DOCSLIB.ORG

Pulmonary Nocardiosis in Suspected Tubercilosis Patients… Susan MM

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Pulmonary Nocardiosis in Suspected Tubercilosis Patients… Susan MM Pulmonary Nocardiosis in Suspected Tubercilosis Patients… Susan MM. et al. 293 REVIEW Pulmonary Nocardiosis in Suspected Tuberculosis Patients: A Systematic Review and Meta-Analysis of Cross-Sectional Studies Susan Mansuri Mehrabadi1, Mina Taraghian2, Aliyar Pirouzi3, Azad Khaledi3, 4*, Alireza Neshani5, Somaye Rashki4 OPEN ACCESS ABSTRACT Citation: Susan Mansuri Mehrabadi, Mina Taraghian, Aliyar Pirouzi, Azad BACKGROUND: nocardiosis is an opportunistic infectious disease khaledi, Alireza Neshani, Somaye Rashki. Pulmonary Nocardiosis in in immunocompromised patients. The most common form of Suspected Tuberculosis Patients: A nocardiosis infection in humans is pulmonary nocrdiosis caused by Systematic Review and Meta-Analysis of inhaling Nocardia species from the environment. Thus, this study Cross-Sectional Studies. Ethiop J Health Sci.2020; aimed to evaluate the pulmonary nocardiosis in patients with 30(2):293.doi:http://dx.doi.org/10.4314/ejhs suspected tuberculosis using systematic review and meta-analysis. .v30 i2.17 Received: November 5, 2019 METHODS: We conducted a systematic search for cross-sectional Accepted: November 11, 2019 studies focused on the pulmonary nocardiosis among patients with Published: March 1, 2020 pulmonary tuberculosis based on the Preferred Reporting Items for Copyright: ©2020 Susan MM., et al. This is an open access article distributed Systematic reviews and Meta-analysis (PRISMA) published from under the terms of the Creative Commons January 2001 to October 2019. The search was conducted in Attribution License, which permits unrestricted use, distribution, and MEDLINE/PubMed, Web of Science, Scopus, Cochrane Library, reproduction in any medium, provided the Google Scholar, Science Direct databases, and Iranian databases. original author and source are credited. Medical subject headings (MeSH) and text words were searched: Funding: Nil Competing Interests: The authors “pulmonary nocardiosis”, “nocardiosis”, OR “nocardial declare that this manuscript was approved infection”, “pulmonary nocardial infections/agents”, AND by all authors in its form and that no “pulmonary tuberculosis”, OR “pulmonary TB”, AND “Iran”. competing interest exists. Affiliation and Correspondence: Two of the reviewers enrolled independently articles published in 1Medical Student, Department of English and Persian languages according to the inclusion and the Medicine, Kazeroun Branch, Islamic Azad University, Kazeroun, exclusion criteria. Comprehensive Meta-Analysis software (Version Iran 3.3.070) was used for meta-analysis. 2Department of Microbiology, RESULTS: Only 4 studies met the eligibility criteria. The School of Basic Sciences, Hamedan Branch, Islamic Azad University, pulmonary nocardiosis prevalence varied from 1.7% to 6.7%. The Hamedan, Iran combined prevalence of nocardiosis among patients with suspected 3Cellular and Molecular Gerash pulmonary tuberculosis in Iran was 4.8% (95% CI: 3-7.3, Q=5.8, Research Center, Gerash University of Medical Sciences, Gerash, Iran Z=12.7). No heterogeneity was observed between studies because 4Infectious Diseases Research I2 was 48.3. N. cyriacigeorgica and N. asteroides were reported as Center, Department of Microbiology and Immunology, the prevalent isolates, respectively. Faculty of Medicine, Kashan CONCLUSIONS: This review showed in patients suspected TB University of Medical Sciences, when they were negative in all diagnosis laboratory tests, Kashan, Iran 5Department of Microbiology and nocardiosis cases which be considered. Virology, Faculty of Medicine, KEYWORDS: Nocardia infection, nocardiosis, Pulmonary Mashhad University of Medical Tuberculosis, Pulmonary Nocardioses Sciences, Mashhad, Iran *Email: [email protected] DOI: http://dx.doi.org/10.4314/ejhs.v30i2.17 294 Ethiop J Health Sci. Vol. 30, No. 2 March 2020 INTRODUCTION affects predominantly people of between 20 and 60 years of age (19). The prevalence of the disease in Nocardiosis is an opportunistic infectious disease Iran is not known and often has been reported as a in