Herpetiform aphthous genital ulcers misdiagnosed as herpes genitalis in a young male and their effective response to colchicine therapy

2019 ◽  
Vol 30 (13) ◽  
pp. 1340-1343
Author(s):  
Snigdha Saxena ◽  
Sidharth Tandon ◽  
Kabir Sardana ◽  
Sonali Bajaj
Keyword(s):  
Correct Diagnosis ◽  
Young Male ◽  
Herpes Genitalis ◽  
Response To Treatment ◽  
Diagnostic Dilemma ◽  
Effective Response ◽  
Genital Ulceration ◽  
Sexually Transmitted ◽  
Aphthous Ulcers ◽  
Cultural Taboos

Genital ulceration can be a source of tremendous stress to the patient, as well as to the family members, and poses a difficult and sensitive diagnostic conundrum for the clinician. Cultural taboos and social stigmas related with the disease often result in the clinician not believing the patient’s version of history and basing the diagnosis entirely upon the clinical picture, aided by diagnostic tests. The clinicians should keep in mind that sexually transmitted infections (STIs), which can cause genital ulceration are very common, but there is a long list of non-sexually acquired causes of genital ulceration, which can lead to a diagnostic dilemma, and these should be considered before labelling the patient as suffering from a STI. We present a rare case of herpetiform genital aphthous ulcers mimicking herpes genitalis and chancroid, which was misdiagnosed repeatedly, and their effective response to treatment with colchicine on subsequent identification of the correct diagnosis.

A case of splenomegaly with RK-39 positivity: A diagnostic pitfall

2021 ◽  
pp. 004947552110206
Author(s):  
Prasad Dange ◽  
Ankesh Gupta ◽  
Richa Juneja ◽  
Renu Saxena
Keyword(s):  
Hereditary Spherocytosis ◽  
Correct Diagnosis ◽  
Young Male ◽  
Differential Diagnoses ◽  
Patient Evaluation ◽  
Serological Testing ◽  
Endemic Region ◽  
Careful Patient ◽  
Diagnostic Pitfall ◽  
Marked Splenomegaly

Long-standing moderate to marked splenomegaly suggests several differential diagnoses, both haematological and infectious, particularly leishmaniasis and malaria in endemic areas. Non-infectious causes may be missed in these regions, especially if pitfalls of serological testing are not considered. Careful patient evaluation is necessary to arrive at the correct diagnosis. We report a case of a young male whose hereditary spherocytosis was initially missed because of RK-39 positivity, splenomegaly and the fact that he hailed from an endemic region.

scholarly journals Role of Circulating Immune Complexes in the Pathogenesis of Canine Leishmaniasis: New Players in Vaccine Development

2021 ◽  
Vol 9 (4) ◽  
pp. 712
Author(s):  
Cristina Cacheiro-Llaguno ◽  
Nuria Parody ◽  
Marta R. Escutia ◽  
Jerónimo Carnés
Keyword(s):  
Immune Complexes ◽  
Vaccine Development ◽  
Correct Diagnosis ◽  
Circulating Immune Complexes ◽  
Response To Treatment ◽  
Canine Leishmaniasis ◽  
Leishmania Infection ◽  
Serum Samples ◽  
Humoral Immune

During canine visceral leishmaniasis (CanL), due to Leishmania infantum (L. infantum), uncontrolled infection leads to a strong humoral immune response. As a consequence of the production of high antibody levels and the prolonged presence of parasite antigens, circulating immune complexes (CIC) are formed, which can be deposited in certain organs and tissues, inducing vasculitis, uveitis, dermatitis and especially glomerulonephritis and renal failure. A method to detect CIC and quantify their levels in serum samples from dogs infected with L. infantum has been recently described. It allowed demonstration of a correlation between CIC levels and disease severity. Thus, CIC measurement may be useful for diagnosis, assessment of disease progression and monitoring response to treatment. This is an interesting finding, considering that there remains an urgent need for identification of novel biomarkers to achieve a correct diagnosis and for optimal disease staging of dogs suffering from Leishmania infection. The objective of the present review is to shed light on the role of CIC in CanL, as well as to highlight their potential use not only as diagnostic and prognostic biomarkers but also as a valuable tool in vaccine development and new immunotherapy strategies to prevent or control disease outcome.

