Cases reported "Lymphadenitis"

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1/35. Disseminated Mycobacterium abscessus infection manifesting as fever of unknown origin and intra-abdominal lymphadenitis: case report and literature review.

    Mycobacterium abscessus is a rapidly growing mycobacterium found in soil and water throughout the world. Disease in immunocompetent patients usually consists of localized skin and soft tissue infections. In contrast, disseminated disease is uncommon, usually presents with rash, and almost always occurs in an immunocompromised host. We describe an unusual case of disseminated M. abscessus infection manifesting as fever of unknown origin and intra-abdominal lymphadenitis, but without rash. Our patient responded well to amikacin and clarithromycin therapy. We also review the literature related to the diagnosis and management of this uncommon disease.
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ranking = 1
keywords = mycobacterium
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2/35. Novel mycobacterium related to Mycobacterium triplex as a cause of cervical lymphadenitis.

    The mycobacterium avium complex (MAC) is an important cause of cervical lymphadenitis in children, and its incidence appears to be increasing in the united states and elsewhere. In areas where mycobacterium tuberculosis is not prevalent, M. avium causes the vast majority of cases of mycobacterial lymphadenitis, although several other nontuberculous mycobacterial species have been reported as etiologic agents. This report describes the case of a child with cervical lymphadenitis caused by a nontuberculous mycobacterium that could not be identified using standard methods, including biochemical reactions and genetic probes. Direct 16S ribosomal dna sequencing showed greater than 99% homology with Mycobacterium triplex, but sequence analysis of the 283-bp 16S-23S internal transcribed spacer (ITS) sequence showed only 95% identity, suggesting that it is a novel species or subspecies within a complex of organisms that includes M. triplex. Mycolic acid high-performance liquid chromatography analysis also identified this isolate as distinct from M. triplex, and differences in susceptibility to streptomycin and rifampin between this strain and M. triplex were also observed. These data support the value of further testing of clinical isolates that test negative with the MAC nucleic acid probes and suggest that standard methods used for the identification of mycobacteria may underestimate the complexity of the genus Mycobacterium. ITS sequence analysis may be useful in this setting because it is easy to perform and is able to distinguish closely related species and subspecies. This level of discrimination may have significant clinical ramifications, as closely related organisms may have different antibiotic susceptibility patterns.
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ranking = 5.0304815021696
keywords = mycobacterium, avium complex, avium, complex
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3/35. cat-scratch disease: considerations for dentistry.

    BACKGROUND: cat-scratch disease, or CSD, results from inoculation of the gram-negative bacillus bartonella henselae via a cat's scratch. A regional lymphadenitis, which usually is cervical, develops and may progress to suppuration. It is necessary to differentiate CSD from other lymphadenopathies. CASE DESCRIPTION: A patient who had close contact with a cat subsequently developed a localized, suppurative cervical lymphadenitis. As B. henselae was identified in 1992, the authors were able to confirm the existence of CSD serologically. Surgical drainage resulted in a successful resolution of the disease process. CLINICAL IMPLICATIONS: As patients with CSD may be seen in the dental office, an awareness of its symptomatology can prevent unnecessary dental intervention and facilitate early treatment.
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ranking = 0.00054626871102346
keywords = bacillus
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4/35. Clinical and pathologic features of mycobacterium fortuitum infections. An emerging pathogen in patients with AIDS.

    The clinical and pathologic features of mycobacterium fortuitum infection in 11 patients with AIDS were characterized. Nine patients had cervical lymphadenitis; 2 had disseminated infection. The infection occurred late in the course of AIDS, and the only laboratory abnormality seen in more than half of patients (7/11) was relative monocytosis. Absolute monocytosis also was seen in 4 of 11 patients. In both cytologic and histologic preparations, the inflammatory pattern was suppurative with necrosis or a mixed suppurative-granulomatous reaction. M fortuitum, a thin, branching bacillus, stained inconsistently in direct smear and histologic preparations. Staining was variable with Gram, auramine, Brown-Hopps, Gram-Weigert, Kinyoun, Ziehl-Neelsen, modified Kinyoun, and Fite stains. Organisms, when present, were always seen in areas of suppurative inflammation. Incorrect presumptive diagnosis, based on misinterpretation of clinical signs and symptoms or on erroneous identification of M fortuitum bacilli as nocardia species, led to a delay in proper therapy for 7 of 11 patients. Definitive therapy after culture identification resulted in complete resolution of infection in all patients except 1.
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ranking = 0.00054626871102346
keywords = bacillus
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5/35. Bubo masquerading as an incarcerated inguinal hernia.

    A 44-year old, male, tattooed, leather jacket clad, Harley-Davidson motorcyclist arrived at the emergency room with a tender, irreducible mass, presenting at the external inguinal ring. In 1998, lung biopsy was read as miliary granuloma. No herniation was found on urgent preperitoneal exploration. Incision of the mass showed acid-fast bacilli. culture later revealed Mycobacterium avium-intracellulare (MAI). A blood count showed CD4 lymphopenia; hiv was negative and remains so 2 years later.
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ranking = 0.67446388522338
keywords = avium-intracellulare, avium
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6/35. Mycobacterium szulgai lymphadenitis mimicking Kikuchi's disease in thailand.

