scholarly journals 1398. Gland Tuberculosis: A Rare Localization of Tuberculosis

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S784-S784
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Amal Chakroun ◽  
Khaoula Rekik ◽  
Chakib Marrakchi ◽  
...  
Keyword(s):  
Gastrointestinal Symptoms ◽  
The Body ◽  
Antitubercular Therapy ◽  
Fixed Dose ◽  
Multisystem Disease ◽  
Skin Reactions ◽  
Disease Evolution ◽  
Evolutionary Features ◽  
Systemic Symptoms ◽  
Loss Of Appetite

Abstract Background Tuberculosis (TB) is a multisystem disease that might affect all organs. Gland TB is characterized with a misleading clinical presentation which often mimic a neoplastic process. The aim of our work was to study the clinical, therapeutic and evolutionary features of gland TB. Methods We conducted a retrospective study including all patients hospitalized for gland TB in the infectious disease department between 1999 and 2020. Results We encountered 28 cases among which 24 were females (85.7%). The mean age was 39±14 years. A rural origin was noted in 15 cases (53.5%). Two patients were previously treated for TB (7.1%). Systemic symptoms of TB included fever (60.7%), asthenia (53.5%), loss of appetite (46.4%) and weight loss (25%). There were 18 cases of breast TB (64.3%), 4 cases of salivary gland TB (14.3%) and 3 cases of ovarian TB (10.7%). Two cases of pituitary TB (7.1%) and one case of adrenal TB (3.6%) were noted. Multifocal TB was noted in 7 cases (25%). Lymph node (17.8%), pulmonary (14.2%) and peritoneal (7.1%) TB were associated with gland TB. Tuberculin skin test was positive in 19 cases (67.8%). The diagnosis was based on histopathological proof in 23 cases (82.1%), microbiological proof in 4 cases (14.3%) and clinically confirmed in one case (3.6%). The median duration of antitubercular therapy was 10 [9-15] months. Patients received fixed-dose combination in 11 cases (39.2%). Adverse effects of antitubercular therapy were noted in 10 cases (35.7%) represented by gastrointestinal symptoms (14.3%), increase in hepatic enzyme levels (14.3%) and skin reactions (7.1%). The disease evolution was favorable in 26 cases (92.9%). Relapse was noted in two cases (7.1%). Conclusion Gland TB included different sites. The presence of systemic symptoms of TB and the diagnosis of TB elsewhere in the body helped through the diagnosis process which requires high index of suspicion. It was mainly based on histological evidence. Disclosures All Authors: No reported disclosures

scholarly journals 246. Particularities of Non-axial Osteoarticular Tuberculosis Among Adults

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S231-S231
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Amal Chakroun ◽  
Khaoula Rekik ◽  
Chakib Marrakchi ◽  
...  
Keyword(s):  
Weight Loss ◽  
Antitubercular Therapy ◽  
Fixed Dose ◽  
Disease Evolution ◽  
Pulmonary Tb ◽  
Common Presentation ◽  
Osteoarticular Tuberculosis ◽  
Evolutionary Features ◽  
Previously Treated ◽  
The Mean

Abstract Background Osteoarticular tuberculosis (TB) represents 1% to 3% of all TB cases, among which spondylodiscitis is the most common presentation of the disease. Non-axial TB is less frequent. We aimed to study the clinical, therapeutic and evolutionary features of non-axial osteoarticular TB. Methods We conducted a retrospective study including all patients hospitalized in the infectious diseases department for non-axial osteoarticular TB between 1999 and 2019. Results We encountered 51 cases, among which 26 cases were males (51%). The mean age was 41±20years. Ten patients were previously treated for TB (19.6%). The revealing symptoms were fever (70.5%), asthenia (68.6%), weight loss (60.7%) and night sweets (43.1%). Arthritis was noted in 20 cases (39.2%) represented by TB of the hip (10 cases), knee (4 cases), shoulder (4 cases) and elbow (2 cases). There were 12 cases of sacroiliac osteoarthritis (23.5%) and 6 cases of femur osteomyelitis (11.7%). Other affected sites included sternum (7.8%), toe (5.9%), tibia (5.9%), mandible (2%), clavicle (2%) and mastoid bone (2%). Multifocal TB was noted in 12 cases (23.5%). Pulmonary TB was associated to osteoarticular TB in 13.7% of cases. The mean duration of antitubercular therapy was 10±5months. Fixed dose combinations were prescribed in 17.6% of the cases. The disease evolution was favorable in 47 cases (92.1%). Relapse was noted in 3 cases (5.8%) and death in one case (2%). Conclusion Non-axial osteoarticular TB was not a rare disease. Multiple sites might be involved which facilitate the diagnosis confirmation. Prolonged antitubercular therapy might be required. Disclosures All Authors: No reported disclosures

scholarly journals 1658. Particularities Of Pulmonary Tuberculosis Among Children