scholarly journals Lipschütz Ulcer: An Unusual Diagnosis that Should Not be Neglected

2021 ◽  
Vol 43 (05) ◽  
pp. 414-416
Author(s):  
Daniela Alexandra Gonçalves Pereira ◽  
Eliana Patrícia Pereira Teixeira ◽  
Ana Cláudia Martins Lopes ◽  
Ricardo José Pina Sarmento ◽  
Ana Paula Calado Lopes
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Clinical Course ◽  
Malignant Tumors ◽  
Sudden Onset ◽  
Drug Reactions ◽  
Genital Ulceration ◽  
Sexually Transmitted ◽  
Inflammatory Processes ◽  
Genital Ulcers

AbstractThe diagnosis of genital ulcers remains a challenge in clinical practice. Lipschütz ulcer is a non-sexually transmitted rare and, probably, underdiagnosed condition, characterized by the sudden onset of vulvar edema along with painful necrotic ulcerations. Despite its unknown incidence, this seems to be an uncommon entity, with sparse cases reported in the literature. We report the case of an 11-year-old girl who presented at the emergency department with vulvar ulcers. She denied any sexual intercourse. The investigation excluded sexually transmitted infections, so, knowledge of different etiologies of non-venereal ulcers became essential. The differential diagnoses are extensive and include inflammatory processes, drug reactions, trauma, and malignant tumors. Lipschütz ulcer is a diagnosis of exclusion. With the presentation of this case report, the authors aim to describe the etiology, clinical course, and outcomes of this rare disease, to allow differential diagnosis of genital ulceration.

scholarly journals Difficulties in the diagnosis of fungal rhinosinusitis – Literature review

2016 ◽  
Vol 6 (21) ◽  
pp. 11-17 ◽  
Author(s):  
Elena Patrascu ◽  
Claudiu Manea ◽  
Codrut Sarafoleanu
Keyword(s):  
Literature Review ◽  
Clinical Examination ◽  
Correct Diagnosis ◽  
Response To Treatment ◽  
Research Directions ◽  
Fungal Rhinosinusitis ◽  
Patients At Risk ◽  
Controversial Topic ◽  
Invasiveness Potential

Abstract Fungal rhinosinusitis is an important pathological entity, a highly controversial topic in the medical world today, by the various research directions it offers. In order to be able to predict a patient’s prognosis and his response to treatment, first we must have a classification of fungal rhinosinusitis. The authors considered it is important to make a distinction between invasive and noninvasive forms of fungal rhinosinusitis. The most important step in the management of fungal rhinosinusitis is to have a correct diagnosis, based on strong criteria, which will lead to a better prognosis of this disease. Because of its invasiveness potential, especially in patients at risk, it is essential to have a correct and fast diagnosis in case of fungal rhinosinusitis, in order to begin the treatment as fast as possible, for a favourable prognosis. The only way to establish diagnosis in a reliable way is to make a detailed clinical examination and to take biopsy samples.

scholarly journals Genital diseases awareness in young male students: Is information necessary to protect them?

2013 ◽  
Vol 85 (1) ◽  
pp. 14
Author(s):  
Nicola Mondaini ◽  
Mauro Silvani ◽  
Teo Zenico ◽  
Fabrizio Gallo ◽  
Franco Rosso ◽  
...  
Keyword(s):  
High School Students ◽  
Observational Study ◽  
Military Service ◽  
Social Impact ◽  
Young Male ◽  
Male Students ◽  
Sexual Disorders ◽  
School Students ◽  
Sexually Transmitted ◽  
Compulsory Military Service

