scholarly journals Subcutaneous phaeohyphomycosis: A rare case

2019 ◽  
Author(s):  
Zahruddin Ahmad ◽  
Diah Mira Indramaya ◽  
Yuri Widia ◽  
Sylvia Anggraeni ◽  
Linda Astari ◽  
...  
Keyword(s):  
Subcutaneous Tissue ◽  
Clinical Manifestations ◽  
Granulomatous Inflammation ◽  
Surgical Excision ◽  
Fungal Culture ◽  
Human Beings ◽  
Nodular Lesions ◽  
Subcutaneous Phaeohyphomycosis ◽  
Tuberculosis Therapy

Phaeohyphomycosis is a rare fungal infection caused by melanized fungi which usually involve the skin and subcutaneous tissue. It is an infrequent cause of infection in human beings. Common clinical manifestations are subcutaneous cystic swellings, which is localized, characterized by subcutaneous asymptomatic nodular lesions that develop after traumatic implantation of fungus from contaminated soil, thorns or wood splinters, especially on extremities. We report a case of subcutaneous phaeohyphomycosis presenting as multiple cystic swellings over the left lower leg with unknown predisposing factors. At first, the patient was misdiagnosed as soft tissue tumor and subcutaneous tuberculosis, then got surgical and anti-tuberculosis therapy respectively, but there was no improvement. Further investigation revealed granulomatous inflammation on histopathology examination and black-coloured colonies identifed as Exophiala dermatitidis on fungal culture. This case of phaeohyphomycosis was successfully treated by itraconazole monotherapy without surgical excision and still under follow-up.

Successful treatment of disseminated granulomatous aspergillosis in an apparently immunocompetent host

2020 ◽  
Vol 50 (4) ◽  
pp. 346-349 ◽  
Author(s):  
Umang Agrawal ◽  
Pratik Savaj ◽  
Kanishka Davda ◽  
Rajeev Soman ◽  
Anjali Shetty ◽  
...  
Keyword(s):  
Granulomatous Inflammation ◽  
Surgical Excision ◽  
Immunocompetent Host ◽  
Short History ◽  
Normal Individuals ◽  
History Of ◽  
One Year ◽  
Work Up ◽  
The Brain

A young Indian man presented elsewhere with a short history of haematuria and cough. Investigations revealed renal and pulmonary lesions. Histopathology of these lesions was reported as mucormycosis. He consulted us two months after onset of symptoms, asymptomatic and clinically well, having received no treatment. In view of clinico-histopathological discordance, a review of the biopsy slides was advised but the patient refused further work-up at that time. One week later, however, he was admitted with left hemiparesis. Brain imaging showed an abscess. He underwent surgical excision of the brain abscess and nephrectomy. Review of previous slides showed septate fungal filaments with granulomatous inflammation. Intraoperative cultures grew Aspergillus flavus. He received voriconazole for one year and is well at his two-year follow-up. His immunological work-up was negative for immunodeficiency. This case illustrates that granulomatous aspergillosis may be an indolent infection in apparently normal individuals and reiterates the importance of interpreting diagnostic reports in conjunction with clinical features.

scholarly journals Solitary Encapsulated Neurofibroma Not Associated with Neurofibromatosis-1 Affecting Tongue in a 73-Year-Old Female

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Sk. Abdul Mahmud ◽  
Neha Shah ◽  
Moumita Chattaraj ◽  
Swagata Gayen
Keyword(s):  
Family History ◽  
Clinical Manifestations ◽  
Surgical Excision ◽  
Neurofibromatosis Type ◽  
Clinical Findings ◽  
Benign Tumors ◽  
History Of

Neurofibromas are benign tumors of nerve cell origin arising due to proliferation of Schwann cells and fibroblasts. They are usually asymptomatic and hence remain undiagnosed. They are commonly found on the skin and intraorally tongue is the most common site for their occurrence. Here, we present a unique case of solitary encapsulated neurofibroma in the oral cavity without any clinical manifestations or family history of Neurofibromatosis type 1 in a 73-year-old female patient who presented with a painless swelling on the tongue. The histopathologic findings closely mimicked benign fibrous histiocytoma. In our case, definitive diagnosis of neurofibroma was made based on clinical findings, family history, and histopathological and immunohistochemical evaluation. Through this case report we want to emphasize the role of biopsy and immunohistochemistry in arriving at a confirmatory diagnosis. The patient was treated by surgical excision and showed no signs of recurrence over a follow-up period of 12 months.

