scholarly journals Tuberculous Gastric Abscess in a Patient with AIDS: A Rare Presentation

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Ekta Nayyar ◽  
Julian A. Torres ◽  
Carlos D. Malvestutto
Keyword(s):  
Opportunistic Infections ◽  
Epigastric Pain ◽  
Extrapulmonary Tuberculosis ◽  
Immunocompromised Host ◽  
Rare Presentation ◽  
Accurate Identification ◽  
Gastric Tuberculosis ◽  
High Clinical Suspicion ◽  
Clinical Syndromes ◽  
Diagnostic Modalities

Tuberculosis is a healthcare concern that affects millions of individuals around the globe. Coinfection with HIV has changed both the clinical presentation and the outcome of the disease dramatically in the last few decades. Extrapulmonary tuberculosis is seen more frequently in the immunocompromised host. An unusual case of gastric tuberculosis in an AIDS patient is reported here. A 49-year-old female with AIDS was admitted for fever and epigastric pain. A gastric submucosal abscess was observed on imaging and confirmed by biopsy showing numerous neutrophils and acid-fast bacilli. Aspirate grewMycobacterium tuberculosis.This report highlights a very unusual presentation of tuberculosis in an immunodeficient patient. High clinical suspicion for opportunistic infections in unusual locations should be maintained in these patients presenting with clinical syndromes that do not respond to standard treatments. New diagnostic modalities facilitate accurate identification of these infections.

scholarly journals A Rare Manifestation of Tuberculosis Presenting in the United States

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Osman Bhatty ◽  
David Waters ◽  
Nicholas Wilka ◽  
Shradha Samuel ◽  
John Horne ◽  
...  
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
The United States ◽  
Care Physician ◽  
Western World ◽  
Gram Stain ◽  
Breast Lump ◽  
Rare Presentation ◽  
High Clinical Suspicion ◽  
Rare Manifestation ◽  
Initial Biopsy

A 64-year-old Bangladeshi female presented to her primary care physician with a tender right breast lump that had been present for 4-5 days along with subjective fevers and malaise. Initial biopsy revealed granulomas, but Ziehl-Neelsen and Gram stain were negative for TB so antibiotics were prescribed for abscess until culture came positive for tuberculosis. She was started on triple therapy for extrapulmonary tuberculosis, an exceedingly rare presentation that requires high clinical suspicion in the Western world.

Isolated multidrug-resistant tubercular tenosynovitis of the flexor tendon of the little finger

2021 ◽  
Vol 14 (2) ◽  
pp. e238339
Author(s):  
Sunny Chaudhary ◽  
Subhajit Maji ◽  
Varun Garg ◽  
Vivek Singh
Keyword(s):  
Flexor Tendon ◽  
Extrapulmonary Tuberculosis ◽  
Functional Limitation ◽  
Clinical Signs ◽  
Multidrug Resistant ◽  
Interesting Case ◽  
Antitubercular Therapy ◽  
Histopathological Diagnosis ◽  
Rare Presentation ◽  
Little Finger

Isolated multidrug-resistant (MDR) tubercular tenosynovitis of the flexor tendons of finger without involvement of wrist is a rare presentation. Tenosynovitis of hand is an uncommon manifestation of extrapulmonary tuberculosis. Pyogenic flexor tenosynovitis of hand is frequently seen and is the closest differential. Non-specific clinical signs may lead to delay in diagnosis, which is often made after biopsy. Management includes surgical excision of necrotic tissue and infected synovium along with antitubercular therapy after histopathological diagnosis. MDR tuberculosis of hand is extremely rare and, to the best of our knowledge, has not been reported in the literature so far. We report an interesting case of MDR tubercular flexor tendon tenosynovitis of the little finger without any pulmonary involvement in an immunocompetent patient. The case was managed by complete synovectomy and second-line antitubercular therapy with complete resolution of disease and had no functional limitation.

