scholarly journals Atypical Presentation of Visceral Leishmaniasis in a HIV-positive Patient from a Nonendemic Area

2011 ◽  
Vol 3 (02) ◽  
pp. 119-121 ◽  
Author(s):  
Dhara H Vyas ◽  
Parul D Shah

ABSTRACTVisceral leishmaniasis (VL), though widely prevalent in India, is not seen in the Rajasthan where the dry, hot and arid climatic conditions create a hostile environment for the growth of the parasite or its vector, the sandfly. We present a case of VL in a patient co-infected with HIV from this region. A 34-year-old known case of a HIV-positive patient presented to the skin department of our hospital with multiple, nontender, erythematous, papulonodular lesions all over the body for 6 months with history of weight loss and low-grade fever. Important examination findings were pallor, inguinal lymphadenopathy and hepatosplenomegaly. Laboratory findings included anemia, leucopenia, hypergammaglobulinemia and altered leucocytes to erythrocyte ratio. Buffy coat examination and bone marrow aspirates showed the presence of leishman bodies inside monocytes and macrophages respectively as well as extracellularly also. The patient was treated with amphotericin B intravenously and responded well to the treatment.

2002 ◽  
Vol 116 (4) ◽  
pp. 288-290 ◽  
Author(s):  
C. V. Praveen ◽  
R. M. Terry ◽  
M. Elmahallawy ◽  
C. Horsfield

Pneumocystis carinii is an opportunistic infection found in patients with impaired immunity. Under favourable conditions the parasite can spread via the blood stream or lymphatic vessels and cause extrapulmonary dissemination. We report a case of P carinii infection presenting as bilateral aural polyps, otitis media and mastoiditis in human immunodeficiency (HIV)-positive patient with no history of prior or concomitant P carinii infection.


2021 ◽  
Author(s):  
Shima Salehi ◽  
Rozita Hosseini Shamsabadi ◽  
Hassan Otukesh ◽  
Reza Shiari ◽  
Monir Sharafi

Abstract Background: Lupus is an inflammatory and autoimmune disease that involves various tissues and organs of the body. Identification of diagnostic elements to rapid identification of seronegative lupus cases is very important in order to prevent morbidity and progression of disease. This study aimed to compare clinical and laboratory findings of seropositive cases with seronegative lupus patients. Methods: This cross-sectional analytic study was performed on 43 children (17 seronegative and 26 seropositive) with lupus who were admitted to Ali Asghar Hospital during 2007-2017. Seropositive patients had anti-nuclear antibody (ANA) titration >1/80, while seronegative patients had ANA titration <1/80 (at the time of disease diagnosis). Clinical and laboratory findings were compared between two groups.Results: Serositis in patients with ANA- was significantly higher than ANA+ (41.17% vs. 23.07%; p = 0.042). ANA- group had higher autoimmune disease history than ANA+ group (42.85% vs. 15.0%; p = 0.041). The family history of the disease in the ANA- group was greater than ANA+ group (50% vs. 23.52%). The percentage of hypertensive patients in ANA- group was higher than ANA+ group (52.94% vs. 26.92%; p = 0.037). Neurologic symptoms in ANA+ and ANA- groups were 38.46% and 17.64%, respectively (p = 0.043). The frequency of patients with thrombocytopenia in ANA+ group was significantly greater than ANA- group (32% vs. 12.5%; p=0.041). There was no significant difference in other clinical and laboratory findings between two groups. Conclusion: Seronegative lupus patients had higher percentage of musculoskeletal symptoms, autoimmune disease history, familial history of disease, and hypertension, while neurological and thrombocytopenia symptoms were higher in seropositive patients compared to seronegative cases. Therefore, evaluation of these factors can be helpful to diagnosis of seronegative patients.