scholarly journals Three-Dimensional Computed Tomography Follow-Up on Spontaneous Bone Healing after Excision of Periorbital Dermoid Cyst: A Case Report

2021 ◽  
Vol 17 (3) ◽  
pp. 213-217
Author(s):  
Hannara Park ◽  
Jaemin Seong ◽  
Hyochun Park ◽  
Hyeonjung Yeo
Keyword(s):  
Computed Tomography ◽  
Dermoid Cyst ◽  
Three Dimensional ◽  
Surgical Excision ◽  
Complete Recovery ◽  
Bony Defect ◽  
Palpable Mass ◽  
Nodular Lesions ◽  
The Right

Dermoid cysts are among the most common periorbital and orbital tumors presenting in childhood. Several studies have shown that dermoid cysts may deform adjacent bones; however, few studies have followed the course of bone regeneration after the excision of a cyst. We report a case of a 29-month-old female infant who presented with a palpable mass over her right lateral eyebrow. Ultrasonography findings suggested a dermoid cyst, and computed tomography revealed a 2.1-cm round bony defect in the right zygoma. After surgical excision of the dermoid cyst, we successfully applied fibrin sealant to eliminate the dead space. Pathological findings showed nodular lesions with flat cystic walls containing lamellated keratin and sebaceous glands, supporting the diagnosis of dermoid cyst. At 6 months postoperatively, a follow-up computed tomography scan confirmed complete recovery of the bone defect in the right zygoma.

scholarly journals Kerion Type of Tinea Capitis Treated with Double Pulse Dose Terbinafine

2016 ◽  
Vol 6 (2) ◽  
pp. 34
Author(s):  
Franky Chandra
Keyword(s):  
Tinea Capitis ◽  
Clinical Manifestations ◽  
Double Pulse ◽  
Microsporum Canis ◽  
Fungal Culture ◽  
Pulse Dose ◽  
Mycologic Cure ◽  
Higher Doses ◽  
Dermatophyte Infection

Objective: Tinea capitis is a common dermatophyte infection affecting hair and skin which always requires systemic treatment to get a clinical and mycologic cure, preventing relapse, and infection spread. Griseofulvin has been the antifungal therapy of choice for tinea capitis, but it often requires higher doses and a longer duration than recommended. Thus, effective alternative antifungal with good oral tolerability and shorter course of treatment are therefore required. The objective of this report is to evaluate the effectiveness of double pulse dose terbinafine for tinea capitis alternative therapy.Method: A case of kerion type of tinea capitis in a two-year-old girl was reported. Diagnosis was established based on clinical manifestations of alopecia, presented as erythematous macule with pustules, hemorrhagic crusts, and scales on the scalp, accompanied with occipital lymphadenopathy. Fungal culture showed growth of Microsporum canis (M. canis) colonies. Patient was treated with doubled pulse dose terbinafine 125 mg/day and 2% ketoconazole shampoo for two months.Result: Clinical improvements were found on 35th day of follow up, while mycologic cure was achieved on 60th day of follow up. Tolerability was excellent and no side effects observed.Conclusion: Double pulse dose terbinafine is effective for kerion type of tinea capitis. Key words: double pulse dose, kerion, M. canis, terbinafine, tinea capitis

scholarly journals Rare Cardiac Myxoma with A Hard Texture: A Case Report

2020 ◽  
Author(s):  
Hongfei Xu ◽  
Yanjia Gu ◽  
Liang Ma ◽  
Yiming Ni ◽  
Weidong Li
Keyword(s):  
Elective Surgery ◽  
Cardiac Myxoma ◽  
Clinical Manifestations ◽  
Surgical Excision ◽  
Cardiac Tumors ◽  
Rare Type ◽  
Primary Tumors ◽  
Case Presentation ◽  
Preoperative Examination

