181/291. vasculitis in a suspected AIDS patient. A 29-year-old male Haitian refugee had generalized lymphadenopathy, weight loss, and bilateral lung infiltrates diagnosed by transbronchial lung biopsy as tuberculosis. He had previously been labeled as having "pre-AIDS," which led to multiple suicide attempts. Four months later, cyanosis and gangrene of both lower extremities necessitated amputation, which revealed vasculitis. ( info) |
| Four parenteral drug abusers with the acquired immunodeficiency syndrome had nonmycobacterial actinomycetales infections. Three patients had nocardiosis and one developed a streptomyces lymphadenitis. There was pericardial involvement in two patients, and two patients died. Presumptive diagnoses were often incorrect, highlighting the risks of empiric therapy in these patients. Four of the nine patients with the acquired immunodeficiency syndrome and nocardia or streptomyces infections whose cases were reported to the Centers for disease Control also had mycobacterial disease. A common susceptibility to these agents may exist in these immunosuppressed patients. ( info) |
| Three cases of extrapulmonary tuberculosis are presented. Retroperitoneal and periportal adenopathy were the major manifestation of the disease detected by ultrasonography in all three cases. All of the patients were subsequently diagnosed as having acquired immunodeficiency syndrome (AIDS). The lymphohematogenous dissemination of the disease and the diagnostic role of ultrasonography are discussed. ( info) |
184/291. Pseudotumoral mycobacterial infection in the head and neck: a clinical study. The clinical aspects of mycobacterial infection of the head and neck are considered as presenting in patients at a cancer hospital over the last 15 years. Some difficulties in diagnosis with respect to the evolution of tuberculosis in this region are discussed. A total of 32 patients with evidence of infection were identified. Twenty-six of these with cervical lymphadenopathy are considered as a group; their clinical features and diagnosis are summarized and a note made of the recent change in the macroscopic quality of the nodes removed. Six cases are given particular attention: two with laryngeal tuberculosis, two with nasal or adenoidal infection and two with atypical mycobacterial infection diagnosed on clinical grounds. ( info) |
185/291. Tuberculous mediastinal lymphadenitis with a chest wall mass. A 14-year-old black female was found to have massive lymphadenopathy and osteomyelitis of the sternum in association with a parasternal mass. Diagnostic studies revealed tuberculosis as the etiology of this patient's skeletal and mediastinal disease. The differential diagnosis of chest wall lesions accompanied by mediastinal disease is discussed. ( info) |
| A 44-year-old man presented with typical symptoms, signs, and laboratory findings of carpal tunnel syndrome. mycobacterium tuberculosis was cultured from the flexor tenosynovium excised at surgery. Tuberculosis should be considered in the differential diagnosis of carpal tunnel syndrome with unexplained chronic synovitis. The diagnosis may be missed unless a tissue specimen is analyzed specifically with acid-fast stain and culture. Therapy should include excision of involved synovium, early postoperative mobilization, and appropriate chemotherapy. ( info) |
187/291. Painful dysphagia in a case of mediastinal tuberculous lymphadenopathy. A patient with mediastinal tuberculous lymphadenopathy is described. Presentation was with rapid onset of painful dysphagia following trauma to the neck. early diagnosis was achieved by mediastinoscopy. ( info) |
188/291. Tuberculous oesophagopulmonary communication: effectiveness of antituberculous chemotherapy. A case report and review of literature. A patient with tuberculous oesophagopulmonary communication diagnosed by oesophagography and confirmed by endoscopy was successfully treated by medical means: a tuberculous aetiology was suggested by the detection of tubercle bacilli in the gastric washings and on culture. On reviewing the medical literature, successful results were reported in 3 adults and 2 children. ( info) |
189/291. Relationship between multicentric reticulohistiocytosis and tuberculosis. Some cases presently classified as multicentric reticulohistiocytosis may represent unusual manifestations of tuberculosis. Antituberculous chemotherapy may be justified in patients who have clinical and histopathologic evidence of multicentric reticulohistiocytosis in association with a positive tuberculin skin test. ( info) |
190/291. Abdominal tuberculosis: a frequent diagnostic challenge. In recent years, abdominal tuberculosis has become rare in many countries even where pulmonary tuberculosis still exists. A case of abdominal tuberculosis is described in a young male who presented with non-specific symptoms together with CT scan findings that simulated abdominal lymphoma. Diagnosis was established during abdominal exploration. The frequency of various presenting manifestations of abdominal tuberculosis are discussed. The report emphasizes the need for a high index of suspicion to save patients unnecessary exploratory laparatomy. ( info) |