scholarly journals Viral form of hemophagocytic syndrome with erythrodermal clinical picture: Case report

2008 ◽  
Vol 61 (7-8) ◽  
pp. 405-408
Author(s):  
Zorica Gajinov ◽  
Nada Vuckovic ◽  
Verica Djuran ◽  
Milan Matic ◽  
Milana Ivkov-Simic ◽  
...  
Keyword(s):  
Case Report ◽  
Hemophagocytic Syndrome ◽  
Skin Lesions ◽  
Lymph Gland ◽  
Oral Antibiotic ◽  
Rapid Improvement ◽  
Activated T Cells ◽  
Laboratory Findings ◽  
Exfoliative Dermatitis ◽  
Clinical Awareness

Introduction Hemophagocytic syndrome is patophysiological entity with proliferation and over-activation of macrophages, with hemophagocytosis and production of proinflammatory cytokines. It arises as hereditary forms, or acquired, during viral, autoimmune or malignant diseases, and is usually a disorder with fulminant course and high incidence of lethal outcome. The precise mechanism is not resolved; it is a consequence of cytokine storm generated by over-activated T cells and macrophages, due to defects in T cellular cytototoxic function and inadequate down-regulation of immune response. Case report A male patient, 26 years old, previously healthy, is presented. Generalized exfoliative dermatitis and lymphadenomegalia had lasted for half a year before admission to the hospital. Hemophagocytosis in lymph gland histology was diagnostic, with T cellular immunohistochemical profile CD3+, CD5-, CD8/-, CD43+/-, CD45RO+, bcl-2+, and numerous CD68+ histiocytes. Apart from elevated titer of Adenovirus serology, other laboratory findings and bone marrow histology were within normal limits. Two weeks of oral antibiotic and topical skin corticosteroid therapy were followed by a rapid improvement of clinical features. Residual skin lesions, linear petechia and flares of pale pink erythema used to recur for the next half a year. During the follow up, two years later there was no lymph gland enlargement, skin rash, or other signs. Discussion The diagnosis of virus-associated hemophagocytic syndrome with mild clinical course and seemingly spontaneous improvement was established, although it did not fulfill all proposed diagnostic criteria. It is possible that it increased the clinical awareness for these mild forms in immune-competent patients could account for the improved recognition of atypical cases with favorable outcome.

scholarly journals Grover’s disease in a patient with atopic dermatitis - a case report

2021 ◽  
Vol 74 (1-2) ◽  
pp. 33-37
Author(s):  
Sanja Jakovljevic ◽  
Ljuba Vujanovic ◽  
Dejan Ogorelica ◽  
Aleksandra Fejsa-Levakov ◽  
Jasmina Sekulic
Keyword(s):  
Case Report ◽  
Immunoglobulin E ◽  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Elevated Serum ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Complete Regression ◽  
Laboratory Findings ◽  
Topical Corticosteroids

Introduction. Grover?s disease is characterized by pruriginous polymorphic rash with a variable course and duration. Although the etiology is still unknown, the disease is often associated with other dermatoses, malignant diseases, use of certain medications, as well as immunosuppression. Case Report. We report a case of a 70-year-old male patient who was referred for examination to the Clinic of Dermatovenereology Diseases, Clinical Center of Vojvodina, due to a rash that lasted for nine months. The first lesions on the skin appeared around the nipples as exudative eczematous plaques. A few months later, identical lesions appeared on the lower legs. During treatment with systemic antihistamines and topical corticosteroids, there were episodes of transient improvements and re-exacerbations. In the meantime, erythematous brownish, round and oval papules appeared on the abdomen and the back, accompanied by intense itch. Laboratory findings revealed eosinophilia and elevated serum immunoglobulin E levels. A skin biopsy of the back lesion was performed and the histopathological examination confirmed the diagnosis of Grover?s disease. After the systemic treatment using corticosteroids and antihistamines, with gradual dose reduction and application of topical corticosteroids and emollients, complete regression of the skin lesions was achieved. Conclusion. Since the clinical manifestations of the disease may be nonspecific and discrete, dermatopathological analysis is of crucial importance in making the correct diagnosis. In patients with atopy, the treatment with systemic corticosteroids, antihistamines and topical agents may lead to regression of skin lesions with a significant improvement in the quality of life.

scholarly journals p-ANCA-Associated Vasculitis Caused by Levamisole-Adulterated Cocaine: A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Michelle R. Carter ◽  
Sorour Amirhaeri
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Delayed Diagnosis ◽  
Complete Recovery ◽  
Skin Lesions ◽  
Laboratory Findings ◽  
Anca Associated Vasculitis ◽  
Urine Toxicology ◽  
Positive Serum ◽  
Toxicology Screening

