Assuntos
Epiglote/microbiologia , Epiglotite/diagnóstico , Mycobacterium tuberculosis , Tuberculose Laríngea/diagnóstico , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Epiglotite/microbiologia , Humanos , Neoplasias Laríngeas/diagnóstico , Masculino , Ilustração Médica , Tuberculose Laríngea/microbiologiaRESUMO
Histoplasmosis is an endemic disease mainly occurring in North America and is rare in China. Confirmation of histoplasmosis should be based on a compatible clinical scenario and a positive culture or histopathology. However, there are still many cases that are misdiagnosed or missed, especially in individuals from non-endemic areas. In recent years, metagenomic next-generation sequencing (mNGS) has led to the accurate and timely diagnosis of some rare and complicated infectious diseases. We describe the case of a 27-year-old Chinese man who had chronic progressive pulmonary lesions without any symptoms for more than 1year, until the lesions reached the epiglottis and led to progressive pharyngeal pain. There were no positive results from bronchoalveolar lavage fluid (BALF) and epiglottis tissue cultures, or from epiglottis and lung pathological examinations, but mNGS was able to identify Histoplasma capsulatum in the epiglottis tissues and BALF as the cause of the lesions. The patient was treated successfully with itraconazole.
Assuntos
Epiglote/microbiologia , Histoplasma/isolamento & purificação , Histoplasmose/microbiologia , Pulmão/microbiologia , Adulto , Povo Asiático , Líquido da Lavagem Broncoalveolar , Epiglote/patologia , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Itraconazol/uso terapêutico , Pulmão/patologia , Masculino , MetagenômicaAssuntos
Epiglote/patologia , Laringe/patologia , Sífilis , Idoso , Epiglote/microbiologia , Humanos , Laringe/microbiologia , MasculinoAssuntos
Infecções Fúngicas do Sistema Nervoso Central/fisiopatologia , Histoplasmose/fisiopatologia , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Infecções Fúngicas do Sistema Nervoso Central/tratamento farmacológico , Infecções Fúngicas do Sistema Nervoso Central/patologia , Erros de Diagnóstico , Epiglote/microbiologia , Epiglote/patologia , Feminino , Granuloma/microbiologia , Granuloma/patologia , Histoplasmose/tratamento farmacológico , Histoplasmose/patologia , Humanos , Pessoa de Meia-Idade , Recidiva , Medula Espinal/microbiologia , Medula Espinal/patologia , Tuberculose Meníngea/patologia , Tuberculose Meníngea/fisiopatologiaRESUMO
The case of a 29-year-old patient with active laryngeal tuberculosis predominantly involving the epiglottis, without pulmonary disease, is presented. The predominant symptoms are dysphagia, odynophagia, and hoarseness. Laryngeal carcinoma, which shares almost the same symptoms and signs, should be ruled out immediately. Laryngeal tuberculosis is discussed with a brief literature review.
Assuntos
Antituberculosos/uso terapêutico , Epiglote/microbiologia , Tuberculose Laríngea/diagnóstico , Adulto , Humanos , Masculino , Mycobacterium tuberculosis , Tuberculose Laríngea/tratamento farmacológico , Tuberculose Laríngea/microbiologiaAssuntos
Candidíase/diagnóstico , Candidíase/tratamento farmacológico , Emergências , Epiglote/microbiologia , Epiglotite/diagnóstico , Epiglotite/tratamento farmacológico , Hospedeiro Imunocomprometido , Idoso , Antifúngicos/uso terapêutico , Candidíase/etiologia , Diagnóstico Diferencial , Epiglotite/etiologia , Epiglotite/microbiologia , Fluconazol/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
We present a 40-year-old woman with pulmonary tuberculosis and epiglottic involvement that was initially misdiagnosed as laryngeal carcinoma. The differential diagnosis and management of epiglottic tuberculosis is reviewed and discussed. Although epiglottic tuberculosis is rare, otorhinolaryngologists should keep in mind the possibility of tuberculosis in the differential diagnosis of laryngeal tumors. Constitutional symptoms and mild chest symptoms should not always be attributed to carcinoma and smoking.
Assuntos
Antituberculosos/uso terapêutico , Epiglote/microbiologia , Tuberculose Laríngea/diagnóstico , Tuberculose Laríngea/tratamento farmacológico , Adulto , Diagnóstico Diferencial , Feminino , HumanosRESUMO
Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is emerging as an important pathogen. However, MRSA rarely causes epiglottitis. We report an adult with epiglottitis due to a CA-MRSA isolate of the USA300 lineage with Panton-Valentine leukocidin. Maintaining vigilance for CA-MRSA as a cause of an expanding spectrum of severe infections is warranted.
