Splenic abscess as a rare symptom of the extrapulmonary tuberculosis – case report

2019 ◽  
Vol 98 (7) ◽  
pp. 297-300
Keyword(s):  
Case Report ◽  
Therapeutic Process ◽  
Extrapulmonary Tuberculosis ◽  
Splenic Abscess ◽  
Diagnostic Process ◽  
Urogenital System ◽  
Tuberculosis Case ◽  
Bacteriological Testing ◽  
Splenic Involvement ◽  
Affected Tissue

Introduction: Extrapulmonary tuberculosis can involve any organ or tissue. It is a rare disease in the Czech Republic with an incidence rate of 0.62 cases per 100.000 persons. It affects mostly immunocompromised patients. The most common sites include lymph nodes, the urogenital system, skin, joints, bones and serous epithelium – the peritoneum, pleura, and pericardium. Splenic involvement is rare. Mycobacterium is a slow growing intracellular parasite. The diagnostic process is very difficult; microbiological diagnosis is critical. Case report: An 84 years old female patient with subcapsular splenic rupture with no trauma history as a cause of anemia. Splenic abscess was diagnosed during surgical revision and splenectomy. Tuberculosis was suspected based on subsequent histological analysis, which was confirmed after nine weeks of peritoneal fluid culture. The surgical procedure and postoperative hospitalization were not associated with any complications. The patient was referred to the respiratory clinic for further treatment. Conclusion: The diagnosis of extrapulmonary tuberculosis including splenic localization should always be considered. A sample from the affected tissue or effusion must be collected in the case of unclear perioperative findings and sent for complete bacteriological testing, including mycobacterial culture. If a tuberculous splenic abscess is found, the therapeutic process should involve its complete drainage in combination with long-term anti-TB medication.

Hemangiopericytoma – a case report of a rare tumour of the parapharyngeal space

2017 ◽  
Vol 6 (2) ◽  
pp. 56-63
Author(s):  
Klaudia Cybulska ◽  
Małgorzata Jarosz ◽  
Anna Rzepakowska ◽  
Kazimierz Niemczyk
Keyword(s):  
Case Report ◽  
Parapharyngeal Space ◽  
Histopathological Examination ◽  
Therapeutic Process ◽  
Surgical Excision ◽  
Lower Limbs ◽  
Diagnostic Process ◽  
Tumour Resection ◽  
Rare Tumour ◽  
Long Term Follow Up

Introduction: Hemangiopericytoma is a mesenchymal tumour originating from pericytes surrounding the capillary vessels. The etiology of this tumour is still unknown. It may be located in any part of the human body. The most common sites are pelvis and lower limbs and less often it occurs in the head and neck. The characteristic signs of hemangiopericytoma are slow growth regardless of the malignancy level and high vascularity. Surgical excision of the tumour with additional radiotherapy is the treatment of choice. Case report: A symptom presentation and diagnostic-therapeutic process in a 71-year-old woman admitted to the Department of Otolaryngology of the Medical University of Warsaw due to increasing bilateral nasal obstruction and dysphagia is herein described. Diagnostic imaging showed highly vascularized tumour in the parapharyngeal space also obstructing the left side of the nasopharynx. After evaluation, tumour resection from the external approach was planned and performed, followed by an uncomplicated postoperative course. Histopathological examination revealed hemangiopericytoma. The patient was qualified for adjuvant radiotherapy. She stays under observation with no signs of recurrence since surgery. Conclusions: Hemangiopericytoma is a rare tumour with a wide variety of clinical presentations and a relapse-free survival that is difficult to predict. Long-lasting asymptomatic tumour growth results in late diagnosis. Imaging and primarily, histopathological examination are fundamental for the diagnostic process. The best outcome is observed after radical surgical treatment. In order to reduce the risk of recurrence, additional radiotherapy is advised. Local recurrence may appear years after finished treatment, therefore long-term follow-up is essential.

scholarly journals T-cell lymphoma masquerading as extrapulmonary tuberculosis: Case report and review of literature

