1/18. agrobacterium yellow group: bacteremia and possible septic arthritis following peripheral blood stem cell transplantation.A 47-year-old male patient developed sepsis and monoarticular arthritis following autologous stem cell transplantation for recurrent Hodgkin's disease. Blood cultures were positive for agrobacterium yellow group. The knee pain and swelling responded promptly to the institution of empirical broad-spectrum antibiotics. Recurrent bacteremia developed necessitating Hickman line removal for eventual resolution of the infection. Transplant physicians should be aware of this unusual pathogen and the potential for both persistent line-related sepsis and possible septic arthritis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/18. hiv-related Hodgkin's disease with central nervous system involvement and association with Epstein-Barr virus.central nervous system (CNS) involvement is a rare occurrence in the course of human immunodeficiency virus (hiv)-related Hodgkin's disease (HD). We report the clinical course of a patient with hiv infection who developed systemic HD, mixed cellularity subtype, later complicated by leptomeningeal involvement. The patient died from his illness, and autopsy was performed. Examining the brain lesion, Epstein-Barr virus (EBV) presence was demonstrated in reed-sternberg cells by immunohistochemistry using an EBER probe for EBV rna. This is the second case report in the English literature of HD involving the CNS in an hiv-positive individual, and the first demonstrating EBV presence. Extranodal presence of Hodgkin's disease in patients with hiv infection is probably related to immunosuppression, and physicians treating this illness should be alert to the potential of unusual sites of involvement.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/18. Simultaneous occurrence of hodgkin disease and tuberculosis: report of three cases.tuberculosis (TB) has been described in association with malignancies including hodgkin disease (HD). We report three cases of simultaneous occurrence of TB and HD. In two of these cases clinical symptoms improved after TB treatment was instituted and before HD was diagnosed. fever recurrence in one case and persistence of mediastinal lymphadenopathy in the other, however, prompted consideration of an additional diagnosis. Interestingly, in one these two patients, both TB and HD diagnosis were obtained from the same lymph node. Since both diseases share many symptoms and signs, physicians faced with initial therapeutic failure when caring for HD and TB patients should be aware of the possibility of the simultaneous occurrence of both diseases.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/18. Fatal hepatic failure secondary to acute herpes simplex virus infection.Acute hepatitis with severe hepatic failure is an uncommon manifestation of herpes simplex virus (HSV) infection. It has been described in both immunocompromised and immunocompetent patients and is usually fatal. Due to the better survival after acyclovir treatment in a few reported cases, physicians need to be aware of the characteristic clinical abnormalities so that early diagnosis and treatment can be implemented. The authors describe an adolescent diagnosed with hodgkin disease who developed fatal hepatic failure secondary to acute HSV. Typical signs and symptoms in patients at risk, when there is no other obvious cause of fulminant hepatitis, should lead to early empirical treatment with acyclovir.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/18. survivors of Hodgkin's disease: prevention of sequelae.Increasing numbers of patients are surviving Hodgkin's disease in their youth, creating an ever larger cohort who need careful attention to long-term preventive medicine in their older years. Vigilance is especially needed for those who received laparotomy, splenectomy, and irradiation for early stage I through stage III disease, the majority of whom are destined to be long-term survivors. With the frequent migration of the young, these patients often fall under the care of a physician other than their original oncologist. The diligent internist, oncologist, emergency room physician, and general practitioner can avoid several simple pitfalls in the long-term care of these young patients now entering middle age.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
