1/14. Tuberculosis verrucosa cutis associated with tuberculous lymphadenitis.A 34-year-old man presented with a large cutaneous lesion on his left thigh that had started as a small papule when he was 13 years of age. The lesion had enlarged slowly over the last 21 years. The patient had received bacillus Calmette-Guerin (BCG) vaccination in childhood. The family history was significant for tuberculosis. Clinical examination revealed a large, purplish-red, indurated plaque measuring 30 x 29 cm on the left thigh, extending to the buttock area. The edges of the lesion had a serpiginous contour with an involuted center (Fig. 1). A left inguinal lymph node was palpated. Chest X-ray and blood cell count were normal. No other focus of disease was identified. Laboratory testing for human immunodeficiency virus (HIV) infection was negative. Purified protein derivative (PPD) intradermal injection disclosed a 19-mm skin induration. Both the cutaneous lesion and the inguinal lymph node were biopsied. Histopathologic sections of the skin fragment showed epidermal hyperkeratosis, neovascular proliferation, and a dense dermal lymphocytic infiltrate. The histopathology of the lymph node demonstrated few granulomas with focal areas of central necrosis. Staining for fungus was negative. Ziehl-Neelsen staining was negative on both the skin and lymph node specimens. culture for fungus and leishmania sp. was negative. Tissue culture on Lowenstein-Jensen medium from skin and lymph node was positive for Mycobacterium colonies after 5 and 7 weeks, respectively. Multidrug therapy was instituted with rifampin 600 mg/day, isoniazid 400 mg/day, and pyrazinamide 2 g/day for 2 months, and then rifampin 600 mg/day and isoniazid 400 mg/day alone for the next 4 months. An excellent response was obtained at the end of treatment (Fig. 2).- - - - - - - - - - ranking = 1keywords = immunodeficiency (Clic here for more details about this article) |
2/14. Focal tuberculous lymphadenitis in an hiv-1 infected patient.A 41-year-old man was admitted to the hospital because of focal swelling of the left supraclavicular lymph nodes. Eighteen months prior to admission, he had been diagnosed with human immunodeficiency virus type 1 (hiv-1) infection and was started on highly active antiretroviral therapy (HAART). He responded well to HAART with an increase in CD4 cell count and improvement in symptoms. However, one year after the initiation of HAART, he developed progressive enlargement of left supraclavicular lymph nodes. An excisional lymph node biopsy was performed for diagnosis, which revealed tuberculous lymphadenitis. rifabutin, isoniazid, and ethambutol were initiated for treatment.- - - - - - - - - - ranking = 1keywords = immunodeficiency (Clic here for more details about this article) |
3/14. Management of isolated extrapulmonary tuberculosis in a pregnant patient.The worldwide incidence of tuberculosis is increasing, largely as a consequence of both the increasing prevalence of human immunodeficiency virus and the emergence of drug-resistant strains. The pulmonary system is typically the primary site of involvement by this infectious disease; however, extrapulmonary disease does occasionally occur. Although uncommon, neck involvement can occur. The usual presentation is bilateral adenopathy from pulmonary dissemination. Tuberculous cervical adenitis in the absence of pulmonary findings is rare. A concurrent diagnosis of pregnancy complicates the treatment of the infected patient. We present a case of isolated, unilateral tuberculous cervical adenitis in a pregnant patient and discuss the multidisciplinary approach necessary for the appropriate management of this unique situation.- - - - - - - - - - ranking = 1keywords = immunodeficiency (Clic here for more details about this article) |
4/14. Duodenal ulcers preceding cervical tuberculous lymphadenitis.lymphadenitis is the most common presentation of extra pulmonary tuberculosis, whereas gastrointestinal localization, particularly duodenal involvement, is rare. We report a case of extra pulmonary tuberculosis with association between cervical lymphadenitis and duodenitis with multiple ulcers, not responsive to treatment with protonic pump inhibitors, in a human immunodeficiency virus-seronegative adult woman of Eritrean origin. Clinical patterns of duodenal TB, diagnostic difficulties and aetiopathogenesis are discussed according to the literature. In this case report it is suggested that tuberculous infection must be considered when duodenal ulcers fail to respond to proton pump inhibitors, especially when the patient comes from an endemic area.- - - - - - - - - - ranking = 1keywords = immunodeficiency (Clic here for more details about this article) |
