1/4. Tuberculous infection of the gracilis muscle and tendon clinically mimicking deep venous thrombosis: sonographic findings.Musculoskeletal tuberculosis usually involves the spine. Tuberculous infection of muscles and tendons is rare. A patient with tuberculous infection of the gracilis muscle and tendon is reported. lower extremity Doppler ultrasound was initially performed, as the physical examination mimicked deep vein thrombosis. Sonography identified the abnormal muscle and tendon and was then used to guide aspiration. The sonographic appearance of the gracilis muscle and tendon is described and compared with correlative MR images.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/4. Disseminated BCG infection following bone marrow transplantation for X-linked severe combined immunodeficiency.An 8-month-old boy with X-linked severe combined immunodeficiency (XSCID) developed disseminated bacille Calmette-Guerin (BCG) infection following BCG vaccination at birth. He initially presented with an abscess at the site of BCG vaccination and was begun on three-drug antituberculous treatment (rifampicin, isoniazid, and pyrazinimide). Dissemination was subclinical prior to a human leukocyte antigen (HLA)-identical bone marrow transplant (BMT) from his sister, following which he presented with an acute erythroderma. A skin biopsy specimen revealed granulomas with epithelial histiocytes and giant cells in the reticular dermis, and numerous acid-fast bacilli (AFB) were present on Ziehl-Nielsen stain. A diagnosis of disseminated BCG disease was made. Despite the addition of a fourth antituberculous agent, ethambutol, he did not recover and developed numerous skin abscesses over the following weeks. Examination of pus from these lesions demonstrated numerous AFB. clarithromycin was added as a fifth antituberculous agent. Despite five-drug antituberculous therapy and monthly intravenous immunoglobulin infusions, recurrent abscesses containing AFB developed intermittently until 7 months posttransplant. At follow-up 1 year post-BMT he showed good general physical improvement. All abscesses had healed with scarring, and no further skin lesions had occurred.- - - - - - - - - - ranking = 0.056189875425316keywords = physical (Clic here for more details about this article) |
3/4. tuberculosis of the breast: rare but still extant. review of the literature and report of an additional case.tuberculosis of the breast is a rare malady that is usually manifested by a unilateral mass suggestive of carcinoma or sometimes of abscess. mammography also suggests carcinoma in most instances. However, at operation, the discovery of necrotic tissue or abscess may lead to the suspicion of infectious or inflammatory disease rather than neoplasm. The diagnosis of tuberculosis may be established by the demonstration of acid-fast bacilli in excised tissue, by culture studies, or by guinea pig inoculation; however, the diagnosis is usually not suspected. In the past, mastectomy was the usual treatment. Today, successful treatment combines antituberculous drug therapy with the removal of infected breast tissue. The prognosis for complete cure is excellent. One case of secondary tuberculous mastitis has been reported herein. The patient, an Egyptian woman residing in the united states since 1973, was treated in egypt for pulmonary tuberculosis at age 17. She presented in 1982 with a breast mass that mimicked carcinoma on physical examination and mammograms, but excisional biopsy and histologic examination revealed a breast abscess that contained caseous material and a solitary acid-fast bacillus. The patient was cured of her disease after appropriate operation and a course of antituberculous drugs. This has been the only documented case of mammary tuberculosis at our institution. Despite its rarity, tuberculosis of the breast should not be forgotten in this age of world travel.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
4/4. tuberculosis arising at the site of physical injury: eight case histories.Eight patients who developed tuberculosis at the site of a recent injury are described. They were all in apparent good health before and at the time of the injury. There are only two precedents of such cases in the literature, and the possible pathogenetic mechanisms are discussed.- - - - - - - - - - ranking = 0.22475950170126keywords = physical (Clic here for more details about this article) |