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PubMed2000

[Chronic septic granulomatosis in a young girl manifesting as invasive pulmonary aspergillosis and flaccid paraplegia].

UNLABELLED: The invasive Pulmonary Aspergillosis (IPA) is the principal cause of death in patients with chronic granulomatosis disease (CGD). It can happen before age of one and can reveal the (CGD). Usually, the transmission of GSD is linked to x in 65% of cases. We report, the case of a girl aged 3 years issued from consanguine marriage referred to hospital for hemoptysia. We note that at 40 days she presents an suppurate adenitis. She is hypotrophic at--3DS without respiratory problem, she have a splenomegaly. The radiography chest note an alveolar and interstitial opacity bilateral, apical right and basal left. There is a biological inflammatory syndrome. During the evolution, the child presents a paraplegia secondary to compression myelitis. A D5 laminectomy in urgency was done. The vertebral Biopsia, the serology and the culture isolate fumigatus aspergillus the GCD is evoqued confirmed by the NBT test who was negative. IN CONCLUSION: --We have to look for GCD in front of pulmonary aspergillus.--The vertebra lesion is secondary to pulmonary lesion.--Our observation is noticeable by the recessive autosomal transmission who was seen in 35% of cases, and by the neurologic complication rarely reported.

Aspergillosis↗

PubMed1975

Yersinia enterocolitica arthritis.

Human infections with Yersinia were first recognized and reported in upper New York State almost 40 years ago. Recently, there have been increasing numbers of reports from Scandinavia of episodes of polyarthritis associated with Yersinia infections. A 6-month-old girl from upstate New York had a fever of 40 C for two weeks and green watery diarrhea, and irritability was noted when she was handled. An evanescent rash was most apparent at times of temperature elevations. Her mother and father had had diarrhea during the month preceding the child's illness. Stool cultures were grown in an effort to identify Yersinia enterocolitica if it was present, and the organism was found. A rise in serum agglutination titer against polyvalent Y. enterocolitica was demonstrated from zero to 1:256 dilutions. Y. enterocolitica is probably a cause of arthritis, mesenteric adenitis, and erythema nodosum in the United States.

Antibodies, Bacterial↗

PubMed2001

[Infectious complications of mandibular osteotomy].

BACKGROUND: Infection is a rare complication after orthognathic surgery. A rate of 1% to 15% has been reported in the literature. We reviewed our experience. MATERIAL AND METHODS: We reviewed retrospectively 60 mandibular osteotomies performed between 1998 and 1999. There were 41 women and 19 men, mean age 24 years. All were given antibiotic therapy using cefamandol 1500 mg preoperatively then 750 mg every 6 hours peroperatively and cefixime 400 mg/d postoperatively for 7 days. Patients were followed for at least 6 months after surgery. RESULTS: There were 10 infections (16% of the cases) involving a hematoma in 2 cases, adenitis in 1, osteitis on a cortical fragment in 2 and osteitis on implanted material in 5. DISCUSSION: We defined infection following orthognathic surgery as a collection or purulent fistula with either a high polynuclear count in the discharge fluid or a positive culture. Both soft tissue (for example infection of a perimandibular hematoma) or bone infections were equally considered. We found two types of risk factors: patient-related or procedure-related. Patient-related factors included smoking, paradontal status, and dental hygiene. The main procedure-related factor was duration of surgery. Measures of prevention include extraction of the wisdom teeth, interruption of smoking, preoperative scaling and careful dental care, rigorous operative technique, antibiotic therapy.

Adolescent↗

PubMed2000

[Mental confusion and multifocal lymphatic and pulmonary tuberculosis. A case report].

This report describes a case of mental confusion associated with ongoing adenitis and pulmonary tuberculosis in a 20-year-old man with no history of psychiatric disorders. Diagnosis was based on clinical and laboratory findings. Tranquillizers improved mental status and antituberculosis treatment was administered before referring the patient to an internal medicine department. The authors emphasize the rarity of these cases in the Senegalese medical literature and discuss possible diagnostic pitfalls.

Acute Disease↗

PubMedDate not supplied

[Acute pancreatitis secondary to typhoid fever in a preschool child].

