Cases reported "Granuloma"

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1/363. Systemic infection with Alaria americana (trematoda).

    Alaria americana is a trematode, the adult of which is found in mammalian carnivores. The first case of disseminated human infection by the mesocercarial stage of this worm occurred in a 24-year-old man. The infection possibly was acquired by the eating of inadequately cooked frogs, which are intermediate hosts of the worm. The diagnosis was made during life by lung biopsy and confirmed at autopsy. The mesocercariae were present in the stomach wall, lymph nodes, liver, myocardium, pancreas and surrounding adipose tissue, spleen, kidney, lungs, brain and spinal cord. There was no host reaction to the parasites. Granulomas were present in the stomach wall, lymph nodes and liver, but the worms were not identified in them. hypersensitivity vasculitis and a bleeding diathesis due to disseminated intravascular coagulation and a circulating anticoagulant caused his death 8 days after the onset of his illness.
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2/363. sarcoidosis with selective involvement of a second liver allograft: report of a case and review of the literature.

    A case of sarcoidosis recurrent in a patient's second liver allograft is described. There was no granulomatous disease seen in the patient's first liver allograft. After the second orthotopic liver transplantation (OLT), the patient was successfully treated for acute rejection, aspergillus infection, and cytomegalovirus viremia. Approximately 2 months after the second OLT, the patient was treated with long-term interferon-alpha for recurrent hepatitis c. Five years after the operation, he experienced liver failure secondary to recurrent hepatitis and underwent a third OLT. This is only the second reported case of sarcoidosis recurrent in the liver parenchyma of a transplanted organ and the first in which interferon-alpha might have played a role.
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3/363. Systemic granulomatous arteritis associated with Epstein-Barr virus infection.

    A 61-year-old woman initially presented with symptoms and findings reminiscent of infectious mononucleosis, and her illness then took a rapidly fatal course. autopsy revealed widespread granulomatous arteritis, with multinucleated giant cells but without eosinophils and fibrinoid necrosis, affecting small arteries and arterioles and infiltration of haemophagocytic histiocytes into many organs. in situ hybridization with Epstein-Barr virus (EBV)-specific oligonucleotide probes showed positive signals in the infiltrating immune cells and epithelial and endothelial cells of the affected organs. EBV-associated haemophagocytic syndrome (EBV-AHS) with systemic granulomatous arteritis was diagnosed. From the immunophenotypes of the infiltrating immune cells, a possible role of CD4 T-cells in the pathogenesis of this haemophagocytic syndrome and granulomatous vasculitis was suggested.
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4/363. steroids treatment of granulomatous hepatitis complicating coxiella burnetii acute infection.

    Granulomatous hepatitis associated with coxiella burnetii acute infection has an adverse clinical course in some patients. Surprisingly, it does not respond to antibiotic but to steroids treatment. A hypersensitivity mechanism has been implicated. A case of granulomatous hepatitis complicating C. burnetii acute infection is reported, which was refractory to antibiotics but, as in four other cases previously reported, showed a complete response to steroids. This case was found to support findings that moderate doses of steroids can be useful in patients with granulomatous hepatitis complicating C. burnetii infection and showing no response to antibiotic treatment.
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5/363. Disseminated bartonella infection with granulomatous hepatitis in a liver transplant recipient.

    Disseminated infection with bartonella spp with granulomatous hepatitis was diagnosed in a liver transplant recipient presenting with fever of unknown origin. Pathological findings on liver biopsy were atypical, with scant granulomas seen only after a second biopsy. The patient responded promptly to antibiotic therapy. Infections caused by bartonella spp should be considered in transplant recipients with fever of unknown origin.
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6/363. herpes zoster in seven disparate dermatomes (zoster multiplex): report of a case and review of the literature.

    Noncontiguous multidermatomal herpes zoster is very rare in both immunocompetent and immunocompromised persons. Most of the reported cases have been limited to 2 noncontiguous dermatomes. This unique presentation has been referred to as zoster duplex unilateralis or bilateralis, depending on whether one or both halves of the body are involved. Granulomatous dermatitis at sites of herpes zoster scars, a rare isotopic response, has only been reported in persons with contiguous dermatomes of zoster. We describe an immunocompromised patient who developed herpes zoster in 7 disparate dermatomes. Three months after resolution of the zoster, the patient developed a granulomatous dermatitis in a zosteriform distribution at the sites of previous infection.
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7/363. Peritoneal sarcoidosis: case report and review of the literature.

    OBJECTIVES: This study was performed to report a patient with peritoneal sarcoidosis and review the literature for similar cases. methods: We described the clinical presentation, course, and outcome of the patient, and reviewed the medical literature from 1966 till 1997 using medline and the key words sarcoidosis, scar, and peritoneum. RESULTS: Our patient presented with a rapidly growing tumor-like mass at the site of an old appendectomy scar. laparoscopy showed a large peritoneal mass and multiple small peritoneal nodules that were found to be noncaseating granulomas by pathology. The medline search uncovered only 16 cases of peritoneal sarcoidosis, most of which presented with ascites. CONCLUSION: This case illustrates the need to consider sarcoidosis, in addition to infections and neoplasms, in the differential diagnosis of peritoneal nodules and exudative ascites.
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8/363. mycobacterium marinum infection from a tropical fish tank. Treatment with trimethoprim and sulphamethoxazole.

    A paronychial granuloma on the left thumb, in a man who kept tanks of tropical fish, was followed by cutaneous nodules on the left upper limb and tender lymph nodes in the left axilla. mycobacterium marinum was isolated from the lesion on the thumb and also from the tank water. Subsidence of the lesions followed administration of trimethoprim and sulphamethoxazole.
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9/363. Ultrasonic demonstration of xanthogranulomatous pyelonephritis.

    An ultrasound examination performed on a young woman with a long history of urinary tract infection demonstrated multiple subcapsular sonolucencies suggestive of multiple abscesses. The combination of the ultrasonic appearance, the clinical history, and a large nonfunctioning kidney with calculi on intravenous pyelography allowed us to suggest the diagnosis of xanthogranulomatous pyelonephritis. Ultrasound plays an even greater role in patients who are allergic to iodinated contrast material in whom intravenous pyelograms and arteriograms may be contraindicated.
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10/363. Dermatophytic granuloma caused by microsporum canis in a heart-lung recipient.

    We present a case of dermatophytic granuloma caused by microsporum canis in a heart-lung recipient. This 66-year-old man was seen for erythematous pustules and papules on the forearm. The diagnosis was suspected after histological examination showing an inflammatory infiltrate in the upper dermis with giant cells containing intracytoplasmic fungal elements. Cultures of the skin biopsy confirmed the diagnosis identifying M. canis. Our case emphasizes the possibility of deep dermatophytic infections in immunocompromised patients. There are only 4 additional reports of M. canis infection responsible for invasion of the dermis in such patients. The follicle involvement probably explains these dermal lesions due to the progression of the dermatophyte from the hair follicle to the dermis. In our observation topical antifungal therapy alone was unsuccessful and fluconazole seems to be the treatment of choice for these M. canis invasive dermal cutaneous infections.
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