Cases reported "Chronic Disease"

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1/23. sarcoidosis-related anterior uveitis in a patient with human immunodeficiency virus.

    BACKGROUND: This is the first ophthalmic report--to our knowledge--of an anterior uveitis secondary to sarcoidosis in a patient infected with human immunodeficiency virus (hiv). Other reported causes of uveitis in hiv-infected patients have included hiv, herpes zoster, tuberculosis, syphilis, toxoplasmosis, cryptococcus, rifabutin prophylaxis for mycobacterium, and protease inhibitors such as ritonavir and indinavir. uveitis secondary to sarcoidosis in the non-hiv population is classically seen in young, female, African-American patients. There are rare reports, found exclusively in the pulmonary literature, of sarcoidosis in hiv-infected patients. CASE REPORT: A 38-year-old African-American male infected with hiv was treated for chronic recurrent anterior uveitis secondary to sarcoidosis. His sarcoidosis was diagnosed 1 month earlier, along with the onset of his uveitis. During the previous 6 years he has been treated with anti-hiv antivirals as well as prophylaxis for opportunistic infections. To date, his infectious disease specialist continues to treat his hiv and systemic sarcoidosis. CONCLUSION: patients with hiv infection in whom sarcoidosis with secondary uveitis develops are very rare. Management of these patients requires careful use of topical and oral steroidal anti-inflammatories to control ocular and systemic sequelae of sarcoidosis. This case initiates some interesting questions about the immunology of sarcoidosis and its presence in immunocompromised patients. Use of steroids in an immunocompromised patient is clinically complex. Further clinical study is needed to elicit the full clinical significance of sarcoidosis and hiv infection.
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ranking = 1
keywords = mycobacterium
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2/23. Cutaneous botryomycosis of the cervicofacial region.

    BACKGROUND: Botryomycosis is a rare, chronic, bacterial infection of insidious onset involving the integument or viscera that often mimics actinomycosis or a deep fungal infection. The pathogenesis is thought to be a symbiotic relationship between the host and the infecting organism. methods: Case report of a patient with a chronic infection involving the cervicofacial region diagnosed as cutaneous botryomycosis arising from a chronic osteomyelitis of the mandible. The diagnosis was based on the chronicity of the infection along with the identification of botryomycotic (bacteria-containing) granules on histopathologic examination. Special stains excluded fungi and mycobacterium. Cultures identified the offending bacteria, and antibiotic therapy was initiated on the basis of the sensitivities, resulting in resolution of this chronic infectious process. A review of the English language literature revealed that this is the first case of cutaneous botryomycosis arising from a chronic osteomyelitis of the mandible. RESULTS: Medical therapy proved curative at 14 months follow-up. Surgery was performed for diagnostic purposes only. CONCLUSIONS: Botryomycosis is exceedingly rare in the head and neck, and consideration of this entity in the differential diagnosis is critical to the diagnosis. The mainstay of therapy is medical with surgery reserved for biopsy and/or excision of persistent disease. Published 2001 John Wiley & Sons, Inc.
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ranking = 1
keywords = mycobacterium
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3/23. Mycobacterium avium intracellulare otitis media.

    Atypical mycobacterial infections of the middle ear are extremely rare. To our knowledge, only eight cases have been reported in the literature, five of which involve Mycobacterium avium intracellulare. We present a case of culture-proven, M. avium intracellulare otomastoiditis in an 8-year-old boy with common variable immunodeficiency syndrome. The patient clinically presented with pain and otorrhea. The histopathology was marked by acid-fast bacilli-laden histiocytes. Consideration of this entity in the differential diagnosis of chronic, recalcitrant otorrhea can lead to timely diagnosis, treatment, an decreased morbidity.
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ranking = 1.4677117886406
keywords = avium
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4/23. Human infections due to Mycobacterium lentiflavum.

    Three cases of human disease due to Mycobacterium lentiflavum are reported. In the first, the mycobacterium was responsible for chronic pulmonary disease in an elderly woman; in the second, it gave rise to cervical lymphadenitis in a child; and in the third, it caused a liver abscess in a young AIDS patient.
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ranking = 1
keywords = mycobacterium
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5/23. A pancreatic abscess 7 years after a pancreatojejunostomy for calcifying chronic pancreatitis.

