scholarly journals CMV Colitis in Immunocompetent Patients: 2 Cases of a Diagnostic Challenge

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Maria Paparoupa ◽  
Viola Schmidt ◽  
Helgard Weckauf ◽  
Huy Ho ◽  
Frank Schuppert

CMV infections are generally thought to be opportunistic by immunosuppression. Many literature cases though indicate that CMV infections can be also observed in immunocompetent patients. We present an unusual case of an extensive concentric benign stenosis due to CMV colitis and a case of coexistence with Crohn’s Disease, both observed in nonimmunosuppressed individuals. The right diagnosis was set after implementation of multiple unsuccessful treatment strategies. Our purpose is therefore to familiarize clinicians involved with the diagnosis and treatment of gastroenterological diseases with this entity.

2002 ◽  
Vol 126 (7) ◽  
pp. 849-852
Author(s):  
Sandra Wajstaub ◽  
Pratima Deb ◽  
Katherine A. Chorneyko

Abstract Malignant spindle cell tumors of the parotid gland are a diagnostic challenge. We present an unusual case of such a tumor that occurred in the right parotid gland of a 53-year-old man. The clinical and histologic assessments were consistent with a primary sarcoma of the parotid gland. The tumor was composed of sheets of pleomorphic, spindle-shaped cells with an area of bone formation. By immunohistochemistry, the tumor cells were positive for vimentin and negative for epithelial markers. Electron microscopy revealed mesenchymal cells containing moderate amounts of rough endoplasmic reticulum. The major differential diagnostic considerations were spindle cell carcinoma, carcinosarcoma, and primary undifferentiated sarcoma with osseous metaplasia. The lack of epithelial features and the benign appearance of the bone formation led to a diagnosis of undifferentiated sarcoma of the parotid gland.


Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Manan Abdulrahman Alhkbany

: The Coronavirus disease 2019 (COVID-2019) has emerged as a new public health crisis with the WHO officially declaring it as a pandemic on 30 January 2020. In December 2019, the virus originated in bats and was transmitted to humans through an unknown intermediary animal in Wuhan, Hubei province, China. As of 18 May 2020, there are 4,730,968 reported cases of Covid-19, with 315,488 deaths. Direct contact among individuals is the most common transmission method, primarily through droplets released during coughing or sneezing. The incubation period of the virus oscillates between 2 to 14 days. The commonly reported symptoms include fatigue, sore throat, cough, and fever. Most of the people are asymptomatic or show mild symptoms. The elderly individuals and people with comorbidities show severe symptoms. The disease is diagnosed by using the real-time reverse transcription-polymerase chain reaction (RT-PCR) testing method. A blood test is also used to detect the antibodies to the virus, which are usually released after infection. The typical laboratory findings indicate elevated C-reactive proteins (CRP) with normal or low white blood cell counts; the chest CT scan demonstrates ground-glass opacities (GGO) and bilateral pneumonia in most patients. Supportive treatment is available, and research on the right treatment using existing drugs is ongoing. Several pharmaceutical companies and research institutions are focusing on the development of a vaccine. The review summarizes and provides an update on the pathogenesis, diagnosis, and treatment strategies in the management of Covid-19.


2019 ◽  
Vol 70 (4) ◽  
pp. 1476-1478
Author(s):  
Laura Raducu ◽  
Adelaida Avino ◽  
Cristina-Nicoleta Cozma ◽  
Sorin Nedelea ◽  
Andra-Elena Balcangiu-Stroescu ◽  
...  

Verrucous carcinoma of the scrotum is an extremely rare disease and most cases are thought to result from poor hygiene and chronic inflammation. Currently, it has not been well characterized, the etiology, diagnosis and treatment remaining poorly understood. We present the case of a 50-year-old male patient diagnosed with verrucous carcinoma of the right hemiscrotum. Wide surgical excision was performed. Favorable outcomes can be achieved by surgery, even without any adjuvant therapy, but patients should be carefully followed up.


2018 ◽  
Vol 18 (12) ◽  
pp. 979-988 ◽  
Author(s):  
Antonio Di Sario ◽  
Paola Sassaroli ◽  
Luigi Daretti ◽  
Giulia Annulli ◽  
Laura Schiada ◽  
...  