2021 ◽  
Author(s):  
Lagan Paul ◽  
Shalin Shah ◽  
Manisha Agarwal ◽  
Shalini Singh

Abstract BackgroundVogt–Koyanagi–Harada (VKH) disease is an autoimmune disorder which affects numerous organs of the body. We report two cases of Optic Nerve Head neovascularisation (NVD) in diagnosed cases of Vogt Koyanagi Harada(VKH) disease.FindingsCase 1: A 40 years female presented with acute loss of vision in both eyes for 10 days. She had multiple serous detachments in both eyes and diagnosed as acute VKH disease. After treatment, she was observed to have NVD later on OCT Angiography(OCTA). Case 2: A 52 years old man presented with history of sudden blackouts in front of left eye since 4 months. He was a case of chronic VKH and NVD was seen clinically and on OCTA. ConclusionThe exact etiopathogenesis of neovascularization in Harada’s disease is unclear. The low grade inflammations acts as a stimulus and can induce disc neovascularization even in the absence of vascular occlusion. ONH vessels appear to be more susceptible to developing NVD than retinal vessels in presence of chronic inflammation.


Author(s):  
J.R. Rashid ◽  
P.M. Nyakundi ◽  
G. Kirigi ◽  
D. Kinoti ◽  
M.K. Wasunna

2016 ◽  
Vol 10 (3) ◽  
pp. 600-604 ◽  
Author(s):  
Vamshidhar Vootla ◽  
Rafeeq Ahmed ◽  
Masooma Niazi ◽  
Bhavna Balar ◽  
Suresh Nayudu

Primary colonic adenocarcinoma and synchronous rectal carcinoids are rare tumors. Whenever a synchronous tumor with a nonmetastatic carcinoid component is encountered, its prognosis is determined by the associate malignancy. The discovery of an asymptomatic gastrointestinal carcinoid during the operative treatment of another malignancy will usually only require resection without additional treatment and will have little effect on the prognosis of the individual. This article reports a synchronous rectal carcinoid in a patient with hepatic flexure adenocarcinoma. We present a case of a 46-year-old Hispanic woman with a history of hypothyroidism, uterine fibroids and hypercholesterolemia presenting with a 2-week history of intermittent abdominal pain, mainly in the right upper quadrant. She had no family history of cancers. Physical examination was significant for pallor. Laboratory findings showed microcytic anemia with a hemoglobin of 6.6 g/dl. CT abdomen showed circumferential wall thickening in the ascending colon near the hepatic flexure and pulmonary nodules. Colonoscopy showed hepatic flexure mass and rectal nodule which were biopsied. Pathology showed a moderately differentiated invasive adenocarcinoma of the colon (hepatic flexure mass) and a low-grade neuroendocrine neoplasm (carcinoid of rectum). The patient underwent laparoscopic right hemicolectomy and chemotherapy. In patients diagnosed with adenocarcinoma of the colon and rectum, carcinoids could be missed due to their submucosal location, multicentricity and indolent growth pattern. Studies suggest a closer surveillance of the GI tract for noncarcinoid synchronous malignancy when a carcinoid tumor is detected and vice versa.


2021 ◽  
Vol 8 ◽  
Author(s):  
Young Min Cho ◽  
Sara Guevara ◽  
Judith Aronsohn ◽  
James M. Mumford ◽  
Linda Shore-Lesserson ◽  
...  

This case report describes a 60 year-old Black-American male with a past medical history of human immunodeficiency virus (HIV) infection and hyperthyroidism, who suffered a bilateral spontaneous pneumothorax (SP) in the setting of coronavirus disease 2019 (COVID-19) pneumonia. SP is a well-established complication in HIV-positive patients and only recently has been associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. While HIV and COVID-19 infections have been independently linked with increased risk of SP development, it is unknown if both infections interact in a synergistic fashion to exacerbate SP risk. According to the Centers for Disease Control and Prevention (CDC), patients living with HIV have a higher risk of developing severe COVID-19 infection and the mechanism remains to be elucidated. To the best of our knowledge, this is the first report of a HIV-positive patient, who in the setting of SARS-CoV-2 infection, developed bilateral apical spontaneous pneumothorax and was later found to have a left lower lobe tension pneumothorax. This case highlights the importance of considering SP on the differential diagnosis when HIV-positive patients suddenly develop respiratory distress in the setting of SARS-CoV-2 infection.


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