A rare case of a patient with an unusual skin rash after using cocaine is presented. A clinical diagnosis of levamisole-induced vasculitis was made based on initial presentation of purpuric skin lesions involving the ears and positive cocaine on urine toxicology screening. The diagnosis was confirmed after laboratory findings of neutropenia, positive serum levamisole, and a histopathologic test of the skin lesions. The pathophysiology of this condition is discussed. Treatment with methylprednisolone and prednisone led to the resolution of the neutropenia and complete recovery of the skin lesions. With the growing use of levamisole-tainted cocaine, clinicians should be aware of the symptoms of vasculitis and neutropenia induced by this combination of drugs to avoid unnecessary tests and delayed diagnosis.

scholarly journals Easy to manage when recognized: Case report of Cutaneous Larva Migranss

2021 ◽  
Vol 8 (1) ◽  
pp. 1026-1031
Author(s):  
Dunja Vesković ◽  
Dejan Ogorelica ◽  
Siniša Sević ◽  
Aleksandra Fejsa-Levakov ◽  
Branislava Gajić ◽  
...  
Keyword(s):  
Case Report ◽  
Urban Communities ◽  
Parasitic Infection ◽  
Skin Lesions ◽  
Temperate Climate ◽  
Larva Migrans ◽  
Laboratory Findings ◽  
Clinical Appearance ◽  
Careful Clinical Examination

Introduction: Cutaneous larva migrans (CLM) is a syndrome, defined by clinical appearance of slowly migrating cutaneous eruption caused by inoculation with animal hookworms larvae in the skin. Despite the typical clinical presentation, CLM is frequently misdiagnosed due to its rarity in temperate climate urban communities. Case Report: We report a case of a 42-year old female, admitted to an outpatient clinic with eruption of multiple intense pruritic, erythematous, exudative papules and oval plaques, located predominately on the back. The patient claimed that skin lesions started three weeks before the examination, during her vacation in Thailand, and at first, was taught to be caused by a contact with jelly fish. Lesions were treated unsuccessfully with oral antihistamines and various topical corticosteroids, which lead to more questions regarding the differential diagnosis. Dermoscopical and histopathological findings were indicative of parasitic infection, most likely CLM. A three-day course of oral albendazole, 400 mg daily, resulted in complete cure of the disease. Conclusions: Careful clinical examination and detailed history taken from the patient are fundamentals for creating a set of differential diagnoses, that can be further clarified by the use of laboratory findings, imaging methods (including dermoscopy) and biopsy with histopathology. Although CLM has a benign self-limiting course, intense itch may substantially impact the quality of life, and possible visceral involvement or concomitant parasitic infection may lead to serious health deterioration in unrecognized cases.

scholarly journals An incidental case of biliary fascioliasis with subtle clinical findings: US and MRCP findings

2013 ◽  
Vol 47 (2) ◽  
pp. 125-127
Author(s):  
Hakan Önder ◽  
Faysal Ekici ◽  
Emin Adin ◽  
Suzan Kuday ◽  
Hatice Gümüş ◽  
...  
Keyword(s):  
Case Report ◽  
Bile Duct ◽  
Magnetic Resonance ◽  
Biliary Obstruction ◽  
Fasciola Hepatica ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Clinical Findings ◽  
Imaging Studies ◽  
Laboratory Findings ◽  
Acoustic Shadow

Background. Fascioliasis is a disease caused by the trematode Fasciola hepatica. Cholangitis is a common clinical manifestation. Although fascioliasis may show various radiological and clinical features, cases without biliary dilatation are rare. Case report. We present unique ultrasound (US) and magnetic resonance cholangiopancreatography (MRCP) findings of a biliary fascioliasis case which doesn’t have biliary obstruction or cholestasis. Radiologically, curvilinear parasites compatible with juvenile and mature Fasciola hepatica within the gallbladder and common bile duct were found. The parasites appear as bright echogenic structures with no acoustic shadow on US and hypo-intense curvilinear lesions on T2 weighted MRCP images. Conclusions. Imaging studies may significantly contribute to the diagnosis of patients with subtle clinical and laboratory findings, particularly in endemic regions.

Fatal cutaneous anthrax in a heroin user

2013 ◽  
Vol 127 (4) ◽  
pp. 423-425 ◽  
Author(s):  
S Meghji ◽  
O Judd ◽  
E Carr
Keyword(s):  
Case Report ◽  
Mortality Rate ◽  
Drug Users ◽  
Heroin User ◽  
Intravenous Drug Users ◽  
Cutaneous Anthrax ◽  
The Uk ◽  
Clinical Awareness ◽  
Symptoms And Signs ◽  
Typical Picture

AbstractBackground and objective:Cutaneous anthrax usually has a mortality rate of less than 1 per cent. However, since December 2009 there have been more than 13 deaths in the UK due to anthrax-contaminated heroin. We therefore wish to raise clinical awareness of this treatable disease.Case report:We describe the case of a heroin user with an equivocal presentation of cellulitis in the neck. Within 36 hours, this led to death due to cutaneous anthrax.Conclusion:Whilst cutaneous anthrax remains rare, this case report aims to raise awareness of the fact that the symptoms and signs of this condition in intravenous drug users may not always fit the typical picture.

