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1.
APMIS ; 128(1): 61-64, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31691353

RESUMO

Francisella tularensis is a zoonotic bacterium which causes the infection tularemia. It colonizes invertebrates and vertebrates, counting wildlife animals and rodents. Humans can become infected through several pathways including contaminated food, water, and handling animals and due to bites from vectors. Ticks are known to cause tularemia in humans, though their role as a disease transferring vector is not well understood. We describe two case reports of tularemia transferred by ticks on Southern Zealand, Denmark. Case 1: A 49-year-old woman presented with lymphadenopathy and an unhealed sifting wound after a tick bite. Serology tests for F. tularensis were initially negative but turned positive five weeks after symptom onset, when abscess drainage was performed. Gentamicin and ciprofloxacin treatment improved the patient's clinical condition, and she completely recovered. Case 2: A 74-year-old man presented with malaise, fever, and an abdominal ulcer allegedly caused after a vector bite. CRP and leukocytes were increased, while serology tests for F. tularensis were negative. Doxycycline treatment improved the patient's clinical condition, and he completely recovered. Three weeks after symptom onset, renewed serology tests for F. tularensis were positive.


Assuntos
Antibacterianos/uso terapêutico , Carrapatos/microbiologia , Tularemia/diagnóstico , Tularemia/transmissão , Idoso , Animais , Ciprofloxacino/uso terapêutico , Dinamarca , Doxiciclina/uso terapêutico , Feminino , Francisella tularensis , Humanos , Linfadenopatia/microbiologia , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
2.
Rev Soc Bras Med Trop ; 52: e20190044, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31618305

RESUMO

We present a case of atypical presentation of secondary syphilis with extensive lymph node involvement and pulmonary lesions, initially suspected as lymphoma. The patient presented with weight loss, dry cough, chest pain, palpable lymph nodes in several peripheral chains, and multiple pulmonary nodules and masses on chest imaging. The key features for secondary syphilis diagnosis were a lymph node biopsy suggestive of reactive lymphadenopathy, positive serologic tests for syphilis, and complete recovery after antisyphilitic treatment.


Assuntos
Pneumopatias/diagnóstico , Linfadenopatia/diagnóstico , Linfoma/diagnóstico , Sífilis/diagnóstico , Adulto , Biópsia , Diagnóstico Diferencial , Humanos , Pneumopatias/microbiologia , Linfadenopatia/microbiologia , Masculino , Sífilis/complicações , Tomografia Computadorizada por Raios X
3.
Mymensingh Med J ; 28(4): 854-861, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31599251

RESUMO

Lymph node enlargement is a common presenting complaint in outpatient and inpatient department. The present observational cross sectional study was conducted in department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period from December 2014 to May 2016 to evaluate etiologies of significant lymphadenopathy by clinical, histopathological and microbiological assessment. Biopsy/FNA materials of 177 patients of 18-75 years age range with significant lymphadenopathy were sent for histopathology/cytology, Gram stain & culture, AFB stain & culture and Gene Xpert. Among them, 102(57.62%) were granulomatous lymphadenitis, 52(29.38%) were lymphoma, 12(6.78%) reactive lymphadenitis, 7(3.95%) metastatic malignancy, 2(1.13%) atypical lymphoid hyperplasia, 1(0.57%) myeloid sarcoma and 1(0.57%) chronic sialadenitis. Growth of MTB was on 23(22.55%) cases; among 102 granulomatous lymphadenitis and Gene Xpert was positive in 73(71.56%) cases with 100% Rif. sensitive. Gene Xpert is an important tool for diagnosis of tuberculous lymphadenitis. Time of symptoms to diagnosis of most of the TBL patients was within 2-8 months.


Assuntos
Linfadenopatia/diagnóstico , Bangladesh , Estudos Transversais , Humanos , Linfadenopatia/microbiologia , Neoplasias , Tuberculose dos Linfonodos
5.
Ticks Tick Borne Dis ; 10(5): 1142-1145, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31213411

