1/19. abscess formation as a complication of parenteral methylphenidate abuse.case reports of five patients suffering from either skin abscesses or cellulitis following parenteral methylphenidate abuse are presented. Four patients had similar lesions consisting of abscesses or cellulitis which demonstrated typical signs and symptoms of an infective process and were treated with local symptomatic therapy, incision and drainage if indicated, and systemic antibiotics. The fifth patient suffered from a circular, necrotic, nonpurulent ulcer on the dorsum of the right foot which produced no local or systemic toxic effects. Attempts to culture a responsible organism yielded streptococcus viridans, an organism which is normal flora of the skin and, although opportunistic, is generally considered nonpathogenic. These cases further substantiate the belief that local vasospasm, chemical irritation, or both, produced by the methylphenidate solution may primarily cause a necrotic ulcer susceptibble to secondary bacterial infection.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
2/19. association of lymphocytic colitis with linear IgA dermatosis.The case of a 66-year-old female patient is presented, who suffered from chronic watery diarrhea. In addition, she developed linear IgA dermatosis after oral treatment of a presumed yeast infection with nystatin. To evaluate the reason for her diarrhea, colonoscopy was performed. The macroscopic aspect of the colon mucosa was described as normal with no specific alterations for chronic inflammatory bowel disease or for bacterial infections. In contrast, the histologic examination revealed the typical characteristics of lymphocytic colitis. This disease is thought to be caused by immunological reactions against as yet unknown luminal antigens. After treatment with steroids and dapsone the diarrhea as well as the skin disease disappeared. To our knowledge, the present report describes for the first time the association of linear IgA dermatosis with lymphocytic colitis after oral treatment with nystatin. A possible causative link between these two disease entities is discussed.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
3/19. Sprouting epidermoid cysts.Five unusually shaped (i.e. 'sprouting') epidermoid cysts in the upper lip, elbow and foot are reported. The tumours seldom produced symptoms. The maximum diameter was 25-48 mm. The complete removal including a sprouting bud is necessary. Histologically, partial to complete cyst wall rupture was recognised. A pulsion diverticulum due to variations in the thickness and strength of the cyst wall, a foreign body reaction against inner keratinous mass without obvious bacterial infection, and/or outer fibrous band(s) acting as constriction band(s), are proposed as possible causes of the 'sprouting'.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
4/19. vibrio vulnificus septicemia in a patient with the hemochromatosis HFE C282Y mutation.vibrio vulnificus is an extremely invasive gram-negative bacillus found in marine waters that causes overwhelming bacteremia and shock that is associated with high mortality. Impaired iron metabolism has been implicated in the susceptibility to V vulnificus bacterial infections. We report a case of fatal V vulnificus sepsis in a 56-year-old man who died within 1 to 3 days after consuming raw seafood. At autopsy, he was found to have micronodular cirrhosis and iron overload. Postmortem genetic analysis revealed the presence of the hemochromatosis gene (HFE) C282Y mutation. To our knowledge, this is this first documented fatal case of V vulnificus infection in a patient proven to carry the HFE C282Y mutation. Because this patient was heterozygous for the major hereditary hemochromatosis mutation and was not previously diagnosed with clinical iron overload, the spectrum of clinical susceptibilities to V vulnificus infection may include carriers of the C282Y mutation.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
5/19. Cutaneous granulomas masquerading as tuberculoid leprosy in a patient with congenital combined immunodeficiency.Combined immunodeficiency disorders are characterized by abnormalities in cellular and humoral immunity. This classification includes common variable immunodeficiency (CVI), a primary immunodeficiency disorder characterized by hypogammaglobulinemia, recurrent bacterial infections, and significant T-cell abnormalities. Associated autoimmune diseases include rheumatoid arthritis, pernicious anemia, idiopathic thrombocytopenic purpura, and systemic lupus erythematous. Granulomatous lesions in lymphoid tissues, solid organs, and skin have been reported. We describe a patient with CVI who developed cutaneous granulomas with perineural invasion; to our knowledge, this is a previously undescribed feature.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