INTRODUCTION: A case of child with acute pancreatitis associated with typhoid fever is reported herein. CASE REPORT: A four years old child was admitted to the pediatric emergency room with an acute abdomen and fever. He was submitted to a diagnostic laparotomy and mesenteric adenitis was the only finding. During the postoperative period, he persisted with abdominal pain and fever. Laboratory studies and abdominal ultrasonography revealed an acute pancreatitis. Also, Salmonella typhi was isolated from blood and stool cultures. Treatment for pancreatitis included nasogastric catheter and total parenteral nutrition. Typhoid fever was treated with ampicillin. Thereafter, his clinical course was uneventful and he was discharged 13 days after being admitted. CONCLUSIONS: Acute pancreatitis has been associated with typhoid fever. To the best of our knowledge, this is the youngest patient reported in the literature with this association. Possible pathophysiologic mechanisms are reviewed.

Abdomen, Acute↗

PubMedDate not supplied

[Combined diagnosis in breast carcinoma: preoperative role of mammoscintigraphy with Tc99m-sestamibi. Our Experience].

The Authors, taking recent literature on tumoral pathology breast studies in to consideration, studied a group of patients with a node or a suspect adenous zone by clinical and instrumental examination with mammoscintigraphy. 22 patients were selected by clinical examination, mammography and ultrasonography. A mammoscintigraphy (Tc 99m Sestamibi) was performed before the surgical operation. The histologic examination revealed 14 cases of breast cancer; 12 of these (86%) resulted positive after scintigraphy, while 2 were false negative. In this study, the scintigraphic exam and its diagnostic accuracy were analyzed, both in relation to anatomical structure of the mammary gland (thick breast, fibrocystic mastopathy, postsurgical scars, etc.) and also in relation to characteristics of the suspected node, the nature of which was not possible to determine from other exams carried out. In conclusion, after comparison between our experience and those reported in literature, we conclude that because of its high specificity and sensibility the mammoscintigraphy exam assumes an important comparative index in obtaining elements for an additional evaluation when other instrumental examinations are dubious.

Adult↗

PubMed2001

[Splenic abscess and cat-scratch disease].

Cat-scratch disease is caused by a Gram-negative bacillus known as Bartonella henselae. This disease is usually benign and causes regional adenitis that does not require treatment. However, some patients develop more serious atypical forms of the disease including prolonged systemic illness with hepatic and splenic abscesses.A 14-year-old girl was admitted to hospital with a 12-day history of persistent high fever and abdominal pain. Ultrasonography and computerized tomography of the abdomen revealed splenic abscesses. These findings, together with an antecedent of cat exposure, led to the suspicion of cat-scratch disease, which was confirmed by serology. The girl was treated with intramuscular ceftriaxone and clinical evolution was favorable. Splenic cat-scratch disease is infrequent. Cat-scratch disease sometimes presents as fever of unknown origin and consequently this disease should be considered in the differential diagnosis of prolonged fever. Although evolution is usually favorable, antibiotic therapy is recommended in systemic manifestations of cat-scratch disease.

Abscess↗

PubMed2001

[Orf in urban surroundings and religious practices: a study over a 3-year period].

BACKGROUND: Orf is a sheep disease, due to a parapox virus. Men in close contact with these animals may be contaminated. This generally occurs during professional activities. In our clinic, located in the heart of Brussels, we were surprised by the number of orf cases encountered each year, grouped during a short three-week period. PATIENTS AND METHODS: We decided to set up a prospective study of three years. Forty-four cases (14 to 64 years of age) were observed: 14 in 1998, 18 in 1999 and 12 in 2000. There were 29 men and 15 women. RESULTS: Only one patient had professional contact with sheep; 42 were muslims. Forty-two lesions out of 44 developed in the same time span, 10 days earlier each year. Complications observed were: erythema multiforme (7 cases), lymphangitis (3 cases), axillary adenitis (3 cases), eyelid edema (2 cases), generalized maculopapular eruption (2 cases) and contact dermatitis to the cream applied (1 case). DISCUSSION: This peculiar epidemiology can easily be explained: patients are contaminated during a religious feast, Aid el Kebir (the Feast of Sacrifice). On this occasion, they slaughter sheep, which they manipulate with bare hands. Small trauma often occur at that time. We conclude that orf is not only a professional disease but particuliar habits may cause epidemic-type contamination.