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S817-S817
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Amal Chakroun ◽  
Khaoula Rekik ◽  
Fatma Smaoui ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Clinical Symptoms ◽  
Miliary Tuberculosis ◽  
Fixed Dose ◽  
Gastric Aspirate ◽  
Disease Evolution ◽  
Evolutionary Features ◽  
Immunodeficiency Virus ◽  
The Mean ◽  
Prompt Diagnosis

Abstract Background The diagnosis of pulmonary tuberculosis (PTB) among children remains challenging due to the non-specific clinical symptoms, laboratory features and the difficulty of sampling for microbiological investigations. We aimed to study clinical, therapeutic and evolutionary features of PTB among children. Methods We conducted a retrospective study including all children aged ≤ 18 years diagnosed with PTB between 1995 and 2016. Results We encountered 67 children with PTB, among whom 37 (55.2%) were female. The median age was 15 years [1-18years]. According to residency, 36 patients came from rural area (53.7%). We noted 7 cases (10.4%) of miliary tuberculosis (TB). Three cases of pleural TB (4.5%), one case of lymph node TB (1.5%) and one case of neuromeningeal TB were associated to PTB. Induced sputum or gastric aspirate were positive for Mycobacterium tuberculosis in 67.9% of the cases. Serologic tests for human immunodeficiency virus was positive in one case (1.5%). The mean duration of antitubercular therapy was 8 ±2 months. The treatment regimen was based on a quadritherapy for the first 2 months, followed by a bitherapy for the rest of the period. Fixed dose drug combinations were prescribed in 17 cases (25.3%). The disease evolution was favourable in 65 cases (97%). Two patients were dead (3%). There were no relapsing cases. Conclusion Prompt diagnosis and treatment of PTB among children improve the prognosis. Screening for PTB among children exposed to adult tuberculosis is crucial in order to prevent the disease. Disclosures All Authors: No reported disclosures

Linezolid Induced Skin Reactions in a Multi Drug Resistant Infective Endocarditis Patient: A Rare Case

2020 ◽  
Vol 15 (3) ◽  
pp. 222-226 ◽  
Author(s):  
Asha K. Rajan ◽  
Ananth Kashyap ◽  
Manik Chhabra ◽  
Muhammed Rashid
Keyword(s):  
Case Report ◽  
Infective Endocarditis ◽  
Rare Case ◽  
Case Reports ◽  
Multidrug Resistant ◽  
The Body ◽  
Prior History ◽  
Skin Reactions ◽  
Rare Case Report ◽  
Multiple Drugs

Rationale: Linezolid (LNZ) induced Cutaneous Adverse Drug Reactions (CADRs) have rare atypical presentation. Till date, there are very few published case reports on LNZ induced CADRs among the multidrug-resistant patients suffering from Infective Endocarditis (MDR IE). Here, we present a rare case report of LNZ induced CARs in a MDR IE patient. Case report: A 24-year-old female patient was admitted to the hospital with chief complaints of fever (101°C) associated with rigors, chills, and shortness of breath (grade IV) for the past 4 days. She was diagnosed with MDR IE, having a prior history of rheumatic heart disease. She was prescribed LNZ 600mg IV BD for MDR IE, against Staphylococcus coagulase-negative. The patient experienced flares of cutaneous reactions with multiple hyper-pigmented maculopapular lesions all over the body after one week of LNZ therapy. Upon causality assessment, she was found to be suffering from LNZ induced CADRs. LNZ dose was tapered gradually and discontinued. The patient was prescribed corticosteroids along with other supportive care. Her reactions completely subsided and infection got controlled following 1 month of therapy. Conclusion: Healthcare professionals should be vigilant for rare CADRs, while monitoring the patients on LNZ therapy especially in MDR patients as they are exposed to multiple drugs. Moreover, strengthened spontaneous reporting is required for better quantification.

scholarly journals Asymptomatic Eosinophilic Infiltration with Endoscopic and Histological Findings Consistent with Eosinophilic Gastritis

