scholarly journals An Orbital Mass Partially Responsive to Steroid

2021 ◽  
Vol 5 (2) ◽  
Keyword(s):  
Lower Extremity ◽  
Granulomatous Inflammation ◽  
Orbital Pseudotumor ◽  
Orbital Mass ◽  
Hilar Lymphadenopathy ◽  
X Ray ◽  
Bilateral Hilar Lymphadenopathy ◽  
Chest X Ray

A 68 year old woman presented with a progressively enlarging orbital mass. MRI of her brain and orbits was consistent with an orbital pseudotumor. Although there was some improvement in the patient’s pain and the size of the mass, it did not fully resolve.The patient had a biopsy demonstrate non-caseating granulomatous inflammation. A chest X-ray and CT chest demonstrated bilateral hilar lymphadenopathy. Further examination and interviewing of the patient revealed several months of joint paints and lower extremity nodules. The patient was diagnosed with orbital sarcoidosis and was started on methotrexate by a rheumatologist

scholarly journals Role of chest X-ray in tuberculous cervical lymphadenitis

2015 ◽  
Vol 22 (2) ◽  
pp. 125-128
Author(s):  
Rameez Shah ◽  
Debesh Chandra Talukdar ◽  
Md Abu Yousuf Fakir ◽  
Mohammad Zaid Hossain ◽  
AF Mohiuddin Khan ◽  
...  
Keyword(s):  
Radiological Finding ◽  
Neck Surgery ◽  
Tuberculous Lymphadenitis ◽  
Cervical Lymphadenitis ◽  
College Hospital ◽  
Hilar Lymphadenopathy ◽  
X Ray ◽  
Medical College ◽  
Bilateral Hilar Lymphadenopathy ◽  
Chest X Ray

Tuberculous cervical lymphadenitis is not an uncommon entity when it comes to otolaryngology practice in Bangladesh. This study was done in the department of ENT and Head Neck Surgery, Dhaka Medical College Hospital, Dhaka, from January 2012 to January 2013 and was designed to find out chest x-ray abnormalities in apparently chest asymptomatic confirmed tuberculous cervical lymphadenitis without associated diseases. The diagnosis of tuberculous cervical lymphadenitis was confirmed by fine needle aspiration cytology (FNAC) and/or smear for acid-fast bacillus, and chest x-ray (PA view) was done in all confirmed cases (n=183). Normal chest x-ray was found in 132 cases (72.13%) and abnormal chest x-ray in 51 cases (27.87%). Pulmonary infiltration, the commonest radiological finding was detected in 32 cases (17.49%), hilar enlargement in 17 cases (9.29%), right paratracheal opacity in 2 (1.09%), obliteration of costophrenic angles in 3 cases (1.64%) and miliary mottling in one case (0.55%). Upper zonal predominance of lung parenchymal infiltrations was noted in 12.57% and right lung involvement in 16.39%. Single zone was affected in 9.84% cases and multiple zones were involved in 7.65% cases. We observed right hilar enlargement in 6.56%, left hilar lymphadenopathy in 4.37% and bilateral hilar lymphadenopathy in 2.73% cases. We concluded that routine chest x-ray should be done in all tuberculous lymphadenitis before categorization and starting of treatment. DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21521 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 125-128

scholarly journals Chronic Granulomatous Disease: A Rare Hereditary Immuno-deficiency Disorder in a Young Boy with Its Adverse Consequences

2016 ◽  
Vol 33 (3) ◽  
pp. 156-160
Author(s):  
Mamunur Rashid ◽  
Asfia Nigar ◽  
Md Rashidul Hassan
Keyword(s):  
Chronic Granulomatous Disease ◽  
Granulomatous Inflammation ◽  
Primary Immunodeficiency Disease ◽  
Granulomatous Disease ◽  
Phagocytic Cells ◽  
X Ray ◽  
Chest X Ray ◽  
Immunodeficiency Disease ◽  
Bacteria And Fungi ◽  
Long Acting

