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2.
BMC Infect Dis ; 21(1): 103, 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33482743

RESUMO

BACKGROUND: Scalp Eschar and Neck LymphAdenopathy after Tick bite is a zoonotic non-pathogen-specific disease most commonly due to Rickettsia slovaca and Rickettsia raoultii. Diagnosis is mostly based only on epidemiological and clinical findings, without serological or molecular corroboration. We presented a clinical case in which diagnosis was supported by entomological identification and by R. slovaca DNA amplifications from the tick vector. CASE PRESENTATION: A 6-year-old child presented with asthenia, scalp eschar and supraclavicular and lateral-cervical lymphadenopathy. Scalp Eschar and Neck LymphAdenopathy After Tick bite syndrome following a Dermacentor marginatus bite was diagnosed. Serological test on serum revealed an IgG titer of 1:1024 against spotted fever group rickettsiae, polymerase chain reaction assays on tick identified Rickettsia slovaca. Patient was successfully treated with doxycycline for 10 days. CONCLUSIONS: A multidisciplinary approach including epidemiological information, clinical evaluations, entomological identification and molecular investigations on tick, enabled proper diagnosis and therapy.


Assuntos
Dermacentor/microbiologia , Linfadenopatia/diagnóstico , Infecções por Rickettsia/diagnóstico , Rickettsia/isolamento & purificação , Dermatoses do Couro Cabeludo/diagnóstico , Picadas de Carrapatos/complicações , Animais , Criança , Dermacentor/classificação , Doxiciclina/uso terapêutico , Feminino , Humanos , Linfadenopatia/tratamento farmacológico , Linfadenopatia/microbiologia , Pescoço/microbiologia , Rickettsia/genética , Rickettsia/imunologia , Infecções por Rickettsia/tratamento farmacológico , Infecções por Rickettsia/microbiologia , Dermatoses do Couro Cabeludo/tratamento farmacológico , Dermatoses do Couro Cabeludo/microbiologia , Picadas de Carrapatos/microbiologia , Picadas de Carrapatos/parasitologia , Doenças Transmitidas por Carrapatos/diagnóstico , Doenças Transmitidas por Carrapatos/tratamento farmacológico , Doenças Transmitidas por Carrapatos/microbiologia , Resultado do Tratamento
3.
BMC Infect Dis ; 20(1): 495, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32650727

RESUMO

BACKGROUND: Tuberculosis is a disease that may affect any organ of the body. Multifocal tuberculosis involving multiple systems with associated symptoms are rare, which makes the diagnosis challenging. Distinguishing multifocal tuberculosis from lesions metastatic from system malignancy is difficult. Single detection method is difficult to make a diagnosis. A combination of multiple methods is essential. CASE PRESENTATION: A 17-year-old male presented with a 20 days weakness of lower limbs, which aggravated for 6 days. The PET/CT showed increased metabolism of ileocecal intestinal and terminal ileum wall, multiple enlarged lymph node (LNs), multiple osteolytic bone lesions, and soft tissue intensity belong T7 and T8 vertebrae. To confirm the diagnosis of the disease, a biopsy of the mediastinum lymph nodes was carried out. Polymerase chain reaction (PCR) test of the specimen was positive for the Mycobacterium tuberculosis, the T-SPOT and Xpert MTB/RIF test were also positive, which suggested the presence of Mycobacterium tuberculosis. The final diagnosis was multifocal tuberculosis, the patients received the resection of the mass in the spine. Anti-tuberculosis drugs were given. The myodynamia and muscle tension of the patients recovered following the therapy. CONCLUSIONS: Our results indicated that Multifocal tuberculosis should also be taken into consideration when lesions metastatic from system malignancy were suspected from images results even without the clinical symptoms of tuberculosis, and combination of multiple diagnosis methods were essential for the diagnosis of multifocal disease.