Introduction: Few studies on the prevalence of male sexual diseases are currently available due to difficult application of observational studies or andrological disease prevention campaigns on large series of apparently healthy subjects. The medical check-up linked to compulsory military service represented in Italy a valid tool for epidemiological and observational study for 18 year old boys from 1861 to 2004. The stopping of compulsory military service and its related medical check-up could have determined an important social impact in terms of a lower level of attention and care on male genital/sexual diseases. The aim of the present observational study was to check the prevalence of genital/ sexual diseases among young male high-school students and promote an alternative campaign of information among young students. Methods: A prospective observational analytical study on young male students was conducted by 6 urological centres. Genital and sexually transmitted diseases were presented with slides to students in a general assembly. Some students were then counselled and filled out a short questionnaire on their lifestyle. Results: 12,535 students (10,432 males-83.6%) followed the presentation. and 4,897 males (46.7%) decided to be checked-up by the urologist and out of them 1554 (31.7%) presented relevant andrological diseases. Five-hundred students completed the questionnaire concerning their lifestyle. Many of them had not yet experienced condom use during sexual intercourse (27.8%). Drug abuse was reported by 39.6% of subjects and alcohol consumption in 80.8% of them. Conclusions: These data suggest the need for a national information campaign on male sexual disorders to promote sexual health.

scholarly journals Importance of Laparoscopy to Solve the Diagnostic Dilemma of Abdominal Tuberculosis

KYAMC Journal ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 14-17
Author(s):  
Md Saiful Islam ◽  
Md Masudar Rahman ◽  
M Fardil Hossain Faisal ◽  
Md Alamgir Jalil Pramanik ◽  
Muhammad Abdur Rouf
Keyword(s):  
Minimally Invasive ◽  
Diagnostic Laparoscopy ◽  
Abdominal Cavity ◽  
Correct Diagnosis ◽  
Abdominal Tuberculosis ◽  
Diagnostic Dilemma ◽  
Peritoneal Tissue ◽  
Appropriate Treatment ◽  
Liver Surface ◽  
Minimally Invasive Access

Background: Diagnosis of abdominal tuberculosis as well as histopathological confirmation is difficult because of suboptimal access to the intraperitoneal pathology. Laparoscopy provides minimally invasive access to the peritoneal cavity and materials can be collected for confirmation of diagnosis. Objectives: To study the importance of laparoscopy as a tool for the diagnosis of abdominal tuberculosis and initiation of appropriate treatment without delay. Materials & Methods: In this study 25 patients with suspected abdominal tuberculosis were selected within the period of May, 2014 to October, 2014. Diagnostic laparoscopy performed on all patients with biopsy of tissue from accessible sites. Results: Diagnostic laparoscopy with biopsy confirmed the diagnosis in 24 (96%) patients, 23 of these patients (96%) had nodules at different site of abdominal cavity and 19 of these patients (76%) had ascites. In two cases there were nodules over liver surface; biopsy was taken also from both liver nodules. One nodule revealed fibrosis and another nodule revealed tuberculosis. Conclusion: Imaging and culture of ascitic fluid may fail to confirm or exclude abdominal tuberculosis in clinically suspected cases. Laparoscopy with peritoneal tissue biopsy provided rapid and correct diagnosis of abdominal tuberculosis and should be performed early in suspected cases. KYAMC Journal.2021;12(01): 14-17

scholarly journals Clinical and laboratory profiles of genital ulcers (sexually transmitted diseases) in a tertiary care center in northeastern India

2021 ◽  
Vol 12 (2) ◽  
pp. 120-129
Author(s):  
Romita Bachaspatimayum ◽  
Zamzachin Guite ◽  
Thangjam Bijayanti Devi
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Herpes Genitalis ◽  
Tertiary Care Center ◽  
Cross Sectional ◽  
Female Ratio ◽  
Ulcer Disease ◽  
Sexually Transmitted ◽  
Northeastern India ◽  
Genital Ulcers

Background: Genital ulcers are defined as breaches in the continuity of the genital mucosa and/or skin. Sexually transmitted infections (STIs) that cause genital ulcer disease (GUD) are syphilis, chancroid, donovanosis, lymphogranuloma venereum (LGV), and herpes genitalis. This study aimed to investigate the clinical and laboratory profiles of STI-related genital ulcers. Materials and Methods: A cross-sectional two-year study was conducted on patients attending the Outpatient Department of Dermatology, Venereology and Leprosy in a tertiary care center in northeastern India. Selected were 95 patients who presented themselves with STI-related genital ulcers. Detailed history taking and examination were conducted with basic tests to assist the diagnosis. Results: The male-to-female ratio was 3.32:1, and the most common site was the glans and prepuce in males (28.77%) and the labia majora and minora in females (36.36%). 96.84% of patients had superficial ulcers. The KOH mount was positive in 26 patients. The Tzanck smear was positive in 31 patients. RPR was positive in four. HIV was positive in eleven. Herpes genitalis (96.84%) was the most common GUD. Mixed STIs were attested in 41.05% of patients. Conclusion: GUD can take various forms of presentation. The available laboratory tests should be utilized. The possibility of mixed infections should always be kept in mind.

