Cases reported "Ulcer"

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1/23. Necrotizing conjunctival ulceration following subconjunctival depot methylprednisolone injection.

    To report the occurrence of a necrotizing conjunctival ulcer at the site of methylprednisolone injection. A 35-year-old woman underwent a routine extracapsular cataract extraction. Subconjunctival methylprednisolone acetate (Depo-Medrol, Pharmacia & Upjohn, Kalamazoo, MI) was injected at the end of the operation. A necrotizing conjunctival ulcer developed at the site of injection. Necrotic tissue and remnants of the drug were excised, and the conjunctiva healed within 10 days. Postoperative subconjunctival injection of methylprednisolone may cause necrosis and ulceration of the overlying conjunctiva. Subconjunctival and subtendon corticosteroid injections are commonly used in various inflammatory ocular conditions and prophylactically after intraocular operations. We describe a case of conjunctival necrosis at the site of injection, an adverse effect that has been previously reported in only 1 case in the ophthalmological literature.
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keywords = necrotizing
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2/23. balamuthia mandrillaris meningoencephalitis: the first case in southeast Asia.

    We present a case of 23-year-old man with acute meningoencephalitis, accompanied by inflammation of a nasal ulcer. He had been healthy until six months prior to admission to the hospital when he had a motorcycle accident. A star-shaped wound at his nose was incurred after falling into a swamp. A computed tomogram of the brain showed two nonenhancing hypodense lesions at the left caudate nucleus and the right parietal lobe, ependymitis and leptomeningeal enhancement. A skin biopsy showed chronic noncaseous granulomatous inflammation without demonstrated microorganisms. The patient did not respond to the empirical treatment with cloxacillin, ceftriaxone, and amphotericin b, and eventually died on the thirteenth day of hospitalization. At autopsy, hematoxylin and eosin-stained brain sections showed a chronic necrotizing inflammation with numerous amebic trophozoites and rare cysts. Definitive identification of balamuthia mandrillaris was made by fluorescent immunohistochemical analysis. There were 10 naegleria fowleri primary amebic meningoencephalitis, eight acanthamoeba granulomatous amebic encephalitis, and three acanthamoeba meningitis in thailand. To our knowledge, this case is the first reported case of B. mandrillaris in Southeast Asia.
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keywords = necrotizing
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3/23. pyoderma gangrenosum associated with nasal septal perforation, oropharyngeal ulcers and IgA paraproteinemia.

    We report a case of pyoderma gangrenosum (PG) associated with nasal septal perforation, pharyngeal ulcers and IgA paraproteinemia. A 28-year-old woman first developed painful undermined ulcers on her perianal, inguinal and axillary areas when she was 22 years old. Histological findings from the cutaneous ulcers showed dermal and epidermal infiltrate of neutrophils, which was compatible with PG. Laboratory examinations did not detect any associations of systemic diseases other than polyclonal IgA paraproteinemia. Nasal fiberscopy revealed septal perforation and multiple ulcers on her pharynx. The biopsy specimen from the pharyngeal ulcers showed a polymorphous cellular infiltrate without necrotizing vasculitis or granuloma. However, there were no atypical lymphocytes that are typically seen in nasal NK/T lymphoma. By immunohistochemical analysis, the infiltrated lymphocytes were proved to be T cells and Epstein-Barr virus encoded rna (EBER) was not detected. No pulmonary or renal lesions resembling Wegener's granulomatosis were found. Taken together, the nasal septal perforation was considered as nasal involvement of PG.
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ranking = 0.5
keywords = necrotizing
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4/23. Wegener's granulomatosis mimicking a parotid abscess.

    We present the case of a previously healthy 59-year-old man who was under treatment for scleritis and episcleritis when he developed a parotid-gland swelling and pus-producing sinus. On surgical exploration, the features were those of a parotid abscess, but the lesion not only failed to heal post-operatively but increased in size very significantly. There was also severe necrotizing keratitis of the eyes. Due to clinical suspicion and a positive antineutrophil cytoplasmic antibodies test, Wegener's granulomatosis was diagnosed and the patient successfully treated with cyclophosphamide and steroids. Previously, a number of cases of Wegener's granulomatosis causing salivary-gland swelling have been reported in the literature; this is the first case in which the disease has masqueraded as a parotid abscess.
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ranking = 0.5
keywords = necrotizing
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5/23. Community-acquired MRSA bacteremic necrotizing pneumonia in a patient with scrotal ulceration.