RESUMO

BACKGROUND: Tick-borne rickettsioses are infectious diseases caused by obligate intracellular Gram-negative bacteria belonging to the spotted fever groupof Rickettsia. METHODS: We describe an unusual case of SENLAT (Scalp eschar and neck lymphadenopathy after tick bite), caused byRickettsia slovaca, associated with a cellulitis of the face in a 70-year-old woman, and diagnosed using qPCR on a scalp eschar swab. We review the literature regarding cases of SENLAT-associated-cellulitis and case of SENLAT diagnosed by qPCR on scalp eschar swabs. RESULTS: We found only one previous report of SENLAT associated with a cellulitis of the face. It was a nine-year-old French girl diagnosed by seroconversion for Rickettsia sp. Our review of the literature showed that qPCR on eschar swab samples is a less invasive method than performing cutaneous biopsy of the eschar and has good sensitivity and specificity (90% and 100%, respectively). CONCLUSIONS: We report the second case of cellulitis of the face associated with the SENLAT syndrome. Detection of Rickettsia by qPCR on swab sample of the scalp eschar is a simple, noninvasive technique allowing rapid diagnosis and treatment when SENLAT is suspected.


Assuntos
Celulite (Flegmão)/diagnóstico , Linfadenopatia/diagnóstico , Pescoço/patologia , Infecções por Rickettsia/diagnóstico , Rickettsia/isolamento & purificação , Couro Cabeludo/patologia , Idoso , Celulite (Flegmão)/microbiologia , Feminino , França , Humanos , Linfadenopatia/microbiologia , Linfadenopatia/patologia , Infecções por Rickettsia/microbiologia , Infecções por Rickettsia/patologia , Picadas de Carrapatos/microbiologia , Doenças Transmitidas por Carrapatos/diagnóstico , Doenças Transmitidas por Carrapatos/microbiologia , Doenças Transmitidas por Carrapatos/patologia
7.
Dermatol Online J ; 25(2)2019 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-30865411

RESUMO

Mycobacterium marinum is a nontuberculous mycobacteria with worldwide distribution that lives in fresh or salt water and is responsible for infections in fish, and sometimes in humans. Human disease consists mainly of cutaneous nodules, but deep structure involvement may also occur. Diagnosis of M. marinum infection remains a challenge, with a considerable time delay between onset of symptoms and diagnosis. We present a 33-year-old man with no immunosuppressive history who was seen in our department with skin nodules over his hand and forearm, distributed in a sporotrichoid pattern. His hobbies included maintaining an aquarium of tropical fish. Histological examination of the patient's skin biopsy was compatible with the diagnosis of mycobacterial infection, and the Ziehl-Neelsen staining revealed acid-fast bacilli. Molecular techniques confirmed the suspicion of M. marinum infection. A necropsy was performed on one of the patient's fish, more specifically, a Poecilia reticulata, and resulted in identification of M. marinum from its gut. The patient was treated with clarithromycin, ethambutol, and rifampicin for 9 months, with clearance of infection.


Assuntos
Dermatoses da Mão/diagnóstico , Infecções por Micobactéria não Tuberculosa/diagnóstico , Mycobacterium marinum , Úlcera Cutânea/microbiologia , Adulto , Antebraço , Dermatoses da Mão/microbiologia , Passatempos , Humanos , Linfadenopatia/microbiologia , Masculino , Infecções por Micobactéria não Tuberculosa/complicações , Infecções por Micobactéria não Tuberculosa/patologia
9.
BMJ Case Rep ; 12(2)2019 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-30787023

RESUMO

Testicular tuberculosis (TB) is rare, and, because of this, the lack of pathognomonic clinical features and its tendency to mimic other commoner conditions, the diagnosis is frequently delayed or may be missed. In this case, the initial clinical presentation was typical for bacterial epididymo-orchitis in a 38-year-old man. When the patient failed to improve with standard treatment including broadening of antibiotics, the diagnosis was re-considered because some unusual signs suggested testicular malignancy or lymphoma. Further, history-taking and subsequent cross-sectional imaging with CT/MRI identified co-existent pulmonary nodularity, thoracic and abdominal lymphadenopathy and bony changes that, together, raised the suspicion of TB. Mycobacterium tuberculosis was confirmed on DNA-based testing of the hydrocele fluid, although standard acid-fast bacilli culture was negative. This case prompted a review of the literature to explore the optimal steps in the investigation and diagnosis of this rare disease.


