1/286. Cutaneous manifestations of disseminated cryptococcosis.Five patients with disseminated cryptococcosis had lesions on the extremities resembling cellulitis, which evolved into areas of blistering and ulceration in three patients. All had underlying disease and were medically immunosuppressed. Disseminated cryptococcosis appears to present with cellulitis or herpes-like vesiculation more commonly than is currently appreciated. india ink preparations of aspirates from areas of cellulitis or Tzanck preparations from blisters may show characteristic organisms, and make possible an immediate diagnosis of cutaneous cryptococcosis. If cutaneous infection is confirmed by performing biopsies and growing cultures, dissemination must be presumed and the patient treated with a full course of systemic antifungal therapy. With increasing awareness of cutaneous involvement, some cases of disseminated cryptococcosis will be diagnosed sooner, leading to earlier therapy and improved prognosis.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/286. Disseminated cutaneous protothecosis in an immunocompromised host: a case report and literature review.Protothecosis is an infection caused by achloric algae of the genus prototheca. These organisms have been isolated from water, sewage, soil, and the slime flux of trees, and are a known cause of disease in other mammals. Infection in humans occurs after traumatic inoculation, producing localized olecranon bursal or, rarely, systemic disease. Only two previous cases of disseminated cutaneous disease have been reported in patients with defective neutrophil function. We describe a rare case of widespread cutaneous dissemination occurring after an arthropod bite in an immunocompromised patient.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
3/286. Cutaneous infections by papillomavirus, herpes zoster and candida albicans as the only manifestation of idiopathic CD4 T lymphocytopenia.BACKGROUND: Selective depletion of CD4 T lymphocytes is common in both primary and secondary immunodeficiencies. Idiopathic CD4 T lymphocytopenia (ICL) cases are defined as a persistent CD4 T lymphocyte count of less than 300x10(6) cells/L and/or less than 20% of the total T-cell count. METHOD: A 40-year-old woman, with a history of psoriasis and paracetamol allergy, presented with persistent warts of the hands and condylomas of the ano-genitalia. Histological and virological analysis was carried out on genital and cutaneous lesions and peripheral blood. RESULTS: serology for hiv-1, hiv-2, Epstein-Barr virus and parvovirus B19 were negative. There was lymphopenia of 10% CD4 cells, with normal numbers of total leukocytes; there were no other-abnormal immunological findings. dna analysis of cutaneous lesions revealed HPV-49 and HPV-3 in the hands and HPV-6 in the genital region. CONCLUSIONS: The cause of the ICL in this patient is unknown. HPV is not known to be an immunosuppressive agent; it remains to be determined whether the HPV-associated lesions are the cause or the result of immunosuppression.- - - - - - - - - - ranking = 4keywords = infection (Clic here for more details about this article) |
4/286. Treatment of skin and soft tissue infections with cefadroxil, a new oral cephalosporin.Oral cefadroxil in doses of 0-6-1-8 g per day given on twice or three times daily schedules was effective in the treatment of thirty-six patients with infections such as abscesses, carbuncles, cellulitis, furunculosis and impetigo. staphylococcus aureus strains and beta-haemolytic streptococci, alone or in combination, were cultured from lesions before treatment. in vitro studies with test discs showed that all the organisms were sensitive to cefadroxil, but twenty-three of twenty-nine S aureus strains and one of the seven streptococci strains were resistant to penicillin g. Pre- and post-treatment laboratory tests of renal, hepatic and haematopoietic functions produced no evidence of drug toxicity. The cefadroxil dosage effective in this study is lower than that recommended for currently available oral cephalosporins, which must be given on a four times daily schedule.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
5/286. mycobacterium marinum infection from a tropical fish tank. Treatment with trimethoprim and sulphamethoxazole.A paronychial granuloma on the left thumb, in a man who kept tanks of tropical fish, was followed by cutaneous nodules on the left upper limb and tender lymph nodes in the left axilla. mycobacterium marinum was isolated from the lesion on the thumb and also from the tank water. Subsidence of the lesions followed administration of trimethoprim and sulphamethoxazole.- - - - - - - - - - ranking = 4keywords = infection (Clic here for more details about this article) |
6/286. Perineal reconstruction for severe sequela of ecthyma gangrenosum: report of a case.ecthyma gangrenosum is a cutaneous gangrenous disorder which usually follows Pseudomona aeruginosa infection and is found mainly in immunosuppressed children. We describe a case of a five-year-old female with leukemia with a severe perineal ecthyma gangrenosum resulting in a cloaca-like deformity. One year later a perineoplasty with puborectalis interposition and overlapping external anal sphincteroplasty was successfully performed, achieving satisfactory continence.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
7/286. case reports of nocardiosis in patients with human immunodeficiency virus (HIV) infection.INTRODUCTION: We present 4 local cases of nocardiosis in HIV-infected patients and discuss the diagnosis, clinical syndromes and therapy of nocardiosis. CLINICAL PICTURE: Two cases presented with pulmonary nocardiosis, one had a cervical lymph node abscess and one had disseminated nocardiosis with pulmonary, cerebral and soft tissue involvement. TREATMENT: Combination therapy is often employed. Sulphonamides or co-trimoxazole, amikacin, imipenen, minocycline and ceftriaxone are some of the drugs that could be used. OUTCOME: Outcome hinges on the early recognition and optimal treatment of this infection. CONCLUSIONS: Clinical presentations vary and diagnosis is difficult and frequently delayed. Nocardiosis should be suspected in patients who present with pulmonary lesions with soft tissue and/or cerebral abscesses.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
8/286. Type 1 diabetes mellitus masking primary antibody deficiency.A patient with a history of recurrent cutaneous and pulmonary infections, nephrotic syndrome, and an established diagnosis of type 1 diabetes was found to have unsuspected and unrecognised primary immunodeficiency. On review of the case, previous investigations pointed to the correct diagnosis over 10 years earlier. This combination of diagnoses has not previously been reported. The patient is now well on replacement intravenous immunoglobulin therapy, urinary loss of IgG having been specifically excluded before treatment. This case highlights how antibody deficiency can easily be missed despite an obvious infection history unless results are interpreted carefully and in context.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
9/286. Cutaneous (non-HIV) infections.Cutaneous infections continue to represent a large proportion of inpatient dermatology. Though most infectious skin diseases do not warrant hospitalization, some do and can rapidly become fatal if not treated promptly. A selected group of infections are reviewed--primary cutaneous infections, exotoxin-mediated syndromes, and systemic infections--that warrant hospitalization. Dermatologists play a critical role in the synthesis of patient history and appreciation of morphologic skin disease, which, when coupled with appropriate lab tests, may help to establish a diagnosis allowing for the timely implementation of effective and targeted therapy.- - - - - - - - - - ranking = 8keywords = infection (Clic here for more details about this article) |
10/286. Cutaneous lesions of disseminated cryptococcosis as the presenting manifestation of human immunodeficiency virus infection in a twenty-two-month-old child.We report the case of a 22-month-old African boy with cutaneous lesions as the predominant feature of disseminated cryptococcosis (positive blood and cerebrospinal fluid cultures) and as the presenting manifestation of severe vertically acquired HIV infection (CDC C3 category). To our knowledge these cutaneous lesions have never been reported as the initial manifestation of AIDS in children.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
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