Chronic granulomatous disease (CGD) is a primary immunodeficiency disease which results from absence of the NADPH oxidase in the professional phagocytic cells neutrophils, monocytes, macrophages and eosinophils. Deficiency of this oxidase renders the patient liable to infection by bacteria and fungi, and, as the name of the disease suggests, to chronic granulomatous inflammation. Here, a young boy presented with increasing breathlessness and productive cough had recurrent episode of pulmonary infection since his childhood. Repeated Chest X-ray and CT scan showed homogenous opacities at different places of lung in different occasions with bilateral reticulo-nodular opacities. Mulipleoraganisms were isolated from sputum at different times. A nitroblu-tetrazolium test (NBT) was done abroad which was positive and confirmed his diagnosis. Since then, He had prophylactic fluconazol and sulphamethoxazoltrimethoprime daily and pneumocaccal and influenza vaccination regularly and proper treatment of acute infective episodes accordingly. In spite all these measures, repeated infection caused grievous harm to his lung leading to irreversible pulmonary fibrosis and bronchiectasis. As a consequence, he became home bound, oxygen dependant and dependant on regular use of long acting bronchodilators in different form. Hematopoeitic stem cell transplantation was advised which was not affordable for his parents. Now, this young boy is waiting for further assaults to his lungs and further deterioration and ultimate hopeless outcomes.J Bangladesh Coll Phys Surg 2015; 33(3): 156-160

scholarly journals Hypercalcemia, Anemia, and Acute Kidney Injury: A Rare Presentation of Sarcoidosis

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Neeraj Sharma ◽  
Hassan Tariq ◽  
Kalpana Uday ◽  
Yevgeniy Skaradinskiy ◽  
Masooma Niazi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Hematologic Malignancy ◽  
Granulomatous Inflammation ◽  
Kidney Injury ◽  
Transbronchial Biopsy ◽  
Rare Presentation ◽  
X Ray ◽  
Initial Impression ◽  
Chest X Ray ◽  
Noncontrast Computed Tomography

We discuss a case of a 61-year-old woman who presented with substernal chest pain. She was found to have elevated calcium levels, anemia, and acute kidney injury. The hypercalcemia persisted despite therapy with fluids and bisphosphonates. She was found to have nonparathyroid hormone (PTH) mediated hypercalcemia. The chest X-ray did not reveal any pathology. Our Initial impression was likely underlying hematologic malignancy such as lymphoma or multiple myeloma. A bone marrow biopsy was performed that revealed nonnecrotizing granulomatous inflammation. Further workup revealed elevated vitamin 1,25 dihydroxy level, beta-two microglobulin level, and ACE levels. Noncontrast computed tomography (CT) scan of chest showed bilateral apical bronchiectasis, but did not show any lymphadenopathy or evidence of malignancy. Subsequently, a fiber optic bronchoscopy with transbronchial biopsy showed nonnecrotizing granulomatous inflammation consistent with sarcoidosis. After initiating glucocorticoid therapy, the patient’s hypercalcemia improved and her kidney function returned to baseline.

scholarly journals What happens when oral tuberculosis is not treated?

2016 ◽  
Vol 67 (2) ◽  
Author(s):  
A.E. Erbaycu ◽  
Z. Taymaz ◽  
F. Tuksavul ◽  
A. Afrashi ◽  
S.Z. Güçlü
Keyword(s):  
Intestinal Tract ◽  
Granulomatous Inflammation ◽  
Oral Lesions ◽  
Tuberculosis Complex ◽  
Lower Lip ◽  
X Ray ◽  
Radiological Response ◽  
Chest X Ray ◽  
Important Form ◽  
Inner Parts

