scholarly journals Pandora’s Box: Disseminated Coccidioidomycosis Associated with Self-Medication with an Unregulated Potent Corticosteroid Acquired in Mexico

2021 ◽  
Vol 6 (4) ◽  
pp. 207
Author(s):  
Alejandro Jose Coba ◽  
Patricia K. Sallee ◽  
Danielle O. Dixon ◽  
Rahaf Alkhateb ◽  
Gregory M. Anstead
Keyword(s):  
Skin Biopsy ◽  
Biopsy Specimen ◽  
Skin Lesions ◽  
Multiple Organ ◽  
Coccidioides Immitis ◽  
Self Medication ◽  
Dimorphic Fungi ◽  
Organ Systems ◽  
Skin Biopsy Specimen ◽  
Disseminated Disease

Coccidioidomycosis (CM), caused by the dimorphic fungi Coccidioides immitis and C. posadasii, typically presents as acute or chronic pulmonary disease. However, disseminated disease occurs in about 1% of patients. Disseminated CM may affect multiple organ systems, including cutaneous, osteoarticular, and central nervous system sites. Here, we present a case of disseminated CM in a patient from a border city in Texas. The patient had a history of uncontrolled diabetes mellitus and was also taking an over-the-counter medication acquired in Mexico that contained a potent corticosteroid. The patient presented with seizures and was found to have a brain infarct, cavitary lung lesions, synovitis of the knee, multiple skin lesions, and chorioretinitis. The patient had a very high complement fixation titer for Coccidioides; fungal spherules were seen in a skin biopsy specimen, and Coccidioides grew in culture from a sample of synovial fluid and the skin biopsy specimen. This case illustrates the dissemination potential of Coccidioides, the danger of unregulated pharmaceuticals, the importance of thorough history taking, and recognizing risk factors that contribute to disseminated CM.

Renal Manifestations of Tuberous Sclerosis Complex

2020 ◽  
Vol 7 (3) ◽  
pp. 5-19
Author(s):  
Nikhil Nair ◽  
Ronith Chakraborty ◽  
Zubin Mahajan ◽  
Aditya Sharma ◽  
Sidarth Sethi ◽  
...  
Keyword(s):  
Tuberous Sclerosis ◽  
Tuberous Sclerosis Complex ◽  
Gene Disruption ◽  
Treatment Guidelines ◽  
Renal Cysts ◽  
Skin Lesions ◽  
Multiple Organ ◽  
Tsc2 Gene ◽  
Genetic Condition ◽  
Organ Systems

Tuberous sclerosis complex (TSC) is a genetic condition caused by a mutation in either the TSC1 or TSC2 gene. Disruption of either of these genes leads to impaired production of hamartin or tuberin proteins, leading to the manifestation of skin lesions, tumors and seizures. TSC can manifests in multiple organ systems with the cutaneous and renal systems being the most commonly affected. These manifestations can secondarily lead to the development of hypertension, chronic kidney disease, and neurocognitive declines. The renal pathologies most commonly seen in TSC are angiomyolipoma, renal cysts and less commonly, oncocytomas. In this review, we highlight the current understanding on the renal manifestations of TSC along with current diagnosis and treatment guidelines.

scholarly journals Renal Manifestations of Tuberous Sclerosis Complex

2020 ◽  
Vol 7 (3) ◽  
pp. 5-19
Author(s):  
Nikhil Nair ◽  
Ronith Chakraborty ◽  
Zubin Mahajan ◽  
Aditya Sharma ◽  
Sidharth K. Sethi ◽  
...  
Keyword(s):  
Tuberous Sclerosis ◽  
Tuberous Sclerosis Complex ◽  
Gene Disruption ◽  
Treatment Guidelines ◽  
Renal Cysts ◽  
Skin Lesions ◽  
Multiple Organ ◽  
Tsc2 Gene ◽  
Genetic Condition ◽  
Organ Systems

Tuberous sclerosis complex (TSC) is a genetic condition caused by a mutation in either the TSC1 or TSC2 gene. Disruption of either of these genes leads to impaired production of hamartin or tuberin proteins, leading to the manifestation of skin lesions, tumors, and seizures. TSC can manifest in multiple organ systems with the cutaneous and renal systems being the most commonly affected. These manifestations can secondarily lead to the development of hypertension, chronic kidney disease, and neurocognitive declines. The renal pathologies most commonly seen in TSC are angiomyolipoma, renal cysts, and less commonly, oncocytomas. In this review, we highlight the current understanding on the renal manifestations of TSC along with current diagnosis and treatment guidelines.

Borrelia Burgdorferi Shown By PCR from Skin Biopsy Specimen after a Fly Bite

1994 ◽  
pp. 45-48
Author(s):  
Jarmo Oksi ◽  
Inkeri Helander ◽  
Heikki Aho ◽  
Merja Marjamäki ◽  
Matti K. Viljanen
Keyword(s):  
Borrelia Burgdorferi ◽  
Skin Biopsy ◽  
Biopsy Specimen ◽  
Skin Biopsy Specimen

scholarly journals Rapid Detection of Trichodysplasia Spinulosa-Associated Polyomavirus in Skin Biopsy Specimen

2014 ◽  
Vol 2 (4) ◽  
Author(s):  
P. R. P. Urbano ◽  
C. S. Pannuti ◽  
L. C. Pierrotti ◽  
E. David-Neto ◽  
C. M. Romano
Keyword(s):  
Skin Biopsy ◽  
Rapid Detection ◽  
Biopsy Specimen ◽  
Skin Biopsy Specimen

scholarly journals Clinical Utility of Preoperative Assessment in Ovarian Cancer Cytoreduction

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 568
Author(s):  
Pratistha Koirala ◽  
Ashley S Moon ◽  
Linus Chuang
Keyword(s):  
Ovarian Cancer ◽  
Clinical Utility ◽  
Gynecologic Cancer ◽  
Preoperative Assessment ◽  
Late Presentation ◽  
Multiple Organ ◽  
Optimal Management ◽  
Novel Therapies ◽  
Organ Systems ◽  
Disseminated Disease

Ovarian cancer is the deadliest gynecologic cancer, in part due to late presentation. Many women have vague early symptoms and present with disseminated disease. Cytoreductive surgery can be extensive, involving multiple organ systems. Novel therapies and recent clinical trials have provided evidence that, compared to primary cytoreduction, neoadjuvant chemotherapy has equivalent survival outcomes with less morbidity. There is increasing need for validated tools and mechanisms for clinicians to determine the optimal management of ovarian cancer patients.

scholarly journals Disseminated Coccidioidomycosis to the Gallbladder

2020 ◽  
Vol 8 ◽  
pp. 232470962091063
Author(s):  
Kulraj Grewal ◽  
Tushar Bajaj ◽  
Greti Petersen ◽  
Augustine Munoz ◽  
Arman Froush ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Rare Case ◽  
Immunocompromised Patient ◽  
Percutaneous Cholecystostomy ◽  
Coccidioides Immitis ◽  
Quadrant Pain ◽  
Dimorphic Fungi ◽  
Bile Drainage ◽  
Intravenous Amphotericin ◽  
Disseminated Disease

Coccidioidomycosis is an infection caused by inhalation of arthroconidia produced by dimorphic fungi in the genus Coccidioides. Forty percent of patients will develop an influenza-like illness with symptoms suggestive of a mild and self-limited respiratory infection; however, 5% of these individuals will develop extrapulmonary disseminated disease. An immunocompromised patient presented with right upper quadrant pain, ultrasound with pericholecystic fluid, in which a percutaneous cholecystostomy contained biliary fluid that grew the fungus Coccidioides immitis. Patient was initiated on intravenous amphotericin therapy and was followed closely with postoperative bile drainage with eventual laparoscopic cholecystectomy. We present a very rare case of disseminated coccidioidomycosis to the gallbladder.

Coccidioidomycosis in Dogs and Cats: A Review

2008 ◽  
Vol 44 (5) ◽  
pp. 226-235 ◽  
Author(s):  
Angela Graupmann-Kuzma ◽  
Beth A. Valentine ◽  
Lisa F. Shubitz ◽  
Sharon M. Dial ◽  
Barbara Watrous ◽  
...  
Keyword(s):  
Variable Degree ◽  
Coccidioides Immitis ◽  
Coccidioides Posadasii ◽  
Cutaneous Lesions ◽  
Dimorphic Fungi ◽  
Tissue Samples ◽  
Causative Agents ◽  
Pulmonary Infiltration ◽  
Disseminated Disease ◽  
Radiographic Changes

The dimorphic fungi Coccidioides immitis and Coccidioides posadasii are the causative agents of coccidioidomycosis. Dogs and cats residing in and visiting endemic areas are at risk of exposure to infectious arthrospores. The primary infection is pulmonary and frequently results in chronic cough. Disseminated disease is common and causes cutaneous, osseous, cardiac, ocular, nervous system, or other organ disease. Radiographic changes include a variable degree of interstitial pulmonary infiltration, hilar lymphadenopathy, and osseous lesions. Serological titers support the diagnosis, but definitive diagnosis relies on identification of Coccidioides in cytological or tissue samples. Coccidioidomycosis should be considered in any dog or cat that has been potentially exposed during the previous 3 years and is presented with chronic illness, respiratory signs, lameness, lymphadenopathy, nonhealing cutaneous lesions, or neurological, ocular, or cardiac abnormalities.

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