scholarly journals A case report of Talaromyces marneffei Oro-pharyngo-laryngitis: a rare manifestation of Talaromycosis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Thanyarak Wongkamhla ◽  
Piriyaporn Chongtrakool ◽  
Anupop Jitmuang
Keyword(s):  
Pathological Examination ◽  
Fungal Culture ◽  
Unusual Manifestation ◽  
Case Presentation ◽  
Thai Woman ◽  
Amphotericin B Deoxycholate ◽  
Rare Manifestation ◽  
Oral Itraconazole ◽  
The Right

Abstract Background The incidence of Taralomyces marneffei infection in HIV-infected individuals has been decreasing, whereas its rate is rising among non-HIV immunodeficient persons, particularly patients with anti-interferon-gamma autoantibodies. T. marneffei usually causes invasive and disseminated infections, including fungemia. T. marneffei oro-pharyngo-laryngitis is an unusual manifestation of talaromycosis. Case presentation A 52-year-old Thai woman had been diagnosed anti-IFNɣ autoantibodies for 4 years. She had a sore throat, odynophagia, and hoarseness for 3 weeks. She also had febrile symptoms and lost 5 kg in weight. Physical examination revealed marked swelling and hyperemia of both sides of the tonsils, the uvula and palatal arches including a swelling of the epiglottis, and arytenoid. The right tonsillar biopsy exhibited a few intracellular oval and elongated yeast-like organisms with some central transverse septum seen, which subsequently grew a few colonies of T. marneffei on fungal cultures. The patient received amphotericin B deoxycholate 45 mg/dayfor 1 weeks, followed by oral itraconazole 400 mg/day for several months. Her symptoms completely resolved without complication. Conclusion In patients with anti-IFN-ɣ autoantibodies, T. marneffei can rarely cause a local infection involving oropharynx and larynx. Fungal culture and pathological examination are warranted for diagnosis T. marneffei oro-pharyngo-laryngitis. This condition requires a long term antifungal therapy.

scholarly journals Large papillary fibroelastoma of right atrium, an unusual case of respiratory distress in a young man

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yan Le Ho ◽  
Pui Fong Ng ◽  
Sotheenathan Krishinan ◽  
Basheer Ahamed Abdul Kareem
Keyword(s):  
Right Atrium ◽  
Clinical Manifestations ◽  
Clinical Information ◽  
Interatrial Septum ◽  
Papillary Fibroelastoma ◽  
Case Presentation ◽  
Intracardiac Masses ◽  
The Right ◽  
Embolic Risk

Abstract Background Papillary fibroelastomas are rare but benign cardiac tumour that are often found on cardiac valvular surfaces. Their clinical manifestations ranging from clinically asymptomatic to substantial complications that are usually secondary to systemic embolism. Multiple theories have been proposed to explain the pathophysiology of its formation. Case presentation We reported a rare case of large papillary fibroelastoma in the right atrium of a young gentleman which was complicated with pulmonary embolism. Transthoracic echocardiography identified a large pedunculated mass measuring 3.4cmX3.4cmX2cm in right atrium with stalk attached to interatrial septum. The intracardiac mass was resected surgically, which revealed papillary fibroelastoma in histology examination. Conclusion Differential diagnosis of intracardiac masses requires clinical information, laboratory tests and imaging modalities including echocardiography. Incidentally discovered papillary fibroelastomas are treated on the basis of their sizes, site, mobility and potential embolic complications. Due to the embolic risk inherent to intraacardiac masses, surgical resection represents an effective curative protocol in treating both symptomatic and asymptomatic right sided and left sided papillary fibroelastomas, with excellent long term postoperative prognosis.

scholarly journals Tubocutaneous Fistula

2015 ◽  
Vol 2015 ◽  
pp. 1-2
Author(s):  
Krishnaveni Nayini ◽  
Clive Gie
Keyword(s):  
Early Diagnosis ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Fistulous Tract ◽  
Rare Condition ◽  
Diagnosis And Treatment ◽  
Case Presentation ◽  
Child Birth ◽  
The Right

Introduction. Tubocutaneous fistula is a very rare condition; most cases described in the literature are secondary to endometriosis, tuberculosis, and complications of child birth and gynecological operations.Case Presentation. We report a case of 40-year-old woman who presented with tubocutaneous fistula secondary to pelvic inflammatory disease which was diagnosed in the setting of persistent discharging wound in the right groin.Conclusion. Tubocutaneous fistula is a rare condition. Salpingectomy and resection of fistulous tract is the treatment of choice as is treating the underlying cause. Early diagnosis and treatment of these patients are essential for avoiding long term complications.

