scholarly journals Pulmonary Malakoplakia by Rhodococcus equi in an HIV-Infected Patient in Mexico: A Case Report

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Victor H. Ahumada ◽  
Ivan Ortiz-Monasterio ◽  
Jose L. Hernandez ◽  
Amy B. Peralta
Keyword(s):  
Infected Patient ◽  
Susceptibility Testing ◽  
Rare Condition ◽  
Mortality Rates ◽  
Rhodococcus Equi ◽  
Case Presentation ◽  
Immunodeficiency Virus ◽  
Pathologic Findings ◽  
Immunocompetent Patients ◽  
Inflammatory Tissue

Background. Rhodococcus equi-related pulmonary malakoplakia is a rare condition with few reported cases; hereby, we present a case associated with advanced human immunodeficiency virus (HIV) infection, and thus far to our knowledge, the first report in Mexico. It is estimated that approximately 10% of the infections occur in immunocompetent patients, whereas the rest are immune deficient, targeting virtually any organ. Histologically, malakoplakia is characterized by the buildup of infiltrated inflammatory tissue as a consequence of the gathering of histiocytes embedded with concentric inclusions. The diagnosis relies on the cultures and the susceptibility testing as well as the pathologic findings compatible with the disease. Case Presentation. We present a 25-year-old male patient with persistent nonproductive cough for over a year and with weight loss, who comes to the emergency department with recent fever, swollen and tender lymph nodes, and hemoptysis. The patient gets diagnosed and treated for Rhodococcus equi-related pulmonary malakoplakia. Conclusion. Knowing the involvement of Rhodococcus in HIV is fundamental for the diagnosis and optimal treatment, which although unknown, a combination of antibiotics with intracellular penetration, on-time resection, and a proper immune reconstitution represents the best approach. Prognosis varies with mortality rates from 34% to 54%.

scholarly journals Osteonecrosis of the humeral head in a human immunodeficiency virus-infected patient under tenofovir disoproxil fumarate–emtricitabine–lopinavir/ritonavir for 10 years: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Kalilou Diallo ◽  
Bruce Shinga Wembulua ◽  
Mohamadou Aidara ◽  
Armel Alleyo ◽  
Noel Magloire Manga
Keyword(s):  
Human Immunodeficiency Virus ◽  
Femoral Head ◽  
Humeral Head ◽  
Infected Patient ◽  
Left Shoulder ◽  
Aseptic Necrosis ◽  
Case Presentation ◽  
Immunodeficiency Virus ◽  
Aseptic Osteonecrosis ◽  
Bone Remains

Abstract Background Human immunodeficiency virus-infected patients are 100 times more likely to develop aseptic osteonecrosis compared with the general population. While 90% of cases concern the femoral head, the involvement of humeral bone remains rare. Case presentation We report a case of aseptic osteonecrosis of the left humeral head complicating antiretroviral therapy in a female, 46-year-old, Bissau-Guinean human immunodeficiency virus-infected patient received in a context of progressive pain in the left shoulder followed by limitation of articular movements. Standard x-ray of the shoulder allowed us to make the diagnosis by showing a typical image of osteonecrosis. The treatment was medical combined with physiotherapy. Conclusions Aseptic osteonecrosis should be systematically looked for in human immunodeficiency virus patients on antiretroviral treatment. In addition to femoral head aseptic necrosis, the involvement of the humeral bone should also be considered.

scholarly journals The Presentation of Multiple Perforations in the Small Bowel as Cytomegalovirus Related Immune Reconstitution Inflammatory Syndrome in an HIV-infected Patient: a Case Report

2021 ◽  
Author(s):  
Wang Yanli ◽  
Xuyong Lin ◽  
Yuji Li ◽  
Ying Wen
Keyword(s):  
Small Bowel ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Infected Patient ◽  
Immune Reconstitution ◽  
Opportunistic Infections ◽  
Exploratory Laparotomy ◽  
Pathological Examination ◽  
Case Presentation ◽  
Immunodeficiency Virus ◽  
Inflammatory Syndrome

