1/30. An unusual case of pneumocystis carinii presenting as an aural mass.Extrapulmonary involvement of organs with the protozoan pneumocystis carinii is rare. We describe a case of pneumocystis carinii presenting as an erosive aural mass in a young male patient with acquired immunodeficiency syndrome. As far as the authors are aware such an example has never been described in a British journal and is the first case worldwide where otic pneumocystosis has extended into the middle cranial fossa. We also present a review of the literature on otological manifestations of pneumocystis carinii.- - - - - - - - - - ranking = 1keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
2/30. autopsy case of alcoholic hepatitis and cirrhosis treated with corticosteroids and affected by pneumocystis carinii and cytomegalovirus pneumonia.A case of the very early phase of pneumocystis carinii pneumonia in a human immunodeficiency virus (hiv)-negative man with alcoholic hepatitis and cirrhosis treated with steroids is presented. A 40-year-old man with a 10-year history of alcohol abuse was admitted to hospital with jaundice, fever and macrohematuria. Laboratory examinations revealed neutrophilic leukocytosis and a serum bilirubin level of 13.9 mg/dL. The serum bilirubin level rose to 28.5 mg/dL over 1 month. prednisolone administered orally for 10 days produced a slight improvement in the jaundice and fever. After an interval of a week, it was resumed and maintained for 22 days (total dose, 1555 mg) until the patient died of a massive hemorrhage from ruptured vessels of a gastric ulcer. An autopsy disclosed P. carinii pneumonia in the lower lobe of the left lung, cytomegalovirus infection in both lungs and the esophagus, and esophageal candidiasis. To our knowledge, this is the first report of P. carinii pneumonia together with cytomegalovirus infection in an hiv-negative alcoholic patient. The present case suggests that a rare opportunistic infection such as P. carinii pneumonia might be caused by treating cirrhosis and alcoholic hepatitis with corticosteroids, even if only for a relatively short period.- - - - - - - - - - ranking = 0.12493717887454keywords = immunodeficiency (Clic here for more details about this article) |
3/30. pneumocystis carinii infection presenting as an intra-abdominal cystic mass in a child with acquired immunodeficiency syndrome.We describe the case of a pediatric patient with acquired immunodeficiency syndrome (AIDS) with an unusual large, fluid-filled intra-abdominal cystic lesion in which pneumocystis carinii trophozoites were identified. Extrapulmonary P. carinii infection should be considered in the differential diagnosis of an intra-abdominal cystic mass in a child with AIDS.- - - - - - - - - - ranking = 5keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
4/30. pneumocystis carinii infection in bilateral aural polyps in a human immunodeficiency virus-positive patient.pneumocystis carinii is an opportunistic infection found in patients with impaired immunity. Under favourable conditions the parasite can spread via the blood stream or lymphatic vessels and cause extrapulmonary dissemination. We report a case of P carinii infection presenting as bilateral aural polyps, otitis media and mastoiditis in human immunodeficiency (hiv)-positive patient with no history of prior or concomitant P carinii infection.- - - - - - - - - - ranking = 0.62468589437268keywords = immunodeficiency (Clic here for more details about this article) |
5/30. pneumocystis carinii infection in the middle ear.pneumocystis carinii is the opportunistic pathogen frequently causing pneumonitis in the acquired immunodeficiency syndrome. Extrapulmonic manifestation of P carinii is unusual and is commonly associated with severe systemic illness, other immune deficiency status, malignancy, or immune suppression. We describe a case of acquired immunodeficiency syndrome with manifestations of P carinii otitis media with severe otalgia and conductive hearing loss.- - - - - - - - - - ranking = 2keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
6/30. pneumocystis carinii peritonitis. Antemortem confirmation of disseminated pneumocystosis by cytologic examination of body fluids.Histologic confirmation of extrapulmonary pneumocystis carinii infection in the acquired immunodeficiency syndrome has usually required organ biopsy when the diagnosis was made antemortem. Three cases of Pneumocystis peritonitis were studied in which confirmation of extrapulmonary dissemination was achieved by cytologic examination of ascitic fluid. patients presented with characteristic choroidal lesions, transudative ascites, profound hypoalbuminemia, and hepatic dysfunction. Cytologic examination of ascitic fluid confirmed extrapulmonary dissemination of pneumocystis. All three patients died despite a minimum of 2 weeks of standard therapy. Cytologic examination of body fluids to confirm dissemination of Pneumocystis may obviate the need for organ biopsy. Disseminated pneumocystosis should be included in the differential diagnosis of ascites or peritonitis in a patient at risk for human immunodeficiency virus--associated opportunistic infections. The presence of transudative ascites may be characteristic of this syndrome.- - - - - - - - - - ranking = 1.1249371788745keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