2021 ◽  
pp. 652-656
Author(s):  
Kazuki Yamamoto ◽  
Takeshi Okamoto ◽  
Katsuyuki Fukuda
Keyword(s):  
Asymptomatic Patient ◽  
Gastrointestinal Symptoms ◽  
The Body ◽  
Eosinophilic Infiltration ◽  
Histological Findings ◽  
High Power Field ◽  
Medical Checkup ◽  
Endoscopic Findings ◽  
Eosinophilic Gastritis ◽  
History Of

Eosinophilic gastritis often presents with gastrointestinal symptoms in the absence of abnormal endoscopic findings. On the other hand, endoscopic changes due to eosinophilic infiltration in an asymptomatic patient are rare. A 29-year-old woman with a history of asthma on steroid inhalers presented for an annual medical checkup. Esophagogastroduodenoscopy revealed diffuse white granular patches in the body of the stomach, suggestive of eosinophilic gastritis. Histology showed over 100 eosinophils per high-power field, also consistent with eosinophilic gastritis. As the absence of symptoms precluded the diagnosis of eosinophilic gastritis, the patient was diagnosed with asymptomatic eosinophilic infiltration of the stomach.

scholarly journals Anti-PD-1-Induced Hidradenitis Suppurativa

2021 ◽  
Vol 8 (1) ◽  
pp. 37-39
Author(s):  
Alexia Maillard ◽  
Damien Pastor ◽  
Rastine Merat
Keyword(s):  
Adverse Events ◽  
Hidradenitis Suppurativa ◽  
Checkpoint Inhibitors ◽  
Latency Period ◽  
The Body ◽  
Skin Reactions ◽  
Zinc Gluconate ◽  
Severe Acne ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Mucocutaneous adverse events are commonly observed under immune checkpoint inhibitors (ICIs) therapy. Here, we report the case of a 43-year-old male patient with a stage IIIC melanoma disease who developed hidradenitis suppurativa (HS) three months after the beginning of an anti-PD-1 (nivolumab) adjuvant therapy. The patient had no comorbidities other than obesity and severe acne during adolescence. After an unsuccessful course of lymecycline while he was still treated with nivolumab, he gradually improved under zinc gluconate therapy and, more importantly, after nivolumab cessation. HS is a recurrent follicular inflammatory disease in the apocrine gland-bearing areas of the body often associated with obesity, metabolic syndrome, tobacco smoking, inflammatory bowel diseases, psoriasis, and arthritis. In our patient, the latency period between drug initiation and onset of HS symptoms and the improvement after immunotherapy discontinuation, argued strongly in favor of an anti-PD-1-induced HS. Anti-PD-1 therapies often trigger T cells-mediated adverse events that mimic Th17-mediated inflammatory and neutrophilic diseases. We suggest that HS, as other pustular skin reactions and ICIs-induced neutrophilic colitis, can be part of the anti-PD-1 mucocutaneous adverse event spectrum.

scholarly journals 1641. A Comparative Analysis Of Lymph Node Tuberculosis Between Children And Adults

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S810-S810
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Amal Chakroun ◽  
Khaoula Rekik ◽  
Fatma Smaoui ◽  
...  
Keyword(s):  
Lymph Node ◽  
Family History ◽  
Extrapulmonary Tuberculosis ◽  
Diagnostic Delay ◽  
Disease Evolution ◽  
Evolutionary Features ◽  
Significant Difference ◽  
History Of ◽  
Adults And Children ◽  
Lymph Node Tuberculosis

Abstract Background Lymph node tuberculosis (LNTB) represents the most common site of extrapulmonary tuberculosis. Among children, due to non-specific clinical features, the diagnosis is often delayed. We aimed to compare the clinical, therapeutic and evolutionary features of LNTB between adults and children. Methods We conducted a retrospective study including patients hospitalized for LNTB in the infectious diseases and pediatric department between 1993 and 2018. Children aged ≤18 years were included. Results Overall, we encountered 231 cases of LNTB. There were 40 children (17.3%) with a mean age of 11±4 years and 191 adults (82.7%) with a mean age of 42±16 years. As to gender, females were more affected (adults: 67% vs children: 70%), with no significant difference (p >0.05). A family history of tuberculosis was significantly more frequent among children (20% vs 6.3%; p=0.01). Raw milk consumption (38.2% vs 30%; p >0.05) and close contact with animals (29.8% vs 35%; p >0.05) were noted among both adults and children. Fever (53.4% vs 32.5%; p=0.01), night sweats (35.8% vs 10%; p=0.001), loss of appetite (38.2% vs 17.5%; p=0.01) and weight loss (35.1% vs 15%; p=0.01) were significantly more frequent among adults. Tuberculin skin test was positive in 75.8% of the cases among adults and in 86.2% of the cases among children (p >0.05). Multifocal tuberculosis was significantly more frequent among adults (23.8% vs 5.7%; p=0.01). Antitubercular therapy was prescribed for a mean duration of 10±4 months among adults and for 9±3 months among children, with no significant difference (p >0.05). Side effects of antitubercular drugs were more frequent among adults (33% vs 10.3%), with a significant difference (p=0.004). Comparison of the disease evolution showed no significant difference between adults and children, regarding recovery (94.8% vs 90%), relapse (5.2% vs 5%) and death (0.5% vs 2.5%). Conclusion The clinical presentation of LNTB among children was less common and misleading. A family history of tuberculosis and a high index of suspicion might shorten the diagnostic delay. Disclosures All Authors: No reported disclosures

