scholarly journals Pulmonary foreign body granulomatosis in a chronic user of powder cocaine

2017 ◽  
Vol 43 (4) ◽  
pp. 320-321 ◽  
Author(s):  
Shruti Khurana ◽  
Ankit Chhoda ◽  
Sandeep Sahay ◽  
Priyanka Pathania
Keyword(s):  
Foreign Body ◽  
Miliary Tuberculosis ◽  
Histopathological Analysis ◽  
Significant Weight Loss ◽  
Chronic User ◽  
Initial Impression ◽  
Antituberculosis Treatment ◽  
Night Sweats ◽  
History Of ◽  
Clinical Profiles

ABSTRACT We describe the case of a 33-year-old man, a chronic user of powder cocaine, who presented with dyspnea, fever, night sweats, and significant weight loss. Chest HRCT revealed centrilobular nodules, giving an initial impression of miliary tuberculosis. Therefore, he was started on an empirical, four-drug antituberculosis treatment regimen. Four weeks later, despite the tuberculosis treatment, he continued to have the same symptoms. We then performed transbronchial lung biopsy. Histopathological analysis of the biopsy sample revealed birefringent foreign body granuloma. A corroborative history of cocaine snorting, the presence of centrilobular nodules, and the foreign body-related histopathological findings led to a diagnosis of pulmonary foreign body granulomatosis. This report underscores the fact that pulmonary foreign body granulomatosis should be included in the differential diagnosis of clinical profiles resembling tuberculosis.

scholarly journals Ruxolitinib Associated Tuberculosis Presenting as a Neck Lump

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Eamon Shamil ◽  
David Cunningham ◽  
Billy L. K. Wong ◽  
Piyush Jani
Keyword(s):  
Clinical Manifestations ◽  
Miliary Tuberculosis ◽  
Cervical Lymphadenopathy ◽  
Selective Inhibition ◽  
Antituberculosis Therapy ◽  
Night Sweats ◽  
History Of ◽  
Neck Lump ◽  
One Year

Tuberculosis is an opportunistic infection with protean clinical manifestations. We describe a case of Ruxolitinib induced miliary tuberculosis presenting as a neck lump. A 78-year-old female presented with a two-month history of right-sided neck lump associated with fever, night sweats, and significant weight loss. She had a past medical history that included myelofibrosis, being treated with Ruxolitinib. Examination demonstrated 4 × 4 cm right-sided cervical lymphadenopathy. A chest radiograph showed extensive shadowing in both lungs. CT scan demonstrated perilymphatic nodes in addition to the cervical mass. An ultrasound-guided biopsy of a cervical lymph node demonstrated confirmedMycobacterium tuberculosisinfection. It was hypothesized that use of Ruxolitinib through its selective inhibition of Janus-activated kinases 1 and 2 resulted in immunosuppression and miliary tuberculosis in this patient. The medication was stopped and a 12-month regime of antituberculosis therapy commenced. She remained well at one-year follow-up with resolution of lung involvement. Clinicians should consider tuberculosis as a differential diagnosis for patients presenting with a neck lump, particularly in those taking immunosuppressant medication such as Ruxolitinib. A multidisciplinary approach is needed to promptly treat the tuberculosis and consider discontinuation of Ruxolitinib.

Foreign Body Pulmonary Granulomas in an Abuser of Nasally Inhaled Drugs

PEDIATRICS ◽  
1991 ◽  
Vol 88 (1) ◽  
pp. 159-161
Author(s):  
DANIEL COREY JOHNSON ◽  
ANN PETRU ◽  
PARVIN H. AZIMI
Keyword(s):  
Drug Abuse ◽  
Foreign Body ◽  
Intravenous Drug ◽  
Intravenous Drug Abuse ◽  
Intermittent Fever ◽  
Inhaled Drugs ◽  
Night Sweats ◽  
History Of ◽  
Nasal Inhalation ◽  
Pulmonary Granulomas

