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infectious mediastinitis

Noman Lateef, Abdul Haseeb, Uzair K Ghori, Abubakar Tauseef, Mustafa Dawood, Syed M Hasan Kazmi
Rosai-Dorfman disease (RDD) is a rare, benign, and predominantly nodal disease that most commonly presents as bilateral, painless cervical lymphadenopathy; although inguinal, axillary, mediastinal, and hilar lymphadenopathy has also been reported. Apart from nodal involvement, RDD has extranodal manifestations involving bone, soft tissue, and liver as well as constitutional symptoms of fever, night sweats, and weight loss, which make it reasonable to rule out the infectious, autoimmune, and malignant conditions as the differential diagnosis...
January 2, 2018: Curēus
Paolo di Russo, Carlo Tascini, Maria Elena Benini, Carlotta Martini, Paolo Lepori
Background: Propionibacterium acnes ( P. acnes ) is a microaerophilic anaerobic Gram-positive rod responsible for acne vulgaris. Although it is often considered to be a skin contaminant, it may act as a virulent agent in implant-associated infections. Conversely, spontaneous infectious processes have been rarely described. Case Description: Here, we describe a 43-year-old female with C1-C2 spondylodiscitis attributed to P. acnes infection. Despite long-term antibiotic treatment, computed tomography demonstrated erosion of the C1 and C2 vertebral complex that later warranted a fusion...
2018: Surgical Neurology International
Hiroshi Furukawa, Takeshi Honda, Takahiko Yamasawa, Hisao Masaki, Kazuo Tanemoto
BACKGROUND: We retrospectively evaluated the initial clinical experience of the surgical management of extensive dissecting thoracic aortic aneurysm (TAA) via the semi-clamshell approach. METHODS: Thirteen patients (3 women and 10 men, mean age 67 ± 15 years) who underwent elective surgical intervention for extensive dissecting TAA via semi-clamshell approach in our institute between May 2007 and April 2017 participated in this study. Regarding surgical techniques, left thoracotomy with transverse sternotomy was initially performed via the third or fourth intercostal space following an incision from the right sternal borderline to the anterior axillary line on the left sternal borderline...
February 22, 2018: General Thoracic and Cardiovascular Surgery
Jared James, Yasser M Sammour, Andrew R Virata, Terri A Nordin, Igor Dumic
BACKGROUND DRESS is a rare, life threatening syndrome that occurs following exposure to certain medications, most commonly antibiotics and antiepileptics. While sulfonamide antibiotics are frequently implicated as causative agents for DRESS syndrome, furosemide, a nonantibiotic sulfonamide, has not been routinely reported as the causative agent despite its widespread use. CASE REPORT A 63 year old male who started furosemide for lower extremity edema 10 weeks prior presented with diarrhea, fever of 39.4°C, dry cough and maculopapular rash involving >50% of his body...
February 14, 2018: American Journal of Case Reports
Reema Bansal, Amod Gupta, Ritesh Agarwal, Mohit Dogra, Garvit Bhutani, Vishali Gupta, M R Dogra, Deeksha Katoch, Ashutosh Nath Aggarwal, Aman Sharma, Raje Nijhawan, Ritambara Nada, Uma Nahar Saikia, Pranab Dey, Digambar Behera
PURPOSE: To report the role of CT chest and cytology in suspected tubercular and sarcoid uveitis. METHODS: This is a retrospective, interventional case series of 376 uveitis patients with suspected ocular tuberculosis (TB)/sarcoidosis seen between January 2010 and April 2015 at the Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh. All underwent CT chest, and had following inclusion criteria: (1) Presence of active granulomatous anterior/intermediate/posterior uveitis or panuveitis; (2) a documented tuberculin skin test/QuantiFERON-TB Gold test; (3) all other causes of infectious/non-infectious uveitis ruled out...
February 8, 2018: Ocular Immunology and Inflammation
Nick D Van Skike, Nana K Minkah, Chad H Hogan, Gary Wu, Peter T Benziger, Darby G Oldenburg, Mehmet Kara, Deborah M Kim-Holzapfel, Douglas W White, Scott A Tibbetts, Jarrod B French, Laurie T Krug
Gammaherpesviruses encode proteins with homology to the cellular purine metabolic enzyme formyl-glycinamide-phosphoribosyl-amidotransferase (FGARAT), but the role of these viral FGARATs (vFGARATs) in the pathogenesis of a natural host has not been investigated. We report a novel role for the ORF75A vFGARAT of murine gammaherpesvirus 68 (MHV68) in infectious virion production and colonization of mice. MHV68 mutants with premature stop codons in orf75A exhibited a log reduction in acute replication in the lungs after intranasal infection, which preceded a defect in colonization of multiple host reservoirs including the mediastinal lymph nodes, peripheral blood mononuclear cells, and the spleen...