6/18. Mediastinal mass following chemotherapeutic treatment of Hodgkin's disease: recurrent tumor or thymic hyperplasia?hyperplasia of the thymus is a normal physiologic response in infants and children during recovery from life-threatening illness. New, recurrent, or residual mediastinal masses in children treated for malignant disease present a diagnostic dilemma. Are these masses recurrent disease or simply normal reactive thymic hyperplasia? Our experience from 1979 to 1986 includes 14 children aged 1 to 17 years (mean 7.4 years) who were identified with new or recurrent mediastinal masses during or after chemotherapeutic treatment for malignant disease (lymphoma 9, wilms tumor 2, leukemia 1, osteosarcoma 1, malignant teratoma 1). The mediastinal masses were treated by a variety of methods depending on the attending physician's preference (close observation 2, oral steroids 5, steroids and subsequent biopsy 1, open biopsy 6). Chest roentgenograms of "observation only" patients have showed stable mediastinal changes without clinical evidence of recurrent disease. patients treated with steroids showed resolution of the mediastinal masses in 48 hours to seven days, without recurrence. patients undergoing open biopsy showed only thymic hyperplasia and/or lymph nodes. We suggest a stepwise approach to evaluation of these patients. Mediastinal masses occurring during, or shortly following, chemotherapeutic treatments of malignant disease should first be treated with oral prednisone (60 mg/m2/d x 7 to 10 d). If the patient shows a complete or partial resolution, then follow-up includes frequent chest roentgenograms and/or a second course of steroids. If the mass fails to respond to steroids, or enlarges, then open biopsy through a minithoractomy will clarify the diagnosis. Follow-up of our patients is from 3 months to 7 1/2 years (mean 5 years).(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/18. A case of eosinophilic meningo-encephalitis accompanied by eosinophilic inflammation of the myenteric plexus in Hodgkin's disease.A case of Hodgkin's disease with eosinophilia in the cerebrospinal fluid without blood eosinophilia is presented. An additional remarkable feature was the finding of eosinophilia in Auerbach's myenteric plexus. cerebrospinal fluid eosinophilia is usually associated with blood eosinophilia and this is often caused by helminthic infections of the CNS. The finding of cerebrospinal fluid eosinophilia without blood eosinophilia in any patient with Hodgkin's disease should point the physician to the possibility of a localization of tumour in the CNS.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/18. Fatal pulmonary reaction from low doses of bleomycin. An idiosyncratic tissue response.There were two cases of fatal interstitial pneumonia secondary to bleomycin sulfate administration. Although bleomycin pulmonary toxicity is generally thought to be dose-related and occurs infrequently with a total cummulative dose less than 300 to 400 units, the two reactions reported here occurred with doses of 105 and 165 units. Fatal bleomycin-induced pneumonia has been previously reported at these low dosages, and physicians should be aware that this toxic reaction may occur as an idiosyncratic response. Previous thoracic irradiation may be a predisposing factor. patients receiving bleomycin should be meticulously monitored by interrogation for cough, dyspnea, and chest pain; by auscultation for rales; by serial chest roentgenograms; and by determinations of vital capacity and single-breath carbon monoxide diffusing capacity.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/18. Autoimmune disorders complicating adolescent Hodgkin's disease.Four adolescents with Hodgkin's disease also developed autoimmune diseases. There were two idiopathic thrombocytopenic purpura (ITP), one polymyositis, and one scleroderma. The first two patients developed ITP in the absence of a spleen, and with their Hodgkin's disease in remission. The first patient with Hodgkin's disease has been continuously free of cancer for over five years. The second patient was a 17-year-old male whoe Hodgkin's disease recurred, but whose disease was in remission at the time the ITP occurred. The polymyositis occurred in an 18-year-old youth when he was in his initial remission for his Hodgkin's disease, but his disease subsequently recurred two years later. This youth presented with Coombs positive autoimmune hemolytic anemia. The polymyositis did not respond to therapy, and he is left with severe muscle wasting and weakness; however, the polymyositis is now quiescent. The scleroderma occurred in an 18-year-old female who had been continuously free of Hodgkin's disease for eight years. The scleroderma did not respond to drug therapy and she now has moderate skin changes, but remains in continuous remission of her Hodgkin's disease. Although there are a few reports of Hodgkin's disease and concurrent autoimmune disorders, physicians dealing with cancer in adolescents should be aware of this association.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/18. Cryptococcal pneumonia: a fulminant presentation.A 32-year-old presented with fulminant, bilateral airspace pneumonia due to cryptococcus neoformans while under cytotoxic therapy for advanced Hodgkin's disease. We alert physicians to this rapidly progressive form of cryptococcosis which has been poorly described previously and which may closely mimic bacterial pneumonia.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
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