Development of pulmonary granulomas from injected foreign substances is a known complication of intravenous drug abuse.1 We observed the development of foreign body granulomas in the lungs of a patient who abused methamphetamines solely by nasal inhalation. CASE REPORT J.R. was a 15-year-old white boy who presented with a 1-month history of intermittent fever, night sweats, pleuritic chest pain on inspiration, and cough. He specifically denied anorexia, weight loss, intravenous drug abuse, homosexuality, known exposure to asbestos or silicone, or contact with birds or hay. He admitted to a severalmonth history of snorting "crank," a powdered form of methamphetamines. He had smoked one pack of cigarettes per day for the previous year.

scholarly journals Adenocarcinoma of the Lung Mimicking Miliary Tuberculosis

2020 ◽  
Vol 13 (1) ◽  
pp. 139-144
Author(s):  
Dawlat Khan ◽  
Mohammed Danjuma ◽  
Muhammad Umar Saddique ◽  
Khaled Abdelfattah Hasan Murshed ◽  
Mohamed A. Yassin
Keyword(s):  
Kinase Inhibitor ◽  
Primary Lung Cancer ◽  
Miliary Tuberculosis ◽  
Chest Imaging ◽  
Shortness Of Breath ◽  
Adenocarcinoma Of The Lung ◽  
Initial Impression ◽  
Common Etiology ◽  
History Of ◽  
Indian Male

Miliary shadows on chest imaging have wide differential diagnoses. The most common etiology is infectious, such as miliary tuberculosis (TB) and histoplasmosis, but miliary shadows can be the presentation of sarcoidosis, pneumoconiosis, and secondary metastasis to the lungs from primary cancers of the thyroid, kidney, and trophoblasts as well as sarcomas. Here we present the case of a 35-year-old Indian male who presented with a 2-month history of dry cough and shortness of breath. Chest imaging showed diffuse bilateral miliary nodules. The initial impression was that of miliary pulmonary TB. Subsequent bronchoscopy with a transbronchial biopsy confirmed the diagnosis of pulmonary mucinous adenocarcinoma with brain metastasis, which is a rare and unusual presentation of primary lung cancer. The tumor was positive for ALK5A4 and PD-L1, and the patient was started on tyrosine kinase inhibitor immunotherapy, with a favorable response.

Tuberculosis, an old disease, still present in Romania

Farmacist ro ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 6-13
Author(s):  
Cristina Daniela Marineci ◽  
Cristina Elena Zbârcea ◽  
Simona Negreş
Keyword(s):  
Miliary Tuberculosis ◽  
Latency Period ◽  
Latent Tuberculosis ◽  
Multidrug Resistant ◽  
Active Immunization ◽  
Sputum Smear ◽  
The European Union ◽  
Directly Observed Therapy ◽  
Resistant Tuberculosis ◽  
Antituberculosis Treatment

Tuberculosis is a chronic infection, most often affecting the lungs, which usually manifests after a latency period from primary infection with Mycobacterium tuberculosis. Symptoms are generally nonspecific, with fever, cough, weight loss and malaise. The diagnosis is based on microscopic examination of sputum smear and rapid diagnostic molecular tests, which are increasingly used today. Genotypic tests for establishing the strain involved and phenotypic antibiograms for early detection of drug resistance should guide the initiation of treatment but are still expensive. Treatment of active tuberculosis is done with combination of antimycobacterial drugs, administered for at least 6 months. The antituberculosis treatment has several purposes: to cure the patient, to reduce the risk of recurrence, to prevent the installation of chemo-resistance, to prevent complications and to reduce mortality, as well as to limit the spread of the infection. Drug combinations are used to prevent the development of resistance. The administration is long-lasting in order to achieve the sterilization of foci that are difficult to access by medicines, ensuring healing and relapse prevention. Generally, standard pharmacological protocols are used. In order to increase the adherence to the treatment and its completion, often the anti-tuberculosis treatment is done under direct observation, in what is called directly observed therapy. Undesirable effects of anti-tuberculosis drugs should be detected early and managed appropriately. Recently, many cases of tuberculosis are resistant to the first-line drugs isoniazid and rifampicin (multidrug-resistant tuberculosis), or to these drugs, fluoroquinolones and at least one injectable antimycobacterial drugs (extensively drug-resistant tuberculosis). Especially the treatment of the latter is difficult to do, because there are not currently too many therapeutic options. That is why it is important to detect the resistance early and to establish the appropriate treatment. Treatment of latent tuberculosis usually involves the administration of isoniazid for 9 months. BCG vaccination is an active immunization method used in countries with high incidence of tuberculosis (Romania being the country of the European Union with the highest incidence of tuberculosis), protecting mainly against miliary tuberculosis, a spread form of tuberculosis, severe especially in children.  