scholarly journals Acute Iodine Toxicity from a Suspected Oral Methamphetamine Ingestion

2014 ◽  
Vol 7 ◽  
pp. CCRep.S20086 ◽  
Author(s):  
Marilyn N. Bulloch
Keyword(s):  
Case Report ◽  
Gastrointestinal Symptoms ◽  
Liver Function Tests ◽  
Oral Ingestion ◽  
Methamphetamine Abuse ◽  
Normal Limits ◽  
Naturally Occurring ◽  
History Of ◽  
Systemic Symptoms ◽  
Iodine Toxicity

Background Iodine is a naturally occurring element commercially available alone or in a multitude of products. Iodine crystals and iodine tincture are used in the production of methamphetamine. Although rarely fatal, iodine toxicity from oral ingestion can produce distressing gastrointestinal symptoms and systemic symptoms, such as hypotension and tachycardia, from subsequent hypovolemia. Objective The objective of this case report is to describe a case of iodine toxicity from suspected oral methamphetamine ingestion. Case Report A male in his early 20′s presented with gastrointestinal symptoms, chills, fever, tachycardia, and tachypnea after orally ingesting a substance suspected to be methamphetamine. The patient had elevated levels of serum creatinine, liver function tests, and bands on arrival, which returned to within normal limits by day 4 of admission. Based on the patient's narrow anion gap, halogen levels were ordered on day 3 and indicated iodine toxicity. This is thought to be the first documented case of iodine toxicity secondary to suspected oral methamphetamine abuse. Conclusion Considering that the incidence of methamphetamine abuse is expected to continue to rise, clinicians should be aware of potential iodine toxicity in a patient with a history of methamphetamine abuse.

619 HIGH DISCOVERY RATE OF GASTRODUODENAL EOSINOPHILIA BUT NOT EOSINOPHILIC ESOPHAGITIS IN PATIENTS WITH CHRONIC GASTROINTESTINAL SYMPTOMS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Nicholas Talley ◽  
Amol Kamboj ◽  
William Chey ◽  
Henrik Rasmussen ◽  
Brian Lacy ◽  
...  
Keyword(s):  
Eosinophilic Esophagitis ◽  
Gastrointestinal Symptoms ◽  
High Rate ◽  
Systematic Evaluation ◽  
Tissue Eosinophilia ◽  
Severity Scores ◽  
Gi Symptoms ◽  
Multi Center Study ◽  
Loss Of Appetite ◽  
Duodenal Biopsies

Abstract   Although the prevalence of eosinophilic gastrointestinal disorders (EGIDs) is increasing, there is evidence that eosinophilic gastritis and/or duodenitis (EG/EoD) are underdiagnosed. Patients with EG/EoD often present with chronic, non-specific gastrointestinal (GI) symptoms, similar to patients with functional GI disorders. We hypothesized that systematic evaluation, including multiple esophageal, gastric and duodenal biopsies, of patients with chronic GI symptoms might reveal a high rate of gastroduodenal eosinophila, with or without eosinophilic esophagitis (EoE). Methods We performed a prospective multi-center study of patients with non-specific GI symptoms for ≥6 months, from 20 sites. Patients completed a questionnaire assessing abdominal pain, abdominal cramping, early satiety, bloating, nausea, vomiting, diarrhea, and loss of appetite. Those with daily average symptom severity scores ≥3/10 for any single symptom underwent esophagogastroduodenoscopy (EGD) with collection of 4 esophageal (EoE), 8 gastric, and 4 duodenal biopsies, analyzed by central pathologists. Histologic criteria for EoE was ≥15eos/hpf in ≥1 esophageal site and for EG/EoD was peak eosinophil counts ≥30/hpf in ≥5 gastric hpfs and/or 3 duodenal hpfs—criteria used in randomized trials. Results Of 556 patients screened, 405 (73%) met symptom criteria and underwent EGD; 181 patients (45%, mean age 45, 73% female) who underwent EGD met the histologic criteria for EG/EoD, and of these, 7% also had EoE diagnosed. Overall 2% met histologic criteria for EoE alone. Of patients who met the histologic criteria for EG/EoD, 93% were previously diagnosed with gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), or functional dyspepsia (FD) (Figure 1). The average duration of GI symptoms in the screened population as well as those that met histologic criteria for EG/EoD was 11 years. Conclusion Forty-five percent of patients with moderate-to-severe GI symptoms who underwent EGD met histologic criteria for EG/EoD. Over 90% of these patients had previously been diagnosed with GERD, IBS, and/or FD, and had minimal overlap with EoE. EGD with systematic gastroduodenal biopsies, and intentional evaluation for tissue eosinophilia, should be performed in patients with chronic GI symptoms. Accurate diagnosis of EG/EoD is required for appropriate, targeted treatment and improved outcomes of patients with moderate-to-severe GI symptoms.