Assuntos
Mycobacterium tuberculosis/isolamento & purificação , Dor/diagnóstico , Doenças Testiculares/microbiologia , Hidrocele Testicular/microbiologia , Tuberculose Urogenital/tratamento farmacológico , Cavidade Abdominal/diagnóstico por imagem , Cavidade Abdominal/microbiologia , Cavidade Abdominal/patologia , Adulto , Antituberculosos/administração & dosagem , Antituberculosos/uso terapêutico , Diagnóstico Diferencial , Epididimite/diagnóstico , Epididimite/tratamento farmacológico , Humanos , Linfadenopatia/microbiologia , Linfadenopatia/patologia , Imagem por Ressonância Magnética , Masculino , Orquite/diagnóstico , Orquite/tratamento farmacológico , Dor/etiologia , Doenças Testiculares/diagnóstico , Hidrocele Testicular/genética , Testículo/patologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Tuberculose Urogenital/diagnóstico , Tuberculose Urogenital/microbiologia
10.
Vet Radiol Ultrasound ; 60(2): E20-E23, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28547920

RESUMO

A Staffordshire terrier presented for evaluation of a chronic, nonproductive cough that was unresponsive to antibiotic therapy. A large mass identified in the pulmonary hilum was most consistent with tracheobronchial lymphadenopathy on radiographic and computed tomography (CT) images. Bronchoscopy confirmed a mass compressing the dorsal portion of the intrathoracic trachea. Bronchoscopic biopsies of the tracheal mass revealed necrosuppurative and eosinophilic inflammation with intralesional Pythium insidiousum hyphae. Pythiosis should be included as a differential diagnosis for tracheobronchial lymphadenopathy and bronchopneumopathy in dogs, especially when the patient is from or has visited a region endemic for Pythium insidiosum.


Assuntos
Broncopatias/veterinária , Tosse/veterinária , Doenças do Cão/diagnóstico , Pneumopatias/veterinária , Linfadenopatia/veterinária , Pitiose/diagnóstico , Doenças da Traqueia/veterinária , Animais , Broncopatias/diagnóstico , Broncopatias/diagnóstico por imagem , Broncopatias/microbiologia , Broncoscopia/veterinária , Tosse/diagnóstico por imagem , Diagnóstico Diferencial , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/microbiologia , Cães , Pneumopatias/diagnóstico , Pneumopatias/diagnóstico por imagem , Pneumopatias/microbiologia , Linfadenopatia/diagnóstico , Linfadenopatia/diagnóstico por imagem , Linfadenopatia/microbiologia , Masculino , Pitiose/diagnóstico por imagem , Pitiose/microbiologia , Pythium/fisiologia , Radiografia/veterinária , Tomografia Computadorizada por Raios X/veterinária , Doenças da Traqueia/diagnóstico , Doenças da Traqueia/diagnóstico por imagem , Doenças da Traqueia/microbiologia
13.
Med Sante Trop ; 28(3): 255-256, 2018 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-30270827

RESUMO

The authors report the case of a 22-year-old man referred seven months after the onset of papulo-nodular skin lesions, lymphadenopathy, splenomegaly and hepatomegaly. Mycologic and histologic examination of skin lesions enabled the diagnosis of African histoplasmosis, by Histoplasma capsulatum var duboisii. The lymph nodes were caseous. The culture in Lowenstein-Jensen medium was negative.


Assuntos
Histoplasmose/diagnóstico , Linfadenopatia/diagnóstico , Linfadenopatia/microbiologia , Humanos , Masculino , Senegal , Adulto Jovem
14.
Pan Afr Med J ; 30: 116, 2018.
Artigo em Francês | MEDLINE | ID: mdl-30364372

RESUMO

Rhinoscleroma is a specific granulomatous and chronic disorder with insidious evolution. It is causes by pathogen Klebsiella rhinoscleromatis. It mainly occurs in the nasal cavities and positive diagnosis is sometimes problematic. We report the case of a 19 year old female patient presenting with rhinoscleroma considered atypical due to its rare nasopharyngeal localization and its exceptional association with cervical lymphadenopathy in the right submandibular angle region. Anatomopathological exam revealed Mikulicz's cells, thus enabling the diagnosis. The patient underwent antibiotic therapy with ciprofloxacin for 16 weeks associated with washing of nasal cavities with physiological saline solution. Patient's outcome was favorable during the 14-month follow-up period.


