1/45. Fine needle aspiration in the diagnosis of pulmonary paracoccidioidomycosis.Six cases of pulmonary paracoccidioidomycosis diagnosed only by transthoracic fine needle aspiration are presented. The clinical and radiological presentation is varied. The most frequent use of this technique will permit the diagnosis of early lesions of mycosis.- - - - - - - - - - ranking = 1keywords = ill (Clic here for more details about this article) |
2/45. Potential errors in recognition of erysipelothrix rhusiopathiae.Here we describe four isolations of erysipelothrix rhusiopathiae associated with polyarthralgia and renal failure, septic arthritis, classic erysipeloid, and peritonitis. Although the biochemical identification was straightforward in each case, recognition presented a challenge to the clinical microbiologist, since in three cases E. rhusiopathiae was not initially considered due to unusual clinical presentations, in two cases the significance might not have been appreciated because growth was in broth only, and in one case the infection was thought to be polymicrobic. Because the Gram stain can be confusing, abbreviated identification schemes that do not include testing for H(2)S production could allow E. rhusiopathiae isolates to be misidentified as lactobacillus spp. or enterococcus spp. in atypical infections.- - - - - - - - - - ranking = 1keywords = ill (Clic here for more details about this article) |
3/45. Contact dermatitis to Asparagus officinalis.A 53-year-old farm worker presented with a 3-year history of an occupational allergic contact dermatitis to asparagus. The dermatitis cleared quickly with courses of systemic corticosteroids but relapsed within days of further exposure to asparagus. The genera Asparagus is made up of some 300 species. It belongs to the family liliaceae which includes tulips, onions and garlic. Asparagus contains asparagin, coniferin and the glucoside vanillin. The allergen may be a plant growth inhibitor, 1,2,3-Trithiane-5-carboxylic acid, which is present in young shoots.- - - - - - - - - - ranking = 1keywords = ill (Clic here for more details about this article) |
4/45. Invading basal cell carcinoma of the jaw: an under-evaluated complex entity.Basal cell carcinoma (BCC) is a locally invasive neoplasm, rarely metastatic, yet capable of significant local destruction and disfigurement. Invasion into the bone is uncommon and only a few cases of invasion into facial bones, but never to the mandible or maxilla, have been described. We report three patients with BCC lesions invading their jaws, as a consequence of which either their mandible or maxilla had to be partially resected. This resulted in facial mutilation which required comprehensive multi-disciplinary therapy to restore function and esthetics. Such therapy requires a combination of modalities offered by both plastic and maxillofacial surgeons, as well as oral and dental rehabilitators.- - - - - - - - - - ranking = 3keywords = ill (Clic here for more details about this article) |
5/45. Recurrent infestation of the mastoid cavity with Caloglyphus berlesei: an occupational hazard.Mite infestation of the ear is an unusual clinical problem that is easily cured with simple measures and recurrent infestation has not been reported till date. We present here a patient who developed recurrent infestation of otherwise healthy mastoid cavities with the storage mite Caloglyphus berlesei, secondary to occupational exposure. This kind of recurrent mite infestation of the ear has not been described before.- - - - - - - - - - ranking = 1keywords = ill (Clic here for more details about this article) |
6/45. Three cases of acute methyl bromide poisoning in a seedling farm family.We encountered three patients (Patient I: 39-year-old man, Patient II: 34-year-old woman, and Patient III: 5-year-old girl) with acute methyl bromide poisoning, which had occurred as a result of exposure to the gas that leaked from methyl bromide cans stored in a warehouse of a seedling farm. Since all three patients exhibited almost the same initial symptoms, i.e., severe vomiting, tonic convulsions and clouding of consciousness, botulism was suspected at first. However, subsequent inquiry revealed that 27 cans of methyl bromide had been stored in the building that the patients lived in, and that the cans had been damaged a few days before the onset of the patients' illness by a thrashing machine that was being moved by them to another location. Inspection revealed that all the cans of methyl bromide had passed the expiry date and were corroded. Even though none of the cans had been used, three cans with a capacity of 750 g were found to be empty. plasma bromide ion concentrations were determined to be high (72.9 microg/ml, 67.8 microg/ml and 91.5 microg/ml; normal level, < 5 microg/ml), and acute methyl bromide poisoning was diagnosed 8 days after admission of the patients to the hospital. Hemodialysis (peritoneal lavage in the case of the child) was performed immediately, after which the plasma bromide ion concentrations returned to normal and the general condition of the patients gradually improved.- - - - - - - - - - ranking = 12.704198975331keywords = illness, ill (Clic here for more details about this article) |