scholarly journals Adenomatoid Hyperplasia of The Oral Cavity: A Diagnostic Dilemma

2021 ◽  
Author(s):  
Ali ALTINDAĞ ◽  
Poyzan Bozkurt ◽  
Burak Bilecenoğlu ◽  
Kaan Orhan
Keyword(s):  
Oral Cavity ◽  
Correct Diagnosis ◽  
Age Distribution ◽  
Salivary Gland Tumor ◽  
Histological Evaluation ◽  
Gland Tumor ◽  
Diagnostic Dilemma ◽  
Location Data ◽  
Wide Range ◽  
Review Study

This review study presents literature review and discusses the clinical significance of Adenomatoid Hyperplasia, a commonly misdiagnosed lesion. This rare entity has been seldom presented and is not well enough described in the literature. Only 15 reports with 95 cases could be attained during the online literature search using the keywords: Adenomatoid, Tumor, Hyperplasia, Minor salivary Glands. Data revealed a tendency towards the male gender. Age distribution of patients did not reveal a tendency towards a specific age group but presented a peak incidence in the 4th and 5th decades. Location data revealed a tendency towards the palate, especially the hard palate. Most of the presented cases were asymptomatic and the most common initial diagnosis made was salivary gland tumor. It was concluded that, adenomatoid hyperplasia of the oral cavity may resemble a wide range of pathologies and in order to differentiate and to achieve a correct diagnosis, histological evaluation is fundamental.

scholarly journals Retracted: Diagnostic Dilemma of a Diaphragmatic Hernia

2018 ◽  
Vol 4 (3) ◽  
Author(s):  
Salman Yahya ◽  
Sonia Zafar ◽  
Hafsa S. Babar
Keyword(s):  
Diaphragmatic Hernia ◽  
Turning Point ◽  
Rare Complication ◽  
Young Male ◽  
Acute Ischemia ◽  
Radiological Findings ◽  
Diagnostic Dilemma ◽  
High Index Of Suspicion ◽  
Disease Free

Diaphragmatic hernia post esophagectomy is a rare complication but a reality in its existence. It is typically difficult to diagnose but highly depends on keeping high index of suspicion. In our case report, the young male who underwent esophagectomy for esophageal carcinoma, remained disease free and stable in his 9 months follow up, suddenly presented in the emergency department with the symptoms of shortness of breath, chest pain, vomiting and tachycardia. The case was typically complicated by the initial treatment given for acute ischemia and cardiogenic shock. Radiological findings proved to be helpful and turning point in the diagnosis and overall management.

scholarly journals Acute heart failure due to COVID-19 related myocardial injury and de novo hypertensive cardiomyopathy: a challenging diagnosis

2021 ◽  
Author(s):  
Matteo Pernigo ◽  
Marco Triggiani ◽  
Emanuele Gavazzi ◽  
Ilaria Papa ◽  
Alberto Vaccari ◽  
...  
Keyword(s):  
Myocardial Injury ◽  
De Novo ◽  
Correct Diagnosis ◽  
Young Male ◽  
Organ Damage ◽  
Severe Illness ◽  
Myocardial Inflammation ◽  
Tubular Injury ◽  
Myocardial Thickening ◽  
Left Ventricle Dysfunction

We report a COVID-19 case with acute heart and kidney failure in a healthy young male. Echocardiography showed severe systolic and diastolic left ventricle dysfunction, with diffuse myocardial thickening. Cardiac MRI showed aspects of focal myocarditis, and hypertensive cardiomyopathy. Renal biopsy demonstrated limited acute tubular injury, and hypertensive kidney disease. Coronary angiography excluded critical stenoses. Unlike what we initially suspected, myocardial inflammation had a limited extent in our patient; severe hypertension causing cardiomyopathy and multi-organ damage, not diagnosed before, was primarily responsible for severe illness. Correct diagnosis and guidelines-directed treatment allowed a favorable course.

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