2019 ◽  
Vol 19 (27) ◽  
pp. 2494-2506 ◽  
Author(s):  
Congcong Zhu ◽  
Yunjie Zhu ◽  
Huijun Pan ◽  
Zhongjian Chen ◽  
Quangang Zhu

Melanoma is a malignant skin tumor that results in poor disease prognosis due to unsuccessful treatment options. During the early stages of tumor progression, surgery is the primary approach that assures a good outcome. However, in the presence of metastasis, melanoma hasbecome almost immedicable, since the tumors can not be removed and the disease recurs easily in a short period of time. However, in recent years, the combination of nanomedicine and chemotherapeutic drugs has offered promising solutions to the treatment of late-stage melanoma. Extensive studies have demonstrated that nanomaterials and their advanced applications can improve the efficacy of traditional chemotherapeutic drugs in order to overcome the disadvantages, such as drug resistance, low drug delivery rate and reduced targeting to the tumor tissue. In the present review, we summarized the latest progress in imaging diagnosis and treatment of melanoma using functional nanomaterials, including polymers, liposomes, metal nanoparticles, magnetic nanoparticles and carbon-based nanoparticles. These nanoparticles are reported widely in melanoma chemotherapy, gene therapy, immunotherapy, photodynamic therapy, and hyperthermia.


2020 ◽  
Vol 1 (1) ◽  
pp. 58-68
Author(s):  
Ayesha Aftab ◽  
Syed Babar Jamal ◽  
Syeda Marriam Bakhtiar

Background: Obesity is an emerging pandemic considered to be an outcome of change in lifestyle owing to more processed food and the use of mechanical locomotives. Obesity has not only appeared as a problem in the esthetic appearance of an individual rather is a serious health issue due to its associations with various chronic diseases such as coronary and cardiovascular problems, hypertension, osteoarthritis, type-II diabetes mellitus, hyperlipidemia, and certain cancers. It is estimated that 30 percent of the world’s population, i.e. approximately 2.1 billion people, are victims of obesity. In addition to environmental causes, various genes and a group of genes are reported to be increasing the suceptibility of obesity. Objective: Pakistan is a heterogeneous population, an amalgam of various races, therefore, narrowing down the list of obesity-associated genes and their functional variance could help molecular biologists to select potential SNPs in the Pakistani population for molecular diagnosis and treatment. Method: The extraction of a set of obesity-associated genes has been performed by using Polysearch2. SNPs for each gene are retrieved from dbSNP. RegulomeDB and SNPinfo tools have been used for the functional analysis of SNPs retrieved against the Pakistani population. For the prediction of potential deleterious SNPs, SIFT, Polyphen-2, MUTTASTER, MUTASSESSOR, and LRT (likelihood ratio test) are utilized. Functional analysis of potential deleterious SNPs has been performed by studying protein stability and mapping of identified SNPs to protein structure. For the protein stability analysis, I-Mutant and SNPs3D have been used. Results: Four genes FTO, POMC, LEPR, and MC4R and further analysis revealed 3 deleterious SNPs in FTO, 4 in POMC, 1 in LEPR, and 1 in MC4R. Conclusion: This research was designed to identify obesity-associated genes and the most impactful deleterious SNPs in these genes. These findings will be helpful for the molecular biologists and pharmacists to design better and focused diagnosis and treatment strategies.


Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Jessica Ellis ◽  
Keziah Austin ◽  
Sarah Emerson