Adolescent↗

PubMed2002

[Impact of transrectal microwave hyperthermia on hemodynamics and prostatic cell membranes in chronic prostatitis].

An Aden-Ch apparatus programming complex made in our country was used for transrectal microwave hyperthermia in 75 patients with chronic prostatitis. In addition to its good clinical results achieved in most patients, the complex restored hemodynamics and stabilized the status of prostatic cell membranes. The complex described in the paper may be recommended for the treatment of chronic prostatitis.

Adult↗

PubMed1975

[Venereal granuloma (donovaniasis) in France].

The study of six cases of MacLeod-Donovan chancre, 2 in Paris, 4 in Brest, in young men coming from the West Indies, showed after 15 days incubation, a balano-preputial lesion consisting of an oval-shaped granuloma, 1 to 4 cm diameter, raised, indurated, ulcerated, reddish-yellow, spontaneously painful, bleeding easily, accompanied in 50 p. 100 of cases by inguinal adenitis, due to secondary infection. Swabs, which should be repeated, showed Donovan bodies within numerous histiocytes. The inactivity of penicillin may be contrasted with the rapidly favourable effect of streptomycin, chloramphenicol or aureomycin.

Adult↗

PubMed2002

Pathology of a mouse model of x-linked chronic granulomatous disease.

A colony of knockout mice (gene designation Cybb tm1) has been maintained at this institution for 5 years. These mice are lacking the b subunit of NADPH oxidase and are susceptible to experimental infection with Aspergillus fumigatus. The purpose of this study was to document the spontaneous diseases present in these mice which are a murine model of X-linked chronic granulomatous disease and to compare these lesions to those of chronic granulomatous disease in humans. Lesions were documented in 72 mice submitted to the necropsy service. All 72 mice had an acidophilic macrophage pneumonia, and 16 also had lobar suppurative and necrotizing pneumonias caused by Paecilomyces sp. (11 of the 16 mice), A. fumigatus (3 mice), Rhizopus sp. (1 mouse), or Candida guilliermondii (1 mouse). Of the 72 animals, 36 had severe bacterial suppurative and necrotizing to pyogranulomatous pneumonias; lung abscesses yielded cultures of Pseudomonas aeruginosa (n = 3), Enterococcus (n = 6), Staphylococcus aureus (n = 2), S. xylosus (n = 1), coagulase-negative Staphylococcus sp. (n = 4), gram-negative enteric bacilli (n = 6), Klebsiella pneumoniae (n = 1), and Proteus mirabilis (n = 2). Thirteen mice had a necrotizing and suppurative adenitis of the cervical lymph nodes caused by coagulase-negative Staphylococcus sp.; S. aureus, S. xylosus, and S. equorum were recovered from abscesses in the cervical lymph nodes, extremities, and head. Splenomegaly was found in 30 animals and lymphadenopathy in 11 mice. The array of spontaneously occurring infectious diseases and lesions in these mice is similar to that of human patients with chronic granulomatous disease.

Animals↗

PubMed2002

The adult neck mass.

Family physicians frequently encounter neck masses in adult patients. A careful medical history should be obtained, and a thorough physical examination should be performed. The patient's age and the location, size, and duration of the mass are important pieces of information. Inflammatory and infectious causes of neck masses, such as cervical adenitis and cat-scratch disease, are common in young adults. Congenital masses, such as branchial anomalies and thyroglossal duct cysts, must be considered in the differential diagnosis. Neoplasms (benign and malignant) are more likely to be present in older adults. Fine-needle aspiration and biopsy and contrast-enhanced computed tomographic scanning are the best techniques for evaluating these masses. An otolaryngology consultation for endoscopy and possible excisional biopsy should be obtained when a neck mass persists beyond four to six weeks after a single course of a broad-spectrum antibiotic.

