1/7. Tuberculous otitis media: two case reports and literature review.Tuberculous otitis media can be difficult to diagnose because it can easily be confused with other acute or chronic middle ear conditions. Compounding this problem is the fact that physicians are generally unfamiliar with the typical features of tuberculous otitis media. Finally, the final diagnosis can be difficult because it requires special culture and pathologic studies. To increase awareness of this condition, we describe two cases of tuberculous otitis media and we review the literature.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/7. facial paralysis caused by tuberculosis in a 2.5-month-old infant.We describe an infant who presented with a cervical mass and ear discharge that did not respond to broad-spectrum antibiotics. Tuberculous infection was diagnosed after the onset of respiratory distress. Persistent otorrhoea that does not respond to conventional antibiotics or facial paralysis in a child with a discharging ear should alert the physician to a diagnosis of tuberculosis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/7. Fatal pulmonary Mycobacterium abscessus infection in a patient using etanercept.A case of fatal pulmonary Mycobacterium abscessus infection in a 56-year-old man is reported. The patient had a longstanding history of seropositive, nodular rheumatoid arthritis with severe joint manifestations that had been treated with a regimen of prednisone, leflunomide, and etanercept. He presented to our facility with complaint of productive cough, persistent fevers, pleuritic chest discomfort, and dyspnea at rest. The patient was admitted to hospital, placed in isolation, a left-sided chest tube was inserted (left pneumothorax identified), and sputum acid-fast bacteria stains and cultures were obtained. Fluorochrome stains demonstrated numerous acid-fast bacteria, and M. abscessus was recovered from the culture media. He was treated with a regimen of amikacin, cefoxitin, and clarithromycin. He initially responded well, and was discharged home with this regimen. He remained afebrile with decreased cough and sputum production until 15 days after discharge when he was again admitted to hospital, with acute onset dyspnea and right-sided chest discomfort (right pneumothorax identified). He ultimately expired, due to overwhelming pulmonary infection, 20 days after readmission to hospital. autopsy revealed acid fast bacilli in the setting of numerous, bilateral, necrotic, granulomatous, cavitary pulmonary lesions. Based on its mechanism of action, we propose an association between the use of etanercept, a tumor necrosis factor alpha (TNF-alpha) inhibitor, and this case of fatal pulmonary mycobacterial infection. We recommend that physicians exercise cautious clinical judgment when initiating etanercept therapy in persons with underlying lung disease, especially in communities in which mycobacterial organisms are highly prevalent. We also advise physicians to maintain a high level of vigilance for late onset granulomatous infection in persons using etanercept.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
4/7. M marinum infections in a Chesapeake Bay community.Their proximity to Eastern virginia's abundant waterways has given the authors experience in managing the destructive tenosynovitis and deep tissue infections caused by M marinum. They present nine cases, discuss diagnosis and treatment, review the literature, and urge urban physicians to be on the alert for the disease in patients recently returned from fishing trips.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/7. mycobacterium marinum infection in a 4-year-old child.Infections with mycobacterium marinum are uncommon in children but should be considered by a physician confronted with chronic, poorly healing skin lesions. A case of such an infection in a 4-year-old child is presented. Presenting signs and symptoms, differential diagnosis, and treatment of these infections are discussed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/7. Mycobacterium terrae tenosynovitis: chronic infection in a previously healthy individual.We have described a case of Mycobacterium terrae tenosynovitis in an otherwise healthy individual. The chronic nature of this infection suggests that aggressive surgical and medical therapy is the most prudent course for physicians faced with this infection.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/7. mycobacterium avium-intracellulare from a Vietnamese refugee.mycobacterium avium-intracellulare grew from the sputum of a Vietnamese woman, a recent immigrant, seen at a tuberculosis clinic in Birmingham, alabama. The possibility that she had acquired this Mycobacterium in her native Vietname was considered, since current literature, indicates these agents have no predictable geographic patterns of distribution. Data indicate that outside the united states group III mycobacterial isolates are most common in japan, western australia, and parts of canada. No data are available for vietnam. US physicians should be alert for possible nontuberculous mycobacteria in the 115,768 Vietnamese immigrants known to have entered the united states in the mid-1970s.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |