scholarly journals Granulomatous Mastitis Due to Non-Tuberculous Mycobacteria: A Diagnostic and Therapeutic Dilemma

2021 ◽  
Vol 11 (2) ◽  
pp. 228-234
Author(s):  
Owais Ahmed Patel ◽  
Girish D. Bakhshi ◽  
Amogh R. Nadkarni ◽  
Zarin S. Rangwala

Non-tuberculous mycobacterial (NTM) infections of the breast are rare. These infections present as cellulitis of the breast or breast abscess. Their diagnosis poses a challenge as they manifest signs of acute inflammation, unlike tuberculous mycobacterial infections which present in a chronic pattern. However, on aspiration of pus from the site of infection, primary smear may show acid fast bacilli. This poses a diagnostic dilemma. The present case is that of a 34-year-old woman who presented with recurrent mastitis. She had history of right breast swelling, for which surgical excision had been performed three months prior at another facility. Her histopathology had showed cystic granulomatous neutrophilic mastitis (CNGM). The patient again presented with right breast abscess which was confirmed on ultrasonography. Incision and drainage along with removal of necrotic tissue was done. Primary smear of pus showed acid fast bacilli on Ziehl–Neelson staining. Bacterial culture and line probe speciation revealed non-tuberculous mycobacterium M. abscessus, which responded well to prolonged anti-microbial therapy. These rapidly growing NTM require prolonged treatment and are quite often recurrent. M. abscessus is a rare cause of CNGM, with this being only the third reported case in literature. A brief case report with a review of literature is presented.

2019 ◽  
Vol 18 (1) ◽  
pp. 145-148
Author(s):  
Devesh Sanjeev Ballal ◽  
Balaji Jayasankar ◽  
Gabriel Rodrigues ◽  
Ranjini Kudva

Background: Morel-Lavallée Lesion (MLL) or Morel-Lavallée Seroma (MLS) is a posttraumatic seroma that occurs following a closed degloving injury. It is very important for trauma surgeons to be aware of this relatively rarely reported entity as early diagnosis increases the likelihood of successful management. Case report: We present a patient, wherein the patient had no history of trivial trauma and presented with a gradually growing swelling of left thigh, that was clinically and radiologically diagnosed as a soft tissue neoplasm, successfully managed by surgical excision and were reported to be a MLS. The clinical diagnostic dilemma was solved by the histopathologist! Conclusion: A differential diagnosis of MLL should be kept in mind in patients presenting with soft tissue swellings. Bangladesh Journal of Medical Science Vol.18(1) 2019 p.145-148


2021 ◽  
pp. 1-2
Author(s):  
Sonu Kumar Batham

Introduction: - Fibroid are commonly found in uterus and cervix but rarely may found other sites (broad ligament, ovary, Vulva, vagina etc). Here we are presenting a rare case of Vulval Fibroid. Case Report: - A 25 years old woman G4P3L3 with 37 weeks pregnancy presented to OPD with complaint of severe pain at perineal region. There was history of fall in bathroom 1 month ago. On examination there was a swelling at right vulvo-vaginal junction of 4x4 cm, (probably bartholin cyst) with firm smooth surface, with no signs of acute inflammation, for that Incision and drainage was done and an organized mass was resected out. On histopathlogical examination, it was found to be a leiomyoma with myxoid degeneration. Discussion :- fibroids rarely presents with pain and inflammation and on the other hand bartholin’s cyst or abscess mostly presents with pain and inflammation, so detailed history and examination with broad suspicion are the keys to differentiate between Bartholin’s cyst and vulval fibroids.


2014 ◽  
Vol 7 (2) ◽  
pp. 87-89 ◽  
Author(s):  
Neelam Wadhwa ◽  
PP Singh ◽  
Vipin Arora ◽  
Pankaj Verma ◽  
Khyati Bhatia

ABSTRACT A rare case of sinonasal paraganglioma is described. A 40-year-old female patient presented with 2 years history of unilateral nasal obstruction and bleeding. CT scan demonstrated an expansile enhancing mass involving bilateral ethmoids, right nasal cavity and right maxillary sinus. Histopathological diagnosis was neuroendocrine tumor with possibility of paraganglioma. A subtotal maxillectomy with excision of mass performed. Primary nonchromaffin paraganglioma of nose and paranasal sinus is a very rare tumor, these lesion pose diagnostic challenge to clinicians and pathologist. Only twenty five cases are reported in review of literature. Surgical excision is the mainstay of treatment. How to cite this article Arora V, Verma P, Singh PP, Wadhwa N, Bhatia K. Sinonasal Paraganglioma: A Case Report and Review of Literature. Clin Rhinol An Int J 2014;7(2):87-89.


Author(s):  
Sameer Kaura

10% of pleomorphic adenomas occur in the minor salivary glands with the palate being the most common site. Pleomorphic adenomas account for the majority of palatal tumours; however, minor salivary gland tumours have a higher risk of malignancy compared to tumours of the major salivary glands, so definite diagnostic evaluation should be executed. A case of 26-year-old man with a longstanding history of a soft palate pleomorphic adenoma which required excision under general anaesthetia We discuss the appropriate preoperative investigations, operative technique for surgical excision, histopathologic interpretation for this patient and brief review of literature for pleomorphic adenoma.


2016 ◽  
Vol 02 (02) ◽  
pp. 082-084
Author(s):  
Mranalini Verma ◽  
Punita Lal

AbstractLeiomyosarcoma (LMS) of the tongue is an extremely rare mesenchymal tumor. Till now, we came across about 24 cases of tongue LMS reported in the literature. Here, we are presenting the case of a 50-year-old female with 4 months history of ulcerative growth on the tongue along with difficulty in swallowing and tongue movement who was diagnosed with LMS of the tongue on histopathology. He was managed with surgical excision followed by radiotherapy without any recurrence or metastasis after 6 months of follow-up.


