Cases reported "Granuloma"

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1/22. Mycobacterium intracellulare as a cause of a recurrent granulomatous tenosynovitis of the hand.

    We report a case of recurrent granulomatous tenosynovitis with M. intracellulare in a 55-year-old hiv negative diabetic woman. Identification of the causative agent further than belonging to the M. avium-intracellulare complex is provided by specific PCR-amplification of genomic dna and sequencing of an hypervariable region within its 16S rna gene. Sixteen months antibiotic regimen of rifabutin and clarithromycin led to a complete resolution of the tenosynovitis.
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ranking = 1
keywords = avium
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2/22. A case report of mycobacterium marinum infection of the hand.

    We report a case of mycobacterium marinum infection of the hand presenting initially as triggering of the digits.We like to highlight the unusual source of the infection and difficulty of diagnosis in this case as well as the various treatment modalities.
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ranking = 34.652350577423
keywords = mycobacterium
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3/22. Obstructive granulomatous bronchiolitis due to mycobacterium avium complex in an immunocompetent man.

    While the development of pulmonary disease due to mycobacterium avium complex (MAC) infection is most commonly associated with underlying predisposing factors, this organism occasionally causes symptomatic disease in otherwise normal individuals. patients with MAC pulmonary disease most often present with cavitating granulomas, but a spectrum of pathologic changes has been described. The authors present a case of MAC pulmonary disease in an immunocompetent, middle-aged man with no identified predisposing factors. The diagnostic biopsy disclosed the unusual finding of noncaseating granulomas with predominant involvement of bronchioles, corresponding to the patient's obstructive and restrictive pulmonary dysfunction.
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ranking = 5
keywords = avium
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4/22. Isolated pituitary granuloma by atypical Mycobacterium in a nonimmunosuppressed woman.

    A 32-year-old woman presented with a 10-day history of fever (38.0 degrees C), headaches, nausea, vomiting and a 6-month history of diabetes insipidus and amenorrhoea. Two months previously she had undergone a surgical drilling of the right mastoid area because of mastoiditis. Endocrine investigation showed elevated serum prolactin levels, secondary adrenal and gonadal failure and a normal thyroid function. Cranial MRI scan revealed a contrast enhancing intrasellar mass (approximately 2 cm) of heterogeneous appearance with suprasellar extension and thickening of the pituitary stalk. Lumbar puncture was suggestive of aseptic meningitis. The Ziehl-Neelsen stain of cerebrospinal fluid (CSF) and the tuberculin skin test were both negative. The pituitary mass was removed with a transsphenoidal approach. Histological examination demonstrated destruction of the adenohypophysis by epithelioid granulomas with partial caseous necrosis and microabscess formation, suggestive of a mycobacterial infection. A polymerase chain reaction analysis performed on paraffin-embedded tissue was positive for mycobacterial dna. According to the individual 16S sequence, it was identified as Mycobacterium malmoense, an atypical nontuberculous mycobacterium (NTM). In conclusion, this is the first case of an isolated pituitary granuloma caused by an NTM infection in a nonimmunosuppressed patient.
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ranking = 8.6630876443558
keywords = mycobacterium
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5/22. Massive mycobacterial choroiditis during highly active antiretroviral therapy: another immune-recovery uveitis?

    PURPOSE: To describe the ocular presentation of disseminated mycobacterial disease occurring during immune-recovery in a patient with acquired immune deficiency syndrome (AIDS). STUDY DESIGN: Case report and literature review. PARTICIPANTS: A 41-year-old AIDS patient with a prior diagnosis of cytomegalovirus retinitis. methods: The patient developed progressive, bilateral multifocal choroiditis with panuveitis 2 months after beginning and responding to highly active antiretroviral therapy. His left eye became blind and painful and was enucleated. Pathologic examination revealed massive choroiditis with well-formed, discrete granulomas and multiple intracellular and extracellular acid-fast organisms within the choroidal granulomas. culture and polymerase chain reaction of vitreous specimens revealed mycobacterium avium complex (MAC). RESULTS: Empiric, and later sensitivity-guided, local and systemic antibiotic therapy was used to treat the remaining right eye, but it continued to deteriorate. Despite medical therapy, three vitrectomies and repeated intravitreal injections of amikacin, a total retinal detachment ensued. One week after the third vitrectomy, the patient died from mesenteric artery thrombosis in the setting of disseminated mycobacterial disease. CONCLUSIONS: This is the first report of ocular inflammation as the presenting finding in the recently recognized syndrome of immune-recovery MAC disease. Pathogenesis of this entity is related to an enhanced immune response to a prior, subclinical, disseminated infection. The formation of discrete granulomas, normally absent in MAC infections in AIDS, reflects this mechanism.
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ranking = 1
keywords = avium
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6/22. Primary sclerosing lipogranuloma with broad necrosis of the scrotum.

