Cases reported "Lymphadenitis"

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1/4. Cyclic hematopoiesis: human cyclic neutropenia.

    Human cyclic neutropenia is a relatively rare disorder of unknown etiology. Study of patients and animals with the disorder has led to important information regarding the differentiation of blood cells and control mechanisms of hematopoietic regulation. It has a world-wide distribution, occurs in both sexes, and, in about one-fourth of the patients, a family history has been obtained. While usually benign, deaths from overwhelming infections occur. In addition to cycling of neutrophils, in the majority of cases the monocytes cycle and in about one-fifth of the cases eosinophils are elevated. In a small number of patients, cycling of platelets and reticulocytes occurs. Cycles of colony stimulating factor are present. Cycles of bone marrow cells are easily demonstrable. The recent transfer of human cyclic neutropenia following allogenic bone marrow grafting confirms the hypothesis that the disorder is of bone marrow origin. The following subjects are covered in this review article: A. Definition, history, and incidence; B. Etiology, geographic distribution, mode of transmission; C. Symptoms, physical signs, diagnosis, clinical course; D. Clinical laboratory studies; E. Experimental studies; F. prognosis; G. Treatment. It is felt that human cyclic neutropenia represents a heterogeneous group of disorders and that much remains to be learned about its cause(s).
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2/4. Suppurative granulomatous lymphadenitis caused by corynebacterium ovis (pseudotuberculosis).

    A 30-year-old previously healthy man developed cervical adenopathy associated with mild constitutional symptoms. Corynebacterium ovis was isolated in pure culture from lymph node tissue on two separate occasions, and small gram positive organisms were identified in both lymph nodes with tissue gram stain. Histopathologically, the nodes displayed suppurative and necrotizing granulomas. Of eight previously reported cases of C. ovis lymphadenitis in man, all but one have involved inhabitants of rural australia, most of whom had contact with sheep, an animal reservoir of C. ovis. Necrotizing granulomas were usually observed. The patient described was an American urban dweller with a history of raw milk ingestion. We believe this to be the first reported case of C. ovis lymphadenitis from the united states. C. ovis infection should be considered n the differential diagnosis of localized lymphadenitis with necrotizing and/or suppurative granulomas. In evaluation of granulomatous lymphadenitis tissue gram stain should be performed and culture of a diphtheroid organism not readily dismissed.
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3/4. Cervical lymphadenitis caused by a fastidious mycobacterium closely related to mycobacterium genavense in an apparently immunocompetent woman: diagnosis by culture-free microbiological methods.

    Fastidious mycobacteria usually infect immunocompromised hosts (human immunodeficiency virus-infected or otherwise immunosuppressed patients). We here describe severe lymphadenitis, caused by a fastidious mycobacterium closely related to mycobacterium genavense, in an apparently immunocompetent woman, whose brother had died from an unidentified mycobacterial infection in 1969. A variety of techniques, including inoculation of nude mice, histopathology, electron microscopy, lipid analysis, ATP measurements, and molecular biology, were used to characterize this mycobacterium. All attempts to culture the etiological agent on many different media failed. The organism multiplied only in congenitally athymic nude mice. Although phenotypically similar to M. genavense, the mycobacterium differs from M. genavense by three nucleotides of the 16S rRNA gene sequence. Various antimycobacterial drugs were administered, including gamma interferon, but multiple relapses occurred. Finally, therapy with a combined regimen of clarithromycin, clofazimine, rifabutin, and ethambutol was curative. To our knowledge, this is the first report of lymphadenitis in an apparently immunocompetent patient, caused by a noncultivable mycobacterium sp. closely related to M. genavense. This study emphasizes the importance of employing a variety of diagnostic approaches such as the inoculation of laboratory animals, histopathology, electron microscopy, lipid analysis, ATP measurements, and molecular biology to characterize novel microorganisms that cannot be cultured in vitro.
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4/4. corynebacterium pseudotuberculosis is a cause of human necrotising granulomatous lymphadenitis.

    corynebacterium pseudotuberculosis is a well recognised pathogen of farm animals, particularly sheep and goats. Human infection is a rare occurrence. This report describes suppurative lymphadenitis occurring in an adolescent boy who had contact with farm animals. The histological differential diagnosis of suppurative granulomatous lymphadenitis is discussed, and the importance of lymph node culture is stressed.
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