    We present herein a case of a 75-year-old Japanese man who had developed a pancreatic abscess 7 years after a longitudinal pancreatojejunostomy for chronic pancreatitis. The patient, a heavy drinker of alcohol, underwent surgical decompression of a ductal obstruction to relieve persistent abdominal pain due to severely calcifying chronic pancreatitis. After the surgery, he stopped drinking alcohol and was treated with insulin to control secondary diabetes mellitus. Thereafter, his symptoms disappeared. Seven years after the surgery, however, he was hospitalized due to obstructive jaundice, high-grade fever, and right hypochondria pain. Ultrasound and computed tomographic scans of the abdomen both disclosed a cystic mass, approximately 6 cm in size, in the pancreatic head. magnetic resonance imaging strongly suggested a pancreatic abscess with necrotic fluid and debris. First, percutaneous transhepatic cholangiodrainage (PTCD) was done to treat the progressively obstructive jaundice. Subsequently, fine-needle aspiration of the pancreatic abscess was performed under ultrasound guidance. enterococcus avium and klebsiella oxytoca were revealed by culture of abscess aspirates. He was successfully cured by treatment with both appropriate antibiotic and continuous PTCD for the obstructive jaundice.
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ranking = 0.24461863144011
keywords = avium
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6/23. Chronic mycobacterium avium complex infection of the central nervous system in a nonimmunosuppressed woman.

    We report the case of a woman who developed chronic meningitis and a brain abscess due to Mycobacterium avium, without immunosuppressed state. She was treated with antituberculous drugs but the infection progressed and she died 4 years after first becoming ill. The occurrence of CNS infection with M. avium in the absence of acquired immunosuppression is rare. Its diagnosis is difficult, delaying clinical recognition and appropriate therapy.
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ranking = 1.4677117886406
keywords = avium
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7/23. Bronchus-associated lymphoid tissue lymphoma arising in a patient with bronchiectasis and chronic Mycobacterium avium infection.

    We describe a 67-year-old woman with bronchiectasis and mycobacterium avium complex infection who underwent wedge resection of her pulmonary infiltrates because they were progressing despite antibiotic therapy. In addition to the expected granulomatous changes, she was found to have a B-cell lymphoma of bronchus associated lymphoid tissue (BALT). Despite normal bone marrow morphology, marrow involvement was demonstrated by flow cytometry. Her lymphoma remains suppressed with antimycobacterial therapy 6 months after resection of bulk disease.
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ranking = 1.2230931572005
keywords = avium
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8/23. Mycobacterium lentiflavum infection in immunocompetent patient.

    Mycobacterium lentiflavum is a recently described nontuberculous mycobacterium that has mainly clinical importance in young children with cervical lymphadenitis and in immunocompromised patients. We describe a case of chronic pulmonary infection in an immunocompetent patient. Our observation confirms clinical, diagnostic, and treatment difficulties in the management of M. lentiflavum infection.
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ranking = 1
keywords = mycobacterium
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9/23. brain abscess due to enterococcus avium.

    We report the first case of brain abscess due to enterococcus avium in a 19-year-old man with chronic otitis media since childhood. The patient presented to the emergency department in a comatose condition. Contrast-enhanced brain computed tomography scan showed a hypodense area with ring enhancement in the right temporal lobe and mass effect with subfalcine and transtentorial herniation. Emergency temporal burr hole operation was performed and pus drained out, but the patient succumbed to his illness. culture of the aspirated pus yielded growth of gram-positive cocci identified as E avium, an infrequent pathogen of human infections. The association of E avium with brain abscess further extends the clinical spectrum of this rare pathogen.
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ranking = 1.7123304200807
keywords = avium
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10/23. Chronic necrotizing pulmonary aspergillosis complicated by a cavitary lesion caused by Pulmonary Mycobacterium-avium complex disease.

    A 66-year-old woman who had undergone one year's treatment for pulmonary nontuberculous mycobacterial disease due to Mycobacterium avium (rifampicin, ethambutol, clarithromycin, streptomycin-->levofloxacin) five years earlier was admitted to our hospital because of continuous fever and a newly detected abnormal chest shadow, which was like a fungus ball in the right upper lobe on chest computed tomography in the giant cavitary lesion caused by pulmonary Mycobacterium-avium complex (MAC) disease. A diagnosis of chronic necrotizing pulmonary aspergillosis (CNPA) complicated by pulmonary MAC disease was made because aspergillus niger was isolated from several sputum specimens, anti-aspergillus antibody was positive, and clinical symptoms such as fever, were disclosed with the radiological finding of a fungus ball-like shadow and an infiltration shadow around the cavity. The patient had received various forms of antifungal chemotherapy, but the clinical effect had been poor. Since then, she had been slowly worsening. Although mycetomas, with the typical appearance of a fungus ball on a chest radiograph, have been reported to easily form in cavitary lesions caused by previous pulmonary tuberculosis, we believe, as illustrated by the present case, that they could also form in such lesions caused by pulmonary MAC disease, since the frequency of pulmonary nontuberculous mycobacterial disease has recently been increasing in comparison with that of pulmonary tuberculosis.
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ranking = 1.4677117886406
keywords = avium
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