Malaria among migrants in a university hospital in Colombia during 2018: A case series

2020 ◽  
pp. 004947552098130
Author(s):  
Fabián R Carreño-Almánzar ◽  
Adán Coronado-Galán ◽  
Sonia A Cala-Gómez ◽  
Agustín Vega-Vera
Keyword(s):  
Latin American ◽  
Previous History ◽  
Case Series ◽  
Cross Sectional Study ◽  
Imported Malaria ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
History Of ◽  
Clinical Profiles

Imported malaria has increased in Colombia since 2015 and has been attributed to migrants coming from Venezuela. We present a series of malaria cases, nested in a retrospective cross-sectional study between 2017 and 2018, aimed at calculating the prevalence of medical diseases among immigrants in a University Hospital in Colombia. Among 154 immigrants admitted for medical causes between 2017 and 2018, 8 were diagnosed with malaria, all due to Plasmodium vivax. Of these, seven had uncomplicated malaria, five had a previous history of malaria, one was critically ill, but none died. We highlight that, similar to other case series of imported malaria, Latin American migrants were young, with similar clinical profiles, having a low proportion of severe cases, and P. vivax was the most frequent cause.

scholarly journals Tuberculosis presenting as dacryoadenitis in the USA

2019 ◽  
Vol 12 (11) ◽  
pp. e231694 ◽  
Author(s):  
Harry Ross Powers ◽  
Mark Anthony Diaz ◽  
Julio C Mendez
Keyword(s):  
Correct Diagnosis ◽  
Developed Countries ◽  
Histopathological Analysis ◽  
Orbital Mass ◽  
Antituberculosis Therapy ◽  
The Usa ◽  
History Of ◽  
Patient’S History ◽  
High Degree ◽  
Filipino Woman

A 25-year-old Filipino woman living in the USA was evaluated for a 5-month history of left eye pain and a subsequent orbital mass. Histopathological analysis of the lacrimal mass showed a mixed inflammatory process with necrotising granulomas and positive cultures for Mycobacterium tuberculosis. She was treated with antituberculosis therapy, with resolution of symptoms. Tuberculosis dacryoadenitis is extremely rare in the USA and other developed countries. It requires a high degree of clinical suspicion with special attention to the patient’s history to make the correct diagnosis. It can be treated successfully with antituberculosis therapy.

IJV thrombophlebitis: be wary of the occult

2021 ◽  
Vol 14 (3) ◽  
pp. e238813
Author(s):  
Pamela Oshinyemi ◽  
Charlotte Lee ◽  
Antony Gough-Palmer ◽  
Iain McKay-Davies
Keyword(s):  
Colorectal Adenocarcinoma ◽  
Palliative Chemotherapy ◽  
Jugular Vein ◽  
Thrombus Formation ◽  
Locally Advanced ◽  
Patients With Cancer ◽  
Occult Malignancy ◽  
Night Sweats ◽  
History Of ◽  
Nose And Throat

A 43-year-old woman was referred to the Ear, Nose and Throat Department with a 3-day history of left-sided neck pain and swelling associated with fevers and night sweats. She also reported a cough, oral thrush and a dental extraction more than a month previously. A CT scan of the neck with contrast revealed left internal jugular vein (IJV) thrombophlebitis and the patient was initially managed for suspected Lemierre’s syndrome. Subsequent investigations revealed a locally advanced metastatic colorectal adenocarcinoma as the cause of her thrombosis, which was deemed inoperable. The patient was referred to oncology and commenced on palliative chemotherapy.The incidence of thrombophlebitis in patients with cancer is high. Although the IJV is a relatively uncommon site of thrombus formation, IJV thrombophlebitis is associated with significant morbidity and mortality. As it may be the first manifestation of an occult malignancy, a neoplastic cause should always be considered.

