1/14. pneumocystis carinii pneumonia (PCP) at Ga-Rankuwa Hospital.pneumocystis carinii is recognized as one of the leading causes of death in AIDS patients in developed countries but its role in this regard in developing countries appears to be less prominent. Sub-Saharan African countries, in spite of their high hiv prevalence, have hardly recorded any cases. We report the first microbiologically proven case of PCP in an adult patient at Ga-Rankuwa Hospital. A 37 year old African woman was referred to Ga-Rankuwa Hospital from the local clinic for chest infection with a non productive cough that had not responded to conventional treatment. On admission, she was febrile, emaciated and in respiratory distress with oral thrush. Chest radiography showed diffuse bilateral infiltrations and a preliminary diagnosis of atypical pneumonia and tuberculosis was made. The patient was begun on penicillin, gentamicin, contrimoxazole and anti-tuberculosis therapy. Laboratory investigations revealed a low haemoglobin, positive hiv test (after counselling) and pneumocystis carinii trophozoites and cytes in the bronchoalveolar larvage specimen. In spite of appropriate treatment the patient died within three days. One wonders whether the outcome for this middle aged woman with advanced hiv infection would have been different had appropriate cotrimoxazole therapy been administered at the primary health care centre. It must be noted that PCP may no longer be a rare disease in sub-Saharan countries and intensive investigations should be carried out to avoid losing patients with treatable infectious diseases.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
2/14. The association of secondary tonsillar and laryngeal tuberculosis: a case report and literature review.Tonsillar and laryngeal tuberculosis are rare diseases. We report a case with a tonsillar and laryngeal lesion. Histopathological and bacteriological examinations established the diagnosis of tonsillar and laryngeal tuberculosis associated with asymptomatic pulmonary focus.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
3/14. A renal transplant recipient with pulmonary tuberculosis and visceral leishmaniasis: review of superimposed infections and therapy approaches.Visceral leishmaniasis (VL) is an acute or subacute disease that is almost invariably fatal if untreated. It is a rare disease in renal transplant recipients and frequently reported together with other infectious agents. A 39-year-old renal transplant patient was admitted to hospital for elective coronary surgery. In the post-operative period, he developed spiking fever and non-productive cough and his general condition deteriorated. While he was taking medication for non-specific pneumonia, a cavitary lesion occurred in his lung, and he had the diagnosis of pulmonary tuberculosis and antituberculous treatment was started. Despite treatment, his fever continued. As the patient developed pancytopenia and splenomegaly, a bone marrow aspiration was done. Evaluation of bone marrow aspirate indicated Leishmania parasites. He was successfully treated with a more intensive liposomal amphotericin (L-AmB). Complete cure was achieved during follow-up period of 10 months without clinical relapse. In the existence of fever and long-standing pancytopenia, VL should be suspected although the patient had another proved infection and did not live or visit an endemic area. L-AmB usage can be safely preferred for treatment of selected renal transplant recipients with VL as first-line therapy.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
4/14. Tuberculosis in healthcare workers caring for a congenitally infected infant.OBJECTIVE: To assess the extent of nosocomial transmission of tuberculosis among infants, family members, and healthcare workers (HCWs) who were exposed to a 29-week-old premature infant with congenital tuberculosis, diagnosed at 102 days of age. DESIGN: A prospective exposure investigation using tuberculin skin test (IST conversion was conducted. Contacts underwent two skin tests 10 to 12 weeks apart. Clinical examination and chest radiographs were performed to rule out disease. isoniazid prophylaxis was administered to exposed infants at higher risk. SETTING: A neonatal intensive care unit in an urban hospital in Brussels, belgium. PARTICIPANTS: Ninety-seven infants, 139 HCWs, and 180 visitors. RESULTS: Newly positive TST results occurred in HCWs who had been in close contact with the infant. Six (19%) of 32 primary care nurses and physicians had TST conversions and received treatment. Among the 97 exposed infants, 85 were screened and 34 were identified as at higher risk of infection. Of these, 27 received preventive isoniazid. None of the infants and none of the 93 other infants' family members evaluated were infected. CONCLUSIONS: Congenital tuberculosis in an infant poses a risk for nosocomial transmission to HCWs. delayed diagnosis of this rare disease and close proximity are the most important factors related to transmission.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