Scabies superimposed on skin lesions of adult T-cell leukemia/lymphoma: case report and literature review

2008 ◽  
Vol 47 (11) ◽  
pp. 1168-1171 ◽  
Author(s):  
Rieko Kabashima ◽  
Kenji Kabashima ◽  
Ryosuke Hino ◽  
Takatoshi Shimauchi ◽  
Yoshiki Tokura
Keyword(s):  
Case Report ◽  
T Cell ◽  
Literature Review ◽  
Skin Lesions ◽  
T Cell Leukemia ◽  
Cell Leukemia ◽  
Adult T Cell Leukemia

Specific skin lesions in hairy cell leukemia at presentation: case report and review of literature

2009 ◽  
Vol 27 (2) ◽  
pp. 559-561 ◽  
Author(s):  
N. Čolović ◽  
M. Peruničić ◽  
V. Jurišić ◽  
M. Čolović
Keyword(s):  
Case Report ◽  
Hairy Cell Leukemia ◽  
Skin Lesions ◽  
Hairy Cell ◽  
Review Of Literature ◽  
Cell Leukemia

A Case Report of Ascariasis of the Common Bile Duct in a Patient Who Had Undergone Cholecystectomy

2000 ◽  
Vol 124 (8) ◽  
pp. 1231-1232
Author(s):  
Glenda Amog ◽  
Jeffrey Lichtenstein ◽  
Steven Sieber ◽  
Hani El-Fanek
Keyword(s):  
Case Report ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Epigastric Pain ◽  
Pancreatic Neoplasm ◽  
Ultrasound Finding ◽  
Laboratory Findings ◽  
Live Worm ◽  
Endoscopic Extraction ◽  
The Common

Abstract This is a case report of ascariasis of the common bile duct in a 65-year-old man from Colombia who had undergone prior cholecystectomy. The patient presented with postprandial epigastric pain and a 20-lb weight loss. The laboratory findings were remarkable for peripheral blood eosinophilia. The ultrasound finding was suggestive of periampullary or pancreatic neoplasm. He underwent endoscopic retrograde cholangiopancreatography with endoscopic extraction of a motile, live worm identified as Ascaris lumbricoides. Roundworm infestation should always be suspected in immigrants from endemic areas who present with hepatobiliary symptoms.

Abstract 1122‐000205: Bilateral ACA Stroke ‐ A Case Report of an Unusual Presentation

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Tejeswi Suryadevara ◽  
Bhavya Narapureddy ◽  
Carlos Y Lopez ◽  
Karen C Albright
Keyword(s):  
Case Report ◽  
Brain Magnetic Resonance Imaging ◽  
Whole Body ◽  
Rapid Improvement ◽  
Stroke Registry ◽  
Disconnection Syndrome ◽  
Leg Weakness ◽  
Anatomic Variants ◽  
Computed Tomography Angiogram ◽  
Cerebrovascular Risk

Introduction : Bilateral ACA strokes are rare, with one stroke registry reporting 2 cases out of 1490 strokes (1). These strokes are even less common in the absence of anatomic variants, such as an azygos ACA. Diagnosis may be difficult given the variability in clinical presentation. Methods : This is a case report. Results : A 51‐year‐old right handed man with no cerebrovascular risk factors on no antithrombotic medications presented two hours from last known well with complaints of generalized weakness, inability to speak or move, and feeling numb all‐over during intercourse. He reported rapid improvement in symptoms. Emergency room exam was notable for right leg weakness (3/5) and left leg plegia with intact sensation. Hoover’s sign was positive in the left leg and the patient was able to bear some weight while standing with a two‐person assist. A computed tomography angiogram (CTA) of his head and neck was preliminarily interpreted as normal. No azygos ACA or single internal carotid artery origin for the ACAs were present. His exam improved to an isolated left foot dorsiflexor and plantar flexor weakness. The decision was made not to use thrombolytics based on his symptoms and exam which were improving and not entirely consistent with acute stroke. Brain magnetic resonance imaging demonstrated bilateral parasagittal acute strokes. It was later noted the that non‐contrast head CT demonstrated bilateral hyperdense ACAs. Conclusions : This case demonstrates the difficulty in diagnosing bilateral ACA infarcts in a previously healthy adult in the setting of whole‐body numbness and positive Hoover’s sign. In retrospect, his transient inability to speak or move may have been transient akinetic mutism or callosal disconnection syndrome. Additionally, this case emphasizes the importance of evaluating for the hyperdense ACA sign (2) in patients complaining of bilateral leg weakness.

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