1/12. Case report. Mycotic arteritis due to aspergillus fumigatus in a diabetic with retrobulbar aspergillosis and mycotic meningitis.A 74-year-old man with diabetes mellitus type II, retinopathy and polyneuropathy suffered from exophthalmus, ptosis and diplopia. magnetic resonance imaging and computer tomography showed a space-occupying process in the right orbital apex. An extranasal ethmoidectomy accompanied by an orbitotomia revealed the presence of septated hyphae. aspergillus fumigatus was grown from the tissue. After surgical removal of the fungal masses, therapy with amphotericin b (1 mg kg(-1) body weight) plus itraconazole (Sempera, 200 mg per day) over 6 weeks was initiated. Five months later the patient's condition deteriorated again, with vomiting, nausea and pain behind the right eye plus increasing exophthalmus. Antifungal therapy was started again with amphotericin b and 5-fluorocytosine. neutropenia did not occur. The patient became somnolent and deteriorated, a meningitis was suggested. Aspergillus antigen (titre 1:2, Pastorex) was detected in liquor. Anti-Aspergillus antibodies were not detectable. Both the right eye and retrobulbar fungal masses were eradicated by means of an exenteratio bulbi et orbitae. However, renal insufficiency and an apallic syndrome developed and the patient died. At autopsy, a mycotic aneurysm of the arteria carotis interna dextra was detected. The mycotic vasculitis of this aneurysm had caused a rupture of the blood vessel followed by a massive subarachnoidal haemorrhage. In addition, severe mycotic sphenoidal sinusitis and aspergillosis of the right orbit were seen, which had led to a bifrontal meningitis.- - - - - - - - - - ranking = 1keywords = blood vessel (Clic here for more details about this article) |
2/12. Localized versus systemic vasculitis: diagnosis and management.Localized vasculitis restricted to a specific anatomic site or organ is often histologically indistinguishable from more severe, systemic forms of vasculitis. By definition, localized vasculitis involves blood vessels within a confined vascular distribution or single organ without clinical evidence of generalized inflammation. Important factors that determine treatment and prognosis, in what appears initially to be a localized process, include histopathologic type, organ site, and the presence of systemic inflammatory markers and symptoms. The major issue is whether single organ vasculitis is actually an isolated form of the disease in which case surgical excision is curative, or whether the single organ involvement is simply a precursor of more threatening systemic vasculitis. The Birmingham Vasculitis Activity Score is a valuable tool to identify those patients with concurrent systemic involvement. The physician's recognition of a localized versus systemic vasculitic process is important in terms of making the correct diagnosis, prescribing treatment, and arranging appropriate clinical follow-up.- - - - - - - - - - ranking = 1keywords = blood vessel (Clic here for more details about this article) |
3/12. Polyarteritis associated with yersinia enterocolitica infection.A patient developed polyarteritis, predominantly affecting the muscles, 10 days after a yersinia enterocolitica O:3 infection. Immunoperoxidase staining showed yersinia enterocolitica O:3 antigen in the subendothelial layer of the blood vessels. This suggests that vasculitis should be considered as a rare manifestation of yersinia enterocolitica infection.- - - - - - - - - - ranking = 1keywords = blood vessel (Clic here for more details about this article) |
4/12. Viruslike particles in granulomatous angiitis of the central nervous system.Neuropathologic examination of the brain of a 67-year-old woman with a 5-month history of progressive multiple neurologic deficits showed granulomatous angiitis of the small parenchymal and leptomeningeal blood vessels of the brain and spinal cord. Electron microscopy of formalin-fixed brain disclosed intranuclear viruslike particles resembling herpesvirus. Although definitive proof cannot be established without further virologic tests, this previously unreported finding suggests that some cases of granulomatous angiitis of the central nervous system may result from viral infection.- - - - - - - - - - ranking = 1keywords = blood vessel (Clic here for more details about this article) |
5/12. Case report: fatal gastrointestinal hemorrhage in mixed connective tissue disease.We have presented the case of a young woman with MCTD who died of gastrointestinal bleeding due to fibrinoid necrosis of blood vessels of the small and large intestine. This appears to be the first recorded occurrence of such findings in MCTD.- - - - - - - - - - ranking = 1keywords = blood vessel (Clic here for more details about this article) |
