1/5. Simultaneous occurrence of hodgkin disease and tuberculosis: report of three cases.Tuberculosis (TB) has been described in association with malignancies including hodgkin disease (HD). We report three cases of simultaneous occurrence of TB and HD. In two of these cases clinical symptoms improved after TB treatment was instituted and before HD was diagnosed. fever recurrence in one case and persistence of mediastinal lymphadenopathy in the other, however, prompted consideration of an additional diagnosis. Interestingly, in one these two patients, both TB and HD diagnosis were obtained from the same lymph node. Since both diseases share many symptoms and signs, physicians faced with initial therapeutic failure when caring for HD and TB patients should be aware of the possibility of the simultaneous occurrence of both diseases.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/5. Retroperitoneal perforation of the colon caused by colonic tuberculosis: report of a case.We present a 25-year-old, hiv-negative patient from kosovo, with no significant past medical history, who was admitted to a local hospital for nonspecific upper abdominal discomfort. He was transferred to us after a retroperitoneal mass with contact to the right colonic flexure had been found during workup. colonoscopy demonstrated an edemateous area with a central fistula in the right flexure, and histology showed caseous necrosis. Although neither bacteriology nor histology could detect any germs, gastrointestinal tuberculosis seemed to be very probable. laparotomy with a segmental resection of the colon was performed to remove the fistula-bearing segment, and histologic examination of the resected specimen confirmed the intraoperative suspect of a retroperitoneal colonic perforation. Again, all cultures from the specimen were negative for tuberculosis, but polymerase chain reaction of a regional lymph node revealed acid-fast bacilli of the mycobacterium tuberculosis/bovis species. Although the patient had no other sites of tuberculosis infection like pulmonary or urinary, he received adjuvant standard tuberculosis treatment for six months. At control examination one year after the operation, the patient was free of recurrence and in very good general condition. We report this extremely rare presentation of gastrointestinal tuberculosis to sensitize physicians to tuberculosis again, because incidence rates are increasing and this disease will certainly play a more important role in the future.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/5. Atypical mycobacterial cervicofacial lymphadenitis in children: a disease as old as mankind, yet a persistent challenge.The diagnosis of atypical cervicofacial lymphadenitis is often not readily clinically apparent. parents may bring a child to the physician's attention long before the development of the classic findings. When assessing the child with acute-onset cervicofacial lymphadenitis, there are 2 imperative clinical determinations: Is the lymphadenitis of viral, bacterial, or mycobacterial etiology? If of mycobacterial etiology, is it an atypical or tuberculous mycobacterial process? The goal in management is to avoid misdiagnosis and lengthy duration of symptoms before appropriate therapy is instituted. This paper includes a case study-based review of the evaluation, diagnosis, and management of cervicofacial lymphadenitis in children due to atypical mycobacterial organisms.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/5. Papulonecrotic tuberculid in childhood.A case of papulonecrotic tuberculids of anterior abdominal wall with active tuberculous cervical lymph gland in a 12-year-old girl was demonstrated. This case illustrated the fact that although the papulonecrotic tuberculid is a rare entity, physicians should be aware of its existance to be considered in the differential diagnosis of dermatological lesions. Lesions, which appear in crops resembling chickenpox, with a longer duration and a strongly positive tuberculin test should lead to the diagnosis of papulonecrotic tuberculid. The investigations should include biopsy and demonstration of an active tuberculous foci. The lesions will regress if the patient receive antituberculosis therapy. Misdiagnosis and postponement of treatment with specific drugs may give rise to unsatisfactory consequences.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/5. Cases from the aerospace medicine residents' teaching file. Case #58. Scrofula.A patient presenting with dysphagia was treated for bacterial lymphadenitis with broad spectrum antibiotics by an internist and an otolaryngologist. The clinical picture, histopathology, diagnosis, aeromedical disposition, and a brief, but pertinent historical background are described. The case was unique in that the diagnosis would have been missed had it not ultimately been for the timely intervention and advice of a senior preventive medicine physician. The physician recognized the high probability of extrapulmonary tuberculosis manifesting itself as scrofula. Tuberculosis cases in the united states have begun to climb in number and alertness to this infection is warranted.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |