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1/159. Purulent pericarditis with tamponade in a postpartum patient due to group F streptococcus.

    Bacterial pericarditis with cardiac tamponade is a life-threatening disorder that has been associated with a variety of organisms. There is usually an associated underlying condition or a seeding of the pericardium from an infection elsewhere. We report the development of cardiac tamponade and a subsequent pericardial constriction due to group F streptococcus purulent pericarditis. We believe this to be the first report of a postpartum patient with purulent pericarditis.
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ranking = 1
keywords = infection
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2/159. hiv-associated eosinophilic folliculitis in an infant.

    hiv-associated eosinophilic folliculitis (hiv-EF), which is a well-known entity in adults, has not been described in children. Although Ofuji's disease (OD) or eosinophilic pustular folliculitis (EPF) has been described in children and shares histopathologic features with hiv-EF, it is a distinct entity with characteristic clinical features. We report the occurrence of eosinophilic folliculitis in an 8-month-old hiv-positive patient and discuss the clinical, pathologic and possible pathogenetic aspects thereof. In addition, differences in the clinical manifestations of the present case and that of I-EPF are addressed. Because of clinicopathologic similarities between the present case and hiv-associated eosinophilic folliculitis (hiv-EF) in adults, we believe that eosinophilic folliculitis in this patient represents a cutaneous manifestation of hiv infection, rather than co-incidental occurrence of the infantile form of Ofuji's disease in an hiv-positive patient.
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ranking = 1
keywords = infection
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3/159. Neutrophilic lobular (pustular) panniculitis associated with rheumatoid arthritis: a case report and review of the literature.

    Rheumatoid nodules, which affect the subcutis around joints, are the most frequent specific cutaneous lesions of rheumatoid arthritis (RA). panniculitis is a rarely reported and nonspecific complication of RA. We report a 42-year-old woman with seropositive RA who presented with a 2-month history of lower leg panniculitis. biopsy of a leg nodule showed a lobular neutrophilic infiltrate with lipophages and central basophilic necrosis. In addition, focal changes of lipomembranous fat necrosis indicative of ischemic damage were identified at the margins of the lobular infiltrate. Neutrophilic lobular panniculitis is commonly detected in panniculitis secondary to bacterial infections, pancreatitis, and factitial causes. However, this pattern of panniculitis has also been reported in some cases of erythema nodosum-like lesions found in Behcet disease or bowel bypass syndrome and in rare cases of seropositive RA. These reported histologic findings fall into the spectrum of neutrophilic vascular reactions described by Jorizzo and Daniels for RA-associated dermatoses. In view of these findings. RA and related neutrophilic dermatoses (e.g., Behcet disease) should be included in the differential diagnosis of neutrophilic lobular panniculitis.
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ranking = 8.1200017840962
keywords = bacterial infection, infection
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4/159. Failure of granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor in a patient with Kostmann syndrome.

    We present a seven-month-old boy referred to our hospital with a history of recurrent suppurative infections starting in his neonatal period. anemia, absolute neutropenia absolute neutrophil count (ANC: 500 cells/microl), pneumonia, purulent otitis media and maturational arrest of granulocytes at promyelocyte-myelocyte level in bone marrow were detected on his admission. He was diagnosed as Kostmann syndrome and recombinant human granulocyte colony-stimulating factor (rhG-CSF) therapy was started at a dose of 10 microg/kg/d, gradually increasing up to 120 microg/kg/d in sequential seven-day courses. As there was no response, rhG-CSF was stopped and recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) was started subcutaneously with 2.5 microg/kg/d and was escalated by doubling the dose every seven days to 20 mg/kg/d. By this therapy absolute neutrophil count (ANC) transiently reached above 500 cells/microl, but eosinophilia developed with a total white cell count of 88.200 cells/microl, and a differential count showing 86 percent eosinophils. Since eosinophilia of this magnitude has deleterious effects, and neutrophil production did not significantly increase, we tried combined therapy with rhG-CSF and rhGM-CSF at doses of 10-20 microg/kg/d and 5-10 microg/kg/d, respectively, without any effect on absolute neutrophil count. The patient succumbed from sepsis eight months after the diagnosis.
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ranking = 1
keywords = infection
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5/159. An unusual form of stevens-johnson syndrome with subcorneal pustules associated with mycoplasma pneumoniae infection.

    We report a 10-year-old girl in whom stevens-johnson syndrome (SJS) (with acute gingivostomatitis and conjunctivitis) was associated with a pustular eruption clinically and histologically similar to Sneddon-Wilkinson subcorneal pustulosis. This is a very rare form of SJS, the true incidence of which is probably underestimated.
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ranking = 4
keywords = infection
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6/159. Synchronous pyomyositis and septic hip arthritis.

    The authors report a rare concomitant pyogenic infection of the iliopsoas, iliacus and external obturator muscles and of the hip joint in a 68-year-old woman. Because the patient showed the classic symptomatic triad of limping, hip pain and fever, in addition to positive hip arthrocentesis, the diagnosis of septic hip arthritis was routine, but the simultaneous pyomyositis was almost overlooked. Unusual localised heat and swelling on the front of the proximal thigh prompted a CT scan that identified remarkable muscle abscesses in addition to the septic arthritis. Surgical debridement and antibiotics resolved the infection relatively rapidly without sequelae. We noted that reaching a definitive diagnosis of such a concomitant infection requires a suspicion of the presence of pyomyositis, which can be definitively determined using advanced imaging studies.
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ranking = 3
keywords = infection
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7/159. Wegener's granulomatosis triggered by infection?

    Wegener's granulomatosis is a systemic disease of unknown origin, although recent studies suggest that auto-immune mechanisms and infection play a role in the pathogenesis of this disease. Wegener is characterized by a necrotizing vasculitis involving the lungs (pulmonary infiltrates), the upper airways and the kidneys (rapidly progressive glomerulonephritis). We present a case of a male patient admitted because of progressive deterioration of the general condition with weight loss, a unilateral neck mass, unilateral purulent rhinorrea and fever. CT-scan evaluation demonstrated a unilateral expanding mass in the sing-nasal cavity, obliterating the ethmoid complex. MRI revealed signs of intracranial inflammatory reaction and onset of absedation. A malignancy was suspected but a diagnosis of Wegener's granulomatosis was established based on histologic criteria (nasal biopsy) and a positive titer for anti-cytoplasmic antibodies (cANCA). During follow-up, nasal carriage of Staphyloccocus Aureus could be documented. An overview of Wegener's granulomatosis will be provided with emphasis on the potential role of acute infections as a trigger for Wegener's granulomatosis and the head and neck manifestations.
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ranking = 6
keywords = infection
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8/159. rifabutin-associated hypopyon uveitis in human immunodeficiency virus-negative immunocompetent individuals.

    OBJECTIVE: To report the occurrence of rifabutin-associated hypopyon uveitis in human immunodeficiency virus (hiv)-negative immunocompetent individuals. DESIGN: Retrospective case series. PARTICIPANTS: Three hiv-negative subjects on rifabutin and clarithromycin for mycobacterium avium complex infections with hypopyon uveitis are described. One subject was iatrogenically immunosuppressed because of a prior lung transplant. Two subjects had no known immunosuppressive conditions. INTERVENTION: Topical and regional steroid therapy. Discontinuation of rifabutin was required in two subjects. MAIN OUTCOME MEASURES: visual acuity, resolution of hypopyon, anterior uveitis, and vitreitis. RESULTS: All subjects had resolution of hypopyon after therapy, two within 24 hours of beginning topical steroids. Vitreitis resolved with the discontinuation of rifabutin in two subjects. Chronic low-grade anterior uveitis and vitreitis were observed in the remaining subject, whose rifabutin dose was lowered but not discontinued because of active mycobacterium avium complex osteomyelitis. CONCLUSIONS: rifabutin-associated uveitis is well described in hiv-positive individuals, but it has been reported only once in an hiv-negative individual. We report two cases of hypopyon uveitis in immunocompetent individuals and one case in an immunosuppressed hiv-negative individual. All three subjects were receiving concurrent rifabutin and clarithromycin. awareness that this entity can occur in hiv negative and nonimmunosuppressed individuals and that it can mimic infectious endophthalmitis may spare the subject from an invasive workup of systemic infection.
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ranking = 2
keywords = infection
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9/159. Cutaneous sinus tract from remaining tooth fragment of edentulous maxilla.

    Cutaneous sinus tract of dental origin usually arises from chronic dental infections. These tracts usually appear as suppurative lesions of the chin or neck. Because many patients with this lesion do not have any complaints of oral symptoms, these lesions are often diagnosed incorrectly and overlooked, and are also treated ineffectively. A case of an unusual presentation of a chronic suppurative granuloma on nasolabial fold, which originated from the remaining tooth fragment of edentulous maxilla, is reported. Treatment with removal of the tooth fragment as well as the sinus tract resulted in complete healing of the lesion. This report emphasizes the importance of awareness of the possible dental origin of facial sinuses, despite their unusual location.
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ranking = 1
keywords = infection
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10/159. Zenker's diverticulum associated with multilevel cervical osteomyelitis.

    STUDY DESIGN: A case report of cervical osteomyelitis possibly associated with a Zenker's diverticulum perforation. OBJECTIVES: To present clinical, radiologic, and surgical findings of a cervical osteomyelitis due to a Zenker's diverticulum perforation. SUMMARY OF BACKGROUND DATA: A 56-year-old patient was in an intensive care unit for a severe head injury. He was fed via a nasogastric tube. Four months later he developed a pyogenic cervical vertebral infection. methods: Plain films and magnetic resonance imaging showed a diffuse cervical osteomyelitis. Investigation of his dysphagia revealed a Zenker's diverticulum. RESULTS: After administration of antibiotics and surgical treatment of the diverticulum, the cervical infection resolved. Plain films and magnetic resonance imaging showed healing with vertebral fusion. CONCLUSIONS: Cervical osteomyelitis is uncommon. Only one case of direct contamination leading to cervical vertebral osteomyelitis after esophageal perforation has been previously described. Direct contamination of the prevertebral soft tissues by bacteria traveling through the fistula may have occurred. The development of vertebral osteomyelitis in this case is consistent with the hypothesis of direct contamination. Management relies on appropriate antimicrobial therapy and surgical management of the diverticulum. The association of Zenker's diverticulum with vertebral osteomyelitis and discitis is a unique, previously undescribed situation.
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ranking = 2
keywords = infection
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