1/18. Cervical lymphadenitis and cat scratch disease (CSD): an overlooked disease?Cat Scratch disease (CSD) is a benign disease characterized by regional lymphadenopathy affecting most frequently the head and neck region in children and young adults. In the present paper, the authors describe four cases of CSD focusing on clinical history, diagnostic management and therapy. The main germ responsible for this lymph node disease is bartonella henselae. diagnosis is based on history, serology and histological findings. Clinical evolution is generally favorable despite the fact that complications occur in about 5% to 13% of patients including encephalitis, hepatitis and Parinaud's oculoglandular syndrome. Antibiotic treatment is only considered for highly symptomatic patients. Surgical excision of the lymphadenopathy is useful to establish the diagnosis when serology is not available and/or when the adenopathy become fluctuating. The authors emphasize the increasing incidence of patients with CSD in the ENT population and the algorithm for CSD disease affecting the cervical lymph nodes.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/18. The supratrochlear lymph nodes: their diagnostic significance in a swollen elbow joint.In the differential diagnosis of a swollen elbow, the palpation of the supratrochlear glands is useful. They are not enlarged in a traumatic elbow joint. They are enlarged, discrete and shotty in rheumatoid arthritis. In tuberculosis, they are enlarged, matted and they may caseate and form a cold abscess on the medial aspect of the supratrochlear region of the arm.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
3/18. Preoperative histologic assessment of head and neck lesions using cutting needle biopsy.OBJECTIVE: This study assessed the clinical utility of cutting needle biopsy in which a newly developed Monopty biopsy instrument (MBI) (Monopty, Bard Urologic Division; Covington, Ga) was used in the preoperative assessment of head and neck lesions. STUDY DESIGN: Needle biopsies were performed with the MBI in 16 cases of head and neck lesions that included lesions in lymph nodes, salivary glands, palate, and soft tissue. RESULTS: High-quality histopathologic specimens were obtained without complications in all biopsies performed, and the diagnostic target tissue was obtained in 15 of 16 cases. Diagnoses made from MBI needle biopsy specimens were consistent with the final diagnoses made from subsequent surgical materials in 14 cases, and the accuracy rate was 88%. None of the samples demonstrated significant rush artifacts or obscuring blood, both of which are problems commonly associated with manual biopsy techniques. CONCLUSIONS: This technique offers a safe and effective means of obtaining adequate tissue for the histological assessment of head and neck lesions.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
4/18. nontuberculous mycobacteria-induced parotid lymphadenitis successfully limited with clarithromycin and rifabutin.OBJECTIVES/HYPOTHESIS: Nontuberculous mycobacterial adenitis of the parotid gland is often difficult to diagnose. The rarity of these infections in the parotid region and the lack of specific guidelines pose a treatment challenge to the clinician. Three cases of nontuberculous mycobacterial adenitis are presented, with clinical response to antibiotics before surgery. STUDY DESIGN: Retrospective chart review was made of children up to 18 years of age presenting with a parotid mass diagnosed as nontuberculous mycobacterial infection. methods: Three patients (age range, 15 to 30 mo) with nontuberculous mycobacteria-induced parotid lymphadenitis were treated with a combination antibiotic regimen of clarithromycin and rifabutin or with clarithromycin alone. RESULTS: All three patients responded clinically to the antibiotic treatment as evidenced by a smaller mass size and resolution of the overlying discoloration. Subsequent parotidectomy or biopsy appeared to be easier to perform because of decreased inflammation and edema and a more readily dissectible facial nerve. CONCLUSION: Children with nontuberculous mycobacteria-induced parotid lymphadenitis should be started on a trial of antibiotic treatment before surgery. Although surgery remains the definitive treatment modality, a larger study of preoperative antibiotic use against nontuberculous mycobacterial adenitis of the parotid in children is necessary.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
5/18. Atypical mycobacterial cervical lymphadenitis with extensive local spread: a surgical disease.Atypical (nontuberculous) mycobacterium is an uncommon cause of cervical lymphadenitis in immunocompetent children. Rarely, this disease progresses to locoregional destruction of the deep structures of the neck including salivary glands. Recent reports suggest medical monotherapy as an effective treatment of this disease. We report three cases of children who experienced progression to locoregional disease while on appropriate antibiotics. We suggest that the patient population to benefit from medical monotherapy has yet to be adequately defined. In our experience, surgical therapy is the only effective treatment for locoregional disease.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
6/18. Intraglandular toxoplasmosis lymphadenitis of the parotid gland.toxoplasmosis is a protozoan infection manifested by systemic findings as well as generalized or localized lymphadenopathy. Although lympadenitis is the most common clinical form, involvement of the intraglandular nodes within the parotid gland found is a rare occurrence during the course of the disease. This unusual form may mimic a parotid mass, and can cause difficulties in differential diagnosis. In this article, a case of intraglandular parotid lymphadenitis which developed due to toxoplasmosis is presented, and the relevant literature is reviewed.- - - - - - - - - - ranking = 11keywords = gland (Clic here for more details about this article) |
