A diagnostic challenge of invasive sellar neuroaspergillosis in an immunocompetent patient

Medical tourism is the pursuit of more affordable surgeries; however, this comes at the risk of suboptimal standards and potential for life-threatening complications. In this case, we describe the diagnostic challenge of cytomegalovirus (CMV) pneumonia in a 40-year-old woman who experienced wound dehiscence and subsequent blood transfusion-transmitted CMV as complications of liposuction in the Dominican Republic. We explore the role of histopathology in the diagnosis of disseminated CMV, discuss the underlying aetiology of CMV pneumonia in this patient and weigh the risks and benefits of initiating antiviral therapy in an immunocompetent patient with CMV disease.

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Diagnostic challenge between Crohn's disease and intestinal tuberculosis in chronic diarrhea with ulcerated jejunal stenosis: a case report

Revista de Gastroenterología del Perú ◽

10.47892/rgp.2020.404.1174 ◽

2020 ◽

Vol 40 (4) ◽

pp. 346

Author(s):

Valeria Costa-Barney ◽

Andrés F. Delgado-Villarreal ◽

Ana María Leguízamo ◽

Rómulo Darío Vargas

Keyword(s):

Weight Loss ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Chronic Diarrhea ◽

Intestinal Tuberculosis ◽

Immunocompetent Patient ◽

Diagnostic Challenge ◽

Correct Treatment ◽

Antituberculosis Treatment ◽

Patient At Risk

Intestinal tuberculosis and Crohn's disease are a diagnostic challenge because of the clinical, radiological and endoscopic similarity. The histological and microbiological findings are positive in less than 50%, which delays the correct treatment, putting the patient at risk. We reported a 34-year-old immunocompetent patient with 4 years of malabsorptive diarrhea, weight loss, nocturnal diaphoresis, abdominal pain and an ulcer with stenosis in the jejunum was found; she mpirical antituberculosis treatment with clinical improvement. Later the culture was positive for M. tuberculosis.

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Oral presentation of histoplasmosis in an immunocompetent patient: a diagnostic challenge

Australian Dental Journal ◽

10.1111/adj.12187 ◽

2014 ◽

Vol 59 (3) ◽

pp. 386-388 ◽

Cited By ~ 8

Author(s):

F Iqbal ◽

M Schifter ◽

HG Coleman

Keyword(s):

Oral Presentation ◽

Immunocompetent Patient ◽

Diagnostic Challenge

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Invasive aspergillosis of the skull base in an immunocompetent patient: a diagnostic challenge

BMJ Case Reports ◽

10.1136/bcr-2021-245517 ◽

2021 ◽

Vol 14 (11) ◽

pp. e245517

Author(s):

Alexandra Borges ◽

Lìgia Ferreira ◽

Ricardo Pacheco ◽

Isabel Fonseca

Keyword(s):

Skull Base ◽

Fungal Infections ◽

Immunocompetent Patient ◽

Imaging Features ◽

Round Cell ◽

Diagnostic Challenge ◽

Small Round Cell ◽

Tropical Climates ◽

Small Round Cell Tumour ◽

Immunocompetent Patients

We describe the case of a 32-year-old man from Cape Verde having headache and increasing visual loss. Clinical and radiological investigations disclosed a massive destructive lesion involving the anterior and central skull base, orbit and nasoethmoid region initially interpreted as a malignant small round cell tumour. Surgical biopsies were negative for neoplasm, showing an intense inflammatory infiltrate together with fungus, later characterised as Aspergillus flavus spp. The patient was immunocompetent with no evidence of congenital or acquired immunodeficiencies. Invasive fungal infections in immunocompetent patients are rare and can be a diagnostic challenge. The best diagnostic clues include the patient’s origin from tropical climates, imaging features and the identification of fungal hyphae on pathology specimens. Although a devastating disease in immunocompromised patients, craniocerebral aspergillosis in immunocompetent patients carries a better prognosis. Available literature supports the combined used of ‘conservative’ surgical resection and antifungal therapy as the best treatment option.

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Central Nervous System Vasculitis for Cryptococcosis in an Immunocompetent Patient

Diseases ◽

10.3390/diseases6030075 ◽

2018 ◽

Vol 6 (3) ◽

pp. 75 ◽

Cited By ~ 1

Author(s):

Dan Zimelewicz Oberman ◽

Liliana Patrucco ◽

Carolina Cuello Oderiz

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Cryptococcus Neoformans ◽

Cryptococcal Meningitis ◽

Fungal Pathogen ◽

Immunocompetent Patient ◽

Central Nervous System Vasculitis ◽

Diagnostic Challenge ◽

Threatening Condition ◽

Life Threatening

Cryptococcal meningitis is a life-threatening condition caused by a fungal pathogen, Cryptococcus neoformans, that can infect both immunosuppressed and immunocompetent hosts. It is an important cause of morbidity and mortality in severely immunodeficient patients. However, in an immunocompetent patient it represents a diagnostic challenge, mainly because it is extremely rare, but also because of its nonspecific clinical manifestation. Neurovascular involvement in cryptococcal meningitis is rare and not well known and only few reports have described this association. We describe a cryptococcal meningitis in an immunocompetent patient associated with central nervous system vasculitis.

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Hepatic Candidiasis in an Immunocompetent Patient: A Diagnostic Challenge

Cureus ◽

10.7759/cureus.13935 ◽

2021 ◽

Author(s):

Zorays Moazzam ◽

Amman Yousaf ◽

Zahid Iqbal ◽

Ahmad Tayyab ◽

Muhammad Hashim Hayat

Keyword(s):

Immunocompetent Patient ◽

Diagnostic Challenge

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Disseminated histoplasmosis presenting as pyoderma gangrenosum‐like ulcers in an apparently immunocompetent patient: multiple red herrings presenting a diagnostic challenge

International Journal of Dermatology ◽

10.1111/ijd.14923 ◽

2020 ◽

Vol 59 (9) ◽

Author(s):

Vishal Gupta ◽

Saurabh Bhatia ◽

Pankhuri Dudani ◽

Sudheer Arava ◽

Naren Hemachandran ◽

...

Keyword(s):

Pyoderma Gangrenosum ◽

Immunocompetent Patient ◽

Diagnostic Challenge ◽

Disseminated Histoplasmosis

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Isolated Retropancreatic Tuberculous Lymphadenitis Mimicking Carcinoma: A Diagnostic Challenge

Case Reports in Gastrointestinal Medicine ◽

10.1155/2016/7295496 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

H. Kuriry ◽

R. Alenezi ◽

A. Alghamdi ◽

A. M. Swied

Keyword(s):

Weight Loss ◽

Lymph Node ◽

Obstructive Jaundice ◽

Unusual Case ◽

Immunocompetent Patient ◽

Tuberculous Lymphadenitis ◽

Rare Entity ◽

Diagnostic Challenge ◽

First Case ◽

The Common

Tuberculosis as a cause of obstructive jaundice is a rare entity with only a few cases reported in the literature. Patients with this condition usually present with a protracted illness, jaundice, and weight loss, which may be confused with malignancies. We are reporting unusual case of isolated enlarged tuberculous lymph node compressing the common bile duct in the retropancreatic region and causing obstructive jaundice in an immunocompetent patient which to the best of our knowledge is the first case of isolated retropancreatic tuberculous lymphadenitis in Saudi Arabia.

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