2021 ◽  
Vol 4 (2) ◽  
pp. 069-071
Author(s):  
Ade-Ojo Idowu Pius ◽  
Ipinnimo Oluwadare Martins

Primary umbilical cutaneous endometriosis is a rare umbilical endometrioma that affects women who are within the reproductive age group. It may be associated with infertility and severe dysmenorrhea and can be difficult to diagnosed in an asymptomatic patient. We report a case of a 38-year-old nulliparous with seven years history of infertility and severe dysmenorrhea. Her hormonal profile assay and hysterosalpingogram results were normal while her husband semen analysis was also within normal range. She complained of monthly bleeding from a painful rubbery multilobate cutaneous nodule on the umbilicus of one year duration. She was diagnosed of cutaneous endometriosis. The diagnosis was confirmed histologically and she had surgical excision with good outcome.


Author(s):  
Rakesh Kumar Gupta ◽  
◽  
Nidhi Rai ◽  

Echinococcosis is a zoonotic disease commonly known, as hydatid disease is endemic in India and mostly caused by Echinococcus granulosus. Hydatid cyst most commonly involves liver followed by lungs with a frequency of 60% and 20–30% respectively. Rarely, it can primarily involve pelvic organs in females such as uterus, ovaries, fallopian tubes etc. either separately or sometimes together, which may mimic malignancy and create diagnostic dilemma. Till date, around 30 case reports of primary fallopian tube hydatid disease are reported, however none of them mentioned bilateral involvement. Herein, we report a case of bilateral fallopian tubal hydatid disease in a 45-years-old female presented with a 4 months history of lower abdominal pain and abdominal distension with review of literature


2017 ◽  
Vol 1 (3) ◽  
pp. 161-164 ◽  
Author(s):  
Katherine Nolan ◽  
Reema Ishteiwy ◽  
John Alexis ◽  
Martin Zaiac ◽  
Anna Nichols

A 51-year-old female with a history of rheumatoid arthritis was admitted for progressive fevers, chills and malaise. Five weeks prior, she started minocycline for an RA exacerbation. Two weeks after starting minocycline she developed an abscess on her right ankle that was treated at an urgent care facility with ceftriaxone and trimethoprim-sulfamethoxazole. She had minimal improvement so was switched to clindamycin. She developed additional abscesses on her right ankle and right axilla and spiking fevers so she was treated with incision and drainage under general anesthesia. Routine blood work obtained prior to surgery revealed severe neutropenia (0.74 103/ul) and the patient was urgently referred to the emergency department.  Skin biopsy was obtained on admission and revealed ulceration, necrosis, acute and chronic inflammation, vasculitis with vascular thrombosis and rod-shaped bacteria in blood vessel walls and lumina consistent with ecthyma gangrenosum. The following day tissue and blood cultures confirmed the growth of Pseudomonas aureginosa. Bone-marrow biopsy showed decreased granulopoiesis and hematopoiesis, and a diagnosis of minocycline-induced agranulocytosis presenting as ecthyma gangrenosum was made.  The patient had dramatic improvement with appropriate antibiotic therapy, discontinuation of minocycline and initiation of filgrastrim. She has remained healthy without recurrence for 17 months.    


2020 ◽  
Vol 13 (12) ◽  
pp. e237076
Author(s):  
George Vatidis ◽  
Eirini I Rigopoulou ◽  
Konstantinos Tepetes ◽  
George N Dalekos

Hepatic brucelloma (HB), a rare manifestation of brucellosis, refers to liver involvement in the form of abscess. A 35-year-old woman stockbreeder was admitted due to 1-month history of evening fever, sweating and weight loss, while she was on 3-week course of rifampicin/doxycycline for suspected brucellosis. On admission, she had hepatosplenomegaly and a systolic murmur, while cholestasis, increased inflammation markers and a strong-positive Wright-Coombs test were the main laboratory findings. As blood and bone marrow cultures were unrevealing, further investigation with CT imaging showed a central liver calcification surrounded by heterogeneous hypodense area being compatible with HB. Material from CT-guided drainage tested negative for Brucella spp. After failure to improve on a 10-week triple regiment, surgical excision was decided and Brucella spp were identified by PCR. Our case highlights challenges in establishing HB diagnosis, which should be considered on the right epidemiological context and when serological and radiological evidence favour its diagnosis.


BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Apoorva Khajuria ◽  
Tuba Rahim ◽  
Mariam Baig ◽  
Kai Leong ◽  
Apoorva Khajuria

Abstract Introduction Despite perianal abscess being a common presentation, certain aspects of its management remain controversial, especially the routine use of intra-operative swab cultures. Methods A retrospective review of patients that underwent incision and drainage procedures for a perianal abscess over a six-month period was undertaken. Results Over 6 months, 50 patients were identified. The male to female ratio was 3:1 and median ASA score was 1. Only 6/50 patients presented with recurrent abscess and 1 patient had history of inflammatory bowel disease. On the basis of operative findings, 39 patients (78%) had uncomplicated abscess (not associated with cellulitis, sinus or fistula); swab cultures were performed in 26 (67%) of these patients. All patients were discharged on the same day; microbiology reports did not impact the treatment and no patients were followed up in clinic post-operatively or presented with recurrence. The number of unnecessary microbiology swabs undertaken in this cohort equates to approximately 52 unnecessary swabs a year. The cost of one swab is £10.10p, which means £520 could potentially be saved annually. Conclusion Routine intra-operative swab cultures do not impact management decisions, add to unnecessary costs and therefore should not be undertaken in uncomplicated or first presentation of peri-anal abscesses.


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