scholarly journals The largest reported intrathoracic lipoma: a case report and current perspectives review

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Mohammed Aldahmashi ◽  
Abdalmotaleb Elmadawy ◽  
Mahmoud Mahdy ◽  
Mohamed Alaa
Keyword(s):  
Single Case ◽  
Tumor Resection ◽  
Pathological Examination ◽  
Complete Excision ◽  
Case Presentation ◽  
Medical Checkup ◽  
Excellent Outcome ◽  
The Right ◽  
Intrathoracic Mass

Abstract Background The huge size intrathoracic lipomas are very rare. Few cases have been reported worldwide. To our knowledge, this presented case is one of the few cases reported. Here we report a single case as very huge intrathoracic lipoma compressing the right lung and displacing the diaphragm and liver downward. It has been managed by right posterolateral thoracotomy and complete excision, with excellent outcome. Case presentation A 32-year-old male presented with a symptomatic right intrathoracic mass, which was confirmed to be a lipomatous tumor using computed tomography. A penduculated tumor originating from the mediastinal pleura was resected through the conventional right posterior thoracotomy. Pathological examination indicated a diagnosis of fibrolipoma. Conclusion The tumor was symptomatic and relatively huge when detected during a medical checkup. This enabled the successful tumor resection via conventional thoracotomy approach. Although intrathoracic lipomas are histologically benign, careful observation and follow-up are crucial due to the possibility of recurrence.

scholarly journals Periocular Cutaneous Mucormycosis Caused by Saksenaea erythrospora

2017 ◽  
Vol 14 (04) ◽  
pp. 209-212
Author(s):  
Bunyada Putthirangsiwong ◽  
Pornchai Mahaisavariya ◽  
Weerawan Chokthaweesak ◽  
Dinesh Selva
Keyword(s):  
Complete Recovery ◽  
Molecular Techniques ◽  
First Case ◽  
Chronic Dacryocystitis ◽  
Oral Itraconazole ◽  
Periocular Region ◽  
Cutaneous Mucormycosis ◽  
The Right

Abstract Saksenaea erythrospora is a rare pathogen in humans. Ten adult cases have been previously reported, eight manifested with cutaneous infection, and two presented with invasive rhinosinusitis infection. The authors present a 16-month-old boy with progressive painful mass at the right medial canthus and upper cheek that was unresponsive to broad-spectrum antibiotics. He underwent an anterior orbitotomy and biopsy. Histopathology revealed broad nonseptate sterile hyphae and grew S. erythrospora, which was confirmed by molecular techniques. The patient was treated with intravenous liposomal amphotericin B and oral itraconazole combined with aggressive surgical debridement. The patient made a complete recovery without long-term complications at 4 months of follow-up. Primary cutaneous mucormycosis caused by S. erythrospora may rarely involve the periocular region and mimic chronic dacryocystitis. We report the first case of pediatric periocular cutaneous mucormycosis caused by S. erythrospora.

scholarly journals The Giant Paraganglioma of The Sigmoid Mesentery：A Case Report

2021 ◽  
Author(s):  
Xinxin Wang ◽  
Yuan Li ◽  
Xiaojun Yang
Keyword(s):  
Perioperative Period ◽  
Primary Treatment ◽  
Pathological Examination ◽  
Pelvic Cavity ◽  
Preoperative Preparation ◽  
Case Presentation ◽  
Anesthesia Monitoring ◽  
Painless Mass ◽  
Slow Growing

