1/24. Eosinophilic cellulitis (Well's syndrome): a new case description.BACKGROUND: Wells' syndrome was first described by Wells in 1971 as a recurrent granulomatous dermatitis with eosinophilia and was later named eosinophilic cellulitis. It is defined by the following criteria: (i) sudden onset of annular or circinate erythematous-edematous patches that rapidly evolve to morphea-like blue-slate-colored plaques; (ii) a histological picture usually characterized by the presence of 'flame figures'; (iii) non-constant blood hypereosinophilia. methods: We describe the case of a 49-year-old woman who reported the sudden appearance of a few hard, pasty, oval-shaped, reddish-violet, moderately itchy, erythematous-edematous patches on both arms about 2 months before our observation. RESULTS: The remote pathologic history showed that the woman have been submitted to quadrantectomy with lymph node dissection followed by cobalt therapy for breast cancer. Based on the pharmacological history, intake of drugs was excluded. Routine blood chemistry and instrumental tests did not show any alteration, nor did assays of the main autoantibodies, complement, circulating immunocomplexes, or tumor markers. CONCLUSIONS: Histologically the picture was compatible with the diagnosis of Eosinophilic cellulitis. Following topical corticosteroid therapy the lesion healed rapidly. It relapsed 2 months later, and was again cured with the same topical treatment. No further relapses were observed in a 1 year follow-up.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
2/24. adenocarcinoma of the esophagus presenting as orbital cellulitis.A 56-year-old man was seen with signs and symptoms consistent with orbital cellulitis. Computed tomographic scan showed a localized bony defect in the sphenoid wing, on which a biopsy was performed through a lateral orbitotomy. Pathologic examination of the surgical specimen revealed mucinous adenocarcinoma, and metastatic workup revealed an extensive lower esophageal malignant neoplasm. Arch Ophthalmol. 2000;118:986-988- - - - - - - - - - ranking = 0.80021157024793keywords = neoplasm (Clic here for more details about this article) |
3/24. Acute phlegmonous jejunitis and viridans streptococcal peritonitis associated with bronchial carcinoma.A 61-y-old man developed acute non-specific phlegmonous jejunitis associated with relatively mild diffuse peritonitis. Bacteriological cultures of the abundant peritoneal fluid resulted in only growth of viridans streptococci (streptococcus mitis and S. salivarius). Antibiotic treatment had a favourable effect, but a hitherto unknown bronchial cancer led to his death 5 months later. It is assumed that this peculiar case was the result of the immunosuppressive effect related to the malignant neoplasm (opportunistic infection).- - - - - - - - - - ranking = 0.80021157024793keywords = neoplasm (Clic here for more details about this article) |
4/24. Massive localized lymphedema: additional locations and association with hypothyroidism.We report the second series of a new entity called "massive localized lymphedema in morbidly obese patients" (MLL), recently described in medical literature. Our 6 cases present additional locations as well as an association with hypothyroidism. Huge masses, of longstanding duration ranging from 9 months to 8 years, afflicted the thigh, popliteal fossa, scrotum, suprapubic and inguinal region, and abdomen of morbidly obese adults. Although clinical impressions were generally of a benign process, including lipoma and recurrent cellulitis, the possibility of a malignant neoplasm could not be eliminated. Poorly defined and non-encapsulated, these skin and subcutaneous lesions were most remarkable for their sheer size, measuring 50.6 cm in mean diameter (range, 38-75 cm) and weighing a mean of 6764.5 g (range, 2,060-12,000 g) The overlying skin exhibited the induration and peau d'orange characteristic of chronic lymphedema. Grossly and histologically, a prominent marbled appearance, rendered by fibrous bands intersecting lobules of adipose tissue, simulated sclerosing well differentiated liposarcoma. However, the absence of atypical stromal cells, atypical adipocytes, and lipoblasts precluded the diagnosis of well differentiated liposarcoma. Instead, reactive features, encompassing lymphatic vascular ectasia, mononuclear cell infiltrates, fibrosis, and edema between the collagen fibers, as well as ischemic changes including infarction and fat necrosis, established the diagnosis of MLL. Although the pathogenesis of MLL may be as simple as obstruction of efferent lymphatic flow by a massive abdominal pannus and/or prior surgery, the presence of hypothyroidism in 2 of our patients suggests an alternative pathogenesis. Recognition of this entity by both clinicians and pathologists should avert a misdiagnosis as a low-grade liposarcoma.- - - - - - - - - - ranking = 0.80021157024793keywords = neoplasm (Clic here for more details about this article) |