    Mycobacterium szulgai is rarely found to be a cause of reported infection. Two thirds of cases were reported as pulmonary presentations, while the rest were infections of soft tissues or bone. In thailand, few pulmonary infections due to M. szulgai have been reported. This is the first case of M. szulgai lymphadenitis confirmed by tissue culture. The patient presented with prolonged fever and tender enlarged cervical nodes. Histological findings showed large histiocytes with necrotic background compatible with Kikuchi's disease. However, the culture proved the case to be one of M. szulgai infection. That means this mycobacterium should be included in the differential diagnosis of fever with lymphadenitis.
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ranking = 1
keywords = mycobacterium
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7/35. diagnosis, management and surgical treatment of non-tuberculous mycobacterial head and neck infection in children.

    The aim of this study was to present our experience with the clinical characteristics of non-tuberculous mycobacterial (NTM) head and neck lymph node infections, the use of modern diagnostic tools and the appropriate therapeutic measures. We have reviewed the cases of 14 Caucasian children with NTM head and neck lymphadenitis who were treated in our clinic in the last 5 years. Three of the patients were male and 11 were female. Their age ranged from 15 to 98 months (mean age 45.7 /- 21.76 months). Cervical lymph nodes were involved in all of our cases, while the submandibular region was found to be the area mostly affected. Overlying skin was involved in 7 cases. diagnosis was based on intradermal skin testing with specific antigens for atypical mycobacteria, histological examination and specimen culture. skin tests were positive for NTM in all of the patients with a predilection for mycobacterium avium complex. The diagnosis was confirmed by histological examination in 13 cases. Specimen culture was positive in 9 cases, most of them growing M. avium-intracellulare complex. Treatment included complete surgical excision of the affected lymph nodes and the overlying skin, as well as functional neck dissection when required. A second procedure was performed in 2 patients. Successful evaluation of NTM infections of the head and neck lymph nodes should include a detailed history, thorough physical examination and specific laboratory investigations. The treatment of choice is complete surgical excision of all affected tissue.
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ranking = 0.70043856363756
keywords = avium-intracellulare, avium complex, avium, complex
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8/35. Atypical mycobacterial tuberculosis--a diagnostic and therapeutic dilemma? case reports and review of the literature.

    In immunocompetent preschool children cervical lymphadenitis is a common clinical presentation of atypical mycobacteria. Its rapid diagnosis and treatment is still a challenge, because accurate diagnostic procedures for atypical mycobacteria are still not yet available in routine practice. Two children suffered from craniojugular (16 months old girl) and infraauricular (2.5 years old boy) located neck masses which showed resistance to the medical treatment. In the first case an abscess splitting took place initially, followed by an anti-tubercular drug treatment and necessary surgical reintervention. In the second case surgical removal of all involved lymph nodes, infiltrated surrounding soft tissue and involved skin areas were followed by medical treatment. In both cases presumed infection with mycobacterium tuberculosis was not confirmed, but atypical mycobacteria could be isolated both. In the first case atypical mycobacterium could be specified as mycobacterium avium complex and in the second case as mycobacterium malmoense. Both bacilli showed sensitivity towards medical treatment with clarithromycin, whereby in one case only the surgical reintervention led to a complete removal of clinical symptomatic. In cases of presumed tuberculous neck lymph node infections differential diagnosis of an atypical mycobacterial lymphadenitis should always be supposed, because medical and surgical treatment differ fundamentally.
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ranking = 4.2085284541358
keywords = mycobacterium, mycobacterium avium complex, mycobacterium avium, avium complex, avium, complex
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9/35. mycobacterium bovis versus mycobacterium tuberculosis as a cause of acute cervical lymphadenitis without pulmonary disease.

    Bovine tuberculosis remains a common disease of cattle in countries such as mexico. Children eating unpasteurized dairy products from Mexican cattle can develop mycobacterium bovis cervical lymphadenitis. However, the bovine mycobacterium can be misdiagnosed as mycobacterium tuberculosis based on standard laboratory testing. Accurate speciation is important for selection of the preferred antibiotic regimen for treatment of mycobacterium bovis infection.
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ranking = 1
keywords = mycobacterium
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10/35. Mycobacterium malmoense lymphadenitis in spain: first two cases in immunocompetent patients.

    Reported here are two cases of Mycobacterium malmoense lymphadenitis that occurred in two immunocompetent children in spain. To the best of our knowledge, these are the first documented cases of extrapulmonary infection by M. malmoense in spain. This report serves to draw attention to this emerging nontuberculous mycobacterium that is gaining increasing recognition as a pulmonary and extrapulmonary pathogen in different countries.
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ranking = 1
keywords = mycobacterium
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