7/18. Ulceroglandular tularemia: a typical case of relapse.tularemia is an infectious disease that continues to occur sporadically and in epidemics in the united states. It is characterized as an acute febrile illness with constitutional symptoms associated with skin, glandular, respiratory, or gastrointestinal involvement. tularemia usually can be treated effectively with streptomycin. Relapse most often occurs when patients are treated with bacteriostatic agents such as chloramphenicol or tetracycline. We present a case of ulceroglandular tularemia distinguished by its relapse after initial streptomycin/doxycycline therapy and subsequent slow response to additional streptomycin.- - - - - - - - - - ranking = 6keywords = gland (Clic here for more details about this article) |
8/18. tularemia: a 30-year experience with 88 cases.Drawing upon our experience with 88 cases and a survey of the English literature, we reviewed the clinical, pathophysiological, and epidemiological aspects of tularemia. tularemia can be thought of as two syndromes--ulceroglandular and typhoidal. This dichotomy simplifies earlier nomenclature and emphasizes the obscure typhoidal presentation. Clinical manifestations suggest that the two syndromes reflect differences in host response. In ulceroglandular tularemia the pathogen appears to be well contained by a vigorous inflammatory reaction. pneumonia is less common and the patient's prognosis is good. In typhoidal disease there are few localizing signs; pneumonia is more common; and the mortality without therapy is much higher, suggesting that the host response is somehow deficient. francisella tularensis is an extremely virulent pathogen capable of initiating infection with as few as 10 organisms inoculated subcutaneously. During an incubation period of 3 to 6 days the host responds first with polymorphonuclear leukocytes and then macrophages. granulocytes are unable to kill the pathogen without opsonizing antibody leaving cellular immunity to play the major role in host defense. One to 2 weeks after infection, a vigorous T-lymphocyte response can be detected in vitro with lymphocyte blast transformation assays and in vivo with an intradermal skin test, which, unfortunately, is not commercially available. Humoral immunity, often used as a diagnostic modality, appears 2 to 3 weeks into the illness. Cellular immunity is long-lasting, accounting for the common reoccurrence of localized disease upon repeated exposures to the pathogen. There are no symptoms that distinguish the ulceroglandular from the typhoidal syndrome. A pulse-temperature dissociation is seen in less than half of the patients. The location of ulcers and enlarged lymph nodes give a clue to the likely vector since lesions located on the upper extremities are more commonly associated with mammalian, and those of the head and neck and lower extremities with arthropod, vectors. pharyngitis, pericarditis, and pneumonia can complicate both syndromes, although the latter is much more common in typhoidal disease. hepatitis, usually of a mild degree, is common and occasionally erythema nodosum is seen. No specific laboratory tests characterize tularemia, and cultures of the pathogen are often difficult to obtain because of the special growth requirements of Francisella tularesis and the inability of many clinical laboratories to handle the dangerous pathogen.(ABSTRACT TRUNCATED AT 400 WORDS)- - - - - - - - - - ranking = 3keywords = gland (Clic here for more details about this article) |
9/18. Oculoglandular syndrome caused by francisella tularensis.Oculoglandular syndrome developed in a 9-year-old boy with a recent history of tick bites and minor eye trauma. francisella tularensis was isolated on chemically supplemented chocolate agar from a swab of a conjunctival ulcer and an aspirate of a preauricular lymph node, confirming the diagnosis of tularemia. In addition, a rise in agglutination titer to the pathogen was detected in paired sera. The differential diagnosis of oculoglandular syndrome is discussed, with emphasis on the clinical characteristics which led to the diagnosis of tularemia.- - - - - - - - - - ranking = 6keywords = gland (Clic here for more details about this article) |
10/18. Late complications after irradiation treatment for cervical adenitis in childhood. A 60-year follow-up study.Irradiation against benign cervical adenitis in children was formerly a widely used form of treatment which has caused a great number of late complications, mostly various benign and malignant tumours in the head and neck area, especially in the thyroid gland. In a follow-up study on 63 individuals irradiated at Karlstad Hospital between 1917 and 1929 we found, in addition to these changes, two hitherto not reported complications. Laryngeal stenoses occurred in 27 cases, 17 of which so severe that they eventually required permanent tracheostomies and 11 had fibrous strictures of the upper esophagus, repeated dilatations have been necessary in many of these cases. These complications were mostly seen in those who had been irradiated at an early age, the laryngeal stenoses appear to be caused by a general retardation or inhibition of the normal growth of the laryngeal cartilages resulting in a microlarynx. One possible explanation for these previously not reported sequelae might be the exceptionally high irradiation doses these persons were exposed to up to 60 years ago.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
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