Cases reported "Uterine Cervicitis"

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1/40. Nested polymerase chain reaction on vaginal smears of tuberculous cervicitis. A case report.

    BACKGROUND: Tuberculous cervicitis (TC) is a rare disease the diagnosis of which is based on the microscopic and/or cultural recognition of mycobacteria. In recent years, the polymerase chain reaction (PCR), especially with double-round amplification ("nested" PCR [nPCR]), has been increasingly used for rapid detection of mycobacteria in clinical samples. CASE: The present case is the first example of tuberculosis diagnosed with the aid of nPCR amplification of mycobacterial dna fragments on smeared and Papanicolaou-stained cytologic material. First detected on vaginal smears, the amplicon IS6110 was subsequently identified also on paraffin-embedded tissue sections. CONCLUSION: The technique described here could also be applied to aspiration cytology smears to give rapid and accurate information on mycobacterial infections. ( info)

2/40. Chlamydial ophthalmia neonatorum.

    A case of chlamydial ophthalmia neonatorum is presented. The importance of early diagnosis and treatment is discussed. ( info)

3/40. Cervicovaginitis emphysematosa mimicking carcinoma of the cervix: a case report.

    Cervicovaginitis emphysematous is a rare self-limiting disease in which multiple gas-filled cysts are present in the submucosa of the upper vagina and ectocervix. We report a case in a 40 year-old trader who presented with clinical features suggestive of carcinoma of the cervix. It is hoped that this case report will heighten the awareness of clinicians and pathologists in the recognition of this unusual condition. ( info)

4/40. Abnormal cervicovaginal smears due to endometriosis: a continuing problem.

    endometriosis may be challenging when identified on cervicovaginal smears (CVS), leading to an incorrect interpretation of high-grade squamous intraepithelial lesion (HSIL), or atypical glandular cells of undetermined significance (AGUS) including adenocarcinoma in situ (AIS). awareness of cervical endometriosis, particularly in predisposed patients, is crucial for a correct diagnosis. While cervical endometriosis has been reported to be a diagnostic pitfall of glandular abnormalities, its characteristic features are still not well-established. This may partially be attributed to the varied cytomorphologic features endometriosis shows, depending on menstrual cycle hormonal changes. We describe our experience with three examples where CVS were interpreted as either AGUS or HSIL, which led to a hysterectomy in 2 of 3 patients. Cervical endometriosis needs to be considered with other well-known benign conditions that mimic glandular abnormalities, including cervicitis, tubal metaplasia, lower uterine segment sampling, and microglandular hyperplasia. Published series and our own experience lead us to suggest that these smears will continue to present diagnostic difficulties. ( info)

5/40. Pneumonitis following inclusion blennorrhea.

    A pregnant woman and her husband had proved chlamydial genital tract infections. She gave birth to a male infant who developed inclusion blennorrhea (inclusion conjunctivitis of the newborn infant). While on topical chemotherapy for his eye disease, the infant developed pneumonitis. Chlamydiae were recovered from his sputum at a time when conjunctival specimens were sterile. This finding raises the possibility that the agent of inclusion conjunctivitis may cause systemic infections in neonates exposed during passage through an infected birth canal. ( info)

6/40. Fitz-Hugh-Curtis syndrome: linear contrast enhancement of the surface of the liver on CT.

    We present a case of Fitz-Hugh-Curtis syndrome (chlamydia trachomatis perihepatitis). Contrast-enhanced CT demonstrated enhancement along the surface of the liver, but it was remarkable on the anterior surface. No other abnormalities suspicious for peritonitis were found. Contrast enhancement of the anterior surface of the liver on CT may support the diagnosis of Fitz-Hugh-Curtis syndrome. ( info)

7/40. Genital tuberculosis in a menopausal woman. A case report.

