1/25. Disseminated BCG infection following bone marrow transplantation for X-linked severe combined immunodeficiency.An 8-month-old boy with X-linked severe combined immunodeficiency (XSCID) developed disseminated bacille Calmette-Guerin (BCG) infection following BCG vaccination at birth. He initially presented with an abscess at the site of BCG vaccination and was begun on three-drug antituberculous treatment (rifampicin, isoniazid, and pyrazinimide). Dissemination was subclinical prior to a human leukocyte antigen (HLA)-identical bone marrow transplant (BMT) from his sister, following which he presented with an acute erythroderma. A skin biopsy specimen revealed granulomas with epithelial histiocytes and giant cells in the reticular dermis, and numerous acid-fast bacilli (AFB) were present on Ziehl-Nielsen stain. A diagnosis of disseminated BCG disease was made. Despite the addition of a fourth antituberculous agent, ethambutol, he did not recover and developed numerous skin abscesses over the following weeks. Examination of pus from these lesions demonstrated numerous AFB. clarithromycin was added as a fifth antituberculous agent. Despite five-drug antituberculous therapy and monthly intravenous immunoglobulin infusions, recurrent abscesses containing AFB developed intermittently until 7 months posttransplant. At follow-up 1 year post-BMT he showed good general physical improvement. All abscesses had healed with scarring, and no further skin lesions had occurred.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/25. streptococcus agalactiae endocarditis and giant pyomyoma simulating ovarian cancer.Group B streptococcus (streptococcus agalactiae) is a common etiology of bacteremia among adults. Pyomyoma is a rare infectious complication of uterine leiomyomas. We report the case of a diabetic postmenopausal woman with a giant pyomyoma simulating an ovarian cancer. It was associated with S. agalactiae endocarditis and deep venous thrombosis of the right external iliac and femoral veins. Treated initially with intravenous penicillin, amikacin, and anticoagulation, the patient later had abdominal hysterectomy with an uneventful recovery. We also review the cases of pyomyoma reported since 1945. Of 14 cases described (including ours), mortality was 21%. endocarditis was never reported in association with pyomyoma. The presence of bacteremia and a leiomyoma should raise suspicion for this disease.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
3/25. Unusual bladder masses in children.Benign and malignant bladder masses in children are extremely rare pathologic lesions. The presentation can include gross hematuria, irritable or obstructive voiding symptoms, and urinary infection. We present 2 cases in which large bladder masses suspicious for malignancy were diagnosed as benign lesions. One patient presented with abdominal pain and frequency 2 weeks after a minor bicycle accident and had a bladder wall abscess with sterile urine. Another child presented with gross hematuria and was found to have a giant cystitis glandularis lesion with no precipitating event or infection. The evaluation and differential diagnosis are discussed, and a review of the literature is presented.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/25. Abscess formation after lip augmentation with silicone: case report.This paper describes the development of an abscess after injection of an alloplastic preparation (silicone) for enhancement of the lower lip. The 56-year-old woman presented with a painful swelling of her lower lip which was incised. Pus drained from the incision. A biopsy was taken. histology revealed homogeneous foreign body inclusions (silicone) with fibrosis, chronic inflammation and multinuclear giant cells. Healing was uneventful with little deformation of the lower lip. Since the number of persons seeking aesthetic lip augmentation is increasing, oral surgeons and dentists should be familiar with adverse effects to filling agents.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/25. mitral valve replacement in a patient with a collapsed lung and a giant abscess.mitral valve replacement was performed on a 75-year-old man with a history of pulmonary tuberculosis. Computed tomography showed a collapsed left lung and counterclockwise rotation of the heart due to a hard abscess. Surgery was performed through a median sternotomy, and extensive pericardial suspension was useful for obtaining an adequate view. Despite poor pulmonary function, the patient was extubated on the day of surgery and had an uneventful postoperative course. Cardiac surgery can be performed in patients with a single functional lung if their preoperative respiratory function is good enough to have daily life without dyspnea.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
6/25. Case report: subcutaneous elemental mercury injection--clinical observations and implications for tissue disposal from the histopathology laboratory.A 31-yr-old man presented to his general physician complaining of pain and swelling in the soft tissue of both hips. He initially denied knowledge of the etiology, but after elemental mercury droplets were expressed from the skin wounds by manual manipulation, he admitted that the source was self-administered sc injections. He did not provide a reason for this or give the time-frame of the injections. The areas of skin discoloration and soft tissue induration were completely excised and the wounds healed uneventfully. blood levels of mercury declined gradually after excision. Examination of the resected skin and subcutis revealed subcutaneous abscesses containing droplets of elemental mercury, released easily when the abscesses were sectioned. Sections showed dark droplets of metallic mercury associated with necrosis and microabscess formation, with areas of foreign body giant cell reaction. Disposal of the residual tissues and mercury by incineration would release the volatile elemental mercury into the atmosphere, where it would subsequently be returned to earth in rain water, be converted to methyl mercury by microorganisms, and enter the food chain. The US Environmental Protection Agency has recommended caution in consuming foods containing methyl mercury and has provided guidelines for consuming foods believed to contain increased amounts of mercury. mercury is readily available in the united states by over-the-counter sales to consumers, and in some cultures elemental mercury is used in ritualistic practices. skin injection cases are infrequent, but histopathology laboratories should recognize this phenomenon and be prepared to dispose of Hg-contaminated tissues in an environmentally sound manner.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/25. Perforated Meckels diverticulum causing giant pseudocyst and secondary appendicitis.Meckels diverticula are known to present with a myriad of complications. However its perforation followed by development of a giant pseudocyst and secondary appendicitis is not reported in literature thus far. We report this complication in a five and half month old infant.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
8/25. Giant nerve abscesses in leprosy.Two leprosy patients with neuritis caused by giant abscesses involving almost the entire ulnar nerve are described. One patient, who also had skin lesions, was diagnosed histopathologically as having borderline tuberculoid leprosy both on skin and nerve biopsy, and the other, with only nerve involvement, belonged to the pure neuritic group. The lepromin test was strongly positive (with a vesicular reaction in one patient) and lymphocyte transformation to mycobacterium leprae antigen was raised. These lesions can be easily mistaken for a peripheral nerve tumour in places where leprosy is uncommon. A brief account of the management of nerve abscess in leprosy is given.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/25. psoas abscess and giant fistula twenty-one years after nephrectomy.Vague abdominal complaints and low back pain are common in modern medicine. We describe the case of a patient who presented these symptoms twenty-one years after a nephrectomy accompanied by persistent elevated erythrocyte sedimentation rate for unknown reason. CT and fistulography showed a psoas abscess and a giant fistula.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
10/25. Nerve abscess simulated by a lipoma in a leprosy patient.A case of suspected giant nerve abscess near the radial nerve in the upper arm of a patient with borderline leprosy is reported. On exploration, it turned out to be a deep seated lipoma. Consideration should be given to exploring nerve masses in leprosy.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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