Pulmonary tuberculosis (TB) is the most important form of the disease, although infection may also occur by way of the intestinal tract, tonsils and skin. Oral lesions consist of persistent ulcers or granulomatous masses. A 50 year old man had been diagnosed “necrotising granulomatous inflammation” following a biopsy of a lesion on lower lip, 21 months before at a medical centre. A chest-X-ray had not been performed and he had not been given any advise in respect of treatment. He was admitted to the hospital with cough, sputum, weakness, weight loss and lesions on his lower lip. In radiology, it was detected that he had supraclavicular, submental, cervical, mediastinal lymphadenopathies, pulmonary infiltrations with cavities, thickening and roughness on left oropharengial tonsil, thickenning on inner parts of larynx and bilateral surrenal thickening. The biopsy of lesions on larynx, tonsil and epiglottis revealed “necrotising granulomatous inflammation” and histopathology supported TB infection. Sputum acid-fast bacilli was positive and culture was positive for Mycobacterium tuberculosis complex. Two months of combination treatment resulted in a gradual relief of the symptoms, radiological response, disappearing of neck swelling and healing of lesions on lip, tonsil and larynx. Although unusual oral cavity manifestations of TB are rare, clinicians should be aware of possible occurrance.

scholarly journals A tüdő nekrotizáló sarcoid granulomatosisa

2021 ◽  
Vol 162 (38) ◽  
pp. 1541-1547
Author(s):  
Noémi Zombori-Tóth ◽  
Katalin Ugocsai ◽  
Árpád Vincze ◽  
József Furák ◽  
László Tiszlavicz ◽  
...  
Keyword(s):  
Standard Form ◽  
Spontaneous Remission ◽  
Rare Entity ◽  
Soft Tissue Density ◽  
Thoracoscopic Resection ◽  
Granulomatous Angiitis ◽  
X Ray ◽  
Bilateral Hilar Lymphadenopathy ◽  
Function Test ◽  
Chest X Ray

Összefoglaló. A nekrotizáló sarcoid granulomatosis a granulomatosus pulmonalis angitisek közé tartozó, ritka kórkép. Egyesek a sarcoidosis variánsának, mások primer pulmonalis vasculitisnek tartják. A kórkép klinikai és patológiai jellegzetességeit két eset bemutatásával ismertetjük. A 20 éves nőbeteg sürgősséggel került pulmonológiai osztályra száraz köhögés, jobb oldali, mély belégzéssel összefüggő mellkasi fájdalom és láz miatt, a 63 éves férfi beteget pedig pneumoniát követő kontroll-mellkasröntgenfelvételen látott elváltozás kivizsgálása során észlelték. Az autoimmun panel vizsgálata, a mikrobiológiai tesztek mindkét betegnél negatívnak bizonyultak, a légzésfunkciós vizsgálat és a bronchoszkópos vizsgálat nem talált eltérést. A mellkas-CT-felvételen lágyrész-denzitású nodulusok látszottak egyoldali dominanciával, a folyamatot nem kísérte a hilusi nyirokcsomók szimmetrikus megnagyobbodása. A nodulusok szövettani vizsgálata vált indokolttá, melyet videoasszisztált torakoszkópos tüdőreszekciós mintavétellel biztosítottak. Mikroszkóposan a tüdőparenchymában gócos nekrózisokat, a környezetükben el nem sajtosodó epitheloid sejtes granulomatosus gócokat, az átfutó artériákban pedig granulomatosus arteritist láttak; a klinikai adatok figyelembevételével a tüdő nekrotizáló sarcoid granulomatosisa diagnózisát állították fel. A tüdőbetegség mindkét betegnél egy év alatt spontán regrediált. Az irodalom adatait és az eseteket összegezve, a tüdő nekrotizáló sarcoid granulomatosisában mikrobiológiai vizsgálatokkal nem igazolható tüdőfertőzés, és az immunológiai kivizsgálás sem tár fel szisztémás autoimmun betegséget; a diagnózis a klinikai kép és a képalkotó vizsgálatok alapján indikált szövettani vizsgálattal állítható fel. A betegség szteroidkezelésre jól reagál, de előfordul spontán regresszió is, az utóbbira láttunk példát. Bár az entitás átmenetet képez a nekrotizáló vasculitisek és a sarcoidosis között, egyre több érv szól amellett, hogy a sarcoidosis spektrumába tartozik. Orv Hetil. 2021; 162(38): 1541–1547. Summary. Necrotizing sarcoid granulomatosis is a rare entity currently classified as a subtype of granulomatous pulmonary angiitis. It is considered to be either a variant of sarcoidosis or a primary pulmonary angiitis. Two cases are demonstrated to present its clinical and pathological features. A 20-year-old female patient was admitted to the department of pulmonology with dry cough, right-sided chest pain during hyperventilation and fever. A 63-year-old male patient was observed with a right-sided lesion on chest X-ray after pneumonia. In both cases, autoimmune panel examination, microbiology tests, spirometry function test and bronchoscopy were unremarkable. Chest CT scans have revealed nodules with soft-tissue density without bilateral hilar lymphadenopathy. In order to clarify the diagnosis, video-assisted thoracoscopic resection (biopsy) was performed. Microscopically, parenchymal focal necrosis with adjacent to non-caseating granulomas and granulomatous angiitis were detected. In both cases, spontaneous remission occurred within a year. Histological examination – integrated with clinical data and radiological tests’ results – is the gold standard form of evaluation to confirm necrotizing sarcoid granulomatosis; furthermore, exclusion of pneumonia and autoimmune diseases are also required. The disease responds well to corticosteroids; moreover, spontaneous remission is often reported, as it happened in both cases. Necrotizing sarcoid granulomatosis is a transition between necrotizing vasculitides and sarcoidosis; although more and more evidence appears supporting the fact that necrotizing sarcoid granulomatosis may belong to the spectrum of sarcoidosis. Orv Hetil. 2021; 162(38): 1541–1547.

