scholarly journals Cerebral vasculitis caused by Talaromyces marneffei and Aspergillus niger in a HIV-positive patient: a case report and literature review

2022 ◽  
Author(s):  
Yidong Gao ◽  
Man Qu ◽  
Chao Song ◽  
Lufeng Yin ◽  
Min Zhang
Keyword(s):  
Aspergillus Niger ◽  
Past History ◽  
Final Diagnosis ◽  
Cerebral Vasculitis ◽  
Positive Patient ◽  
Therapeutic Effects ◽  
Talaromyces Marneffei ◽  
Immunodeficiency Virus ◽  
History Of ◽  
Herpetic Encephalitis

AbstractCerebral vasculitis is a long-standing but flourishing and fadeless research topic. Infections are a frequent cause of cerebral vasculitis, vital to diagnose due to involvement of specific anti-infection treatments. A 65-year-old man visited the hospital for his neurological symptoms without obvious inducements. After admission, radiological examination and comprehensive conventional microbiological tests (CMTs) revealed suspected intracranial infectious vasculitis. Metagenomic next-generation sequencing (mNGS) and reverse transcription-polymerase chain reaction further confirmed that his cerebral vasculitis was caused by Talaromyces marneffei (T. marneffei) and Aspergillus niger (A. niger) co-infection. The patient’s final diagnosis changed from initial herpetic encephalitis, due to the past history of cephalosome and facial herpes and non-significant antiviral therapeutic effects, to fungal cerebral vasculitis. The patient was discharged after use of targeted antifungal therapies on day 18 of his admission, and his associated symptoms disappeared completely at follow-up 3 weeks later. We first illustrated the presence of uncommon cerebral vasculitis caused by T. marneffei and A. niger in a human immunodeficiency virus-positive patient. In clinically suspected patients with infectious cerebral vasculitis, mNGS should be performed to detect potential pathogens if CMTs may not provide useful pathogenic clues, highlighting the importance of mNGS in the diagnosis and treatment of infectious diseases.

Pneumocystis carinii infection in bilateral aural polyps in a human immunodeficiency virus-positive patient

2002 ◽  
Vol 116 (4) ◽  
pp. 288-290 ◽  
Author(s):  
C. V. Praveen ◽  
R. M. Terry ◽  
M. Elmahallawy ◽  
C. Horsfield
Keyword(s):  
Human Immunodeficiency Virus ◽  
Opportunistic Infection ◽  
Pneumocystis Carinii ◽  
Lymphatic Vessels ◽  
Blood Stream ◽  
Positive Patient ◽  
Hiv Positive ◽  
Immunodeficiency Virus ◽  
History Of ◽  
Pneumocystis Carinii Infection

Pneumocystis carinii is an opportunistic infection found in patients with impaired immunity. Under favourable conditions the parasite can spread via the blood stream or lymphatic vessels and cause extrapulmonary dissemination. We report a case of P carinii infection presenting as bilateral aural polyps, otitis media and mastoiditis in human immunodeficiency (HIV)-positive patient with no history of prior or concomitant P carinii infection.

scholarly journals Case Report on Subarachnoid Hemorrhage

2021 ◽  
pp. 274-278
Author(s):  
Reshma Tighare ◽  
Ranjana Sharma
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Communicable Disease ◽  
Past History ◽  
Disease Patient ◽  
Bed Rest ◽  
Final Diagnosis ◽  
Neurological Status ◽  
Hereditary Disease ◽  
Pia Mater ◽  
History Of

Introduction: Subarachnoid haemorrhage (SAH) is caused by intracranial bleeding into the cerebrospinal fluid-filled space between the arachnoid and pia mater membranes on the surface of the brain. Patient History: The 65-year-old female patient was hospitalised to AVBR hospital in neurosurgery ward on December 25, 2020 with the chief complaints of headache, vomiting and episodes of seizures since three days. The patients had episodes of seizures on 21/12/2020 and 24/12/2020. The day later she was admitted to the Intensive Care Unit.she underwent all routine investigations like blood tests, and CT scan. After a thorough examination, the final diagnosis was subarachnoid haemorrhage. Past History: Patient did not have any history of communicable disease, asthma, tuberculosis, or any hereditary disease. Patient was COVID – negative and did not have any significant surgical history. Pharmacology: Patient was treated with proton pump inhibitor, antiemetic, antiepileptic, calcium channel blocker, stool softener analgesic and antipyretic. Management: Inj. Levipril 500 mg, Inj.pan40-40mg, cap.nimodipine 60mg every four hourly, Inj.emset 4 mg, Inj. Neomol 100 ml, Syp. glycerol 30 ml, Syp. Zincovit 2tsp and Tablet Dolo 650mg. Nursing Management: Patient’s vital sign (including blood pressure) and neurological status were monitored with bed rest, pain management and assessment of risk of bleeding. Conclusion: Patient was hospitalised with a threeday history of headache, vomiting, and episodes of seizures actively managed; condition satisfactory.

scholarly journals Mixed cortico-medullary adrenal carcinoma in children: looks are deceptive!!