Assuntos
Epiglote/microbiologia , Resistência a Meticilina , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/diagnóstico , Staphylococcus aureus/isolamento & purificação , Adulto , Humanos , Masculino , Infecções Estafilocócicas/terapiaAssuntos
Epiglotite/microbiologia , Infecções Estreptocócicas/cirurgia , Streptococcus pyogenes , Tonsilite/complicações , Adulto , Antibacterianos/administração & dosagem , Cefuroxima/administração & dosagem , Clindamicina/administração & dosagem , Quimioterapia Combinada , Epiglote/microbiologia , Epiglotite/etiologia , Feminino , Humanos , Recidiva , Língua/microbiologia , Tonsilectomia , Tonsilite/microbiologia , Tonsilite/cirurgiaRESUMO
An important arousal of tuberculosis has been observed in the last years, together with a change in it's clinical patterns, specially the extrapulmonar form, among wich is this laryngeal tuberculosis. This two facts and the marked polymorphism and mimetism proper of this condition may suggest that the Mycobacterium tuberculosis should be included in the differential diagnosis of any atypical lesion of the larynx, in order to obtain an earlier diagnosis excluding carcinoma and instaurate a chimotherapic protocol for minimizing or even avoiding any sequelae. Tuberculous epiglotittis is one of these atypical and unusual forms. The authors report a case of a 67 year-old male and provide a discussion on the diagnostic problems of this condition.
Assuntos
Epiglote/microbiologia , Tuberculose Laríngea/microbiologia , Idoso , Antituberculosos/uso terapêutico , Epiglote/diagnóstico por imagem , Humanos , Laringoscopia , Masculino , Mycobacterium tuberculosis/isolamento & purificação , Pescoço , Radiografia Torácica , Tomografia Computadorizada por Raios X , Tuberculose Laríngea/diagnóstico , Tuberculose Laríngea/tratamento farmacológicoRESUMO
Estamos asistiendo en los últimos años a un resurgir de la tuberculosis, con especial mención a las formas extrapulmonares, entre las que se encuentra la tuberculosis laríngea, a la vez que a un cambio en los patrones típicos de presentación recogidos históricamente en la literatura médica. Estos dos hechos, unidos al conocido polimorfismo y mimetismo de esta enfermedad, hacen que sea importante pensar en el Mycobacterium tuberculosis como el causante de lesiones atípicas objetivadas en la laringe del paciente, para lograr realizar un diagnóstico precoz de la misma que, por un lado, descarte la existencia de carcinoma, y, por otro, permita la instauración inmediata de un protocolo quimioterápico antituberculoso que impida o minimice las posibles secuelas de la misma. La epiglotitis tuberculosa es una de estas formas atípicas e infrecuentes de presentación. Los autores presentan un caso de un varón de 67 años y realizan una discusión de los problemas diagnósticos que presenta esta entidad
An important arousal of tuberculosis has been observed in the last years, together with a change in it's clinical patterns, specially the extrapulmonar form, among wich is this laryngeal tuberculosis. This two facts and the marked polymorphism and mimetism proper of this condition may suggest that the Mycobacterium tuberculosis should be included in the differential diagnosis of any atypical lesion of the larynx, in order to obtain an earlier diagnosis excluding carcinoma and instaurate a chimotherapic protocol for minimizing or even avoiding any sequelae.Tuberculous epiglotittis is one of these atypical and unusual forms. The authors report a case of a 67 year-old male and provide a discussion on the diagnostic problems of this condition
Assuntos
Masculino , Idoso , Humanos , Epiglote/microbiologia , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose Laríngea/microbiologia , Antituberculosos/uso terapêutico , Epiglote , Laringoscopia , Radiografia Torácica , Tomografia Computadorizada por Raios X , Tuberculose Laríngea/diagnóstico , Tuberculose Laríngea/tratamento farmacológicoAssuntos
Epiglote/microbiologia , Histoplasmose/epidemiologia , Idoso , Doenças Endêmicas , Humanos , MasculinoAssuntos
Abscesso/diagnóstico , Epiglote/cirurgia , Epiglotite/microbiologia , Doenças da Laringe/diagnóstico , Abscesso/terapia , Adulto , Epiglote/microbiologia , Epiglotite/diagnóstico por imagem , Epiglotite/terapia , Humanos , Doenças da Laringe/terapia , Laringoscopia , Masculino , RadiografiaAssuntos
Mycobacterium/isolamento & purificação , Tuberculose Laríngea , Acetilcisteína/uso terapêutico , Adulto , Antituberculosos/uso terapêutico , Epiglote/microbiologia , Epiglote/patologia , Etambutol/uso terapêutico , Feminino , Granuloma Laríngeo/patologia , Humanos , Isoniazida/uso terapêutico , Rifampina/uso terapêutico , Tuberculose Laríngea/tratamento farmacológico , Tuberculose Laríngea/patologiaRESUMO
Invasive fungal infections are associated with high morbidity and mortality in immunocompromised patients. We describe an unusual case of concomitant invasive candidiasis and zygomycosis of the tongue and epiglottis that occurred in a young patient with neutropenia during chemotherapy for acute myelogenous leukemia and was successfully treated medically.