scholarly journals Drug Induced Hepatitis pada Tuberkulosis Paru dengan Multisite Tuberkulosis Ekstraparu

2020 ◽  
Vol 5 (2) ◽  
pp. 34
Author(s):  
Made Agustya Darma Putra Wesnawa ◽  
Tutik Kusmiati
Keyword(s):  
Lymph Node ◽  
Pleural Effusion ◽  
Clinical Improvement ◽  
Inguinal Lymph Node ◽  
Granulomatous Inflammation ◽  
The Body ◽  
Major Health Problem ◽  
X Ray ◽  
Antituberculous Drug ◽  
Chest X Ray

Background: Tuberculosis (TB) continues to be a major health problem in developing country. Lung is the most common site for Mycobacterium tuberculosis (MTB) infection, but dissemination may occur to any part of the body resulting in extrapulmonary TB. Hepatotoxicity is one of the most frequent adverse events that occur during TB treatment. Case: A 35-year-old female patient came with cough, dyspnea, fever, abdominal pain, history of mass in right inguinal lymph node, and malnutrition. Histopathology from excisional biopsy of inguinal lymph node showed granulomatous inflammation. Computed tomography of abdomen showed intraabdominal TB. Chest X-ray showed right pleural effusion, with exudate pleural fluid and mononuclear dominant. After 1 week consuming antituberculous drug, patient got nausea and vommiting, increased of ALT and AST, total and direct bilirubin. Antituberculous drug was stopped and switched to levofloxacin, ethambutol, and streptomycin. After clinical improvement and liver function return to normal, desensitization of rifampicin and isoniazide was started. Desensitization started with rifampicin for three days, and followed with isoniazide for three days. In total, the patient got rifampicin, isoniazide, and ethambutol for 9 months. Evaluation of treatments are clinical improvement and weight gain. Acid fast baccili sputum was negatif, no pleural effusion on chest X-ray, and normal abdominal ultrasound. Conclusion: MTB can spread to other organs which cause multisite extrapulmonary TB. Side effect can occur during TB treament, and this is not the reason to stop the therapy. Individual ATD therapy shows good response in this case.