Assuntos
Antibacterianos/administração & dosagem , Ciprofloxacino/administração & dosagem , Klebsiella pneumoniae/isolamento & purificação , Rinoscleroma/diagnóstico , Feminino , Seguimentos , Humanos , Linfonodos/microbiologia , Linfadenopatia/microbiologia , Pescoço , Rinoscleroma/tratamento farmacológico , Rinoscleroma/microbiologia , Resultado do Tratamento , Adulto Jovem
16.
Int J Mycobacteriol ; 7(3): 212-216, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30198498

RESUMO

Background: Tuberculosis is a major global health problem. Tuberculous lymphadenopathy is a most common form of extrapulmonary tuberculosis (EPTB), constitutes 35% of all cases of EPTB. Due to the paucibacillary nature of specimens, smear microscopy and culture offer low sensitivity. Methods: The aim of the present study was to find the clinicodemographic profiles and comparing the performance of Xpert MTB/RIF, conventional polymerase chain reaction (PCR), mycobacteria growth indicator tube (MGIT) 960, histopathological examination, and clinical follow-up of patients in diagnosing of smear-negative tuberculous lymphadenopathy. Results: A total of 140 clinically suspected cervical tuberculous lymphadenitis cases were enrolled in this study. MGIT-960 culture, conventional PCR, and Xpert MTB/RIF were performed. Most of the patients presented with unilateral (87.14%), single (81.42%), matted (87.85%) lymph nodes, 3 cm-6 cm (52.14%), commonly in the right side (68.02%), and associated lung lesion was found in 12.86% of cases. The detection rates of Mycobacterium tuberculosis complex (MTBC) by Xpert MTB/RIF, conventional PCR, and MGIT were 25.71%, 20.71%, and 17.85%, respectively. Both the tests: Xpert MTB/RIF and PCR, PCR and MGIT, Xpert MTB/RIF and MGIT were positive in 15.71%, 15.71%, and 11.42% of cases, respectively. Most of the patients (74.1%) were cured with 6 months of antitubercular drugs. Conclusion: Clinicians often face the diagnostic dilemmas presented in the study. Individual modalities of the diagnosis are available, but all have drawbacks with varied sensitivity and specificity. Combining the available clinical, radiological, and microbiological modality to reach early diagnosis can go a long way to avoid misdiagnosis and unnecessary delay in treatment, especially in cases, without the pulmonary involvement and fulfilling the aim of National Tuberculosis Control Programme for EPTB cases.


Assuntos
Linfonodos/microbiologia , Técnicas de Diagnóstico Molecular/métodos , Tuberculose dos Linfonodos/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antituberculosos/uso terapêutico , Criança , DNA Bacteriano/isolamento & purificação , Feminino , Humanos , Linfadenopatia/microbiologia , Masculino , Técnicas Microbiológicas , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Reação em Cadeia da Polimerase , Sensibilidade e Especificidade , Tuberculose dos Linfonodos/tratamento farmacológico , Tuberculose Pulmonar/diagnóstico , Adulto Jovem
17.
Am J Case Rep ; 19: 906-911, 2018 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-30068900

RESUMO

BACKGROUND Bartonella infection is the causative organism of cat-scratch disease (CSD), which typically presents with self-limited localized lymphadenopathy. In HIV-infected patients, Bartonella infection can cause systemic illnesses with significant morbidity and mortality manifesting as bacillary angiomatosis (BA), hepatic peliosis, splenitis, bacteremic febrile illness, and other organ involvement. To the best of our knowledge, there have been no reports of HIV-infected patients presenting with generalized lymphadenopathy caused by Bartonella infection. We report an unusual case of CSD presenting with generalized lymphadenopathy in an AIDS patient with advanced immunosuppression. CASE REPORT A 44-year-old woman with AIDS, advanced immunosuppression, and intermittent adherence to antiretroviral therapy and medical care, presented with cough and increased generalized tender lymphadenopathy. A lymph node biopsy 1 year earlier was non-diagnostic for tuberculosis, fungal infection, and lymphoproliferative disorders. She remained with generalized lymphadenopathy. A repeat biopsy with the addition of Warthin-Starry silver staining suggested the diagnosis of cat-scratch lymphadenitis. She responded well to a long course of azithromycin antibiotic therapy, with the resolution of lymphadenopathy. CONCLUSIONS Cat-scratch disease may present with prolonged generalized lymphadenopathy, an unusual presentation in HIV patients with advanced immunosuppression. Awareness of the possibility of CSD in a similar clinical scenario may prompt early recognition and management of this disease.