scholarly journals Hematospermia in a returned traveler

2017 ◽  
Vol 11 (1-2) ◽  
pp. 41 ◽  
Author(s):  
Raynell Lang ◽  
Jessica Minion ◽  
Alexander Wong
Keyword(s):  
Schistosoma Haematobium ◽  
Microscopic Analysis ◽  
Lake Malawi ◽  
Clinical Suspicion ◽  
Eastern Africa ◽  
Rare Presentation ◽  
Sexually Transmitted ◽  
Common Complaint ◽  
High Clinical Suspicion ◽  
Global Travel

Hematospermia is a common complaint among patients seen in outpatient urology clinics. The differential diagnosis is broad and includes inflammatory, infectious, neoplastic, structural, systemic, and traumatic causes. The most common infectious causes are uropathogens and sexually transmitted infections. However, with increasing global travel, physicians must maintain a high clinical suspicion for pathogens not endemic to their region, including Echinococcus, Mycobacterium tuberculosis, and Schistosoma.1 We present a case of hematospermia in a traveler returning from Eastern Africa with exposure to Lake Malawi. The patient’s microscopic analysis of semen was positive for Schistosoma haematobium, revealing a rare presentation of S. haematobium infection.

Clinical features of HIV/AIDS patients presenting to an inner city clinic in Ho Chi Minh City, Vietnam

2007 ◽  
Vol 18 (7) ◽  
pp. 482-485 ◽  
Author(s):  
Stephen A Klotz ◽  
Hao Cong Nguyen ◽  
Tam Van Pham ◽  
Liem Thanh Nguyen ◽  
Dong Thi Anh Ngo ◽  
...  
Keyword(s):  
Cell Count ◽  
Opportunistic Infections ◽  
Extrapulmonary Tuberculosis ◽  
Pneumocystis Carinii ◽  
Population Data ◽  
World Health ◽  
Ho Chi Minh City ◽  
Cd4 Cell Count ◽  
To Come ◽  
Cd4 Cell

An outpatient HIV clinic was opened in March 2005 in Binh Thanh District, a poor section of Ho Chi Minh City, Vietnam. Over 1500 patients were seen in the first year. The average age of patients was 27 years. Men represented 77% of the clinic population, women, 23% and children under the age of 16 years of age, 5% of the population. The most common risk factor among men was being an injecting drug user (IDU), 76%, and among women, being married to an IDU HIV-positive man, 35%. Physical signs of disease were uncommon: lymphadenopathy in 24% and hepatomegaly and splenomegaly in 4% and 3%, respectively. Men and women were anaemic at presentation, with a mean haemoglobin of 11.9 g/dL and 11.1 g/dL, respectively. An overwhelming majority of patients had profound immunodeficiency. The mean CD4+ cell count was 164 cells/mL and the median was 69 cells/mL. No correlation was found between the World Health Organization's stage of disease and the CD4+ cell count. Thus, the former is a poor predictor of immunity in this population. Data regarding opportunistic infections diagnosed at the first visit were studied. Candidiasis of the oral pharynx, oesophagus or vagina was found in 34.5% of the patients, and pulmonary and extrapulmonary tuberculosis was found in 32% of the patients. Pneumocystis carinii pneumonia (PCP) was diagnosed in only 3% of the patients. Cotrimoxazole prophylaxis is advocated for HIV-infected Vietnamese, but the incidence of PCP is negligible and resources could be spent elsewhere. The various opportunistic infections seen in this resource-poor clinic setting is likely to be a pattern of presentation of HIV-infected Vietnamese for some time to come.

scholarly journals Rare Presentation of Toxoplasma Pneumonitis in the Absence of Neurological Symptoms in an AIDS Patient and Use of Next-Generation Sequencing for Diagnosis

2020 ◽  
Author(s):  
Moni Roy ◽  
Nikhut Siddique ◽  
Bindu Bathina ◽  
Sharjeel Ahmad
Keyword(s):  
Next Generation Sequencing ◽  
Opportunistic Infections ◽  
Miliary Tuberculosis ◽  
Neurological Symptoms ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Next Generation ◽  
Rare Presentation ◽  
Immunodeficiency Syndrome ◽  
Next Generation Sequencing Ngs ◽  
Generation Sequencing