Abstract Background: Primary tumors of the heart are uncommon but not rare. Myxoma comprises 50% of all benign cardiac tumors in adults and 15% of such tumors in children. Cardiac myxoma is usually soft in texture and has a friable or villous surface, which tends to be associated with embolic events. It is also rare for myxoma to be full of calcium and metastatic bone deposits.Case presentation: We herein present a 58-year-old female patient with cardiac space-occupying lesion within the left atrium, and the lesion is lubricous and hard. Her only symptoms were hypertension, dizziness, and chest stuffiness. After surgical resection, we confirmed that the lesion was atrial myxoma by histopathology examination. The patient recovered uneventfully and was discharged. A 2-year follow-up exam showed no evidence of tumor recurrence.Conclusions: Cardiac myxoma is rare and has various clinical manifestations. It is usually friable and has an irregular surface, making embolic manifestations one of the most common complications. Consequently, immediate surgical excision is suggested upon diagnosis. In our case, the patient had a rare type of cardiac myxoma, which had a hard texture and lubricous surface. In our opinion, this case has a low risk of embolism. We prefer elective surgery rather than emergency surgery to perfect the preoperative examination for this kind of patient.

Clinical Presentation and Outcomes of Surgery for Upper Extremity Lipomas

2021 ◽  
Vol 23 (6) ◽  
pp. 393-400
Author(s):  
Andrzej Żyluk
Keyword(s):  
Upper Extremity ◽  
Clinical Presentation ◽  
Subcutaneous Tissue ◽  
Clinical Manifestations ◽  
Benign Neoplasms ◽  
Fat Tissue ◽  
Benign Lesions ◽  
Telephone Interviews ◽  
Postoperative Scar

Background. Lipomas are benign neoplasms arising from fat tissue, with an incidence in the upper extremity of 1%-3,8%. There is scarce literature on the outcomes of the treatment of lipomas in this region. The objective of this study was to assess clinical manifestations and outcomes of surgery for upper extremity lipomas. Material and methods. The sample comprised 40 patients, including 26 women (65%) and 14 men (35%), at a mean age of 37 years, with lipomas located in the upper limbs. Treatment outcomes were assessed at a mean of 4.2 years after surgery in 27 patients from this group. Results. Most of the tumours (29 cases, 73%) were located in the forearm and arm, with 11 patients (27%) presenting with lipomas of the metacarpus and wrist. In 35 patients (87%), lesions were located superficially, within subcutaneous tissue, whereas in 5 (13%) they were located more deeply, in the metacarpus and in the forearm muscles. The follow-up assessment was conducted as telephone interviews in 27 patients. No recurrence was noted. Seven patients (26%) complained of mild tenderness of the postoperative scar. Conclusions. 1. Lipomas are moderately frequent benign lesions occurring in the upper limb. 2. Surgical treat­ment is effective and the recurrence rate is very low.

scholarly journals Hypophyseal Involvement in Immunoglobulin G4-Related Disease: A Retrospective Study from a Single Tertiary Center

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Yang Liu ◽  
Linjie Wang ◽  
Wen Zhang ◽  
Hui Pan ◽  
Hongbo Yang ◽  
...  
Keyword(s):  
Medical Center ◽  
Immunosuppressive Agents ◽  
Clinical Manifestations ◽  
Surgical Excision ◽  
Pituitary Function ◽  
Pituitary Mass ◽  
Immunoglobulin G4 ◽  
Serum Igg4 ◽  
Tertiary Center

This study aims to outline the clinical features and outcomes of IgG4-related hypophysitis (IgG4-RH) patients in a tertiary medical center. We reviewed clinical manifestations and imaging and pituitary function tests at baseline, as well as during follow-up. Ten patients were included. The mean age at diagnosis of IgG4-RH was 48.4 (16.0–64.0) years. An average of 3 (0–9) extrapituitary organs were involved. Five patients had panhypopituitarism, three had only posterior hypopituitarism, one had only anterior hypopituitarism, and one had a normal pituitary function. One patient in our study had pituitary mass biopsy, lacking IgG4-positive cells despite lymphocyte infiltration forming an inflammatory pseudotumor. Five patients with a clinical course of IgG4-RH less than nine months and a whole course of IgG4-RD less than two years were managed with glucocorticoids, while three patients with a longer history were administered glucocorticoids plus immunosuppressive agents. One patient went through surgical excision, and one patient was lost to follow-up. All patients showed a prompt response clinically, but only three patients had normalized serum IgG4 levels. Two patients who took medications for less than six months relapsed. Conclusions. IgG4-RD is a broad disease, and all physicians involved have to be aware of the possibility of pituitary dysfunction. Younger patients should be expected. The histopathological feature of pituitary gland biopsy could be atypical. For patients with a longer history, the combination of GC and immunosuppressive agents is favorable. Early and adequate courses of treatment are crucial for the management of IgG4-RH. With GC and/or immunosuppressant treatment, however, pituitary function or diabetes insipidus did not improve considerably.