5/14. Corneal endothelial deposits associated with rifabutin use.PURPOSE: The aim of this study was to report on the possible development of corneal endothelial deposits resulting from the use of rifabutin. methods: Case series consisting of 3 patients treated with rifabutin were retrospectively studied. Two of the patients were infected with human immunodeficiency virus. A corneal and external disease specialist performed a complete ophthalmologic exam and obtained medical histories of the patients. RESULTS: All cases developed corneal endothelial deposits after previous use of rifabutin. The deposits were bilateral, yellow-white colored, stellate, and mainly peripheral. CONCLUSIONS: In these 3 cases, the unique positive ocular finding was corneal endothelial deposits, which may be related to the use of rifabutin.- - - - - - - - - - ranking = 1keywords = immunodeficiency (Clic here for more details about this article) |
6/14. esophageal perforation in a patient with acquired immunodeficiency syndrome.Infection with mycobacterium tuberculosis is frequently found in patients with acquired immunodeficiency syndrome and can result in diffuse lymphadenopathy from disseminated disease. A case is presented of esophageal erosion and perforation secondary to mediastinal lymph node enlargement from mycobacterium tuberculosis in a patient positive for human immunodeficiency virus. Emergent surgical intervention required resection of the perforated esophagus, end-cervical esophagostomy, gastrostomy, and feeding jejunostomy. Long-term prognosis is poor owing to acquired immunodeficiency syndrome, therefore, reconstruction at a later date is uncertain.- - - - - - - - - - ranking = 27.994832390106keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
7/14. Actinomycetales infection in the acquired immunodeficiency syndrome.Four parenteral drug abusers with the acquired immunodeficiency syndrome had nonmycobacterial actinomycetales infections. Three patients had nocardiosis and one developed a streptomyces lymphadenitis. There was pericardial involvement in two patients, and two patients died. Presumptive diagnoses were often incorrect, highlighting the risks of empiric therapy in these patients. Four of the nine patients with the acquired immunodeficiency syndrome and nocardia or streptomyces infections whose cases were reported to the Centers for disease Control also had mycobacterial disease. A common susceptibility to these agents may exist in these immunosuppressed patients.- - - - - - - - - - ranking = 26.994832390106keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
8/14. The role of ultrasonography in the detection of extrapulmonary tuberculosis in patients with acquired immunodeficiency syndrome (AIDS).Three cases of extrapulmonary tuberculosis are presented. Retroperitoneal and periportal adenopathy were the major manifestation of the disease detected by ultrasonography in all three cases. All of the patients were subsequently diagnosed as having acquired immunodeficiency syndrome (AIDS). The lymphohematogenous dissemination of the disease and the diagnostic role of ultrasonography are discussed.- - - - - - - - - - ranking = 22.495693658422keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
9/14. Kaposi's sarcoma, tuberculosis and Hodgkin's lymphoma in a lymph node--possible acquired immunodeficiency syndrome. A case report.A patient in whom a single lymph node contained Kaposi's sarcoma, tuberculosis and Hodgkin's lymphoma is reported on. Kaposi's sarcoma was also present in the skin of the legs, and serum antibody titres to cytomegalovirus were elevated. This case may represent acquired immunodeficiency syndrome in a Black South African male.- - - - - - - - - - ranking = 22.495693658422keywords = immunodeficiency syndrome, immunodeficiency (Clic here for more details about this article) |
10/14. Bcg vaccination as a cause of multifocal osteomyelitis in a 12-year-old girl.A 12-year-old girl with multifocal skeletal sclerosis has been investigated. She was BCG vaccinated at birth and developed regional lymphadenitis in her left groin at two months of age. She was healthy until approximately 10 years of age, after which deficient height and weight gain occurred. BCG-itis was diagnosed in skeleton lesions. No evidence of immunodeficiency was found in the patient. After antituberculous treatment, the skeleton lesions, previously seen at bone scan, had disappeared. There has been a dramatic effect on her weight gain, growth and general well-being.- - - - - - - - - - ranking = 1keywords = immunodeficiency (Clic here for more details about this article) |
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