Abstract Background/Aims  A 49-year-old female of Nepalese heritage was referred with right-sided headache, scalp tenderness, and a painful swelling overlying the right temple. She denied any visual or claudicant symptoms but felt systemically unwell with a fever. There were no symptoms suggestive of an inflammatory arthritis, underlying connective tissue disease or vasculitis. She was normally fit and well with no past medical history. She did not take any regular medications and denied using over the counter or illicit drugs or recent travel. On review she had a low grade fever. There was a large tender, erythematous swelling overlying the right temple. Bilaterally the temporal arteries were palpable and pulsatile. Peripheral pulses were normal with no bruits. There was no evidence of shingles (HSV) or local infection. Full systemic examination revealed no other abnormalities. Laboratory tests showed: PV 2.56, CRP 101, total white cell count 14.38 (eosinophils 0.4), albumin 33, Hb 115. Urine dip was normal. Renal function, liver function and immunoglobulins were normal. ANCA was negative. Hypoechogenicity surrounding the right frontal branch of the right temporal artery was seen on ultrasound. There were no discrete masses suggestive of cysts, abscess or tumours. Temporal artery biopsy confirmed the presence of vasculitis; histology demonstrated transmural lymphohistiocytic inflammation, disruption of the elastic lamina and intimal proliferation. Prednisolone was started at 40mg daily. Four weeks after initially presenting she was asymptomatic and her inflammatory markers had normalised. Methods  The case is discussed below. Results  Temporal arteritis, or GCA, is primarily a disease of older adults; with age 50 often used as an inclusion criteria, and is more common in Caucasian populations. Limited reports exist of GCA in younger cohorts, but these are rare. An important differential in younger patients, such as ours, is juvenile temporal arteritis. This rare localised vasculitis affects almost exclusively the temporal artery. It is typically a disease of young males, who present with non-tender temporal swelling. Systemic symptoms are unusual and inflammatory markers are normal. Clinical or laboratory evidence of organ involvement, peripheral eosinophilia or fibrinoid necrosis on histology should prompt consideration of an AAV or PAN. Incidence of GCA increases in correlation with Northern latitude, with highest rates reported in Scandinavian and North American populations. GCA is rare in Asian populations. Higher diagnostic rates in countries where physicians have increased awareness of GCA proposed as an explanation for this difference; however differences in incidence are still observed between Asian and Caucasian populations presenting to the same healthcare providers. Conclusion  GCA is an uncommon diagnosis in younger and non-Caucasian patients. Thorough investigation through ultrasound and biopsy helped increase our diagnostic confidence in this unusual case. Rheumatologists must be alert to atypical presentations in order to deliver prompt and potentially sight-saving treatment. Disclosure  J. Ellis: None. K. Austin: None. S. Emerson: None.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Takehiro Hashimoto ◽  
Ryuichi Takenaka ◽  
Haruka Fukuda ◽  
Kazuhiko Hashinaga ◽  
Shin-ichi Nureki ◽  
...  

Abstract Background Yersinia pseudotuberculosis infection can occur in an immunocompromised host. Although rare, bacteremia due to Y. pseudotuberculosis may also occur in immunocompetent hosts. The prognosis and therapeutic strategy, especially for immunocompetent patients with Y. pseudotuberculosis bacteremia, however, remains unknown. Case presentation A 38-year-old Japanese man with a mood disorder presented to our hospital with fever and diarrhea. Chest computed tomography revealed consolidation in the right upper lobe with air bronchograms. He was diagnosed with pneumonia, and treatment with intravenous ceftriaxone and azithromycin was initiated. The ceftriaxone was replaced with doripenem and the azithromycin was discontinued following the detection of Gram-negative rod bacteria in 2 sets of blood culture tests. The isolated Gram-negative rod bacteria were confirmed to be Y. pseudotuberculosis. Thereafter, he developed septic shock. Doripenem was switched to cefmetazole, which was continued for 14 days. He recovered without relapse. Conclusions We herein report a case of septic shock due to Y. pseudotuberculosis infection in an adult immunocompetent patient. The appropriate microorganism tests and antibiotic therapy are necessary to treat patients with Y. pseudotuberculosis bacteremia.


2021 ◽  
Vol 11 (3) ◽  
pp. 299
Author(s):  
Yeong Jin Kim ◽  
Tae-Young Jung ◽  
In-Young Kim ◽  
Shin Jung ◽  
Kyung-Sub Moon

Postoperative complications after brain tumor surgery occur occasionally and it is important for clinicians to know how to properly manage each complication. Here, we described a rare case of late-onset, subdural fluid collection localized at the resection cavity that caused motor weakness after convexity meningioma resection, requiring differentiation from an abscess, to help clinicians determine treatment strategies. A 58-year-old right-handed female was admitted to the hospital with a headache and posterior neck pain. Brain computed tomography (CT) scans and magnetic resonance (MR) images showed a homogeneously enhanced, calcified, and multi-lobulated mass adjacent to the right motor strip without perilesional edema. The patient underwent surgery without incident or residual deficit and was discharged from the hospital in good condition. Six weeks after surgery, the patient complained of left arm monoparesis without infection-related symptoms. Brain imaging studies showed a localized fluid collection in the resection cavity with an enhanced margin and perilesional edema. Diffusion restriction was not detected. After three months of conservative treatment without surgery or antibiotics, she recovered from the neurologic deficits, and brain imaging studies showed the spontaneous regression of the fluid collection and perilesional edema. Late-onset, localized fluid collection at the resection cavity, which is similar to an abscess, could occur three to eight weeks after meningioma resection. When there are predisposing factors, including blood components and hemostatic materials in the surgical cavity, it is important for clinicians to understand this type of complication and choose conservative management as a feasible strategy.


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