Minoxidil-Induced Pleuro-Pericardial Effusion With Tamponade.

Minoxidil-induced pleuro-pericardial effusion is a diagnosis of exclusion after evaluation for other known causes of pericardial effusion. When complicated by cardiac tamponade, prompt pericardiocentesis and discontinuation of minoxidil can be lifesaving. We report a rare case of minoxidil-induced pleuro-pericardial effusion with tamponade in a patient with end-stage renal disease (ESRD) on hemodialysis who improved with pericardiocentesis and drug withdrawal.

Lymphogranuloma Venereum Mimicking Locally Metastatic Rectal Cancer in an HIV-Negative Man.

Lymphogranuloma venereum (LGV) can present as a sexually transmitted anorectal syndrome and is caused by Chlamydia trachomatis serotypes L1, L2, and L3. It was rare in the western world until a recent outbreak among men who have sex with men (MSM) in Europe and North America. Limited availability of diagnostic tests differentiating LGV from non-LGV C. trachomatis can make the diagnosis challenging. We present a 33-year-old MSM with high-risk sexual behavior and anal atypical squamous cells of undetermined significance (ASCUS), who was evaluated for rectal pain, bleeding, constipation, and weight loss. Computed tomography of the abdomen and pelvis showed rectal wall thickening with pelvic adenopathy, concerning rectal carcinoma, also seen on colonoscopy as a 50% circumferential ulcerating rectal mass. The rectal swab was positive for C. trachomatis by immunofluorescence assay. Pathology confirmed severe active proctitis, but no malignancy. He was treated for presumed LGV proctitis with marked improvement. The case highlights an unusual presentation of LGV with severe inflammation and mass formation mimicking rectal carcinoma. Early identification of possible LGV especially in high-risk patients allows early appropriate treatment.

Cryptococcal lymphadenitis: an unusual initial presentation of HIV infection.

Lymphadenopathy can occur at any stage of HIV infection, with multiple aetiologies including reactive, infectious and malignant. An accurate and timely diagnosis has obvious implications for treatment. We report cryptococcal lymphadenitis as the presenting manifestation of HIV infection. The diagnosis in our patient was eventually confirmed with a lymph node biopsy. Fine needle aspiration cytology has been shown to be a rapid and cost-effective method, which has been used in the diagnosis of lymphadenopathy in HIV infection, and could have been used to make an earlier diagnosis in our patient.