immunocompromised individuals and in people case report. In the USA, the annual incidence rate with healthy immune systems is reported as a case of the disease was reported between 500-1000 (1-4). The nocardiosis spectrum consists of cases (16). In most cases, Nocardia infections are pulmonary, cutaneous, subcutaneous, cerebral, not diagnosed quickly because of a lack of specific cutaneous lymphatic or systematic diseases (3-5). clinical symptoms (20,21). The most common form of nocardiosis infection in Since these organisms are slow to grow, the humans is a pulmonary form caused by inhaling rapid and accurate diagnosis of them from other Nocardia species from the environment. So far, organisms for the treatment of severe infections more than 50 species of Nocardia have been and as well as prevention of brain abscess identified. Of which, the important pathogenic formation is essential. The use of molecular species include N. brasiliensis, N. asteroids methods compared to culture have the high speed, complex, N. pseudobrasiliensis, N. transvalensis, accuracy, sensitivity, and specificity in the and N. otitidiscaviarum (6). Nocardia is a Gram- identification of Nocardia species(22). There is the positive, obligatory aerobic, catalase-positive, non- motility, and relative acid-fast microorganism. It is lack of comprehensive data on the prevalence of pulmonary nocardiosis in Iran. The present study slow-growing and in the culture and tissue thus aimed to evaluate the pulmonary nocardiosis environment often forms filaments that convert in suspected tuberculosis patients using systematic easily to coccus and bacillus forms (7). The main review and meta-analysis of cross-sectional studies. site of Nocardia species is soil, but it is also found in water, sewage and organic residues of plants (8). METHODS AND MATERIALS However, the geographic prevalence of each species may change tremendously over the world, Search strategy: We conducted a systematic and some are rare (9). These opportunistic bacteria search for cross-sectional studies focused on the are facultative intracellular, which with suppressing pulmonary nocardiosis among patients with the immune system, are capable of replacing in pulmonary tuberculosis based on the Preferred different parts of the body including the lungs (10). Reporting Items for Systematic reviews and Meta- Also, they tend to expand to blood circulation and analysis (PRISMA) published from January 2001 cause brain abscesses and skin infections; if they to October 2019. A systematic literature search was are miss-diagnosed and unless timely treated will conducted in MEDLINE/PubMed, Web of Science, be fatal (11). Since patients with immune- Scopus, Cochrane Library, Google Scholar, and deficiency, Hematological malignancies, organ Science Direct databases. Medical subject headings transplant recipients, AIDS, prolonged (MeSH) and text words were searched within titles, consumption of corticosteroids, chronic alcoholism abstracts, and keywords. The search strategy was and diabetes that are deficient in T-cells, are as follows: “pulmonary nocardiosis”, susceptible to pulmonary nocardiosis (12). Some “nocardiosis”, OR “nocardial infection”, patients with nocardiosis usually have a chronic “pulmonary nocardia infections/agents”, AND underlying pulmonary disease and often under “pulmonary tuberculosis”, OR “pulmonary TB”, Long-term treatment with high doses of AND “Iran”. We included articles published in corticosteroids (13). Clinical signs and radiological English and Persian languages. Two reviewers, features of pulmonary nocardiosis are similar to A.K and AN, conducted the literature search. The that of pulmonary tuberculosis, but its progress is reference sections of retrieved studies were faster than tuberculosis having a period of several checked to find further relevant studies. months (14,15). Pulmonary lesions caused by Inclusion and exclusion criteria: All parts of the pulmonary nocardiosis are predominantly local and studies were read to check them against the have no clinical symptoms, and are associated with eligibility criteria. The inclusion criteria were: a) abscess and sometimes pneumonia (16-18). cross-sectional design, and b) assessing infection of