Toxoplasma gondii is a known cause of encephalitis in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients. Toxoplasma pneumonitis is a manifestation of extracerebral toxoplasmosis and can be clinically indistinguishable from other opportunistic infections including Pneumocystis jirovecii pneumonia (PJP) and miliary tuberculosis. In this case report, Toxoplasma pneumonitis and disseminated toxoplasmosis was diagnosed using next-generation sequencing (NGS) and polymerase chain reaction (PCR) assessment. NGS can detect microbial cell-free DNA (cfDNA) circulating in the plasma of over 1,000 pathogens. This case is a rare presentation of Toxoplasma pneumonitis in the absence of neurological symptoms and we discuss the use of NGS of microbial cfDNA and PCR tests that may be utilized for the timely diagnosis of such challenging cases.

scholarly journals Opportunist Coinfections by Nontuberculous Mycobacteria and Fungi in Immunocompromised Patients

Antibiotics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 771
Author(s):  
Ines Joao ◽  
Helena Bujdáková ◽  
Luisa Jordao
Keyword(s):  
Histoplasma Capsulatum ◽  
Opportunistic Infections ◽  
Clinical Symptoms ◽  
Nontuberculous Mycobacteria ◽  
Wide Spectrum ◽  
Case Reports ◽  
Fungal Species ◽  
Mycobacterium Abscessus ◽  
Accurate Identification ◽  
Patient Prognosis

Nontuberculous mycobacteria (NTM) and many fungal species (spp.) are commonly associated with opportunistic infections (OPIs) in immunocompromised individuals. Moreover, occurrence of concomitant infection by NTM (mainly spp. of Mycobacterium avium complex and Mycobacterium abscessus complex) and fungal spp. (mainly, Aspergillus fumigatus, Histoplasma capsulatum and Cryptococcus neoformans) is very challenging and is associated with poor patient prognosis. The most frequent clinical symptoms for coinfection and infection by single agents (fungi or NTM) are similar. For this reason, the accurate identification of the aetiological agent(s) is crucial to select the best treatment approach. Despite the significance of this topic it has not been sufficiently addressed in the literature. This review aims at summarizing case reports and studies on NTM and fungi coinfection during the last 20 years. In addition, it briefly characterizes OPIs and coinfection, describes key features of opportunistic pathogens (e.g., NTM and fungi) and human host predisposing conditions to OPIs onset and outcome. The review could interest a wide spectrum of audiences, including medical doctors and scientists, to improve awareness of these infections, leading to early identification in clinical settings and increasing research in the field. Improved diagnosis and availability of therapeutic options might contribute to improve the prognosis of patients’ survival.

scholarly journals Invasive fungal infections in the immunocompromised host: Mechanistic insights in an era of changing immunotherapeutics

2019 ◽  
Vol 57 (Supplement_3) ◽  
pp. S307-S317 ◽  
Author(s):  
Christopher P Eades ◽  
Darius P H Armstrong-James
Keyword(s):  
Intracellular Signaling ◽  
Fungal Pathogens ◽  
Opportunistic Infections ◽  
Fungal Infections ◽  
Immunocompromised Host ◽  
Adaptive Immune ◽  
Mechanistic Approach ◽  
Molecular Immunology ◽  
Nonspecific Cytotoxicity ◽  
Small Molecular Inhibitors

AbstractThe use of cytotoxic chemotherapy in the treatment of malignant and inflammatory disorders is beset by considerable adverse effects related to nonspecific cytotoxicity. Accordingly, a mechanistic approach to therapeutics has evolved in recent times with small molecular inhibitors of intracellular signaling pathways involved in disease pathogenesis being developed for clinical use, some with unparalleled efficacy and tolerability. Nevertheless, there are emerging concerns regarding an association with certain small molecular inhibitors and opportunistic infections, including invasive fungal diseases. This is perhaps unsurprising, given that the molecular targets of such agents play fundamental and multifaceted roles in orchestrating innate and adaptive immune responses. Nevertheless, some small molecular inhibitors appear to possess intrinsic antifungal activity and may therefore represent novel therapeutic options in future. This is particularly important given that antifungal resistance is a significant, emerging concern. This paper is a comprehensive review of the state-of-the-art in the molecular immunology to fungal pathogens as applied to existing and emerging small molecular inhibitors.