Abstract Background: PGL is originated from pheochromaffin cells in the adrenal paravertebral ganglion and often presented as a slow-growing, painless mass in the clinical, so many PGL are detected by imaging during physical examination. At present, surgery is still the primary treatment for radical treatment of PGL. However, If the disease and medical history cannot be asked in detail before surgery or imaging examination and related tests cannot be finished for diagnosis, the preoperative preparation will be insufficient and increasing the risk of surgery. Here, we reports the treatment of a case with undiagnosed giant sigmoid mesangial PGL before operation.Case presentation: The 56-year-old male patient was admitted to the hospital with "intermittent headache and dizziness for 3 years and aggravation for 1 week". Abdominal and pelvic CT showed that round soft tissue density shadow could be seen beside the left iliac artery in the pelvic cavity. The laparoscopic surgery was performed. The patient's blood pressure increased rapidly when the mass was removed intraoperatively, and decreased sharply when it was removed. Postoperative pathological examination showed that is a PGL.Conclusion: For patients diagnosed as space-occupying lesions accompanied by long-term persistent or intermittent hypertension, careful differentiation and diagnosis should be made in combination with the history and relevant examinations to reduce the misdiagnosis rate of the PGL. Meanwhile, the adequate preoperative preparation, intraoperative anesthesia monitoring and postoperative symptomatic supportive treatment should be done to reduce the risk of surgical treatment of this disease in the perioperative period.

scholarly journals Retrospective analysis of 73 cases of elastofibroma

2020 ◽  
Vol 102 (2) ◽  
pp. 84-93
Author(s):  
R Haihua ◽  
W Xiaobing ◽  
P Jie ◽  
H Xinxin
Keyword(s):  
Soft Tissue ◽  
Age At Onset ◽  
Disease Onset ◽  
Pathological Examination ◽  
Soft Tissue Tumour ◽  
Tissue Tumour ◽  
Short And Long Term ◽  
The Right

Objective Elastofibroma is a rare soft-tissue tumour. This study retrospectively analysed and summarised the clinical, imaging and typical pathological features, together with the short- and long-term surgical outcomes of patients with pathologically confirmed soft-tissue elastofibroma to improve their management. Materials and methods We enrolled 73 patients with pathologically confirmed soft-tissue elastofibroma from January 2010 to December 2018. The general, clinical, diagnostic and treatment-related data, operation notes, pathological examination results and follow-up status were obtained by reviewing inpatient medical records. Disease onset age, sex, tumour location and size were statistically analysed using the chi square and rank sum tests. Results A total of 90 lesions from 73 patients were examined. Among these, 56 patients had single lesions: 27 were under the right scapula, 26 were under the left scapula, 1 at the umbilicus, 1 on the aortic valve, 1 on the right hip and 17 at the bilateral inferior angles of the scapula. The average age at onset was 56.4 years (range: 6–82 years). The male-to-female incidence ratio was about one to three. Tumour diameter and follow-up duration ranged from 2cm to 12cm and from one month to nine years, respectively; recurrence was not observed. The main postoperative complication was wound effusion, occurring in 24 sites among the 90 lesions, corresponding to an incidence rate of 26.7%. Conclusions A correct diagnosis of elastofibroma can be made prior to surgical resection by examining typical clinical features and characteristic imaging findings. Short- and long-term outcomes of local excision are good, with no further recurrence.

scholarly journals Rare misdiagnosed case of penicilliosis marneffei in an immunocompetent patient

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052095948
Author(s):  
Dan Cheng ◽  
Xuhong Ding
Keyword(s):  
Early Stage ◽  
Left Lung ◽  
Immunocompetent Patient ◽  
Pathological Examination ◽  
Fungal Culture ◽  
Tumor Treatment ◽  
Fungal Treatment ◽  
Case Presentation ◽  
Penicilliosis Marneffei ◽  
Anti Fungal

Background Penicilliosis marneffei is a rare disease caused by Talaromyces marneffei, which is endemic in Southeast Asian countries, and usually occurs in immunocompromised or immunodeficient hosts. We report an unusual misdiagnosed case of penicilliosis marneffei in an immunocompetent patient from a non-endemic area of China. Case presentation: A 59-year-old man presented to hospital with a cough and progressive hemoptysis for a 3-month period. Clinical characteristics, radiological abnormalities, and prognosis were analyzed. Detailed examinations, chest computed tomography, and bronchoscopy were performed. The patient was misdiagnosed as having lung cancer and provided anti-tumor treatment for 1 month in the early stage. Imaging and bronchoscopy showed a neoplasm in the basal segment in the left lung, but a tissue biopsy did not establish a diagnosis. He subsequently underwent lobectomy for the lesion. The final pathological diagnosis was penicilliosis marneffei based on immunohistochemical staining. He was then prescribed specific anti-fungal treatment of voriconazole 200 mg twice daily for 12 weeks. Conclusion Timely fungal culture and pathological examination of clinical specimens are critical for the diagnosis of penicilliosis marneffei, especially in non-endemic regions and immunocompetent patients.