2015 ◽  
Vol 4 (2) ◽  
pp. 280 ◽  
Author(s):  
Rita Sood ◽  
Piyush Ranjan ◽  
Sourabh Dutta ◽  
Aanchal Kakkar ◽  
Ankur Goyal ◽  
...  
Keyword(s):  
Case Report ◽  
T Cell ◽  
Cell Lymphoma ◽  
Extrapulmonary Tuberculosis ◽  
T Cell Lymphoma ◽  
Review Of Literature ◽  
Tuberculosis Case

scholarly journals Cervical Pain and Tuberculosis: Case Report

2019 ◽  
pp. 9-12
Author(s):  
Mark R. Jones
Keyword(s):  
Case Report ◽  
Cervical Spine ◽  
Social History ◽  
Extrapulmonary Tuberculosis ◽  
Diagnostic Approach ◽  
Upper Cervical Spine ◽  
Tuberculosis Case ◽  
Presenting Symptoms ◽  
Upper Cervical ◽  
Pain Symptoms

The presenting symptoms of tuberculosis (TB) are varied and may include acute and chronic pain in anatomical regions with active TB infection. Cervical spine TB, although rare, can present with nonspecific symptomatology emanating from the upper cervical spine, leading providers to overlook TB in their diagnostic approach. This case report demonstrates the necessity of a thorough history and physical with particular emphasis on pertinent sociodemographic risk factors for pain medicine clinicians to reliably ensure accurate diagnosis and treatment. A patient with TB of the cervical spine presented as a referral with pain symptoms refractory to standard pharmacologic analgesic regimens. Only with a thorough social history, made difficult by language and sociodemographic barriers, were we able to direct our diagnostic approach to elucidate the etiology, and engage the patient with the appropriate therapy. Key words: Tuberculosis, cervicalgia, cervical spine, extrapulmonary tuberculosis, pregabalin, social history

Recurrent Episodes of Pericardial Effusion as Isolated Manifestation of Tuberculosis: Case Report

2018 ◽  
Vol 15 (1) ◽  
pp. 78-80
Author(s):  
Oscar Westin ◽  
Abbas Ali Qayyum
Keyword(s):  
Case Report ◽  
Pericardial Effusion ◽  
Granulomatous Inflammation ◽  
Physical Contact ◽  
Tuberculosis Case ◽  
Chest X Ray ◽  
X Ray Computed ◽  
Polymerase Chain ◽  
Cytology Report ◽  
Biochemical Examination

Background: Recurrent episodes of isolated pericardial effusion due to tuberculosis, leading to reduced Left Ventricle Ejection Fraction (LVEF), are uncommon. Methods: This is a case report of a previously healthy 32-years old male with tuberculous induced pericardial effusion as isolated manifestation. The only known exposure of tuberculosis was a brother with whom the patient did not have physical contact during the last year. The pericardial effusion repeatedly appeared after being drained a total of three times. Due to recurrent episodes of pericardial effusion, severe thickening of the pericardium, pericardial adherences and increasing affection on the heart, pericardiectomy was ultimately performed. Results: Biochemical examination, chest X-ray, computed tomography of thorax and abdomen and cytology report did not reveal any signs of malignancy, connective tissue disease or other infections including extra-pulmonary/pulmonary tuberculosis. However, the pericardial biopsy was Polymerase Chain Reaction positive (PCR) for tuberculosis DNA and showed granulomatous inflammation with necrosis. After 6 months anti-tuberculous therapy, biochemical parameters, LVEF and the clinical condition of the patient were normalized. Conclusion: Tuberculosis can be difficult to diagnose when it only manifests as pericardial effusion especially if the time for exposure is long before the appearance of symptoms and admission.