scholarly journals ОРНІТОЗ У ПАПУГ

2016 ◽  
Vol 18 (3(71)) ◽  
pp. 105-108
Author(s):  
N.H. Sorokinа ◽  
O.K. Halchynska ◽  
V.S. Lepushynska
Keyword(s):  
Cellular Localization ◽  
Clinical Signs ◽  
The Body ◽  
Atypical Pneumonia ◽  
Disease Etiology ◽  
Obligate Intracellular ◽  
Treatment And Prevention ◽  
Long Time ◽  
Definition Of ◽  
Loss Of Appetite

Psittacosis – a zooanthroponosis infection. In humans, the disease can manifest atypical pneumonia, enteritis, peritonitis, encephalitis. In parrots the disease starts with loss of appetite, drowsiness, weakness, fever, appearance of conjunctivitis, rhinitis and diarrhea. The causative agent of psittacosis in parrots are obligate intracellular microorganism Chlamydophila psittaci, which enters the body through the epithelium of the mucous membranes of respiratory tract. Its reproduction and accumulation occurs in the epithelial, and lymphoid reticulohistiocytosis cells. Chlamydia capable to long time cellular localization, can penetrate into the various organs and systems: the lungs, the nervous, cardiovascular system, liver. Parrot, who had been ill for psittacosis, is usually long remain carriers of Chlamydia. This article contains the definition of «psittacosis» as the disease, etiology, pathogenesis, main clinical features of parrots, pathological changes, especially the diagnosis, treatment and prevention. This materials are can help to owners of parrot and veterinary professionals to understand the disease, clinical signs, modern methods of diagnosis, prevention and therapy of psittacosis. 

scholarly journals Effect of Siguan Acupuncture on Gastrointestinal Motility: A Randomized, Sham-Controlled, Crossover Trial

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Kyung-Min Shin ◽  
Ji-Eun Park ◽  
Sanghun Lee ◽  
Sun-Mi Choi ◽  
Yo-Chan Ahn ◽  
...  
Keyword(s):  
Gastrointestinal Motility ◽  
Acupuncture Treatment ◽  
Gastrointestinal Symptoms ◽  
Sham Acupuncture ◽  
The Body ◽  
Acupuncture Group ◽  
The Real ◽  
Real Acupuncture ◽  
Significant Difference ◽  
Sham Acupuncture Group

Siguan acupoints have been used to treat gastrointestinal symptoms in acupuncture practices for a long time. This study aimed to investigate the effects of Siguan acupuncture on gastrointestinal motility under accelerated conditions using a randomized, sham-acupuncture-controlled, crossover study. Twenty-one healthy male subjects were hospitalized and randomized into either a real acupuncture group (at Siguan acupoints) or a sham acupuncture group. Subjects were administered with mosapride citrate (15 mg a day) for 2 days starting 24 hours before the first acupuncture treatment. Immediately after the administration of radio markers, acupuncture treatment was conducted 4 times at 12-hour intervals. Gastrointestinal motility was assessed using radiograph distribution of the radio-markers located in the small intestine, ascending colon, transverse colon, descending colon, rectum, and outside the body immediately after the first acupuncture treatment and at 6, 12, 24, and 48 hours. After a 2-week washout period, the real acupuncture group in the first session was treated with sham acupuncture in the second session, and vice versa. Gastrointestinal motility was generally reduced in the real acupuncture group compared with the sham acupuncture group throughout the 4 different time points. A significant difference was observed at 24 hours following the first acupuncture treatment (P<0.05).

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