1/52. Interferon gamma (IFN-gamma) deficiency in generalized Epstein-Barr virus infection with interstitial lymphoid and granulomatous pneumonia, focal cerebral lesions, and genital ulcers: remission following IFN-gamma substitution therapy.A 26-year-old previously healthy woman developed granulomatous pneumonitis, encephalitis, and genital ulceration during primary Epstein-Barr virus (EBV) infection. EBV dna was demonstrated by polymerase chain reaction analysis of serum, lung tissue, and genital ulcer specimens. serology verified primary EBV infection. The patient lacked lymphocytes cytotoxic to autologous EBV-transformed B lymphocytes. No spontaneous or in vitro EBV-induced interferon gamma (IFN-gamma) production was evident in peripheral blood. The cells had normal IFN-gamma production when stimulated with staphylococcus aureus exotoxin A. In the bone marrow and peripheral blood, the number of large granular CD56 lymphocytes (natural killer cells) increased 39%-55%, but no CD4 or CD8 cell lymphocytosis was initially found. A partial clinical response was achieved with treatment with acyclovir, corticosteroids, and intravenous gamma-globulin. Because of persistent granulomatous central nervous system and lung involvement, subcutaneous IFN-gamma therapy was started but was discontinued after 3 months because of development of fever, pancytopenia, and hepatitis. This therapy initiated a complete clinical recovery, which occurred parallel to development of EBV-specific cytotoxic CD8 T lymphocytes and normalization of natural killer cell lymphocytosis. These findings provide evidence for an EBV-induced lymphoproliferative disorder due to a T lymphocyte dysfunction associated with a selective lack of IFN-gamma synthesis.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/52. female genital coccidioidomycosis (FGC), Addison's disease and sigmoid loop abscess due to coccidioides immites; case report and review of literature on FGC.We describe a woman with unusual complications of infection with coccidioides immitis--infection of the genital tract and adrenal insufficiency. The patient also had intestinal coccidioidomycosis (cocci) in conjunction with presumed pulmonary, and asymptomatic central nervous system cocci. To our knowledge, concurrent FGC, intestinal and adrenal cocci have not been reported previously. A medline review from 1966-1997 revealed only 1 case of adrenal insufficiency due to cocci. FGC is rare; we identified 12 reported cases since 1929. No combination of investigations or clinical features is sensitive enough to predict FGC. Diagnosis is usually made after microscopy of surgical specimens. FGC presents either as tubo-ovarian disease or endometritis. Treatment generally involves surgical excision and antifungal agents. We hypothesize that an initial trial of antifungals may obviate the need for surgery.- - - - - - - - - - ranking = 0.33333333333333keywords = infection (Clic here for more details about this article) |
3/52. female genital schistosomiasis.schistosoma haemtobium infection in travelers from endemic areas is usually asymptomatic, or presents with hematuria. Uncommon manifestations include neurological syndromes, genital dysaesthesias and watery or blood stained semen. This organism also causes disease within all structures of the female genital tract because of communications between pelvic venous complexes, and can occur long after return home. schistosomiasis may not be suspected, resulting in delays in diagnosis and treatment. We present two cases which illustrate the diverse nature of this condition.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
4/52. cytomegalovirus disease in the lower female genital tract.cytomegalovirus (CMV) can cause life-threatening disease in immunocompromised patients, such as those with human immunodeficiency virus (hiv). It is a rare but important cause of ulceration in the female genital tract. We report on three cases of CMV disease in the female genital tract. One patient presented with vulvar ulceration and fevers, and two patients presented with bleeding cervical lesions. All diagnoses were confirmed by histology. All patients were treated with intravenous ganciclovir with good result. CMV disease of the female genital tract may result in significant morbidity, with fever, pain, bleeding, and superinfection, and it may be associated with the development of pelvic inflammatory disease and cervical intraepithelial neoplasia. There are several options for diagnosis and for safe treatment.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
