1/82. Plasma cell mucositis: a review and case report.The simultaneous involvement of the mucous membranes of the oral cavity and upper aerodigestive tract by lesions characterised clinically by an intensely erythematous, lobulated surface and histologically by a dense connective tissue infiltrate composed of non-neoplastic plasma cells may be called plasma cell mucositis. We present a review of the literature, consisting of 14 cases, outlining the multifocal site distribution, chronicity and systemic background that distinguish this entity and report a single case with confirmation of the polyclonal nature of the plasma cell infiltrate using gene rearrangement studies.- - - - - - - - - - ranking = 1keywords = rate (Clic here for more details about this article) |
2/82. Lemierre's syndrome.Postanginal sepsis, or Lemierre's syndrome, is rare but with life-threatening potential involving mainly infants and adolescents. The morbidity or mortality is caused mainly by lack of knowledge of the syndrome. The 18-year-old boy described here developed a jugular thrombosis 7 days after an angina. fusobacterium necrophorum was isolated from the culture of the excised jugular vein. Secondary embolism involved the lungs, associated with an iliac osteomyelitis and sacroiliitis. Computed tomography was used for diagnosis and follow-up.- - - - - - - - - - ranking = 5.6276605824246keywords = mortality (Clic here for more details about this article) |
3/82. lemierre syndrome: forgotten but not extinct--report of four cases.Four cases of lemierre syndrome are reported in which metastatic abscesses resulted from septic thrombosis of the internal jugular vein secondary to bacterial pharyngitis. While chest radiographic findings were nonspecific, results of computed tomography (CT) of the thorax in each case were highly suggestive of septic pulmonary emboli. Internal jugular venous thrombosis was demonstrated at ultrasonography and contrast material-enhanced CT.- - - - - - - - - - ranking = 0.5keywords = rate (Clic here for more details about this article) |
4/82. Internal jugular vein thrombosis, Lemierre's syndrome; oropharyngeal infection with antibiotic and anticoagulation therapy--a case report.The authors present a case of Lemierre's syndrome that is an uncommon septic thrombophlebitis of the internal jugular vein. A 31-year-old man developed pharyngeal pain one month before hospital admission when he suffered from a severe headache and painful swelling of the left side of his neck. He was diagnosed with tonsillitis. Contrast-enhanced computed tomography and magnetic resonance imaging of the neck revealed the presence of an occlusive thrombosis of the left internal jugular vein and an inflamed mesopharynx. His symptoms and the jugular vein thrombus showed remarkable improvement after administration of antibiotic and anticoagulation therapy. No pulmonary embolism or other metastatic infection were observed. It was suggested that accurate diagnosis during early treatment is essential to obtain a successful prognosis for Lemierre's syndrome.- - - - - - - - - - ranking = 0.5keywords = rate (Clic here for more details about this article) |
5/82. lemierre syndrome: magnetic resonance imaging and computed tomographic appearance.lemierre syndrome consists of septic thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection, usually with fusobacterium necrophorum. Septic metastatic emboli and distant infection are characteristic. We describe the imaging appearance of lemierre syndrome in an adolescent female by both magnetic resonance imaging and computed tomography. This case illustrates the rapid onset and characteristic progression of the rare syndrome of Lemierre. In addition, we used magnetic resonance imaging to effectively distinguish between inflammatory venous thrombosis and abscess, thus avoiding surgery in our patient. Early directed antibiotic therapy is mandatory to ensure good outcome.- - - - - - - - - - ranking = 0.5keywords = rate (Clic here for more details about this article) |
6/82. Kawasaki disease: a diagnostic challenge.Kawasaki disease (KD) is an acute, self-limited, febrile, multi-system vasculitis that predominantly affects the the pediatric population, and is the leading cause of acquired heart disease in children. No etiologic agent for the disease has been identified, there are no diagnostic tests available, and the diagnosis is established by fulfilling a defined set of clinical criteria. We report on a 9-year-old boy who presented initially with symptoms felt to represent a streptococcal infection. He was subsequently shown to meet the criteria for KD, developed cardiac complications of the disease and subsequently demonstrated recovery over a year's period of time. The diagnostic criteria for KD, differential diagnosis, pitfalls in diagnosis, therapeutic recommendations and outcomes are discussed with relevance to this case. Recent print and electronic information sources and references are provided.- - - - - - - - - - ranking = 0.5keywords = rate (Clic here for more details about this article) |