7/45. Cutaneous protothecosis: report of five cases.prototheca, a genus of achlorophyllic algae, is a rare cause of opportunistic infection in humans. About 80 human cases, mostly cutaneous infection caused by P. wickerhamii, have been reported world-wide. We describe the clinicopathological findings and treatments of five cases diagnosed in our department during the period 1991-97. The patients, including four elderly farmers, presented with pyoderma-like lesions or infiltrating papules and plaques on the extensor side of the extremities or face. All patients were immunocompromised, mostly due to systemic or topical steroids. The diagnosis was made in each case by finding typical endospores with morula-like structures in skin biopsy specimens. P. wickerhamii was isolated in four cases in which pretreatment culture of skin tissue was done. Except for one patient who died of asthma, the infection was cured after 2-7 weeks of amphotericin b, ketoconazole, itraconazole or fluconazole. Our cases illustrate that cutaneous protothecosis commonly manifested non-tender, pyoderma-like or infiltrating lesions and should be considered in the differential diagnosis of deep fungal or mycobacterial infection. This rare infection seemed more frequent in our region, possibly due in part to common steroid abuse among old people in taiwan and there was a large population of elderly farmers in our area.- - - - - - - - - - ranking = 1keywords = ill (Clic here for more details about this article) |
8/45. A case of primary tularemic pneumonia presenting with necrotizing mediastinal and hilar lymph nodes.tularemia is an unusual disease caused by the gram-negative coccobacillus francisella tularensis. The clinical features of the disease depend on the route of inoculation. Ulceroglandular and typhoidal forms have been recognized as occurring in tularemia, however primary or secondary pneumonic infections have also been reported. Symptoms, laboratory markers and radiological features are non-specific in tularemic pneumonia. diagnosis is made on clinical grounds and evidence of elevated agglutinating antibodies to F. tularensis (> 1:128). We report a case of primary tularemic pneumonia presenting with pulmonary infiltrates and necrotizing mediastinal and hilar lymph nodes in an otherwise healthy subject from a non-endemic area. diagnosis of tularemia was obtained serologically, and antibiotic therapy with doxycycline and streptomycin resolved symptoms and radiological abnormalities. We suggest that tularemia should be considered in the differential diagnosis of pneumonia with mediastinal and/or hilar lymphadenopathy.- - - - - - - - - - ranking = 1keywords = ill (Clic here for more details about this article) |
9/45. maxillary sinus fusariosis in immunocompetent hosts.We report the first known cases of fusariosis of maxillary sinus with granuloma and oro-antral fistula in two immunocompetent hosts. fusarium solani was demonstrated in the direct microscopic examination and isolated in heavy growth from the biopsy materials. Both these patients were successfully treated with oral ketoconazole (200 mg daily) for three weeks followed by a Caldwell-Luc operation. ketoconazole was continued for two months post-operatively.- - - - - - - - - - ranking = 5keywords = ill (Clic here for more details about this article) |
10/45. hypersensitivity pneumonitis due to occupational inhalation of fungi-contaminated corn dust.hypersensitivity pneumonitis or extrinsic allergic alveolitis can be defined as a lung disease caused by a wide group of antigens that reach the lung by inhalation of organic and/or inorganic dust of various sources. The dust of the stored maize corn has been reported as cause of respiratory symptoms. During the storage process, maize corn dust can be contaminated by moulds and thermophilic actinomycetes, which have not been described until now as the causing antigens of these symptoms. We present a case of occupational hypersensitivity pneumonitis in an agricultural worker who cultured and stored maize corn. Clinical findings, precipitating antibodies, and evolution after having removed him from his work, confirmed the diagnosis. In our case, aspergillus species contaminating the maize corn dust are probably the antigens that caused the disease.- - - - - - - - - - ranking = 1keywords = ill (Clic here for more details about this article) |
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