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Arti Khatri ◽  
Nidhi Mahajan ◽  
Niyaz Ahmed Khan ◽  
Natasha Gupta
Keyword(s):  
Past History ◽  
Case Reports ◽  
Final Diagnosis ◽  
Adrenal Carcinoma ◽  
Case Presentation ◽  
First Case ◽  
Contrast Enhanced ◽  
Paediatric Age ◽  
History Of ◽  
Enhanced Computed Tomography

Abstract Background Mixed cortico-medullary adrenal carcinoma (MCMAC) is an extremely rare entity with scarce literature on its cytomorphology. Case presentation A 2-year-old girl presented with abdominal pain for 3 days and a past history of fever with significant weight loss. On examination, a non-tender left hypochondrial firm mass and an enlarged left supraclavicular node were found. Twenty-four-hour urinary levels of VMA were marginally high. Contrast-enhanced computed tomography of the abdomen showed a suprarenal heterogeneous mass encasing major vessels. Aspiration cytology of both mass and node showed similar features comprising a predominant population of singly scattered large cells with moderate cytoplasm, eccentric nucleus and prominent nucleolus in a necrotic background. Tumour cells expressed Synaptophysin and Melan-A. In view of increasing respiratory distress, debulking surgery was performed, and histopathology of the specimen revealed the presence of both malignant medullary and cortical components supported by immunohistochemistry making a final diagnosis of MCMAC. The patient succumbed to death in the postoperative period. The cytology slides were reviewed and were seen to show a dual cell population. Conclusion Coexistent malignant cortical and medullary tumour of the adrenal gland is the first case reported in the paediatric age group in the literature with only three previous case reports in adults.

scholarly journals Concurrent pulmonary tuberculosis and lepromatous leprosy in a newly diagnosed HIV positive patient: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Josiah T. Masuka ◽  
Zamambo Mkhize ◽  
Somasundram Pillay ◽  
Anisa Mosam
Keyword(s):  
Pulmonary Tuberculosis ◽  
Lepromatous Leprosy ◽  
Positive Patient ◽  
Hiv Positive ◽  
Interdisciplinary Management ◽  
Immunodeficiency Virus ◽  
The Face ◽  
History Of ◽  
Tuberculosis Diagnosis ◽  
High Index Of Suspicion

Abstract Background The leprosy-tuberculosis (TB) co-infection is rarely reported in recent times. However, this dual comorbidity is associated with high mortality and major morbidity. Unrecognised leprosy-TB co-infection may predispose affected patients to rifampicin monotherapy and subsequent drug resistance. Case presentation A 35 year old migrant, human immunodeficiency virus (HIV) positive male worker presented with 6 month history of symmetric infiltrative nodular plaques of the face and distal, upper extremities. A few days after initial dermatology presentation, a sputum positive pulmonary tuberculosis diagnosis was made at his base hospital. Subsequent dermatology investigations revealed histology confirmed lepromatous leprosy and a weakly reactive rapid plasma reagin test. The presenting clinical features and laboratory results were suggestive of lepromatous leprosy coexisting with pulmonary tuberculosis in an HIV positive patient. Conclusions This case illustrates the occurrence of leprosy with pulmonary tuberculosis in an HIV infected patient and the difficulties in interpreting non-treponemal syphilis tests in these patients. This case also highlights the need for a high index of suspicion for co-infection and the need to exclude PTB prior to initiation of rifampicin containing multi-drug therapy (MDT). Interdisciplinary management and social support are crucial in these patients.

scholarly journals Cirrhosis of liver: demographic and virological profile with emphasis on mode of transmission among patients presenting in a tertiary care hospital of Bangladesh

2020 ◽  
Vol 10 (3) ◽  
pp. 192-199
Author(s):  
Md Abdullah Al Mamoon ◽  
Arif Mahmud ◽  
Riad Md Moshaed Hossain ◽  
Shireen Ahmed ◽  
Sarker Mohammad Sajjad ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Female Patient ◽  
Past History ◽  
Positive Patient ◽  
P Value ◽  
Diabetic Patients ◽  
Urban Background ◽  
History Of ◽  
Male Patients ◽  
Cirrhosis Of Liver