6/12. Periarteritis of coronary arteries with severe eosinophilic infiltration. A new pathologic entity (eosinophilic periarteritis)?A 40 year-old male presented symptoms of angina pectoris for about nine years and expired with symptoms of unstable angina, changing pattern at the terminal stage. At autopsy, both right and left coronary arteries of the subepicardial region were grayish white and elastic hard. Histologically, inflammatory infiltration was localized in adventitia of coronary arteries located in the subepicardial region. Inflammatory cells infiltrated into the adventitia were mostly eosinophiles. The medial smooth muscle cells were well preserved and the intima showed irregular thickening with fibrosis. Vascular obstruction or recanalization could not be observed. As a result of these findings, it was considered that these inflammatory changes of the coronary arteries could be termed eosinophilic periarteritis. These inflammatory changes could not be found in the intramural coronary arteries. Rather extensive fibrosis could be seen in the muscle layer centering about the posterior wall of the left ventricle. No findings of angiitis could be detected in the blood vessels except subepicardial coronary arteries.- - - - - - - - - - ranking = 1keywords = blood vessel (Clic here for more details about this article) |
7/12. Acute vascular rejection involving the major coronary arteries of a cardiac allograft.A case of acute vascular rejection occurring in a cardiac allograft is presented. The rejection was characterized by prominent lymphocytic infiltration of the major coronary arteries in a pattern similar to that observed in acute vascular rejection occurring in renal allografts. Additionally, there was electron microscopic evidence of endothelial damage of smaller vessels. In addition to routine light microscopic evaluation of heart biopsies obtained in this case, immunofluorescent staining of biopsies for IgG, IgM, C3, Clq, fibrinogen, T cells, B cells, and Ia human leukocyte antigen (HLA-DR) was also performed. These studies suggest that antibodies may have been important in the terminal rejection episode described in this case. Furthermore, immunofluorescent staining detected continuing endothelial cell damage, reflected as Ia antigen positivity of allograft blood vessels, despite apparent improvement of rejection as judged by light microscopy.- - - - - - - - - - ranking = 1keywords = blood vessel (Clic here for more details about this article) |
8/12. Acute congestive heart failure due to the arteritis of rheumatoid arthritis: early diagnosis by endomyocardial biopsy: a case report.A 49-year-old man with rheumatoid arthritis presented with acute congestive heart failure. Acute viral myocarditis was suspected clinically as a gallium-67 myocardial scan was positive. Percutaneous catheter-directed biopsy of the right ventricular endomyocardium, however, revealed heavy endothelial deposits of IgM in the small blood vessels of the myocardium. prednisone therapy resulted in normalization of both the myocardial gallium-67 scan and left ventricular ejection fraction with resolution of the symptoms of congestive heart failure. This is the first report documenting rheumatoid arteritis antemortem by myocardial biopsy.- - - - - - - - - - ranking = 1keywords = blood vessel (Clic here for more details about this article) |
9/12. Ultrastructural changes of skeletal muscles in polyarteritis nodosa and in arteritis assoicated with rheumatoid arthritis.Muscle biopsies from two cases of polyarteritis nodosa (PN) and one of arteritis in assoication with rheumatoid arthritis (RA) were examined by electron microscopy. The histological changes were similar in all three cases. The endothelial cells of the small blood vessels were often hypertrophied. Inflammatory reaction was present mainly in the vicinity of the blood vessels. Individual muscle fibres showed mostly nonspecific degenerative changes. In a case PN, however, annulate lamellae were present in a small number of the muscle fibres. The annulate lamellae have been reported, to our knowledge, in the human skeletal muscles only in a few cases of polymyositis. In addition, two cases, one of PN and of arteritis with RA, showed fine filamentous inclusions in the muscle fibres. Changes were also noted in the motor end-plate. A sural nerve biopsy in a case of arteritis with RA showed changes both in axons and myelin sheaths, in addition to the changes in the blood vessels similar to those in the muscle.- - - - - - - - - - ranking = 3keywords = blood vessel (Clic here for more details about this article) |
10/12. Pathogenesis of varicella-zoster angiitis in the CNS.A 20-year-old man with Hodgkin's disease experienced ophthalmic zoster with dissemination and CNS involvement. At autopsy, he was found to have granulomatous angiitis involving the basilar artery, and electron microscopy revealed virus-like particles in the outer layers of the vessel walls, but not the endothelium. This suggests that granulomatous angiitis of the CNS in varicella-zoster infections results from direct viral invasion of blood vessels, perhaps by contiguous spread from cranial nerves.- - - - - - - - - - ranking = 1keywords = blood vessel (Clic here for more details about this article) |
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