Burkitt lymphoma of the ovaries mimicking sepsis: a case report and review of the literature.

BACKGROUND: It is not unusual for systemic diseases to mimic sepsis and, in any case, the clinician should thoroughly investigate this possibility. CASE PRESENTATION: We present the case of a 21-year-old Greek woman who presented to the Intensive Care Unit of our hospital with severe septic shock - multiple organ failure as a result of a suspected gynecological infection of the ovaries. An immediate improvement of her clinical condition in combination with strong clinical suspicion and negative cultures led to the differential diagnosis of diseases other than sepsis. Based on the results of the biopsies that were obtained by research laparotomy, our patient suffered from primary Burkitt ovarian lymphoma. Her clinical condition improved with supportive treatment and chemotherapy. Chemotherapy is the dominant treatment for Burkitt's lymphoma, while surgery or radiotherapy has no place. CONCLUSIONS: All intensivists should be aware of clinical conditions that mimic sepsis as early diagnosis can lead to appropriate therapy and avoid unnecessary diagnostic tests and antibiotic abuse.

Actinomyces israelii: a rare cause of thoracic empyema.

Actinomyces israelii usually causes chronic suppurative and granulomatous infections. Isolated pleural effusion due to Actinomycosis is rare. This report describes an unusual case of thoracic empyema caused by A. israelii with sudden onset and rapid deterioration that failed to respond to chest tube drainage and antibiotherapy. Empyema drainage and visceral parietal pleurectomy by a left postolateral thoracotomy proved to be of vital importance and a permanent solution.