scholarly journals Dermatofibrosarcoma protuberans – a wolf in sheep’s clothing: a case report and review of the literature

2021 ◽  
Vol 11 (3) ◽  
pp. 246-249
Author(s):  
Mohammad Kamrul Ahsan ◽  
Md Rashedul Islam
Keyword(s):  
Subcutaneous Tissue ◽  
Skin Flap ◽  
Dermatofibrosarcoma Protuberans ◽  
Surgical Excision ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Diagnostic Work ◽  
Work Up ◽  
Slow Growing

Dermatofibrosarcoma protuberans (DFSP) is a locally invasive and slow growing tumor of the subcutaneous tissue. It rarely metastasizes but progressive and recurs frequently after surgical excision. The trunk and proximal extremities are the most common sites of the disease. A 53-year-old woman presented to dermatology outpatient department with a 3-cm, firm, violaceous and multinodular mass located on the left upper shoulder. Diagnostic work-up including magnetic resonance imaging and histopathological findings of biopsy were consistent with DFSP. The patient underwent wide local excision with skin flap reconstruction. No recurrence has been observed during ten months of follow-up. BIRDEM Med J 2021; 11(3): 246-249

scholarly journals Mycobacterial identification on homogenised biopsy facilitates the early diagnosis and treatment of laryngeal tuberculosis

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 508-512
Author(s):  
Zhenjun Yu ◽  
Ruyue Lu ◽  
Meifu Gan ◽  
Xi Tu ◽  
Zebao He
Keyword(s):  
Early Diagnosis ◽  
Vocal Cord ◽  
Clinical Manifestations ◽  
Granulomatous Inflammation ◽  
Blood Chemistry ◽  
High Rate ◽  
Gene Chips ◽  
History Of ◽  
Tuberculosis Therapy ◽  
Laryngeal Tuberculosis

AbstractIntroductionThe incidence of laryngeal tuberculosis has increased gradually in recent years. Laryngeal tuberculosis has strong infectivity and atypical clinical manifestations. Hence, establishing the early diagnosis of laryngeal tuberculosis is considered difficult, resulting in the high rate of misdiagnosis of laryngeal tuberculosis and increased rates of tuberculosis infection.ObjectiveThis study aimed to describe a case of laryngeal tuberculosis detected using the mycobacteria gene chips technology, facilitating the early diagnosis and the treatment of laryngeal tuberculosis.Case presentationA 27-year-old woman presented with a 7-day history of hoarseness, with a normal routine blood chemistry test and chest computed tomography results. Histological analysis of the vocal cord biopsy showed granulomatous inflammation and the negative acid-fast stain test. The mycobacteria gene chips method was used to directly examine the vocal cord tissue treated with homogenate, and the Mycobacterium tuberculosis was successfully identified. Thus, the early diagnosis of laryngeal tuberculosis and the drug sensitivity of rifampin and isoniazid were confirmed. The patient recovered after undergoing a 1-year standard anti-tuberculosis therapy.ConclusionsMycobacterial identification on homogenised biopsy using the mycobacteria gene chips method significantly facilitates the early diagnosis and the treatment of tuberculosis.

Isolated Lateral Meniscal Tear in the Dog

1988 ◽  
Vol 01 (03/04) ◽  
pp. 152-154
Author(s):  
S. Johnson ◽  
D. Hulse
Keyword(s):  
External Rotation ◽  
Femoral Condyle ◽  
Meniscal Tear ◽  
Lateral Meniscus ◽  
Surgical Excision ◽  
Human Beings ◽  
Stifle Joint ◽  
Microscopic Pathology ◽  
Bucket Handle Tear ◽  
Bucket Handle

degenerative changes of the involved stifle joint associated with a “bucket handle” tear of the caudal body of the lateral meniscus. Surgical excision of the torn section of meniscus was beneficial in the first patient but this patient had persistant difficulty with the leg after exercise. Gross and microscopic pathology of the involved stifle in the second patient showed the meniscal lesion to be associated with severe cartilage fibrillation of the overlying lateral femoral condyle. As in human beings, the mechanism of injury may have been placement of the foot during vigorous external rotation of the femur with the stifle flexed. Extension of the limb from this position could have resulted in an isolated tear of the lateral meniscus.

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