February 1, 2018: PLoS Pathogens
Estefania Rivera, Yaron Gesthalter, Paul Vardelaan, Alex Chee, Adnan Majid
A 65-year-old woman, never smoker, with medical history of hypertension, nonischemic cardiomyopathy, and moderate pulmonary hypertension presented with symptomatic bilateral pleural effusions. Thoracentesis revealed a lymphocyte predominant transudate and was negative for malignancy, microbiologic cultures were negative for an infectious cause. Chest tomography showed mediastinal and bilateral hilar lymphadenopathy, lymph node biopsy with endobronchial ultrasound-guided transbronchial needle aspiration showed non-necrotizing granulomas compatible with sarcoidosis...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
Damaris Pena, Gilda Diaz-Fuentes, Sindhaghatta Venkatram
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has increasingly been performed for the diagnosis and staging of thoracic malignancies. Findings of a necrotic lymph node raise concern for infectious process and malignancy. A hypoechoic area on ultrasound/EBUS within a lymph node without blood flow is suggestive of pathologies like infections or malignancy. Inspection of the fluid could suggest a diagnosis; clear aspirates usually suggest bronchogenic or mediastinal cysts and purulent material suggests abscesses or necrotic lymph nodes...
2017: Case Reports in Pulmonology
Masahiro Ikeda, Toshihisa Asakura, Kazuhiko Uwabe, Kozo Morita, Atsushi Iguchi, Hiroshi Niinami
A 62-years-old female had undergone ascending aortic replacement with homograft for graft infection and mediastinitis after initial replacement of ascending aorta due to acute type A dissection. Ten years after homograft replacement, follow up computed tomography showed acute growing saccular aneurysm of the homograft without infectious symptoms. We urgently performed Bentall procedure and hemiarch replacement successfully. Pathological diagnosis was true aneurysm of the homograft. She was discharged from hospital without any complication and has been quite uneventful 7 years after surgery...
September 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Barbara Saenz-Ibarra, Victor G Prieto, Carlos A Torres-Cabala, Auris Huen, Priyadharsini Nagarajan, Michael T Tetzlaff, Jonathan L Curry, Doina Ivan, Phyu P Aung
Coccidioidomycosis is the major systemic mycoses, considered to be 1 of the most infectious fungal diseases. In symptomatic patients, the most common manifestation is pulmonary disease, but many other organs can be affected. Disseminated disease occurs in 1%-5% of all patients affected by coccidioidomycosis and can affect any organ, with the skin, central nervous system, and musculoskeletal system being reported as the most prevalent. Here, we report a 42-year-old male farmer from the west Texas who presented with an approximately 2-month history of progressive shortness of breath and dyspnea on exertion, weight loss, and night sweats...
August 24, 2017: American Journal of Dermatopathology
Praneet Iyer, Mohammad Ibrahim, Waqas Siddiqui, Ahmed Dirweesh
Association of SIADH with malignancy was first reported in 1957, when it was described in two patients with bronchogenic carcinoma. While the association with small cell lung cancer (SCLC) is well known, that with non small cell lung cancer (NSCLC) has been rarely reported. We report a case of 70 year old male who was found to have hyponatremia secondary to SIADH. Radiological tests revealed right hilar lung mass with mediastinal adenopathy. Bronchoscopic biopsy revealed non-small cell lung cancer of type squamous cell...
2017: Respiratory Medicine Case Reports
Yujiro Yokoyama, Takahiro Nakagomi, Daichi Shikata, Rumi Higuchi, Toshio Oyama, Taichiro Goto
BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a useful and less invasive procedure for the definitive diagnosis of mediastinal and hilar lymph nodes. However, infectious complications can occur after EBUS-TBNA, although they are extremely rare. CASE PRESENTATION: A 66-year-old man with necrotic and swollen lower paratracheal lymph nodes underwent EBUS-TBNA. A mediastinal abscess developed 9 days post-procedure. Surgical drainage and debridement of the abscess were performed along with lymph node biopsy followed by daily washing of the thoracic cavity...
July 14, 2017: World Journal of Surgical Oncology
Lamyae Amro, Saloua El Fadili, Hind Serhane, Hafsa Sajiai, Salma Ait Batahar
Hydatid cyst is an infectious disease which is quite frequent in Morocco. Pelvic and pancreatic locations of this parasitic infection are rare, namely exceptional. We report the case of a 66-year old patient who was operated for liver hydatic cyst 6 years before, presenting for chest pain associated with hydatidoptysis. Chest X-ray objectified left hydropneumothorax. Thoraco-abdominopelvic CT showed mediastinal liquid mass as well as multiple hepatic, pancreatic (isthmus), pelvic and left under diaphragmatic cystic lesions...