Pathogenic potential of Parabacteroides distasonis revealed in a splenic abscess case: a truth unfolded

2020 ◽  
Vol 13 (12) ◽  
pp. e236701
Author(s):  
Anitha Gunalan ◽  
Rakhi Biswas ◽  
Balamurugan Sridharan ◽  
Thirthar Palanivelu Elamurugan
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Antimicrobial Therapy ◽  
Splenic Abscess ◽  
Rare Entity ◽  
Normal Flora ◽  
Pathogenic Role ◽  
Pathogenic Potential ◽  
Open Splenectomy

Splenic abscess is a rare entity, however if unrecognised or left untreated, it is invariably fatal. We herein report a case of splenic abscess in a 40-year-old man presenting with fever, left-sided abdominal pain, altered sensorium and vomiting. On clinical examination, hepatosplenomegaly was noted and the ultrasound of the abdomen showed multiple hypoechoic regions in the upper pole of spleen, and the diagnosis of splenic abscess was made. The patient received antimicrobial therapy and underwent an open splenectomy with full recovery. Pus aspirated from the splenic abscess grew an unusual organism named Parabacteroides distasonis. In the literature, there are only a few recorded cases of P. distasonis causing splenic abscess. Through this case report, we would like to emphasise the pathogenic role of P. distasonis in causing clinical disease, as this organism is typically known to constitute a part of the normal flora.

scholarly journals Concomitant cemento-osseous dysplasia and aneurysmal bone cyst of the mandible: a rare case report with literature review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Han-Gyeol Yeom ◽  
Jung-Hoon Yoon
Keyword(s):  
Case Report ◽  
Head And Neck ◽  
Aneurysmal Bone Cyst ◽  
Cystic Lesion ◽  
Bone Cyst ◽  
Neck Region ◽  
Diagnostic Process ◽  
Simultaneous Occurrence ◽  
Head And Neck Region ◽  
Osseous Dysplasia

Abstract Background Concomitant cemento-osseous dysplasia (COD) and aneurysmal bone cyst (ABC) are rare in the head and neck region. In our search of the English language literature, we found only one case report describing the simultaneous occurrence of COD and ABC in the head and neck region. Here, we report a case of COD associated with ABC. Further, we performed a systematic search of the literature to identify studies on patients with COD associated with nonepithelial lined cysts of the jaws. Case presentation The patient was a 32-year-old woman who was referred from a private dental clinic because of a cystic lesion below the mandibular right first molar. She had no pain or significant systemic disease. After performing panoramic radiography and cone-beam computed tomography, the imaging diagnosis was COD with a cystic lesion, such as ABC or solitary bone cyst. Excisional biopsy was performed, which revealed concomitant COD and ABC. Conclusion This case of ABC associated with COD provides insight for the diagnostic process of radiographically mixed lesions with cystic changes.

scholarly journals Tuberculous Pachymeningitis Presenting as a Diffused Dural Thickening in a Patient with Chronic Headache and Recurrent Neurological Abnormalities for More than a Decade: A Case Report and a Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
C. L. Fonseka ◽  
T. E. Kanakkahewa ◽  
S. D. A. L. Singhapura ◽  
J. S. Hewavithana ◽  
L. P. Kolambage ◽  
...  
Keyword(s):  
Case Report ◽  
Chronic Headache ◽  
Facial Nerve Palsy ◽  
Extrapulmonary Tuberculosis ◽  
Granulomatous Inflammation ◽  
Mantoux Test ◽  
Resonance Imaging ◽  
Neurological Signs ◽  
Neurological Abnormalities ◽  
Contrast Enhanced

Background. Tuberculous pachymeningitis is a rare form of extrapulmonary tuberculosis usually suspected from the detection of thickening of the dura in contrast-enhanced magnetic resonance imaging. Progressive nature of the disease can lead to chronic headache with focal neurological signs due to compression from the thickened dura. Case Report. We report a 40-year-old female who presented with chronic headache over a decade associated with recurrent neurological abnormalities including optic neuritis, hemisensory loss, migraine, facial nerve palsy, and recurrent vertigo. Although there was an initial perceived response to steroids, the patient had a subsequent progressive course. On investigations, she was found to have a diffused dural thickening on contrast MRI with a strongly positive Mantoux test with caseating necrotizing granulomatous inflammation on dural histology. With initiation of antituberculous medication with steroids, the patient markedly improved, and the medication for tuberculosis was continued for a year with good response. Conclusion. Primary tuberculous pachymeningitis should be suspected in a patient complaining of prolonged headache with focal neurological signs when MRI evidence of dural thickening is detected, and another focus of tuberculosis was not found. Prompt suspicion with image-guided dural biopsy for histology would help to confirm the diagnosis.

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