Adult↗

PubMed1975

Immunoblastic lymphosarcoma, a cytological and clinical entity?

We have studied 20 cases of haematosarcomas belonging to lymphosarcomas (T or B-cell markers, absence of the reticulosarcoma characters in sections, on smears, with conventional and scanning electron microscopy). Their cells which appear as large pyroninophilic cells on sections, as large very basophilic cells with blastic nuclei and often cytoplasmic vacuoles on smears, as having many polyribosomes and usually no ergastoplasm with conventional electron microscopy, and as large cells of the lymphocytic series with scanning electron microscopy resemble the cells which we described in adenitis in 1955 (9) and in the graft-versus-host-reaction in 1961 (6), which Gowans (15) showed resulted from lymphocyte transformation, and which Dameshek (10) called immunoblasts. Many of these cases of immunoblastic lymphosarcoma (ILS) identified on their cytohistological characteristics [also recognized by Lukes et al. (24, 25) and Lennert et al. (21, 22)], present aetiological, clinical and pronostic characters which let us suppose that it may be not only a cytological entity but also a cytoclinical entity : a) it affects males in 85% or the subjects; eight patients came from mediterranean countries outside France; two patients had a history of chronic rheumatoid manifestations; b) the disease was at stage IV at the first presentation in 10 patients out of 20; it was revealed by profound (mediastinal or abdominal) localizations in 60% of cases (12 out of 20); it presented a hypoglobulinaemia in eight out of 13 patients; in six out of the 15 patients treated before leukaemic conversion, the chemotherapy usually efficient in lymphosarcoma (LS) failed to induce remission. This type of LS has a poorer prognosis than other types of LS (median for all stages : eight months). It led to the death either after its conversion to leukaemia (nine out of 20 cases), or by vital organ (as brain or kidney) infiltrations.

Diagnosis, Differential↗

PubMed2002

Sigma receptor scintigraphy with N-[2-(1'-piperidinyl)ethyl]-3-(123)I-iodo-4-methoxybenzamide of patients with suspected primary breast cancer: first clinical results.

UNLABELLED: The aim of this study was to investigate the potential of a new iodobenzamide, N-[2-(1'-piperidinyl)ethyl]-3-(123)I-iodo-4-methoxybenzamide (P-(123)I-MBA), to visualize primary breast tumor in humans in vivo. Tumor accumulation of benzamides is based on a preferential binding to sigma receptors that are overexpressed on breast cancer cells. METHODS: P-(123)I-MBA (148-185 MBq) was administered to 12 patients with a mammographically suspicious breast mass. Two hours after administration, whole-body and spot images of the healthy and the diseased breast were obtained. RESULTS: A focal increased tracer accumulation was observed in 8 of 10 patients with histologically confirmed breast cancer (mean tumor-to-background ratio, 2.04). No uptake was seen in a case of lymphatic adenitis. CONCLUSION: This preliminary patient study shows that P-(123)I-MBA accumulates in most breast tumors in vivo. Future work should focus on the relationship between P-(123)I-MBA uptake and the proliferative activity of cells to anticipate use of this technique as a tool to noninvasively assess the degree of tumor proliferation.

Adult↗

PubMed2002

Aspiration cytology for diagnosis of tuberculosis--perspectives in India.

Tuberculosis (TB) a common cause of mortality can readily be diagnosed by fine needle aspiration. The technique is a simple, cost effective, out patient procedure with a high diagnostic accuracy both in adults and children. The diagnostic morphologic findings comprise of epithelioid cell granulomas and giant cells with or without necrosis. Often an acute inflammatory exudate is obtained. Stain for acid fast bacilli immensely augments diagnosis especially in cases where necrosis or an inflammatory exudate is obtained. Culture studies on aspirated material are time consuming though diagnosis is enhanced. PCR can be applied to detect mycobacterial DNA and has been applied on aspirated material and found to be more sensitive in the detection of tuberculosis. In children TB of lymph nodes is readily identified and so also from other sites such as bone and soft tissues. In children FNAC also plays a role in detection of BCG adenitis, infection with atypical mycobacteria and co-existing infections such as HIV and AIDS.

