1/6. Isolated pneumocystis carinii infection of adrenal glands causing Addison's disease in a non-immunocompromised adult.pneumocystis carinii is primarily an opportunistic pathogen infecting patients with AIDS and other immunocompromised patients, and ordinarily does not affect immunocompetent persons. We report isolated P. carinii infection of bilateral adrenal glands in a non-immunocompromised adult male, leading to fatal Addisonian crisis. diagnosis of P. carinii was established on the basis of cytopathology and microbiological tests, using conventional staining techniques and direct immunofluorescence on ultrasound-guided fine needle aspirates and trucut needle biopsy specimen from adrenal glands. P. carinii pneumonia and other fungal infections of the adrenal glands were excluded by appropriate tests. Absence of hiv infection was established by negative ELISA for hiv I and II antibodies and Western blot analysis at the time of presentation and 45 d later. Normal blood total leukocyte and CD4 lymphocyte counts and IgG and IgA levels confirmed the immunocompetent status of the patient. The patient improved with anti-Pneumocystis treatment and corticosteroid replacement, but succumbed to an episode of Addisonian crisis triggered by a diarrheal illness.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/6. Case report: disseminated pneumocystis carinii infection in a patient with the acquired immune deficiency syndrome causing thyroid gland calcification and hypothyroidism.We present the case of a homosexual male patient with the acquired immune deficiency syndrome (AIDS) who developed disseminated infection with pneumocystis carinii. He presented with symptoms and signs of thyroid disease, and developed thyroid gland calcification. This was later histologically proven to be due to P. carinii infection. Disseminated P. carinii infection is rare, and this case represents the first report to our knowledge of thyroid gland involvement causing both hypothyroidism and calcification.- - - - - - - - - - ranking = 0.85714285714286keywords = gland (Clic here for more details about this article) |
3/6. pneumocystis carinii thyroiditis. Report of three cases and review of the literature.pneumocystis carinii infection of the thyroid gland has previously been described in only four living patients with acquired immunodeficiency syndrome, three of whom had been receiving inhaled pentamidine prophylaxis against P carinii pneumonia. We treated three additional patients with P carinii thyroid involvement, all of whom were receiving aerosolized pentamidine. Two of our patients presented with clinical features suggestive of subacute granulomatous thyroiditis. The diagnosis of P carinii in our patients, as well as in the previously described patients, was established by thyroid fine-needle aspiration and Gomori's silver methenamine stains. The recent emergence of P carinii infection of the thyroid gland is likely related to the use of inhaled pentamidine prophylaxis, which appears to predispose to the development of extrapulmonary pneumocystosis. Clinicians need to be aware of the possibility of P carinii thyroiditis and should use aspiration and Gomori's methenamine silver staining in studying patients with the acquired immunodeficiency syndrome who have a painful (or other unexplained) thyroid mass so as to be able to initiate prompt and appropriate therapy.- - - - - - - - - - ranking = 0.28571428571429keywords = gland (Clic here for more details about this article) |
4/6. pneumocystis carinii thyroiditis diagnosis by fine needle aspiration cytology: a case report.BACKGROUND: Extrapulmonary infection or dissemination of pneumocystis carinii (PC) is rare, but under certain conditions the parasite can spread via the bloodstream or lymphatic vessels. Systemic pneumocystosis most often involves the lymph nodes, stomach, spleen, liver, skin, pancreas, choroid and eye. Isolated lesions containing PC have also been identified in the thyroid. CASE: A 41-year-old homosexual male infected with the human immunodeficiency virus (hiv) developed a PC infection in the thyroid gland. The patient had had thrush and anal herpes since being diagnosed as hiv positive in 1984. In 1992 the patient developed a mass in the area of the right lobe of the thyroid gland. Smears from fine needle aspiration cytology of the thyroid mass revealed epithelioid cells. However, a cell block revealed numerous PC organisms on Gomori methenamine-silver stain; that finding was confirmed by an excisional biopsy. The patient had not previously been diagnosed with PC pneumonia. CONCLUSION: Our case of thyroid involvement with PC expands the clinical spectrum of extrapulmonary pneumocystosis in patients with the acquired immunodeficiency syndrome. We believe that in these patients the incidence of Pneumocystis thyroiditis will continue to rise and be reported.- - - - - - - - - - ranking = 0.28571428571429keywords = gland (Clic here for more details about this article) |
5/6. Perforation of the small intestine in a patient with disseminated pneumocystis carinii infection in AIDS.Perforation of the small intestine due to a segmental transmural pneumocystis carinii infiltrate of the whole circumference was found in a surgical resection specimen as the cause of an acute abdomen in a 48-year-old heterosexual male patient suffering from acquired immunodeficiency syndrome. On autopsy, a disseminated pneumocystis carinii infection was found involving spleen, thyroid gland and lymph nodes. The origin of this disseminated infection was a recurrent and severe pneumocystis carinii pneumonia, which was first diagnosed two years before death and was treated with success. The hitherto unknown complication of an extrapulmonary pneumocystis carinii infection described here extends the spectrum of lethal complications of opportunistic infections in acquired immunodeficiency syndrome.- - - - - - - - - - ranking = 0.14285714285714keywords = gland (Clic here for more details about this article) |
6/6. central nervous system pneumocystosis in a patient with AIDS.Extrapulmonary involvement with pneumocystis carinii has been described in 0.5%-2.5% of persons with AIDS. One hundred nine patients with AIDS and confirmed extrapulmonary pneumocystosis were identified, and seven of these patients (including our patients) had central nervous system (CNS) pneumocystosis. Of these seven patients, six had prior AIDS-related complications, and three had previous P. carinii pneumonia. Six patients had CNS symptoms, one of whom underwent a focal neurological examination. No cases were diagnosed before death. The involved sites were the cerebral cortex (2 patients), meninges (2), pituitary gland (1), putamen (1), and nonspecified locations (3). In two patients, organisms were seen around blood vessels, and in five patients there was concurrent neuropathology. In summary, CNS involvement with P. carinii usually occurs as a late complication of AIDS and probably represents hematogenous dissemination.- - - - - - - - - - ranking = 0.14285714285714keywords = gland (Clic here for more details about this article) |