5/14. Congenital pulmonary tuberculosis associated with maternal cerebral tuberculosis--florida, 2002.In 2002, congenital tuberculosis (TB), a rare disease with nonspecific signs and symptoms, was diagnosed in an infant in florida. If untreated, congenital TB is fatal, which underscores the importance of suspecting congenital TB in newborns and infants who are at risk and who have unexplained febrile illnesses. This report summarizes the investigation of the case in florida. Health-care practitioners should administer a tuberculin skin test to women who have risks for mycobacterium tuberculosis infection and treat those who have latent TB infection (LTBI) to prevent maternal and congenital TB disease.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
6/14. erythema induratum and active pulmonary tuberculosis.The etiology of erythema induratum, a rare disease of the skin in the united states but occasionally seen in natives of Asian countries, remains a source of debate. Its association with tuberculosis, although strongly suspected for more than one century, has not been clearly defined. We report a case of erythema induratum occurring in a young Chinese woman in the setting of active pulmonary tuberculosis. Both diseases promptly responded to antituberculous therapy. The diagnosis of erythema induratum should urge the clinician to search for a source of active tuberculosis, and treatment should be initiated accordingly.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
7/14. Pulmonary sporotrichosis: review of treatment and outcome.Four culture-documented cases of pulmonary sporotrichosis, three primary infections and one with multisystem involvement, are presented. Two of these patients are the first reported cases of primary lung disease treated with ketoconazole. This antifungal agent appears to be ineffective in eradicating this infection. The four cases, as well as a review of the literature, illustrate several important aspects of this rare disease. Pulmonary sporotrichosis is most commonly found in males with a history of alcohol abuse who are between the ages of 30 and 60. The infection is usually confined to the parenchyma of the lung but can involve hilar and mediastinal lymph nodes, pleura, skin, subcutaneous tissue, and joints. All but two cases have been reported in the united states, and the majority reside within states bordering the missouri or mississippi rivers. Direct occupational or environmental exposure appears to be an important predisposing risk factor. The onset of the disease is insidious, presenting in a manner similar to many other granulomatous or neoplastic diseases. Tuberculosis is the most common suspected diagnosis before confirmation of sporotrichosis. The chest radiograph most commonly demonstrates upperlobe cavitary disease with surrounding parenchymal infiltrates. The diagnosis can be suspected with high serologic titers or skin-test positivity, but needs to be confirmed by culture. The organism can usually be grown from sputum, as well as routine bronchoscopic procedures, open-lung biopsy specimens or pleural fluid. Histologic examination shows granulomas of both the caseating and noncaseating varieties. Frequently, organisms can be seen in necrotic areas of the lung tissue by diastase-modified GMS or PAS staining. Staining by direct fluorescent antibody technique can also be done and appears to be highly specific. Treatment is controversial, but total surgical resection of diseased lung as well as a perioperative regimen of SSKI or amphotericin b appears to be the most efficacious therapy. Medical therapy alone with SSKI or amphotericin b may be useful in selected cases but has been disappointing in the majority of reports. The imidazoles are usually ineffective, and the search for more effective medical therapy continues.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
8/14. Wegener's granulomatosis diagnosed by open lung biopsy.A 21 year old man was diagnosed as having Wegener's granulomatosis at thoracotomy. Treatment with prednisolone and cyclophosphamide was initiated but the patient died 4 months later. Wegener's granulomatosis is a rare disease which should be considered in the differential diagnosis of pulmonary malignancies, tuberculosis and lung abscess. early diagnosis is mandatory for a favourable outcome. Open lung biopsy is recommended, if other examinations have failed, as large representative biopsies can be obtained.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
9/14. Duodenal tuberculosis.Duodenal tuberculosis is a very rare disease and is usually associated with active pulmonary tuberculosis. These patients may present with symptoms and initial radiographic findings of pyloric canal obstruction. Hypotonic duodenography may reveal a submucosal mass with no other specific changes. The lesion is unpredictable. It may respond to medical therapy but it may also progress and require surgical intervention.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
10/14. Congenital tuberculosis. A report of a probable case.Extensive miliary pulmonary tuberculosis in a 17-day-old infant born to a mother with pulmonary tuberculosis is described. It was assumed that the patient probably had congental tuberculosis. We report our findings to draw attention to a rare disease where a high index of suspicion, timely diagnosis and adequate management are essential if treatment is to be successful.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
| | Next -> |