5/24. Treatment of a wound infection in a patient with mantle cell lymphoma.This case study examines the impact of a severe wound infection on a patient undergoing chemotherapy for the treatment of mantle cell lymphoma. The study illustrates how life threatening an infection can become in a patient whose body is compromised as a consequence of both disease and chemotherapy treatment. A number of specialist products were required in order to overcome the infection, debride and heal the wound. These included larval therapy, vacuum-assisted closure and leptospermum honey. While this case study focuses on the successful outcome of one particular patient it aims to raise awareness of the role of specialist products, both old and new, in improving healing rates of complex wounds.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
6/24. Bipolaris-induced orbital cellulitis.We report a patient who rapidly developed unilateral proptosis and complete ophthalmoplegia following blunt trauma to the orbit. Computed tomography (CT) scan revealed a mass involving the sinuses and orbit with erosion of the cribriform plate. biopsy of this suspected neoplasm revealed features consistent with allergic aspergillus sinusitis, but cultures later grew a Bipolaris species. Our review of the literature suggests that when allergic fungal sinusitis involves the orbit, Bipolaris is a more commonly isolated organism than aspergillus. Additionally, extraocular motility impairment and proptosis occur more frequently than visual loss. Treatment is controversial, but surgical drainage followed by corticosteroids is the most often recommended therapy.- - - - - - - - - - ranking = 0.80021157024793keywords = neoplasm (Clic here for more details about this article) |
7/24. sepsis in a renal transplant recipient due to Citrobacter braakii.Cellulitis is usually caused by organisms such as beta-hemolytic streptococci and staphylococcus aureus. Citrobacter are gram-negative bacilli that can cause opportunistic infections in immunocompromised hosts. They are rarely implicated in skin or soft tissue infections. The genus Citrobacter has been respeciated according to genetic relatedness. Citrobacter braakii refers to the genomospecies 6 of the citrobacter freundii complex. There are no detailed studies of infections caused by the newly formed specific genetic species. We report a case of C. braakii infection in a renal transplant patient receiving immunosuppressive therapy. The patient's lower extremity cellulitis did not respond to conventional antibiotic therapy. blood cultures grew C. braakii. Sensitivity studies and treatment with appropriate antibiotics resulted in prompt recovery. Immunosuppressive therapy in renal transplant recipients predisposes to infection by unusual pathogens, and this should be suspected when lack of a clinical response to conventional antibiotics is observed. We believe this is the first reported case of C. braakii cellulitis and bacteremia in a renal transplant recipient.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
8/24. Relapsing polychondritis: an unusual cause of painful auricular swelling.Auricular pain, redness, and swelling are usually the result of infectious cellulitis. However, relapsing polychondritis is another cause of this symptom complex and is the result of an autoimmune phenomenon. It presents with inflammation and destruction of both articular and nonarticular cartilage, with the external ear and joint cartilage most often involved. Although usually indolent with multiple acute exacerbations, relapsing polychondritis can be rapidly fatal if the airway or cardiovascular system is involved. We present a case of relapsing polychondritis initially mistaken for auricular cellulitis. The clinical manifestations and course of relapsing polychondritis are reviewed, along with the emergency department management.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
9/24. Paravertebral infection (phlegmon) demonstrated by FDG dual-head coincidence imaging in a patient with multiple malignancies.A 66-year-old woman was referred for a bone scan to assess back pain on a background of breast cancer, melanoma, and rheumatic heart disease. The scan appearance was suspicious for a localized soft tissue neoplasm. An FDG coincidence positron emission tomography (PET) study demonstrated a large FDG-avid soft tissue abnormality. staphylococcus aureus was isolated from a subsequent needle biopsy. This case illustrates the use of FDG-PET in infection imaging, as well as demonstrating the potential pitfalls in nuclear oncology. Because FDG is not tumor-specific, accumulation in benign lesions may give rise to false-positive results despite a high pretest probability for malignancy.- - - - - - - - - - ranking = 0.80021157024793keywords = neoplasm (Clic here for more details about this article) |
10/24. Reactive angioendotheliomatosis in association with a well-differentiated angiosarcoma.A 55-year-old white female with a complex medical history including mixed connective tissue disease and peripheral vascular disease developed a group of red-purple papules on her proximal medial thigh that was followed, five months later, by the development of a large violaceous patch. She reported a history of radiation to this site (for melanoma) during her childhood. She was admitted to the hospital with a presumptive diagnosis of cellulitis, but failed to respond to antibiotics. A biopsy was performed and demonstrated a well-differentiated angiosarcoma arising in conjunction with reactive angioendotheliomatosis. Excision of the lesion was performed, and fifteen months of follow-up have shown no recurrence or metastasis.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
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