1/12. Subcutaneous cysticercosis involving the eyelid: sonographic diagnosis.A 25-year-old man and a 14-year-old boy presented with neurocutaneous cysticercosis involving the eyelid. Both patients had hundreds of scattered subcutaneous cysticerci. They were arranged in clusters over the sternocleidomastoid muscle in the neck. Such clustering of cysticerci is highly suggestive of central nervous system (CNS) involvement, as both the sternocleidomastoid muscle and the CNS are supplied by the carotid artery and cysticerci travel via the hematogenous route. We used ultrasonography to diagnose subcutaneous cysticercosis, which showed characteristic low reflective cysts and high reflective scolices inside. Although subcutaneous cysticerci are inconsequential, their verification is important in the diagnosis of more severe CNS involvement. They may be confused with other painless swellings such as lymphadenopathies, neurofibromas, and epidermoid cysts.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
2/12. Subcutaneous and cerebral cysticercosis.Cysticercosis is a human infestation, which is considered the most common cause of seizures worldwide. The subcutaneous lesions can help in the diagnosis of neurocysticercosis. We describe a case of a 45-year-old patient with multiple cutaneous nodules first seen 2 years ago that were increasing in number, and normal neurologic and fundoscopic examination. Neurologic symptoms started 3 months before hospital admission as a mild headache and muscular weakness. The imaging examinations showed a massive central nervous system involvement. physicians must be aware of the importance of subcutaneous nodule examination for the diagnosis of neurocysticercosis.- - - - - - - - - - ranking = 1.4503093294111keywords = central nervous system, nervous system, cerebral (Clic here for more details about this article) |
3/12. Fatal granulomatous amebic encephalitis caused by balamuthia mandrillaris presenting as a skin lesion.Granulomatous amebic encephalitis is an uncommon central nervous system (CNS) infection, usually caused by acanthamoeba spp., which generally occurs in immunocompromised individuals. balamuthia mandrillaris is a recently described free-living ameba that occasionally causes fatal CNS disease. The infection might start from a minor, slowly progressive, skin ulceration that can be present for weeks to months before neurologic changes occur. The clinical and histologic presentation is easily confused with many other diseases. Accurate diagnosis requires an awareness of this unusual presentation of amebiasis and identification of the amebic trophozoites in tissue and culture. Special stains are helpful, but immunofluorescence assays or electron microscopy is required to identify the organism as B mandrillaris. We present a fatal case of granulomatous amebic encephalitis that began as a cutaneous infection in an immunocompetent host.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
4/12. Disseminated cutaneous acanthamebiasis: a case report and review of the literature.The genus acanthamoeba includes species of free-living soil and water ameba that have been implicated in a small number of human diseases. acanthamoeba species have been identified as the etiologic agents in 2 well-defined clinical entities, amebic keratitis and granulomatous amebic encephalitis (GAE). Less commonly, acanthamoeba species have been identified as the cause of disseminated disease in debilitated and immunocompromised patients. Cutaneous acanthamebiasis, often a reflection of disseminated disease, is an increasingly recognized infection since the emergence of acquired immunodeficiency syndrome (AIDS) and the use of immunosuppressive drugs. The disease portends a poor prognosis and is uniformly fatal if the infection involves the central nervous system (CNS). We describe a patient with advanced AIDS who presented with disseminated cutaneous lesions, headache, and photophobia, and in whom a diagnosis of cutaneous acanthamebiasis was made based on the results of a skin biopsy. A multidrug therapeutic regimen was begun that included sulfadiazine; the patient responded favorably to treatment. This paper also reviews 36 previously reported cases of cutaneous acanthamebiasis with delineation of clinical, diagnostic, histologic, and prognostic features, as well as discusses treatment options.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
5/12. Disseminated strongyloidiasis presenting as purpura.We report a patient with disseminated strongyloidiasis who was being treated with steroids for cerebral edema caused by brain metastases from urinary bladder carcinoma. He had extensive purpura involving the abdomen, arms, and thighs. A skin biopsy specimen showed numerous larvae of strongyloides stercoralis. Subsequently, rhabdoid larvae of S. stercoralis were isolated in the stool and the sputum. The patient died 2 days later despite thiabendazole therapy.- - - - - - - - - - ranking = 0.11257733235276keywords = cerebral (Clic here for more details about this article) |