5/52. Unilateral tubo-ovarian abscess and intrauterine contraceptive devices.The association of unilateral tubo-ovarian abscess and the presence or use of an intrauterine contraceptive device (IUD) appears to be a definite clinical entity. Four cases of unilateral tubo-ovarian abscess in patients using the IUD are presented. Three patients had a Dalkon Shield IUD and one had a Lippes Loop. Two patients had unilateral salpingo-oophorectomy while the other 2 had total abdominal hysterectomy and bilateral salpingo-oophorectomy. The differential diagnosis, possible etiology, route and mode of infection, and management are discussed.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
6/52. Value of the erythrocyte sedimentation rate in gynecologic infections.The ESR remains a valuable test in gynecology, specifically when obtained sequentially in cases of pelvic infection. It is nonspecific but has much merit in assessing prognosis and therapeutic measures. In conjunction with laparoscopy and diagnostic ultrasound it plays an important part in the evaluation of abdominal and pelvic infections.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
7/52. malacoplakia of the ovary, fallopian tube and uterus: a case associated with diabetes mellitus.malacoplakia is a chronic xanthogranulomatous inflammation that most commonly affects the urinary tract and the gastrointestinal system of middle-aged women. It is rarely encountered in a female genital tract, and only a handful of cases of malacoplakia of the ovary have been described. We report an unusual case of malacoplakia extensively involving the ovary, fallopian tube and uterus of a 47-year-old woman with poorly controlled diabetes mellitus. escherichia coli was cultured from the ovarian lesion. To our knowledge, such an extensive female genital malacoplakia associated with diabetes mellitus has not been reported before. Widespread or atypical site malacoplakia occurring in a patient with systemic disease may result from a diminution of macrophagocytic function, either under the influence of the systemic illness or related to corticosteroid excess. We propose that diabetes mellitus without appropriate medical control may have resulted in impaired leukocyte function which, when combined with E. coli infection, led to the development of extensive malacoplakia in the genital tract of this patient.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
8/52. Tuboovarian abscess caused by candida glabrata in a febrile neutropenic patient.Deep-seated Candida infections are strongly associated with mortality and morbidity of patients, and need early diagnosis. The frequency of deep-seated fungal infection has recently been growing. We encountered a tuboovarian abscess caused by candida glabrata after chemotherapy with an anticancer drug, methotrexate, in a febrile neutropenic patient. The susceptibilities to fluconazole and amphotericin b were 16 and 0.5 micro g/ml, respectively. Although combination therapy of fluconazole and amphotericin b was effective, left salpingectomy was laparoscopically performed because the left adnexal tumor continued to exist asymptomatically after 1 month.- - - - - - - - - - ranking = 0.33333333333333keywords = infection (Clic here for more details about this article) |
9/52. Recurrent group A Streptococcal genital infection after Puerperal sepsis.Recurrent group A streptococcal infection is a well-known phenomenon. It is well documented as a problem in pharyngotonsillitis and skin infections. This report describes a case of recurrent genital infection after puerperal sepsis caused by group A streptococci.- - - - - - - - - - ranking = 1.1666666666667keywords = infection (Clic here for more details about this article) |
10/52. Extensive condyloma acuminata treated with imiquimod 5% cream: a case report.Genital warts are one of the most common sexually transmitted infections, and are caused by human papillomavirus (HPV) types 6 and 11. Standard treatments for genital warts include cryotherapy, laser therapy, trichloroacetic acid and podophyllotoxin. We report the case of a 21-year-old female with extensive genital warts. A patient-applied, non-destructive therapy was considered to be the most appropriate treatment in this case, due to the extent of the disease and the resulting psychological distress experienced by the patient. She applied imiquimod 5% cream three times per week for a period of 5 weeks, which resulted in complete clearance of all the warts. Minor inflammatory changes were observed during treatment; however, no significant pain was by reported the patient. No recurrences were reported during 2 years of follow-up.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
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