    We have analysed the role played by genital tuberculosis (TBC) in italy today, and in particular in L'Aquila, in the light of a worrying recrudescence. We report the case of a 64-year-old patient, in menopause for the past 11 years or so, referred to the gynecology and obstetrics Clinic of the University of L'Aquila, with an anamnesis of menometrorrhagia since the age of 55. The patient was studied from a gynecological and internist profile including the following procedures: gynecological examination and pap-test, colposcopy, transvaginal scan, chest X-ray, abdominal and pelvic CAT, laboratory tests and Mantoux reaction. The uterus was found to be fibromatous during the gynecological examination and scan, whereas colposcopy revealed a small ectropion and the presence of very adherent yellowish mucus. The Mantoux test was positive. CAT showed cicatricial sequelae in the pulmonary parenchyma. It was decided to perform curettage, but this was prevented by the presence of pyometra. The patient was treated with specific chemotherapy and then underwent total laparohysterectomy with bilateral adnexectomy. The histological findings confirmed genital TBC. Genital TBC is now undergoing a worrying recrudescence. We need to have a full knowledge of the pathology, the diagnostic means with which to discover it and the correct therapeutic instruments to overcome it. ( info)

8/40. An interesting case presentation: a possible new route for perinatal acquisition of Chlamydia.

    chlamydia trachomatis is currently the most common sexually transmitted disease in the united states. The prevalence in pregnant women ranges between 2% and 47%. It is well known that C trachomatis can be transmitted from the genital tract of an infected mother to her newborn infant, causing conjunctivitis or pneumonia or both, along with their longstanding complications. A review of the literature failed to show, however, conclusive evidence of transmission of infection to the newborn infant when the infant was born by cesarean section with intact amniotic membranes. We present a case of a young black woman with a history of chlamydia cervicitis during pregnancy whose infant was delivered by cesarean section because of failure to progress. She gave birth to a healthy term infant who developed ophthalmia neonatorum on the 3rd day of life. Examinations of conjunctival scrapings with direct fluorescent staining (chlamydia MicroTrak) performed on the 1st and 3rd day of life were positive. The initial test was performed because of the maternal history. The infant was mildly symptomatic at the time the study was repeated for confirmation. Our findings strongly suggest the possibility of either transmembrane or transplacental route of infection in the pathogenesis of neonatal chlamydia infection. Further study is needed to confirm this possibility. ( info)

9/40. Uterine cervical diverticulum resembling a degenerated leiomyoma.

    BACKGROUND: Uterine diverticulum is a very rare anomaly. Most previously reported cases were called "pregnancy-associated sacculations," and only 2 cases were considered true uterine diverticula. CASE: A 41-year-old woman presented with fever and lower abdominal pain. An extrauterine mass was detected, and a hysterectomy was performed. Pathological examination revealed a cystic uterine diverticulum lined with cervical glands and myometrium arising from the cervix. The final diagnosis was an infected uterine cervical diverticulum. CONCLUSION: Cervical diverticulum is a rare lesion that should be added to the differential diagnosis of a woman presenting with a pelvic mass. ( info)

10/40. cytomegalovirus infection of the cervix: morphological observations in five cases of a possibly under-recognised condition.

    AIMS: Histologically diagnosed cytomegalovirus (CMV) infection of the cervix is rare and the associated morphological features are not well described. This study describes histopathological findings in five biopsies from four patients with CMV cervicitis. methods: CMV inclusions were identified in five cervical biopsies from four patients in a single institution over eight months. The clinical notes were reviewed, the morphological features documented, and immunohistochemical staining for CMV performed. CMV immunohistochemical staining was also performed on 30 consecutive cervical biopsies in which inclusions were not seen histologically. RESULTS: None of the patients was immunocompromised but one was postnatal. Numbers of CMV inclusions ranged from occasional to abundant and they were located mainly in endocervical glandular epithelial cells but also in endothelial and mesenchymal cells. Inclusions were not seen in squamous cells. Inclusions were eosinophilic and were intracytoplasmic rather than intranuclear. They were positive immunohistochemically for CMV. Associated morphological features included fibrin thrombi within small blood vessels (three cases), dense active inflammatory infiltrates (five cases), lymphoid follicles (two cases), vacuolation of glandular epithelial cells (two cases), and reactive changes in glandular epithelial cells (two cases). CMV inclusions were not identified in the 30 additional cases that underwent immunohistochemical staining. CONCLUSIONS: CMV infection of the cervix may be more common than is thought. patients are usually immunocompetent and require no treatment. Morphological features such as a dense inflammatory cell infiltrate with lymphoid follicles, and especially fibrin thrombi within small vessels, should alert the pathologist to look closely for the pathognomonic CMV inclusion bodies. ( info)
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