6/12. Cutaneous toxoplasmosis.A case of epidermotropic cutaneous toxoplasmosis is reported. The patient, a 53-year-old man with chronic myelogenous leukemia in blast crisis, received a bone marrow allograft but continued to have severe pancytopenia. Numerous diffuse, palpable, purpuric nodules appeared 21 days after the transplant. Organisms were found within the epidermal keratinocytes--both singularly and in cysts. Dermal and neural infiltration was also present. toxoplasma gondii was identified on the basis of the ultrastructural features of the parasite. Possible sources of infection include reactivation of a previous latent infection, transmission through a bone marrow allograft, or nosocomial acquisition.- - - - - - - - - - ranking = 4660.0142123734keywords = toxoplasmosis (Clic here for more details about this article) |
7/12. Cutaneous toxoplasmosis.Nine patients with cutaneous toxoplasmosis had slowly regressing erythema-multiforme-like eruptions or lichenoid, papulonodular and purpurictelangiectatic disorders. The most common histologic finding was subacute histiolymphocytic perivasculitis with frequent demonstration of the parasite. Another group of patients showed similar clinical and histological findings, but the parasite was not evidenced in these.- - - - - - - - - - ranking = 4660.0142123734keywords = toxoplasmosis (Clic here for more details about this article) |
8/12. Disseminated acanthamebiasis in patients with AIDS. A report of five cases and a review of the literature.BACKGROUND: acanthamoeba and Leptomyxida are free-living amebae that cause granulomatous amebic encephalitis, a rare, slowly progressive, fatal neurologic process seen in immunosuppressed hosts. In addition, these organisms produce disseminated cutaneous lesions and involve other organs, particularly in patients with the acquired immunodeficiency syndrome (AIDS). RESULTS: We report five cases of disseminated acanthamebiasis in patients with AIDS, each with cutaneous manifestations but lacking central nervous system involvement. The medial CD4 T-cell count was 0.024 x 10(9)/L. skin lesions included pustules, subcutaneous and deep dermal nodules, and ulcers, most often seen on the extremities and face. Histopathologically, both pustular and vasculitic changes were observed; in all cases, the microscopic identification of organisms was difficult because of the macrophagelike appearance of the microbes in routine sections. CONCLUSIONS: skin lesions are the most common reported presentation of infections caused by acanthamoeba and Leptomyxida organisms in patients with AIDS, a minority of whom have central nervous system manifestations. A high index of suspicion is necessary for both the dermatologist and the dermatopathologist. prognosis is guarded, but early treatment using a combination of intravenous pentamidine and oral fluconazole, sulfadiazine, and flucytosine may be beneficial.- - - - - - - - - - ranking = 2keywords = central nervous system, nervous system (Clic here for more details about this article) |
9/12. Cutaneous manifestations of African trypanosomiasis.BACKGROUND: Dermatologists may evaluate patients with African trypanosomiasis. The currently available dermatologic literature does not review the cutaneous manifestations of African trypanosomiasis. observation: We describe an American man who acquired African trypanosomiasis while hunting in tanzania, and we review and classify the cutaneous findings of this disease. This article reports the results of the first biopsy of a trypanid and depicts trypanosomes on the first touch preparation done from a trypanid biopsy specimen. Rare color photographs of trypanids are shown. CONCLUSIONS: Recognition of the unique cutaneous manifestations of African trypanosomiasis may allow dermatologists to make a rapid diagnosis that is essential for timely treatment and survival. Classifying the disease with primary chancriform, secondary hemolymphatic, and tertiary central nervous system stages should improve the understanding of the complex natural history of African trypanosomiasis.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
10/12. Cerebral and subcutaneous cysticercosis treated with albendazole.BACKGROUND: Cysticercosis is the most common parasitic disease of the central nervous system in the world, but cysticercosis cutis has been reported much less frequently. Because 54% of patients present with subcutaneous nodules, we report here the association of cysticercosis cutis in a patient with neurocysticercosis and review the literature and treatment options. CASE REPORT: The patient presented with multiple, asymptomatic subcutaneous nodules over the trunk and the extremities, associated with central nervous system involvement. Examination of an excised nodule by light microscopy revealed a larval cyst in the deep dermis surrounded partly by a fibrous pseudocapsule. Computed tomographic scanning af the skull showed multiple, nonenhancing, and calcified cycts in both cerebral hemispheres. Treatment with albendazole, 15 mg/kg/day for 30 days, was highly effective. At follow-up 6 months later, most subcutaneous nodules had disappeared or were markedly reduced in size, and the cerebral lesions had much improved. CONCLUSIONS: albendazole, a newer paracidal drug, seems to be more effective and less expensive than some other drugs in use for the treatment of neurocysticercosis.- - - - - - - - - - ranking = 2.2251546647055keywords = central nervous system, nervous system, cerebral (Clic here for more details about this article) |
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