scholarly journals TB MDR Primer dengan Limfadenitis TB pada Wanita SLE

2019 ◽  
Vol 1 (3) ◽  
pp. 81
Author(s):  
Ika Yunita Sari ◽  
Tutik Kusmiati
Keyword(s):  
Granulomatous Inflammation ◽  
Primary Resistance ◽  
X Ray ◽  
Central Java ◽  
Left Pleural Effusion ◽  
Mdr Tb ◽  
History Of ◽  
Chest X Ray ◽  
Mobile Nodule

Background: Primary resistance is the resistance that occurs in patients who have never received treatment OAT or had ever received  treatment OAT is less than 1 month. The incidence of primary MDR in Central Java in 2006 2.07%. Extrapulmonary TB about 15-20%  of all cases of TB, and TB lymphadenitis is the highest form (35% of all extrapulmonary TB). Patients with decreased immune systems  (SLE) can increase the incidence of TB. Research in Spain get 6x higher TB incidence in patients with SLE. Case: We present the case  of 19 year old woman SLE who received treatment for 11 months whose came with shortness of breath and chronic cough since 2 month  prior to admission. In physical examination we found right and left submandibula lymphonodi enlargement as solid, slightly mobile  nodule with diameter 3 cm. Chest X ray showed lung inflammation which suspicion of specific process and minimal left pleural effusion,  and concluded as pulmonary TB. FNAB confirmed lymphadenitis TB with granulomatous inflammation. One of AFB result is positive  and Gene Xpert is MTB positive with rifampicin resistant that make this patient categorized as primary MDR TB with lymphadenitis  TB. This patient received Pirazinamid 1500 mg, Ethambutol 800 mg, Kanamicin 750 mg, Levofloxacin 750 mg, Ethionamide 500 mg,  Cicloserin 500 mg, and B6 100 mg. Conclusion: MDR TB in general occur in patients with a history of OAT previous TB (MDR TB  secondary). Primary MDR TB with lymphadenitis tb is a rare case, but can occur on the condition that decreases the immune system,  one of SLE. This involves multiple immune disorders caused by the use of long-term immunosuppressive therapy. 

Model Helps Reduce Chest X-Ray Usage

2005 ◽  
Vol 39 (9) ◽  
pp. 26
Keyword(s):  
X Ray ◽  
Chest X Ray

Tuberculosis: Diagnostic Challenges in Rural Africa

Praxis ◽  
2019 ◽  
Vol 108 (15) ◽  
pp. 991-996
Author(s):  
Ngisi Masawa ◽  
Farida Bani ◽  
Robert Ndege
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
X Ray ◽  
Molecular Tests ◽  
Rural Settings ◽  
Chest X Ray ◽  
Screening Questions ◽  
Rural Africa ◽  
Tb Diagnostics ◽  
Strip Test ◽  
Urine Strip

Abstract. Tuberculosis (TB) remains among the top 10 infectious diseases with highest mortality globally since the 1990s despite effective chemotherapy. Among 10 million patients that fell ill with tuberculosis in the year 2017, 36 % were undiagnosed or detected and not reported; the number goes as high as 55 % in Tanzania, showing that the diagnosis of TB is a big challenge in the developing countries. There have been great advancements in TB diagnostics with introduction of the molecular tests such as Xpert MTB/RIF, loop-mediated isothermal amplification, lipoarabinomannan urine strip test, and molecular line-probe assays. However, most of the hospitals in Tanzania still rely on the TB score chart in children, the WHO screening questions in adults, acid-fast bacilli and chest x-ray for the diagnosis of TB. Xpert MTB/RIF has been rolled-out but remains a challenge in settings where the samples for testing must be transported over many kilometers. Imaging by sonography – nowadays widely available even in rural settings of Tanzania – has been shown to be a useful tool in the diagnosis of extrapulmonary tuberculosis. Despite all the efforts and new diagnostics, 30–50 % of patients in high-burden TB countries are still empirically treated for tuberculosis. More efforts need to be placed if we are to reduce the death toll by 90 % until 2030.

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