Assuntos
Linfonodos/patologia , Tuberculose/diagnóstico , Adolescente , Antituberculosos/uso terapêutico , Humanos , Linfonodos/microbiologia , Linfadenopatia/microbiologia , Linfadenopatia/patologia , Masculino , Mycobacterium tuberculosis/genética , Reação em Cadeia da Polimerase , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias da Coluna Vertebral/patologia , Tuberculose/tratamento farmacológico
5.
Infection ; 48(3): 471-475, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32128685

RESUMO

BACKGROUND: While Campylobacter jejuni represents the most common cause of bacterial gastroenteritis, Yersinia pseudotuberculosis infections are very rarely diagnosed in adults. CASE: We report on a previously healthy patient who presented several times at our hospital with fever, Guillain-Barré syndrome, recurrent abdominal symptoms and distinct mesenteric lymphadenopathy, respectively. This complicated and diagnostically challenging course of disease was caused by a C. jejuni and Y. pseudotuberculosis coinfection. Antibiotic treatment with doxycycline was effective. CONCLUSION: Broad serology testing was crucial to discover that two concomitant infections were causing the symptoms. This case demonstrates that when a clinical picture is not fully explained by one known infection, another infection with the same underlying risk factor has to be considered, hence "a horse and a zebra".


Assuntos
Infecções por Campylobacter/diagnóstico , Coinfecção/diagnóstico , Gastroenteropatias/diagnóstico , Síndrome de Guillain-Barré/diagnóstico , Infecções por Yersinia pseudotuberculosis/diagnóstico , Adulto , Antibacterianos/uso terapêutico , Infecções por Campylobacter/diagnóstico por imagem , Infecções por Campylobacter/tratamento farmacológico , Infecções por Campylobacter/microbiologia , Campylobacter jejuni/isolamento & purificação , Coinfecção/diagnóstico por imagem , Coinfecção/tratamento farmacológico , Coinfecção/microbiologia , Doxiciclina/uso terapêutico , Febre/microbiologia , Gastroenteropatias/diagnóstico por imagem , Gastroenteropatias/tratamento farmacológico , Gastroenteropatias/microbiologia , Alemanha , Síndrome de Guillain-Barré/diagnóstico por imagem , Síndrome de Guillain-Barré/microbiologia , Humanos , Linfadenopatia/diagnóstico , Linfadenopatia/microbiologia , Masculino , Recidiva , Resultado do Tratamento , Yersinia pseudotuberculosis/isolamento & purificação , Infecções por Yersinia pseudotuberculosis/diagnóstico por imagem , Infecções por Yersinia pseudotuberculosis/tratamento farmacológico , Infecções por Yersinia pseudotuberculosis/microbiologia
6.
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
7.
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
8.
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
10.
Ned Tijdschr Geneeskd ; 1632019 07 18.
Artigo em Holandês | MEDLINE | ID: mdl-31361406

RESUMO

BACKGROUND: Syphilis (lues) is a sexually transmitted infection caused by the spirochete Treponema pallidum. In adolescents, the diagnosis of primary syphilis can be made promptly by taking a sexual medical history and inspecting the glans penis. CASE DESCRIPTION: A 17-year-old male was referred to the paediatric oncology centre for additional diagnostics due to inguinal lymphadenopathy, with a strong suspicion of a malignant lymphoma. None of the physicians took a sexual medical history or investigated the glans penis, as a result of which essential information was lacking. The combination of inguinal lymphadenopathy and the ultrasound findings for the inguinal region made the physicians only consider a malignancy. However, it actually concerned a reactive lymphadenopathy associated with primary syphilis. CONCLUSION: This case demonstrates that a full medical history and thorough physical examination can prevent the need for costly and invasive diagnostics.


Assuntos
Erros de Diagnóstico , Linfadenopatia/microbiologia , Neoplasias/diagnóstico , Sífilis/complicações , Sífilis/diagnóstico , Adolescente , Cancro/microbiologia , Humanos , Canal Inguinal , Linfadenopatia/diagnóstico por imagem , Masculino , Anamnese , Pênis , Exame Físico , Comportamento Sexual , Ultrassonografia
11.
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
13.
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 Mycobacterium não Tuberculosas/diagnóstico , Mycobacterium marinum , Úlcera Cutânea/microbiologia , Adulto , Antebraço , Dermatoses da Mão/microbiologia , Passatempos , Humanos , Linfadenopatia/microbiologia , Masculino , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium não Tuberculosas/patologia
15.
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
19.
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
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