Abstract Background: Multiple perforations in the small bowel as cytomegalovirus (CMV) related immune reconstitution inflammatory syndrome (IRIS) in an human immunodeficiency virus (HIV)-infected patient is very rare. Up to now, only five IRIS-associated cases including our case were reported. We performed pathological examination, metagenomic next-generation sequencing (mNGS), CMV and immune cells immunohistochemical staining for rapid diagnosis and differential diagnosis.Case presentation: We describe a case with multiple perforations in the small bowel as CMV related IRIS in an HIV-infected patient. The patient appeared multiple perforations in the small bowel after 26 days of antiretroviral therapy (ART). The patient underwent exploratory laparotomy. Partial resection and surgical repair of small intestine were performed. CMV enteritis was confirmed by immunohistochemistry staining and other opportunistic infections were excluded by mNGS. However, he died from intestinal obstruction and septic shock at 55 days after surgery. Conclusions: Perforations due to CMV related IRIS are very rare, and usually lack the prodromal period symptoms of abdominal pain and diarrhea. It is not easily foreseen and appears shortly after ART. The condition of intestinal perforations is lethal, and early identification and surgical treatment are lifesaving.

scholarly journals Benign Lymphoepithelial Cyst: An Unusual Cause of Parotid Swelling in Two Immunocompetent Patients

2019 ◽  
Vol 7 (13) ◽  
pp. 2142-2145
Author(s):  
How Kit Thong ◽  
Primuharsa Putra Sabir Husin Athar ◽  
Wan Muhaizan Wan Mustaffa
Keyword(s):  
Histopathological Examination ◽  
Surgical Excision ◽  
Case Presentation ◽  
Important Differential Diagnosis ◽  
Immunodeficiency Virus ◽  
Lymphoepithelial Cysts ◽  
Parotid Swelling ◽  
Slow Growing ◽  
Immunocompetent Patients ◽  
Hiv Negative

BACKGROUND: Lymphoepithelial cysts, which are benign and slow-growing tumours, usually involve the head and neck regions. Benign lymphoepithelial cysts (BLECs) are the most common cause of parotid swelling in human immunodeficiency virus (HIV)-positive patients and are less common in immunocompetent patients. CASE PRESENTATION: Here, we present two cases of immunocompetent patients with long-standing, progressively enlarging parotid swelling. Postoperative histopathological examination of these patients revealed features of BLEC. CONCLUSION: Wide surgical excision is the gold standard for treatment and recurrences is rare. These cases are of particular interest because of the rarity of BLEC in HIV-negative patients and highlight an important differential diagnosis of parotid swelling.

Kaposi Sarcoma of the Penis in an HIV-Negative Patient

2011 ◽  
Vol 15 (2) ◽  
pp. 118-120 ◽  
Author(s):  
Roberto Cecchi ◽  
Michela Troiano ◽  
Maurizia Ghilardi ◽  
Laura Bartoli
Keyword(s):  
Unusual Case ◽  
Kaposi Sarcoma ◽  
Unusual Site ◽  
Case Presentation ◽  
Negative Patient ◽  
Immunodeficiency Virus ◽  
Nodular Lesions ◽  
Immunocompetent Patients ◽  
Hiv Negative

Background: The penis is an unusual site of presentation for Kaposi sarcoma, especially in immunocompetent patients. Case Presentation: A 52-year-old human immunodeficiency virus (HIV)-seronegative man presented with a reddish, 8 mm in diameter nodule on the glans penis near the coronal sulcus. Histopathology after excision of the lesion was consistent with Kaposi sarcoma. No other cutaneous or mucosal manifestations were present. After a follow-up period of 2 years, no recurrence was observed. Conclusion: This unusual case suggests that Kaposi sarcoma should be considered in the differential diagnosis of macular, papular, and nodular lesions involving the penis.

scholarly journals Concurrence of talaromycosis and Kaposi sarcoma in a HIV-infected patient: A case report

2020 ◽  
Author(s):  
Feifei Su ◽  
Xingguo Miao ◽  
Hui Ye ◽  
Shoufeng Yang
Keyword(s):  
Fungal Pathogen ◽  
Infected Patient ◽  
Histopathological Examination ◽  
Kaposi Sarcoma ◽  
Blood Cultures ◽  
Hiv Positive ◽  
Successful Management ◽  
Case Presentation ◽  
Talaromyces Marneffei ◽  
Immunodeficiency Virus