    A-25-year-old man was admitted because of a painless tumor of the scrotum. The patient denied a history of exogenous material injection and trauma in the scrotum. Physical and radiological examination revealed a mass in the scrotum, and blood laboratory tests showed no significant findings except for mild eosinophilia (5.6%). Resection of the mass was performed. The mass was isolated and located in the subcutaneous tissue of the scrotum. The mass was rectangular and symmetrical, and measured 65 x 45 x 15 mm. Histologically, the mass was composed of adipose tissue with fibrosis. Many epithelioid granulomas with multinucleated giant cells of foreign body and Langhans' types and heavy infiltrates of lymphocytes and eosinophils were recognized. Characteristically, the lesion showed broad coagulative and lytic necrosis. Congestion and edema suggestive of ischemia were seen in some areas. Special stains for acid-fast bacteria, gram-positive bacteria and fungi failed to detect any microorganisms. polymerase chain reaction for mycobacterium tuberculosis revealed no reaction products. Immunohistochemically, the majority of lymphocytes were CD45RO-positive T cells, and S-100 protein-positive cells and CD68-positive macrophages were scattered in small amounts. The appearances were typical for sclerosing lipogranuloma except for the necrosis. Although the pathological mechanism of the broad necrosis is unclear, the necrosis might be the result of ischemia. Our case suggests that primary sclerosing lipogranuloma of the scrotum might show broad necrosis, and that T-cell-mediated immune response might play a part in the formation of lipogranuloma.
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ranking = 8.6630876443558
keywords = mycobacterium
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7/22. Granulomatous prostatitis due to mycobacterium avium complex.

    Granulomatous infections of the genitourinary tract are rare, especially those caused by nontuberculous mycobacteria. A case of prostatitis due to mycobacterium avium complex in an immunocompetent man is reported. The patient had sterile pyuria, and a Mantoux skin test, using 5 tuberculin units, was positive (induration, 10 mm in diameter). Pathologic examination of the prostate revealed necrotizing granulomata with acid-fast bacilli, and repeated performance of urine cultures before initiating therapy yielded M. avium complex.
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ranking = 6
keywords = avium
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8/22. Lichenoid and granulomatous dermatitis associated with atypical mycobacterium infections.

    BACKGROUND: Lichenoid and granulomatous dermatitis defines a distinctive pattern of cutaneous inflammation that may be part of the morphologic spectrum of idiopathic lichenoid reactions such as lichen planus and as well may be seen with lichenoid drug reactions, endogenous T-cell dyscrasias and as a feature of certain systemic diseases especially Crohn's disease and rheumatoid arthritis. RESULTS: We encountered three cases of lichenoid and granulomatous dermatitis in which the basis was one of primary cutaneous Mycobacterium infection. In all three cases acid fast stains revealed pathogenic organisms and as well cultures were positive for mycobacterium kansasii in one case and mycobacterium marinum in another. Other features included a prominent perineural and periadnexal lymphocytic infiltrate. CONCLUSIONS: The differential diagnosis of lichenoid and granulomatous dermatitis should also encompass primary cutaneous Mycobacterium infection in addition to the other more characteristic entities associated wtih this distinctive reaction pattern. Infection with Mycobacterium induces a TH1 dominant response which would hence produce an infiltrate.
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ranking = 34.652350577423
keywords = mycobacterium
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9/22. The expanding spectrum of mycobacterium avium complex-associated pulmonary disease.

    nontuberculous mycobacteria (NTM) are increasingly recognized as important pulmonary pathogens. Mycobacterium avium intracellulare complex (MAC) causes most lung infections due to NTM. patients with preexisting lung disease or immunodeficiency are at greatest risk for developing MAC infection. The majority of MAC pulmonary cases, however, occur in immunocompetent elderly women in association with nodular infiltrates and bronchiectasis. More recently, pulmonary disease has also been described in immunocompetent patients after exposure to MAC-contaminated hot tubs. We describe a case of aggressive MAC lung disease in a young immunocompetent female patient without preexisting lung disease whose clinical and pathologic characteristics do not fit into any of these categories and may represent a unique manifestation of MAC lung disease.
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ranking = 5
keywords = avium
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10/22. Choroidal granuloma caused by atypical mycobacterium in a patient with AIDS: a case report.

    The case presented is a chorioretinal granuloma in a patient with AIDS. The neoformation appeared to be caused by atypical mycobacterium, although it was not possible to isolate the germ. The chorioretinal infection caused by atypical mycobacterium in patients with AIDS occurs very rarely and has so far been described only as a post-mortem finding.
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ranking = 51.978525866135
keywords = mycobacterium
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