    methicillin-resistant staphylococcus aureus (MRSA) is being recognized increasingly as a cause of community-acquired infection. The organism usually causes skin and soft tissue infection. Here, we present a patient with community-acquired MRSA pneumonia and review the literature. The patient, a 37-year-old Saudi male with no significant medical history was admitted with fever, respiratory distress and scrotal ulceration. Scrotal swabs and blood cultures grew MRSA. Imaging studies showed necrotizing pneumonia. physical examination and echocardiographic findings revealed no evidence of endocarditis. The patient was treated successfully with 4 weeks of intravenous vancomycin. The infection appears to have originated in the skin and subcutaneous tissues of the scrotum, and subsequently led to necrotizing pneumonia. Community-acquired MRSA pneumonia has been associated with the production of Panton-Valentine leukocidin.
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ranking = 3
keywords = necrotizing
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6/23. Necrotizing duodenitis--a stress-associated lesion?

    We report three cases of stress ulceration exhibiting primarily mucosal abnormalities of the duodenum with duodenal ulceration and linear ulcerations on the duodenal folds which is unique in our experience. We hypothesize that vascular insufficiency during low flow states decreases the ability of mucosa to buffer back-diffused hydrogen ion, leading to mucosal injury and ulceration. The duodenal folds receive an end-arteriole supply and are thus affected before other areas of the duodenum. Given the degree of necrosis associated with these lesions on pathological examination, we have chosen the term necrotizing duodenitis to describe the lesions observed.
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ranking = 0.5
keywords = necrotizing
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7/23. Perianal ulcer: an unusual presentation of Wegener's granulomatosis. Report of a case.

    A 46-year-old man, without remarkable past medical history, had a perianal ulcer that appeared spontaneously two months before presentation. At admission, the ulcer was painless, measuring 4 to 5 cm in diameter and showing detachment and a slightly papillomatous aspect at the edge but without induration of the base. Microscopic examination revealed cutaneous ulceration with a well-developed inflammatory response, a few small vessels with intraluminal thrombosis or necrotizing walls, and isolated microscopic granulomata. No infectious disease was detected. The diagnosis of Wegener's granulomatosis was made six months later, when the disease was clinically evident in three principal sites: upper airways, lung, and kidney. At that time, serum antineutrophil cytoplasmic autoantibodies were detected with indirect immunofluorescence microscopy. There has been an excellent response to immunosuppressive therapy. review of the literature revealed no similar reports.
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ranking = 0.5
keywords = necrotizing
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8/23. Necrotizing sialometaplasia.

    An example of palatal necrotizing sialometaplasia is presented, and the clinical and microscopic features suggestive of squamous-cell carcinoma and mucoepidermal carcinoma are noted. The patient's health status, as shown by a rather thorough work-up, was unremarkable during the period which would seem to preclude a systemic etiology of this disease. The resolution of the lesion with minimal therapy is documented.
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ranking = 1180.8248495574
keywords = necrotizing sialometaplasia, sialometaplasia, necrotizing
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9/23. Necrotizing sialometaplasia.

    Three additional cases of necrotizing sialometaplasia are discussed. Clinical appearance of the lesion is not diagnostic. microscopy shows pseudoepitheliomatous hyperplasia, squamous metaplasia, and acinar necrosis. No atypia is seen. Mucoepidermoid and squamous cell carcinoma are frequent wrong diagnoses. All reported lesions have healed without recurrence regardless of therapy.
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ranking = 1180.8248495574
keywords = necrotizing sialometaplasia, sialometaplasia, necrotizing
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10/23. Necrotizing sialometaplasia after bronchoscopy.

    Since the introduction of necrotizing sialometaplasia into the literature as a distinct pathologic entity in 1975, there have been several reports containing microscopic findings consistent with the disease primarily of the hard palate, but also of the soft palate, major salivary glands, retromolar pad of the mandible, and mucous glands of the nasal cavity. Localized ischemia appears to be a common link. All reported lesions heal with or without surgical intervention. Generous incisional biopsy specimens should be taken and aggressive surgery should be avoided.
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ranking = 1180.8248495574
keywords = necrotizing sialometaplasia, sialometaplasia, necrotizing
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