2017: Pan African Medical Journal
Lanhua Zhang, Shixiong Qiu, Cui Tang, Jinming Xu
Adult community-acquired pneumonia (ACAP) is the most prevalent pulmonary infectious disease that may be asymptomatic or have varying clinical presentations. Patients with ACAP often present with enlarged mediastinal lymph nodes on their chest computed tomography images. However, large irregular swollen lymph nodes are rarely reported in ACAP, and may therefore be confused with enlarged lymph node masses. In the present case report, the patient presented with lymph node masses, which were ameliorated to their normal size following antimicrobial treatment...
July 2017: Experimental and Therapeutic Medicine
Paula Martínez Pascual, Paloma Pinacho Martinez, Eviatar Friedlander, Carlos Martin Oviedo, Bartolome Scola Yurrita
INTRODUCTION: Deep neck infections (DNI) are defined as suppurative infectious processes of deep visceral spaces of the neck. OBJECTIVE: The aim of this study is to review different factors that may influence peritonsillar and deep neck Infections (DNI) and may play a role as bad prognosis predictors. METHODS: We present a retrospective study of 330 patients with DNI and peritonsillar infections who were admitted between January 2005 and December 2015 in a tertiary referral hospital...
April 9, 2017: Brazilian Journal of Otorhinolaryngology
Srikant Mohta, Manish Soneja, Surabhi Vyas, Wasim Khot
An 18-year-old boy presented with acute-onset quadriparesis that had developed 4 weeks prior. He had an intermittent fever and significant weight loss during this period. After extensive investigations, the patient was diagnosed with an acute motor and sensory axonal neuropathy (AMSAN) variant of Guillain-Barre syndrome (GBS) and disseminated tuberculosis with mediastinal lymphadenopathy, pericarditis, and pleural effusion. Plasmapheresis was performed and first-line anti-tubercular therapy was administered...
February 2017: Intractable & Rare Diseases Research
Cyril Marimoutou, Davide Tufo, Hervé Chaudet, Marc Abdul Samad, Gaëtan Gentile, Michel Drancourt
Background: . Cargo ships are medically isolated, yet neglected environments. We aimed to know about medical events onboard cargo ships. Methods: We reviewed all the medical events onboard a large commercial 471-cargo ship company for 4 years. Medical events were recorded within 20 categories as routinely used by Medical Maritime Consulting Centers, using a 4-level medical gravity score. The χ 2 test and logistic regression and correspondence analyses were used for the analysis of qualitative variables...
May 1, 2017: Journal of Travel Medicine
Olivia Sánchez-Cabral, Dina Martínez-Mendoza, Sebastian Fernandez-Bussy, Esmeralda Aspuru-García, Rosa Rivera-Rosales, César Luna-Rivero, José Arturo Martínez-Orozco, Gustavo Reyes-Terán
BACKGROUND: There are few published studies about the usefulness of endobronchial ultrasound (EBUS) in patients infected with human immunodeficiency virus (HIV). The clinical spectrum of likely diseases in this population is varied and differs from patients not infected with HIV. OBJECTIVE: The aim of this study was to measure the usefulness of EBUS-guided transbronchial needle aspiration (EBUS-TBNA) in HIV-infected patients with mediastinal lymphadenopathy. MATERIALS AND METHODS: We conducted an observational, cross-sectional, retrospective, descriptive study on patients with HIV infection and mediastinal lymphadenopathy who underwent EBUS-TBNA between September 2014 and April 2016...
2017: Respiration; International Review of Thoracic Diseases
Masooma Aqeel, Bjorn Batdorf, Horatiu Olteanu, Jayshil J Patel
Introduction: Antisynthetase syndrome (ASS) is characterized by the presence of anti-Jo-1 antibodies in conjunction with clinical findings of fever, polymyositis-dermatomyositis, and interstitial lung disease (ILD). Inflammatory myopathies carry a high risk of malignancy, but this association is less well outlined in ASS. We present the case of a patient with ASS who developed non-Hodgkin's lymphoma with acute hypoxemic respiratory failure. Case Presentation: A 44-year-old female with ASS presented with acute hypoxemic respiratory failure...
January 2017: Journal of Investigative Medicine High Impact Case Reports
Aruna Jahoor, Shekhar Ghamande, Shirley Jones, Carl Boethel, Heath D White
Mediastinitis is a rare complication of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Recent reports of infectious complications following EBUS-TBNA involved oropharyngeal bacteria. Here, we report 2 unusual cases of post-EBUS-TBNA mediastinitis involving Streptococcus pneumoniae and Pseudomonas aeruginosa, which were likely the result of direct inoculation of the organisms at the time of transbronchial needle aspiration. The first case was successfully treated with computed tomography-guided drainage and antibiotics, whereas the second case had >50% distal tracheal obstruction and near total occlusion of the left main stem bronchus, requiring rigid bronchoscopy, stent placement, debulking, and antibiotics...
October 2017: Journal of Bronchology & Interventional Pulmonology
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