Background: Cirrhosis of liver is one of the important cause of liver disease in our country. Worldwide as well as in our country the most common cause of liver cirrhosis is due to hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. Many of the patients with cirrhosis of liver do not know that they have already been affected with this kind of viral induced liver disease. They do not know how it occurs and what to be done afterwards due to lack of adequate knowledge with awareness and lack of proper guidance by the general physicians. The aim of our study is to see the demographic and virological profiles of cirrhosis of liver with their possible modes of transmission. Methods: This cross-sectional study was carried out during the period of July 2018 to June 2019 in Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Dhaka, Bangladesh. Cirrhosis of liver was diagnosed mostly with the help of ultrasonography of whole abdomen and endoscopy of upper GIT. In few selected cases fibroscan of liver and liver biopsy were done. Results: This study included 724 patients who had cirrhosis of liver. Of them 276 cases had viral and 448 cases had non viral causes. We studied among 276 cases who had viral etiology. Male predominated over female (M: F=2.1:1) at presentation. Male patients were mostly in service (25.7%) and female patients were housewives (27.5%).Most of the patients were diabetic (53.3%), within 41-50 years of age (29.0%), urban background (67.0%) and mostly present as compensated than decompensated stage of cirrhosis of liver and it had significant association (p value .007) with liver cirrhosis. Among viral etiology HBV(70.7%)is the leading cause of cirrhosis of liver followed by HCV(28.6%).Both HBV and HCV infections were found more in male than female and it is significantly associated with cirrhosis of liver (p value .001).HBV infections were found more in non-diabetic patients and it is highly significant(p value .000) but HCV infections were found more in diabetic patients but it is not significant(p value .194).Regarding transmission of virus, male patients gave past history of haircut and shaving in barber shop in 37.76% cases for HBV, 27.66% cases for HCV positive patient and for female gave past history of childbirth by midwifery (‘dhais’) in 36.36% cases for HBV, 12.5% cases for HCV positive patient. In case of HBV transmission, history of surgery (23.14%),blood transfusion(4.71%),family history (24.7%) of HBV and in case of HCV history of surgery(16.47%), blood transfusion(9.01%),family history(1.57%) of HCV were found in both male and female patient. History of high risk exposure to multiple sexual partner were found more in HBV than HCV positive male patient. Conclusion: Cirrhosis of liver is more common in male than female patient between the age of 41-50, mostly urban background and present to us more at compensated stage. HBV infection is more common in male non diabetic and HCV infection is more common in female diabetic patient. Male patients with past history of haircut or shaving in barber shop and for female patient with history of delivery by midwifery (‘dhais’) more for HBV than HCV compared to history of blood transfusion more for HCV than HBV positive patient had an important role for virus transmission in our country. Birdem Med J 2020; 10(3): 192-199

scholarly journals Human Herpes Virus-8-Associated Multicentric Castleman's Disease in a Human Immunodeficiency Virus-Positive Patient with a Previous History of Kaposi's Sarcoma

2015 ◽  
Vol 5 ◽  
pp. 59 ◽  
Author(s):  
Guan Huang ◽  
Gavin Low
Keyword(s):  
Human Immunodeficiency Virus ◽  
Previous History ◽  
Castleman’S Disease ◽  
Positive Patient ◽  
Hiv Positive ◽  
Human Herpes ◽  
Human Herpes Virus 8 ◽  
Human Herpes Virus ◽  
Immunodeficiency Virus ◽  
History Of

Human herpes virus-8 (HHV-8)–associated Castleman's disease (CD) is a rare non-cancerous B-cell lymphoproliferative disorder in human immunodeficiency virus (HIV)-positive patients. We report a case of HHV-8–associated CD in an HIV-positive patient with a previous history of Kaposi's sarcoma (KS). The patient presented with progressive splenomegaly and diffuse lymphadenopathy, which can be seen in multicentric CD, KS, and HIV-associated lymphoma. There are no reliable clinical or imaging features to differentiate these diseases. Lymph node biopsy confirmed HHV-8–associated CD and excluded KS and lymphoma. Due to differences in treatment options and prognosis between the three etiologies, it is important for radiologists to include HHV-8–associated CD in the differential diagnosis when encountering HIV-positive patients that present with diffuse lymphadenopathy.