scholarly journals Long‐term recurrence and brain metastasis of nasopharyngeal carcinoma mimicking cystic radiation encephalopathy relapse: a case report

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xuhui Chen ◽  
Lijie Ren ◽  
Guozhen Qiu ◽  
Liming Cao
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Case Report ◽  
Nasopharyngeal Carcinoma ◽  
Brain Metastasis ◽  
Skull Base ◽  
Case Presentation ◽  
Radiation Encephalopathy ◽  
The Right

Abstract Background During medical imaging, cystic radiation encephalopathy and brain metastasis are difficult to differentiate, and hence they are easily misdiagnosed. To our knowledge, a nasopharyngeal carcinoma recurrence after more than seven years with cerebral metastasis that mimicked cystic radiation encephalopathy has not been reported. Case presentation A 52-year-old man was admitted to the hospital owing to weakness of the right limb for one month, which increased in intensity for three days. He had been diagnosed with nasopharyngeal carcinoma in 2011, which was treated by radiotherapy. The patient successively developed cystic radiation encephalopathy and brain metastasis from the nasopharyngeal carcinoma, which mimicked cystic radiation encephalopathy relapse. Left frontotemporal craniotomy, surgical resection of brain metastasis, and repair of the skull base and dura were performed. Postoperative computed tomography showed that midline deviation recovered, and brain edema was reduced. Conclusions This report is significant because brain metastasis from nasopharyngeal carcinoma can masquerade as a benign entity and cause fatal consequences. In patients presenting with cystic radiation encephalopathy, brain metastasis should be considered as a differential diagnosis.

scholarly journals Unilateral tongue mass after iatrogenic lingual nerve injury: A case report

2020 ◽  
Author(s):  
Hyung Chae Yang ◽  
Min-Keun Song
Keyword(s):  
Submandibular Gland ◽  
Nerve Injury ◽  
Anterior Part ◽  
Lingual Nerve ◽  
Taste Disturbance ◽  
Case Presentation ◽  
Nerve Preservation ◽  
The Right ◽  
Electrodiagnostic Study

Abstract Backgroud: This is the first report of hemangioma as a long-term complication of iatrogenic lingual nerve injury during submandibular gland extirpation. Case presentation: A 69-year-old woman presented with a tongue mass, which had grown slowly over 20 years. Submandibular gland (SMG) extirpation performed 40 years prior. MRI and CT revealed evidence of SMG extirpation. In addition, MRI and CT also revealed several enhancing lesions (hemangiomas) in the right sublingual space, as well as in the right anterior part of the tongue. An electrodiagnostic study showed right-sided lingual neuropathy. Psychosensory taste test showed taste disturbance in the affected side tongue. Conclusions: It should be considered to the lingual nerve preservation during the sublingual gland extirpation. It might cause the secondary traumatic pathology.

scholarly journals Pulmonary fungal ball due to Trichophyton successfully managed with oral itraconazole: a case report

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110662
Author(s):  
Hsu-Lin Lee ◽  
Li-Mien Chen ◽  
Chen-Chu Chang ◽  
Guan-Liang Chen
Keyword(s):  
Fungal Infection ◽  
Left Lung ◽  
Lavage Fluid ◽  
Lung Field ◽  
Fungal Culture ◽  
Lung Lobe ◽  
Recommended Treatment ◽  
History Of ◽  
Oral Itraconazole

Pulmonary fungal balls are caused by long-term fungal infection of the lung. They are sometimes a complication of previous cavitary pulmonary tuberculosis. Pulmonary fungal balls caused by Trichophyton are extremely rare. A 65-year-old man who worked in a leather recycling factory was admitted because of a productive cough and shortness of breath. He had a history of tuberculosis with lung destruction. A chest radiograph showed an opacity surrounding an air lucency over the left lung field, and chest computed tomography showed a mass within a cavity, producing a ball-in-hole appearance, over the left upper lung lobe. Bronchoalveolar lavage was performed, and fungal culture of the lavage fluid yielded Trichophyton. After 6 months of treatment with oral itraconazole, the patient’s general condition improved. This case emphasizes the importance of awareness of fungal infection within cavitary lesions of the lung and shows that Trichophyton may be the etiologic organism in such cases. Itraconazole is a recommended treatment of pulmonary fungal balls.

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