patients of lung cancer, we sampled 39 lymph nodes and 21 of them were proved to be positive. TBNA was thought to be of greatest value in the diagnosis of peritracheal mediastinal tumor and peribronchial metastatic lung tumor and in the staging of lung cancer. We used 19-gauge transbronchial histology needle in 8 patients and 2 cases were diagnostic. Low diagnostic yields were probably due to the lack of our experience and it was expected that training on this technique would increase diagnostic utility of the histology needle. No significant complications occurred and all patients tolerated TBNA well.

Biopsy, Needle↗

PubMed2000

[Diagnostic radiology in acute pediatric abdomen].

Acute pediatric abdomen is a very common clinical problem. Clinical and laboratory findings, however, are nonspecific or confusing in many instances. This review article focuses on strategy in diagnosing acute pediatric abdomen. A variety of diseases such as appendicitis, gastroenteritis, mesenteric adenitis, intestinal intussusception, Henoch-Schölein purpura, Crohn's disease, Meckel's diverticulitis, duodenal ulcer, congenital biliary dilatation, ovarian torsion, and anomaly of the internal genitalia are discussed in this article. Selection of an appropriate imaging modality is essential to ensure prompt management. In the majority of cases, ultrasound can provide specific diagnoses, whereas in others valuable supplemental information can be obtained. CT will be reserved for selected patients in whom further information is needed. Indications of MR imaging in the management of acute pediatric abdomen are currently limited. MR imaging, however, is indicated on an emergency or semi-emergency basis in selected conditions including anomaly of the internal genitalia, ovarian torsion, and congenital biliary dilatation.

Abdomen, Acute↗

PubMed2000

[Epidemiologic and microbiological aspects of mycobacteriosis in Slovakia--Mycobacterium szulgai].

The first case of mycobacteriosis caused by M. szulgai in the territory of Czechoslovakia was discovered in the year 1979 in southern Slovakia and was published in our and foreign literature in the year 1981. The purpose of this investigation is to describe the epidemiological situation of the diseases caused by M. szulgai in Slovakia and to compared it with the experiences in chosen developed countries, especially focused on the localization of the disease, factors of transmission, mechanism of transmission and other epidemiological characteristics. The methodology of this paper is based upon surveillance of tuberculosis applied on mycobacterioses. During the period of last 20 years two cases of the disease without mutual epidemiological connection were discovered. In contradiction to other mycobacterioses, diseases caused by M. szulgai, have not the tendency to endemic occurrence. The most often transmission factors are contaminated water and soil. Both cases of M. szulgai in Slovakia suffered from pulmonary diseases. Other localization reported in other countries, for example: olecranon bursitis, skin infections, cervical adenitis, osteomyelitis and renal disease were not reported in our country up to now. (Ref. 23.)

Humans↗

PubMed2000

[Borreliosis associated with Lofgren's syndrome].

A man with positive Borrelia-titres, joint pain, erythema nodosum and fever was treated with penicillin. After finding hilar adenitis Löfgren's syndrome was thought to be more likely and penicillin was discontinued. Later the patient developed symptoms of neuroborreliosis and S-Borrelia IgG was 10 units. After treatment with doxycycline symptoms disappeared and IgG levels fell.

Adult↗