7/30. Cytology of extrapulmonary pneumocystis carinii infection in the acquired immunodeficiency syndrome.Rare cases of extrapulmonary pneumocystis carinii (EPPC) have been seen in patients with acquired immunodeficiency syndrome (AIDS). We report seven such diagnoses of nonpulmonary P carinii (PC) from four AIDS patients between 1986 and 1989. The specimens included fine needle aspirate of liver, spleen, periarticular tissue and pleura as well as ankle fluid, pleural fluid and ascites. In some, but not all, cases the patients had concurrent or previous episodes of PC pneumonia. In all cases the typical granular, eosinophilic aggregates of PC cysts were noted on routine Papanicolaou staining, leading to the definitive detection of PC cysts with Grocott silver stain. In most cases, evidence for granulomalike and neovascularized tissue reaction was present in cytologic material. One specimen demonstrated concurrent acid fast bacilli. In the setting of AIDS, cytology of effusions and masses should include an evaluation for EPPC.- - - - - - - - - - ranking = 5keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
8/30. Otic and ophthalmic pneumocystosis in acquired immunodeficiency syndrome. Report of a case and review of the literature.A case of primary pneumocystis carinii infection involving the left middle ear of a patient with acquired immunodeficiency syndrome is described, and the literature on the otic and ophthalmic pneumocystosis is reviewed. Otic pneumocystosis typically presents as a unilateral polypoid mass, and it is clinically manifested as otalgia, hearing loss, or, sometimes, otorrhea without evidence of current respiratory disease or previous Pneumocystis pneumonia. In contrast, choroidal pneumocystosis usually occurs in a patient with acquired immunodeficiency syndrome with at least one previous episode of Pneumocystis pneumonia and aerosolized pentamidine treatment, it is usually asymptomatic and bilateral, and it may be discovered only because of other concurrent human immunodeficiency virus-related ophthalmic disease. The diagnosis is made clinically, and intravenous antiparasite treatment is successful.- - - - - - - - - - ranking = 6.1249371788745keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
9/30. Pneumocystis colitis in a patient with the acquired immunodeficiency syndrome.We report a case of colonic pneumocystosis in a human immunodeficiency virus (hiv)-positive homosexual male who presented with fever and diarrhea. Stool cultures for bacterial pathogens and examinations for ova and parasites were negative. The diagnosis was made by colonoscopic biopsy which revealed pneumocystis carinii organisms in the lamina propria of the cecum, descending colon, and sigmoid colon. The patient subsequently developed pulmonary and ocular abnormalities consistent with P. carinii involvement of these organs. The diarrhea and other manifestations resolved with antipneumocystis therapy. Many sites of extrapulmonary pneumocystosis have been reported, but we believe this is the first report of colonic P. carinii found in the evaluation of persistent diarrhea in a patient with the acquired immunodeficiency syndrome.- - - - - - - - - - ranking = 5.1249371788745keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
10/30. Clue to fine-needle aspiration diagnosis of pleural pneumocystoma: neovascularization and Langhans' giant cell reaction.Pneumocystis pneumonia is a common component of the acquired immunodeficiency syndrome (AIDS) in the united states. Extrapulmonary pneumocystosis, however, is much less common. Rare cases have been reported in lymph nodes, bone marrow, spleen, pleura, gastrointestinal tract, liver, common bile duct, pancreas, skin, thyroid, and eye. A 39-yr-old man with history of chest wall injuries from gunshot and stabbing presented with multiple pleural masses clinically suspicious of metastatic deposits from an unknown primary. Fine-needle aspiration biopsy of the largest pleural mass revealed extrapulmonary pneumocystis, which led to the diagnosis of AIDS. Similar to the previous reports of pneumocystis mass lesions in extrapulmonary sites, the current case is associated with exuberant vascular proliferation and Langhans' giant cell reaction. Neovascularization and histiocytic influx from the newly formed blood vessels and Langhans' giant cell reaction seem to be a common tissue reaction to the massive deposition of pneumocystis organisms in extrapulmonary sites in patients with AIDS.- - - - - - - - - - ranking = 1keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
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