6/19. When typical is atypical: mycobacterial infection mimicking cutaneous vasculitis.patients with systemic lupus erythematosus (SLE) who present with skin disease pose the clinician with diagnostic challenges. The skin disease can reflect an increase in systemic disease activity suggested by other features of active lupus and, as such, usually responds well to more aggressive immunosuppressive therapy. Other possibilities of skin disease include drug eruptions, skin disease unrelated to SLE and, more rarely, opportunistic skin infection. In patients who show a poor response to more aggressive immunosuppressive therapy, consideration must be given to the possibility of opportunistic infection. A high index of suspicion will allow prompt treatment. We describe two patients with SLE who developed cutaneous atypical mycobacterial infection during immunosuppressive therapy. The diagnosis of cutaneous vasculitis was considered in both cases, but subsequent skin biopsy revealed the correct diagnosis. This report illustrates the importance of skin biopsy in patients with suspected cutaneous lupus who are not responding to immunosuppressive therapy.- - - - - - - - - - ranking = 5keywords = bacterial infection (Clic here for more details about this article) |
7/19. staphylococcus aureus subcutaneous abscess complicating acupuncture: need for implementation of proper infection control guidelines.We report a case of staphylococcus aureus subcutaneous abscess centered over the Jizhong acupuncture point (DU 6) which lies along the Du (Back midline) meridian after acupuncture at the corresponding acupuncture point for low back pain. The patient recovered after surgical debridement and drainage and 5 weeks of cloxacillin therapy. Among the 16 anecdotal case reports of pyogenic bacterial infections complicating acupuncture described in the English literature (medline Search 1996-2002), S. aureus was documented to be the causative agent in 9 (56%). Three patients had septic arthritis, 2 had chronic osteomyelitis, 2 had abscess formation, 1 had chondritis, and 1 had infective endocarditis. Five patients had S. aureus bacteremia. All patients who recovered required prolonged antibiotic treatment of 5-6 weeks, and 6 required drainage and/or debridement. overall, 3 patients (30%) died. S. aureus causes significant morbidity and mortality in patients who receive acupuncture treatment. More resources should be spent on implementation of proper infection control guidelines, as the money lost due to prolonged hospitalization and medication would far exceed that used for implementation.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
8/19. drug eruptions: approaching the diagnosis of drug-induced skin diseases.Adverse drug reactions are a major problem in drug therapy, and cutaneous drug reactions account for a large proportion of all adverse drug reactions. Cutaneous drug reactions are also a challenging diagnostic problem since they can mimic a large variety of skin diseases, including viral exanthema, collagen vascular disease, neoplasia, bacterial infection, psoriasis, and autoimmune blistering disease, among others. Furthermore, determining that a particular medication caused an eruption is often difficult when the patient is taking multiple drugs. In this review, we will describe and illustrate a thoughtful, comprehensive, and clinical approach to the diagnosis and management of adverse cutaneous drug reactions. A morphologic approach to drug eruption includes those that are classified as maculopapular, urticarial, blistering or pustular with or without systemic manifestations. Exanthematous drug eruptions, drug hypersensitivity syndrome, urticaria and angioedema, serum sickness-like reactions, fixed drug eruptions, drug-induced autoimmune blistering diseases, stevens-johnson syndrome, toxic epidermal necrolysis, drug-induced acne, acute generalized exanthematous pustulosis, lichenoid drug eruptions and photosensitivity eruptions will be discussed.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
9/19. Mycobacterial spindle cell pseudotumor of skin.Spindle cell pseudotumors may occur due to mycobacterial infection in immunocompromised hosts, particularly those with acquired immunodeficiency syndrome (AIDS). Most of the reported mycobacterial spindle cell pseudotumors were found in the lymph nodes. We report a case of spindle cell pseudotumor in a 37-year-old man with AIDS who presented with a firm nodule over his right arm. Histologically, the tumor was composed of proliferative spindle cells admixed with histiocytes and inflammatory cells. Ziehl-Neelsen stain revealed many acid-fast bacilli in the spindle cells and histiocytes. The acid-fast bacilli were shown to be mycobacterium avium intracellulare by culture and sequencing of the polymerase chain reaction product of mycobacterial 65-kDa heat shock protein gene. Immunohistochemically, the spindle cells were reactive to CD68, suggesting macrophage differentiation of these cells. It is important for pathologists to recognize this unusual manifestation of mycobacterial infection in immunocompromised patients and avoid mistaking the lesion for a mesenchymal neoplasm.- - - - - - - - - - ranking = 2keywords = bacterial infection (Clic here for more details about this article) |
10/19. Cutaneous sarcoidal reaction in a patient with pulmonary tuberculosis.sarcoidosis is a systemic disorder characterized by non-caseating epithelioid granulomas that may affect any organ system. The etiology of sarcoidosis is unknown, but several immune aberrations are thought to play a role in its pathogenesis. The possible role of mycobacterial infection in the pathogenesis of sarcoidosis has been suggested. In recent studies mycobacterial dna was detected in lung tissues and bronchial lavage fluid of 30% to 50% of patients with sarcoidosis. We report a patient with pulmonary tuberculosis treated successfully three years earlier who developed cutaneous sarcoidosis with negative polymerase chain reaction (PCR) assay for mycobacterial dna of the skin lesion.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
| | Next -> |