scholarly journals Comparison between the density of Langerhans’ cells in the prepuce of neonates and adult males

2018 ◽  
Vol 7 (2) ◽  
pp. 1220-1223
Author(s):  
Felix Mutale ◽  
Elliot Bufuku Kafumukache ◽  
Kaile Trevor
Keyword(s):  
Human Immunodeficiency Virus ◽  
Herpes Simplex ◽  
Langerhans Cells ◽  
Past History ◽  
World Health Organisation ◽  
World Health ◽  
Adult Males ◽  
Varicella Zoster ◽  
Immunodeficiency Virus ◽  
History Of

Langerhans cells (LCs) in epidermis function as sentinel antigen-presenting cells that can capture invading viruses like Herpes Simplex Virus, Varicella-zoster virus and Human  Immunodeficiency Virus (HIV). This interaction between  Langerhans cells and viruses is highly variable depending on the virus. Herpes Simplex induces apoptosis in LCs but HIV does not, instead it presents the HIV to T-cells in lymph nodes which in turn get infected. Langerhans cells in the prepuce are therefore, a portal of entry for HIV. Hence, world health organisation  recommends male circumcision to reduce the densities of  Langerhans cells. Fifteen fresh foreskins were obtained from adult males aged 18 years and above after circumcision, five had past history of ulcerative STI and five fresh foreskins were obtained from neonates. The specimens were fixed using 10% buffered formalin and transported to the histopathology laboratory where the tissues were grossed examined and embedded using paraffin wax. The formalin fixed paraffin blocks were then sectioned into 3-5um sections and then followed by immunohistochemistry staining. The primary monoclonal antibodies (anti-CD1a) targeting Langerhans cells were used and LCs counting was done. The mean Langerhans cells density in neonates was  36.6±5.273/mm2,while adults without past history of ulcerative STIs was 69.4±8.847/mm2 and those with history of ulcerative STIs was 88.4±7.273/mm2.Both age and past history of ulcerative STIs have an influence on the density of Langerhans cell on the prepuce. The neonates showed lower densities than adults. Adults with history of ulcerative STIs had higher densities than those without. Uncircumcised individuals with history of ulcerative STIs maybe more susceptible to acquisition and transmission of HIV through the prepuce than those without such history due to greater LCs densities.Key words: Human Immunodeficiency Virus (HIV), Acquired Immunodeficiency Syndrome (AIDS), Langerhans Cells (LC),Sexually Transmitted Infections (STI).

scholarly journals Metagenomic next-generation sequencing for the early diagnosis of talaromycosis in HIV-uninfected patients: five cases report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qiuhua Chen ◽  
Ye Qiu ◽  
Wen Zeng ◽  
Xuan Wei ◽  
Jianquan Zhang
Keyword(s):  
Tissue Culture ◽  
Next Generation Sequencing ◽  
Antifungal Therapy ◽  
Next Generation ◽  
Case Presentation ◽  
Talaromyces Marneffei ◽  
Immunodeficiency Virus ◽  
History Of ◽  
Effective Diagnosis ◽  
Generation Sequencing

Abstract Background In recent years, talaromycosis is reportedly on the rise in human immunodeficiency virus (HIV)-uninfected patients. However, the misdiagnosis and mistreatment of talaromycosis is more likely in HIV-uninfected patients than in HIV-infected patients because talaromycosis can be easily mistaken for tuberculosis or any other opportunistic infection. Therefore, we used metagenomic next-generation sequencing (mNGS), a novel gene detection method, for the diagnosis of talaromycosis in HIV-uninfected patients. Case presentation We report five cases diagnosed as talaromycosis by mNGS in HIV-uninfected patients, which were further confirmed by tissue culture. There were 3 male and 2 female patients. Two patients had a history of rat contact. The misdiagnosis duration ranged from 88 to 245 days. While the results of tissue culture changed from repeated negative to positive, the mNGS result for Talaromyces marneffei was positive earlier in 4 patients. The reads of Talaromyces marneffei in mNGS ranged from 5 to 414. After antifungal therapy, one of the outcomes was death due to the longest duration of misdiagnosis, and the other outcomes were clinical improvement. Conclusions mNGS is perhaps a rapid and effective diagnosis approach for the early confirmation of talaromycosis. Antifungal therapy is recommended once Talaromyces marneffei was revealed by mNGS. mNGS might reduce misdiagnosis duration and improve prognosis. Through these findings, we hope to provide some reference for talaromycosis in HIV-uninfected patients diagnosed early with the help of mNGS.

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