Ambulatory Surgical Procedures↗

PubMed2002

Spinal brace in tuberculosis of spine.

OBJECTIVE: To present our experience in the management of 22 patients with thoracolumbar spine tuberculosis (TB) using a chemotherapy regimen and locally custom-made spinal brace. METHODS: Twenty-two patients with thoracolumbar spine TB had been treated conservatively by chemotherapy and locally custom-made spinal brace and followed for 36-48 months from June 1996 to June 2000 in the Department of Orthopedics and Trauma, Algamhoria Teaching Hospital, Aden, Republic of Yemen. In 14 cases, 2 vertebrae were involved, whereas in 8 cases involvement was only of one vertebra. All had persistent back pain: 2 had neurological deficit, Frankel grade A and B (9%), and 12 (54%) had gibbus deformity. RESULTS: At the end of the observation period, all patients had no pain (based on the adjective rating scale). Fourteen thoracic and 3 psoas abscesses resolved by 18 months. Four cases (18%) had deterioration of the angle of kyphosis. Five cases (22.5%) had progressive vertebral loss. Twelve cases (84%) had bony fusion at 36 months. CONCLUSION: Chemotherapy regimen and locally custom-made spinal brace is not costly, needs neither admission nor surgical intervention that demands skills and experience and can be recommended for uncomplicated thoracolumbar spinal TB.

Adolescent↗

PubMedDate not supplied

[Towards a diagnostic view of Hyalomma (Hyalomma) aegyptium (Acari, Ixodidae)].

The diagnostic characters of larval, nymphal and adult Hyalomma aegyptium (L., 1758) based on specimens from the territory of most part of the area are given. In the diagnoses of immature stages, was used the characters, which were formerly tested by the author for diagnostics of other Hyalomma species occurring in the former USSR. Commonly used characters and those which were revealed by the author as useful for the majority of Euhyalomma Filippova, 1984 and Hyalommina Schulze, 1919 species, have been used in the diagnoses of male and female. Differential diagnosis of Hyalomma aegyptium. Female: genital orifice as wide arch with straight posterior margin (fig. 2, 5); vestibular part of vagina funnel-like, greatly swollen (fig. 2, 5); setae of alloscutum stick-like, tapering in apical one (figs 2, 3, 4); second segment of palps with proximal narrowing (figs 3, 1, 2); spurs of coxae I widely separated, triangular, wide, subequal in size (fig. 3, 5). Male: any grooves of conscutum absent, except short and pit-like cervical ones (fig. 4); punctation sparce and impressive (fig. 4); adenal shields short and wide, without inner branch, posterior part widened, anteromedian margin straight (fig. 5, 4); spurs of coxae I widely separated, triangular, wide, subequal in size (fig. 6, 5). Nymph: posteromedian setae of alloscutum stick-like and, as a rule, with indented apices (fig. 7, 2); spurs of coxae I large, median spur as equilateral triangle and shorter than lateral one (fig. 7, 8); spurs of coxae II-IV well developed, with acute apices (fig. 7, 8). Larva: posterior part of scutum (behind the eyes) heavy elongated, its apex straight, postero-lateral incisions weakly developed (fig. 8, 1); spurs of coxae I as equilateral triangle in shape and with rounded apices, spurs of coxae II-III very large (fig. 8, 5).

Animals↗

PubMed2003

[Lymphadenitis as a complication following vaccination with Bacillus Calmette-Guérin (BCG)].

A healthy 14-months-old boy developed suppurative adenitis some weeks after Bacillus Calmette Guérin (BCG) vaccination. The tumour grew rapidly, showed fluctuation and eventually incision was needed. Culture of the abscess was negative. The diagnosis was: regional lymphadenitis after BCG vaccination. This suppurative lymphadenitis is a non-serious complication of BCG vaccination and has been reported in 0.1 to 4% of those vaccinated. As the BCG vaccination is given only to the at-risk population in the Netherlands, BCG complications are rare. Non-suppurative nodal swellings are considered a normal post-vaccination reaction and do not require treatment.

BCG Vaccine↗