7/82. Oncocytic laryngeal cysts: a case report and literature review.Some 150 cases of oncocytic laryngeal cysts have been published. We report another case of laryngeal oncocytic cysts with atypical presentation of acute, progressive stridor and sore throat. literature was reviewed with special regard to etiology, clinical presentation, imaging, incidence, localization, associated lesions and treatment options. Oncocytic laryngeal cysts are rare, but may be underreported. They represent a separate clinicopathological entity in the group of all laryngeal cysic lesions and occur in persons over 60 years. The symptomatology varies from asymptomatic to hoarseness and dyspnea. diagnosis is made by histological examination. Treatment is surgical. Although it is a benign lesion, follow up is recommended, as recurrence is possible.- - - - - - - - - - ranking = 0.5keywords = rate (Clic here for more details about this article) |
8/82. A hard thyroid mass due to plasma cell granuloma.Plasma cell granuloma involving the thyroid is very rare. A 29-year-old man with type 1 diabetes mellitus presented with a one-week history of fever, sore throat, neck tenderness and dysphagia. Antibiotics were given but over the next two weeks a hard 8 cm mass in the left lobe of the thyroid developed. Fine needle aspiration was not diagnostic and surgical exploration revealed an inflammatory process arising from the left lobe of the thyroid involving the left sternothyroid muscle and parapharyngeal spaces. histology of multiple biopsies showed plasma cell granuloma. Immunoperoxidase staining demonstrated the presence of IgG, IgM and IgA with predominance of IgG. The residual mass resolved and was impalpable after four weeks. Plasma cell granuloma should be suspected when there is a rapidly developing hard thyroid mass. Open biopsy/removal and histological confirmation are mandatory and residual disease may resolve within weeks.- - - - - - - - - - ranking = 0.5keywords = rate (Clic here for more details about this article) |
9/82. Penicillin treatment failure in group A streptococcal tonsillopharyngitis: no genetic difference found between strains isolated from failures and nonfailures.Despite penicillin (pcV) treatment, tonsillopharyngitis caused by group A streptococci (GAS) is associated with bacterial failure rates as high as 25%. The reason for this rate of failure is not fully understood. One explanation might be that certain dna profiles of GAS strains are responsible for treatment failures. Using arbitrarily primed polymerase chain reaction (AP-PCR), we compared the dna profiles of GAS strains from 4 patients with several treatment failures following pcV treatment of tonsillopharyngitis with the profiles of strains of the same T type from patients who were clinically and bacteriologically cured after a single course of pcV. The isolates were obtained during the same time period and from the same geographic area. Thirty-seven strains of T types 4, 12, and R28 were investigated. Eleven different dna profiles could be detected with the AP-PCR technique. Five dna profiles were identified as T type 12, 3 as T type 4, and 3 as T type R28. The dna profiles of the strains from the 4 patients with several treatment failures differed, but all isolates from each one of these patients exhibited the same or a very similar profile. The dna profiles of the failure strains were also represented in nonfailure strains. treatment failure in these 4 patients therefore seems to be due to insufficient eradication of GAS, rather than to reinfection with a new strain. The finding that the same dna profile can be present in both failure and nonfailure strains suggests that the treatment failure may be to some extent host-related and not only due to bacterial factors.- - - - - - - - - - ranking = 1keywords = rate (Clic here for more details about this article) |
10/82. Acute nosocomial HCV infection detected by NAT of a regular blood donor.BACKGROUND: Routine HCV NAT of blood donors to detect persons in the preseroconversion phase of acute infection was introduced in canada in October 1999. The source of virus exposure was investigated in the first, and to date only, blood donor found to be HCV NAT positive, anti-HCV negative in canada. He was a regular donor with none of the commonly reported risk factors for HCV infection. STUDY DESIGN AND methods: Epidemiologic follow-up revealed that the blood donor had received antibiotics at an outpatient IV clinic 5 weeks before donation. IV solution bags and tubing for individual patients were stored in the clinic, and then the same equipment was used each time the patient returned for the next dose of antibiotics until it was replaced after every 72-hour period. Among eight other patients whose clinic visitation times overlapped was a man with chronic HCV infection. Genomic sequencing of HCV isolates from the blood donor, the patient with chronic hepatitis c, and local controls was carried out to study possible nosocomial infection. RESULTS: Genomic sequencing showed a high degree of relatedness in the hypervariable region of HCV isolates from the blood donor and putative source patient as compared with controls. Detailed molecular analysis of quasispecies of the HCV isolates further indicated that viruses from the two individuals were genetically very close to each other. CONCLUSION: The introduction of routine screening of blood donors by HCV NAT was directly responsible for the early detection and investigation of an unusual case of HCV infection involving a regular donor. Genomic sequencing studies provided firm evidence of patient-to-patient transmission of HCV in an IV clinic. The report clearly demonstrates the value of molecular fingerprinting in tracking nosocomial HCV infections.- - - - - - - - - - ranking = 0.5keywords = rate (Clic here for more details about this article) |
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