scholarly journals Foreign Body in abdomen

2015 ◽  
Vol 14 (2) ◽  
pp. 210-212
Author(s):  
Md Zakirul Alam ◽  
Mohibul Aziz
Keyword(s):  
Abdominal Pain ◽  
Foreign Body ◽  
Medical Science ◽  
X Ray ◽  
Diagnostic Center ◽  
History Of ◽  
Upper Abdominal ◽  
Married Female

A 19 years old married female presented with severe upper abdominal pain, repeated vomiting having history of swallowing a knife 7 months ago was admitted in Mordern Clinic and Diagnostic center, Joypurhat, Bangladesh. USG abdomen & X-ray (fig-1) abdomen were done when presence of a large foreign body (knife fig-3) in abdomen was made which latter on confirmed by Endoscopy of upper GIT (fig-2). Surprisingly the patient kept it in her abdomen for 7 months without any symptoms until the symptoms got worse and compelled her to seek medical help. The knife was removed by laparotomy, gastrotomy with uneventful recovery.Bangladesh Journal of Medical Science Vol.14(2) 2015 p.210-212

scholarly journals Endobronchial Foreign Body Presenting as Exacerbation of Asthma

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
James E. Tsang ◽  
June Sun ◽  
Gaik C. Ooi ◽  
Kenneth W. Tsang
Keyword(s):  
Foreign Body ◽  
Respiratory Distress ◽  
Foreign Bodies ◽  
Main Bronchus ◽  
Fiberoptic Bronchoscopy ◽  
Clinical History ◽  
Medical Personnel ◽  
History Of ◽  
Normal Chest ◽  
Low Dose Computed Tomography

Airway foreign bodies are a leading cause of death among children and require urgent recognition by medical personnel. While most cases are diagnosed readily from a clinical history of acute respiratory distress, some cases remain more indolent and present later. We report the case of a 7-year-old boy who aspirated a “LEGO” toy and presented with a week history of increasing respiratory distress compatible with known asthma. Despite a normal chest X-ray, a low-dose computed tomography showed the presence of a foreign body in the left main bronchus, which was subsequently removed by fiberoptic bronchoscopy. Our case serves to reemphasize the importance of considering airway foreign bodies as a cause of respiratory distress, especially in young children.

scholarly journals Miliary tuberculosis in a paediatric patient with psoriasis

2021 ◽  
Vol 14 (3) ◽  
pp. e237580
Author(s):  
Jacob Kilgore ◽  
Jonathon Pelletier ◽  
Bradford Becken ◽  
Stephen Kenny ◽  
Samrat Das ◽  
...  
Keyword(s):  
Brain Mri ◽  
Miliary Tuberculosis ◽  
Pulmonary Nodules ◽  
Chronically Ill ◽  
Community Acquired Pneumonia ◽  
Oral Antibiotic ◽  
Cavitary Lesion ◽  
Oral Antibiotic Therapy ◽  
History Of ◽  
Chest X Ray

We present a 16-year-old girl with a history of well-controlled psoriasis, on immunosuppression, who sought evaluation in the emergency department for 4 months of fever, cough and unintentional weight loss. The patient had seen multiple providers who had diagnosed her with community-acquired pneumonia, but she was unimproved after oral antibiotic therapy. On presentation, she was noted to be febrile, tachycardic and chronically ill-appearing. Her chest X-ray showed diffuse opacities and a right upper lobe cavitary lesion concerning for tuberculosis. A subsequent chest CT revealed miliary pulmonary nodules in addition to the cavitary lesion. The patient underwent subsequent brain MRI, which revealed multifocal ring-enhancing nodules consistent with parenchymal involvement. The patient was diagnosed with miliary tuberculosis and improved on quadruple therapy. Though rates of tuberculosis are increasing, rates remain low in children, though special consideration should be given to children who are immunosuppressed.

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