Cases reported "Pneumonia, Bacterial"

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1/7. rifabutin-associated hypopyon uveitis in human immunodeficiency virus-negative immunocompetent individuals.

    OBJECTIVE: To report the occurrence of rifabutin-associated hypopyon uveitis in human immunodeficiency virus (hiv)-negative immunocompetent individuals. DESIGN: Retrospective case series. PARTICIPANTS: Three hiv-negative subjects on rifabutin and clarithromycin for mycobacterium avium complex infections with hypopyon uveitis are described. One subject was iatrogenically immunosuppressed because of a prior lung transplant. Two subjects had no known immunosuppressive conditions. INTERVENTION: Topical and regional steroid therapy. Discontinuation of rifabutin was required in two subjects. MAIN OUTCOME MEASURES: visual acuity, resolution of hypopyon, anterior uveitis, and vitreitis. RESULTS: All subjects had resolution of hypopyon after therapy, two within 24 hours of beginning topical steroids. Vitreitis resolved with the discontinuation of rifabutin in two subjects. Chronic low-grade anterior uveitis and vitreitis were observed in the remaining subject, whose rifabutin dose was lowered but not discontinued because of active mycobacterium avium complex osteomyelitis. CONCLUSIONS: rifabutin-associated uveitis is well described in hiv-positive individuals, but it has been reported only once in an hiv-negative individual. We report two cases of hypopyon uveitis in immunocompetent individuals and one case in an immunosuppressed hiv-negative individual. All three subjects were receiving concurrent rifabutin and clarithromycin. awareness that this entity can occur in hiv negative and nonimmunosuppressed individuals and that it can mimic infectious endophthalmitis may spare the subject from an invasive workup of systemic infection.
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2/7. High-resolution computed tomography appearance of pulmonary mycobacterium avium complex infection after exposure to hot tub: case of hot-tub lung.

    Reports detailing mycobacterium avium complex (MAC) infection in an immunocompetent host after exposure to hot tub (hot-tub lung) are few and have not focused on the radiographic presentation. On high-resolution computed tomography (HRCT), hot-tub lung caused by MAC infection closely resembles subacute hypersensitivity pneumonitis and is difficult to distinguish based on imaging parameters alone. Centrilobular nodules of ground-glass attenuation with beading of the interlobular septae are prominent features on HRCT. Correlation of clinical history with radiographic, pathologic, and microbiologic findings are necessary to establish a diagnosis of hot-tub lung.
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keywords = avium
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3/7. Endobronchial carcinoid tumor combined with pulmonary non-tuberculous mycobacterial infection: report of two cases.

    We report here two cases of endobronchial carcinoid tumor complicated with pulmonary infection with non-tuberculous mycobacteria (NTM). Case 1 was an 81-year-old woman with the left lower lobe atelectasis. bronchoscopy showed complete obstruction of the left basal bronchus by a tumor and a sleeve lower lobectomy with mediastinal lymph node dissection was performed. Pathological examination showed typical carcinoid located in the left basal bronchus and many caseous granulomas containing mycobacteria in the lung parenchyma distal to the bronchus. Bacterial examinations of sputum and gastric juice after the operation showed a growth of mycobacterium kansasii. Case 2 was a 50-year-old woman with the atelectasis of the left upper division. bronchoscopy showed complete obstruction of the left upper division bronchus by a tumor and a left upper lobectomy with mediastinal lymph node dissection was performed. Pathological examination showed typical carcinoid located in the left upper division bronchus and many caseous granulomas in the lung parenchyma distal to the bronchus. The Ziehl-Neelsen stain showed many mycobacteria in these granulomas and they were identified as Mycobacterium avium by PCR analysis. Although NTM are not well recognized as possible pathogens of pulmonary infection related to bronchial obstruction by endobronchial carcinoma, our experiences rouse a caution to consider NTM as potential pathogens. We also discuss the possible mechanisms responsible for the specific relationship between carcinoid tumor and TNM.
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4/7. 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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keywords = avium
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5/7. Mycobacterium avium-intracellulare complex pneumonia in a non-hiv-infected individual: an increasingly recognized disease.

    In the past, mycobacterium avium complex (MAC) was considered a colonizing microbe in the immunocompetent host. Today it should be considered a potential pathogen. We present a case of MAC necrotizing pneumonia in a 27-year-old man who tested negatively for the human immunodeficiency virus, had no typical granulomas, and responded rapidly to antimicrobial therapy.
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6/7. Infections in patients with chronic adult T-cell leukemia/lymphoma: case report and review.

    adult T-cell leukemia/lymphoma (ATLL) is caused by the human T-cell lymphotropic virus type I (HTLV-I). ATLL is classified into the smoldering, chronic, lymphoma, and acute subtypes. We describe a North American woman with chronic ATLL who presented with pneumonia caused by pneumocystis carinii, cryptococcus neoformans, mycoplasma pneumoniae, and mycobacterium avium complex. Although opportunistic infections have been documented in patients with ATLL, there are few case reports detailing infectious complications in patients with chronic ATLL.
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7/7. Epstein-Barr virus-associated primary central nervous system lymphoma in a child with the acquired immunodeficiency syndrome. A case report and review of the literature.

    A 34-month-old black boy who had contracted acquired immunodeficiency syndrome from his mother presented with fever, vomiting, and cough. He was cachectic, hypertonic, and developmentally delayed. A brain computed tomography scan revealed masses in the left frontal horn, subependymal, and periventricular regions; secondary edema; and hydrocephalus. The differential diagnosis was cerebral lymphoma versus toxoplasmosis. The patient had disseminated mycobacterium avium-intracellulare infection, lymphoid interstitial pneumonitis, as well as pseudomonas and klebsiella pneumonia. He died of respiratory insufficiency 53 days after admission. The autopsy confirmed a primary cerebral B-cell lymphoma, large cell type, which was positive for Epstein-Barr virus, latent phase, by in situ hybridization. Primary central nervous system lymphomas are rare in children, in contrast to adults. To our knowledge, only five well-documented cases of primary cerebral lymphomas in infants and children with acquired immunodeficiency syndrome have been reported previously. The current study shows that these childhood lymphomas are associated with and presumably caused by Epstein-Barr virus and thus have a pathogenesis similar to that of primary central nervous system lymphomas in adults.
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