Abstract Background: Concurrence of talaromycosis, an opportunistic infection caused by fungal pathogen Talaromyces marneffei and Kaposi sarcoma, the most common neoplasm in patients infected with human immunodeficiency virus (HIV) has only been rarely reported. Despite poor clinical outcomes, clinical characteristics and management of these concurrent diseases in HIV-infected patients has not been described.Case presentation: A 33-year-old, HIV-positive male patient presented to the Department of Infectious Diseases at Wenzhou Central Hospital with cough, sputum expectoration, hemoptysis, rashes on the feet and violaceous plaques in the oral cavity. Chest computed tomography (CT) showed bilateral nodular, patchy shadows and lymphadenectasis. Skin biopsy and histopathological examination suggested Kaposi sarcoma. Talaromyces marneffei was isolated from blood cultures and supported talaromycosis. The patient presented significant resolution of symptoms following chemotherapy for Kaposi sarcoma and antifungal treatment for talaromycosis.Conclusions: Severe medical conditions such as Kaposi sarcoma and talaromycosis may coexist in HIV-infected patients, posing a high mortality risk. Etiological diagnosis and specifically directed treatment are vital for successful management of HIV-infected patients who develop these comorbid diseases

scholarly journals Refractory pharyngeal ulceration due to cytomegalovirus in a patient with HIV infection: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Morichika Osa ◽  
Akihiro Sato ◽  
Maki Sakagami ◽  
Masaki Machida ◽  
Takao Sato ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Pathological Examination ◽  
Cmv Infection ◽  
Case Presentation ◽  
Immunodeficiency Virus ◽  
Before And After ◽  
Infected Cells ◽  
Immunocompromised Hosts ◽  
Inflammatory Syndrome ◽  
Nonspecific Inflammation

Abstract Background Cytomegalovirus (CMV) is an important pathogen among immunocompromised hosts. Typically, CMV in human immunodeficiency virus (HIV) infection causes diseases of the retina, digestive tract, lungs and liver, but there are few cases of CMV infection of the pharynx and larynx. Case presentation A 57-year-old man with HIV infection was admitted because of pharyngeal pain. Before and after admission, pharyngeal biopsies guided by laryngeal endoscopy were performed four times, but pathological examination showed nonspecific inflammation, and the cause of pharyngeal ulceration was unclear. Additionally, the ulceration deteriorated after initiation of retroviral therapy. Laryngomicrosurgery was conducted under general anesthesia to remove tissue, and pathological diagnosis confirmed CMV infection. Pathological features included enlargement of the cytoplasm and nucleus in infected cells, and intranuclear bodies called owl’s eye inclusions. Ganciclovir dramatically improved the symptoms and laryngoscopic findings. Conclusions This case was diagnosed as pharyngitis and pharyngeal ulceration caused by CMV infection, related to immune reconstitution inflammatory syndrome. In previous reports of CMV-induced pharyngeal or laryngeal ulceration in HIV infection, we found six cases similar to our present case. All cases were diagnosed by biopsy. The present case indicates the importance of biopsy for definitive diagnosis. CMV infection should be considered as a differential diagnosis of pharyngeal ulceration in patients with HIV infection.

scholarly journals Septic shock due to Yersinia pseudotuberculosis infection in an adult immunocompetent patient: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Takehiro Hashimoto ◽  
Ryuichi Takenaka ◽  
Haruka Fukuda ◽  
Kazuhiko Hashinaga ◽  
Shin-ichi Nureki ◽  
...  
Keyword(s):  
Septic Shock ◽  
Therapeutic Strategy ◽  
Yersinia Pseudotuberculosis ◽  
Immunocompromised Host ◽  
Immunocompetent Patient ◽  
Case Presentation ◽  
Gram Negative ◽  
Old Japanese ◽  
The Right ◽  
Immunocompetent Patients

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.

Fetal pulmonary choristoma: report of first case and literature review

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Anupam Nanda ◽  
Rajinder Nanda ◽  
Seema Thakur ◽  
Tej Prakash Gupta ◽  
Sudhir Jain ◽  
...  
Keyword(s):  
Literature Review ◽  
Exome Sequencing ◽  
Posterior Fossa ◽  
Spinal Column ◽  
Fetal Autopsy ◽  
Case Presentation ◽  
Antenatal Ultrasound ◽  
Clinical Exome Sequencing ◽  
First Case ◽  
Pathologic Findings

AbstractObjectivesLung tissue choristoma is a very rare disorder where mature lung tissues develop in the site not normal to the lung.Case presentationWe hereby report a first case of fetal pulmonary choristoma in a 23–24 weeks fetus where antenatal ultrasound showed a mass in posterior fossa with severe ventriculomegaly. The mass extended inferiorly in cervical spinal column and thereafter extended in the skin over the back of fetus. Fetal autopsy confirmed these findings. Pathologic findings showed mature lung tissues with bronchi, bronchioles, and alveoli. Clinical exome sequencing showed normal results.ConclusionsWe describe the antenatal ultrasound, fetal autopsy and pathologic findings of an intracranial and cutaneous pulmonary choristoma.

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