scholarly journals Intraluminal Duodenal Diverticulum: A Rare Cause of Chronic Epigastric Pain

2020 ◽  
Vol 06 (02) ◽  
pp. e125-e127
Author(s):  
Shadi Nassar ◽  
Alaa El-Kheir ◽  
Charif Khaled ◽  
Anis Nassar ◽  
Joseph Boujaoude ◽  
...  
Keyword(s):  
Epigastric Pain ◽  
Case Reports ◽  
Duodenal Diverticulum ◽  
Rare Entity ◽  
Epigastric Discomfort ◽  
Asymptomatic Patients ◽  
Intraluminal Duodenal Diverticulum ◽  
Diagnostic Modalities ◽  
Specific Symptoms

AbstractDespite its first identification in 1885, intraluminal duodenal diverticulum remains a rare entity and only a few case reports are found in the literature. Its diagnosis is almost always delayed due to the lack of specific symptoms and to the very vague presentation consisting of mild epigastric discomfort. However, with the aid of new diagnostic modalities and imaging, it has become easier to diagnose this entity when its symptoms persist. Finally, it can remain undiagnosed in asymptomatic patients.

scholarly journals Multicentric Spinal Tuberculosis with Sternoclavicular Joint Involvement: A Rare Presentation

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Balaji Saibaba ◽  
Umesh Kumar Meena ◽  
Prateek Behera ◽  
Ramesh Chand Meena
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Spinal Tuberculosis ◽  
Sternoclavicular Joint ◽  
Joint Involvement ◽  
Socioeconomic Conditions ◽  
Skeletal System ◽  
Rare Presentation ◽  
Competent Patient ◽  
Immunological Status ◽  
Radiological Studies

Background. Tuberculosis is a chronic disease which may have varied presentations. Though pulmonary tuberculosis is the commonest, extrapulmonary tuberculosis involving skeletal system is often seen. Individuals with poor nourishment and immunological status are especially susceptible for disseminated and multicentric tuberculosis.Case Report. We here present a case of tuberculosis involving multiple anatomical locations in an immune-competent patient which was diagnosed with radiological studies and confirmed with histological examination. Patient was put on multidrug antitubercular therapy and responded well to the treatment with improvement in clinical and radiological picture.Clinical Relevance. This report of a rare case makes us aware of the varied presentations which tuberculosis can present with. It should be kept as a differential diagnosis in patients with cough and fever but not responding to conventional treatment. This is even more important in countries with poor socioeconomic conditions.

scholarly journals Acute Kidney Injury, Immune Thrombocytopenic Purpura, and the Infection That Binds Them Together: Disseminated Histoplasmosis

2017 ◽  
Vol 5 (4) ◽  
pp. 232470961774619
Author(s):  
Pooja Sethi ◽  
Jennifer Treece ◽  
Chidinma Onweni ◽  
Vandana Pai ◽  
Sowminya Arikapudi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Immune Thrombocytopenic Purpura ◽  
Opportunistic Infections ◽  
Immunocompromised Patient ◽  
Kidney Injury ◽  
The United States ◽  
Rare Presentation ◽  
Thrombocytopenic Purpura ◽  
Disseminated Histoplasmosis ◽  
Immunodeficiency Virus

Untreated human immunodeficiency virus (HIV) can be complicated by opportunistic infections, including disseminated histoplasmosis (DH). Although endemic to portions of the United States and usually benign, DH can rarely act as an opportunistic infection in immunocompromised patients presenting with uncommon complications such as acute kidney injury and idiopathic thrombocytopenic purpura. We report a rare presentation of DH presenting with acute kidney injury and immune thrombocytopenic purpura in an immunocompromised patient with HIV.

Sign in / Sign up

Export Citation Format

Share Document