Assuntos
Síndrome de Imunodeficiência Adquirida/complicações , Doença da Arranhadura de Gato/diagnóstico , Linfadenopatia/microbiologia , Adulto , Doença da Arranhadura de Gato/complicações , Doença da Arranhadura de Gato/tratamento farmacológico , Diagnóstico Tardio , Feminino , Humanos , Linfadenopatia/tratamento farmacológico
18.
Indian J Med Res ; 147(2): 189-194, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29806608

RESUMO

Background & objectives: : Bartonella henselae causes infections which closely resemble febrile illness and chronic diseases such as tuberculosis and haematological malignancies. There are not many studies on Bartonella infections from India. The present study was undertaken to diagnose B. henselae infection in diverse clinical conditions in a tertiary care hospital in north India. Methods: A total of 145 patients including those with fever and lymphadenopathy, infective endocarditis and neuroretinitis were enrolled in the study. Whole blood, serum and lymph node aspirate and valvular vegetations if available, were obtained. Samples were plated on chocolate agar and brain-heart infusion agar containing five per cent fresh rabbit blood and were incubated at 35°C for at least four weeks in five per cent CO2with high humidity. Immunofluorescent antibody assay (IFA) was done for the detection of IgM antibodies in the serum using a commercial kit. Whole blood was used to perform polymerase chain reaction (PCR) for the citrate synthase gene (gltA). Results: IFA was positive in 11 of 140 (7.85%) patients and PCR was positive in 3 of 140 (2.14%) patients. Culture was negative in all the cases. A higher incidence of Bartonella infection was seen in patients with fever and lymphadenopathy (n=30), seven of whom were children. In ophthalmological conditions, four cases were IFA positive. Interpretation & conclusions: The present study shows that the threat of Bartonella infection is a reality in India. It is also an important treatable cause of fever and lymphadenopathy in children. Serology and PCR are useful tests for its diagnosis. Clinicians should consider. Bartonella: infection in the differential diagnosis of febrile illnesses and chronic diseases.


Assuntos
Infecções por Bartonella/sangue , Bartonella henselae/isolamento & purificação , Citrato (si)-Sintase/sangue , Linfadenopatia/sangue , Zoonoses/sangue , Adolescente , Adulto , Animais , Anticorpos Antibacterianos/sangue , Infecções por Bartonella/microbiologia , Infecções por Bartonella/transmissão , Bartonella henselae/patogenicidade , Doença da Arranhadura de Gato/epidemiologia , Doença da Arranhadura de Gato/transmissão , Gatos , Criança , Reservatórios de Doenças , Feminino , Humanos , Índia/epidemiologia , Linfadenopatia/microbiologia , Linfadenopatia/patologia , Masculino , Pessoa de Meia-Idade , Coelhos , Ratos , Centros de Atenção Terciária , Adulto Jovem , Zoonoses/epidemiologia , Zoonoses/microbiologia , Zoonoses/patologia
19.
J Pak Med Assoc ; 68(4): 653-656, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29808061

RESUMO

Leprosy is a chronic granulomatous disease involving the skin and nerves, leading to a debilitating condition. Leprosy has been controlled in most parts of the world; therefore physicians are not very well versed in the recognition, management and assessment of this disease. The protean manifestations of leprosy often lead to delays in diagnosis and increase the morbidity. We present a case of a 33-year-old male with fever, lymphadenopathy, nodular skin lesions, uveitis and arthritis. Lymphnode, bonemarrow and skin biopsy revealed 3+ AFB smear with negative AFB cultures, leading to the diagnosis of leprosy. The course of illness was complicated by flare of Erythema Nodosum Leprosum (ENL).


Assuntos
Eritema Nodoso/microbiologia , Febre/microbiologia , Hanseníase Virchowiana/complicações , Hanseníase Virchowiana/diagnóstico , Adulto , Artrite/microbiologia , Doença Crônica , Humanos , Linfadenopatia/microbiologia , Masculino , Uveíte/microbiologia
20.
Rev Soc Bras Med Trop ; 51(2): 247-248, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29768565

RESUMO

We present a case involving a 74-year-old woman with cat scratch disease characterized by an enlarged and hard axillary lymph node as well as a palpable breast nodule mimicking a carcinoma. The lymph node and the breast nodule were excised. The pathologic examinations revealed granulomatous lymphadenitis with gram-negative bacilli and an intraductal papilloma. Antibiotic therapy (azithromycin) was prescribed and the patient's clinical evolution was excellent.


Assuntos
Bartonella henselae/isolamento & purificação , Doenças Mamárias/diagnóstico , Doença da Arranhadura de Gato/diagnóstico , Linfadenopatia/diagnóstico , Idoso , Animais , Doenças Mamárias/microbiologia , Neoplasias da Mama/diagnóstico , Doença da Arranhadura de Gato/complicações , Gatos , Diagnóstico Diferencial , Feminino , Humanos , Linfadenopatia/microbiologia
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