Nocardiosis has a worldwide distribution and Nocardia and pulmonary TB. Studies published DOI: http://dx.doi.org/10.4314/ejhs.v30i62.17 Pulmonary Nocardiosis in Suspected Tubercilosis Patients… Susan MM. et al. 295 before 2001, case reports, abstracts, editorials, was used to calculate total effects. Cochran’s Q and literatures reporting inadequate data, case series, I square (I2) tests were used for assessing sources congress articles, meeting reports, letters to editors, of heterogeneity among studies. Publication bias articles published in languages other than English was checked by Egger’s regression asymmetry test. and Persian, duplicate publications, all review RESULTS forms were excluded. This peer-review process was performed independently by two reviewers Study selection: In total, 234 relevant articles were (AK, AN). Finally, discrepancies between two recognized via the initial literature search reviewers were resolved by involving a third (Figure1). About 111 records were excluded due to reviewer. duplications. Fifty-six studies were removed due to Quality evaluation: In the assessment process of the irrelevant titles. Then, abstracts 67 remained the qualities of studies, an appraisal tool for Cross- records were screened. It resulted in the exclusion
Load more

Recommended publications
  • Primary Cutaneous Nocardiosis: a Case Study and Review
    Study Primary cutaneous nocardiosis: A case study and review Arun C. Inamadar, Aparna Palit Department of Dermatology, Venereology & Leprosy, BLDEA’s SBMP Medical College, Hospital & Research Centre, Bijapur, India. Address for correspondence: Dr. Arun C. Inamadar, Professor & Head, Department of Dermatology, Venereology & Leprosy, BLDEA’s SBMP Medical College, Hospital & Research Centre, Bijapur - 586103, India. E-mail: [email protected]. ABSTRACT Background: Primary cutaneous nocardiosis is an uncommon entity. It usually occurs among immunocompetent but occupationally predisposed individuals. Aim: To study clinical profile of patients with primary cutaneous nocardiosis in a tertiary care hospital and to review the literature. Methods: The records of 10 cases of primary cutaneous nocardiosis were analyzed for clinical pattern, site of involvement with cultural study and response to treatment. Results: All the patients were agricultural workers (nine male) except one housewife. The commonest clinical type was mycetoma. Unusual sites like the scalp and back were involved in two cases. Culture was positive in six cases with N. brasiliensis being commonest organism. N. nova which was previously unreported cause of lymphocutaneous nocardiosis, was noted in one patient, who had associated HIV infection. All the patients responded to cotrimaxazole. Conclusion: Mycetoma is the commonest form of primary cutaneous nocardiosis and responds well to cotrimoxazole. KEY WORDS: Primary cutaneous nocardiosis, Mycetoma, Lymphocutaneous nocardiosis INTRODUCTION infection is prevalent. Many of the large series on nocardial infections mention the incidence of Cutaneous nocardiosis presents either as a part of cutaneous nocardiosis without specifying whether the disseminated infection or as a primary infection infection is primary or secondary. Indian reports of resulting from inoculation.
    [Show full text]
  • Granulomatous Diseases: Disease: Tuberculosis Leprosy Buruli Ulcer
    Granulomatous diseases: Disease: Tuberculosis Leprosy Buruli ulcer MOTT diseases Actinomycosis Nocardiosis Etiology Mycobacterium M. leprae M. ulcerans M. kansasii Actinomyces israelii Nocardia asteroides tuberculosis M. scrofulaceum M. africanum M. avium- M. bovis intracellulare M. marinum Reservoir Humans (M. tuberculosis, HUMANS only Environment Environment HUMANS only Environment M. africanum*) (uncertain) Animals (M. bovis) Infects animals Transmission Air-borne route Air-borne route Uncertain: Air-borne NONE Air-borne route to humans Food-borne route Direct contact traumatic Traumatic inoculation endogenous infection Traumatic (M. bovis) inoculation, Habitat: oral cavity, inoculation insect bite? intestines, female genital tract Clinical Tuberculosis (TB): Leprosy=Hansen’s Disseminating Lung disease Abscesses in the skin Broncho-pulmonary picture pulmonary and/or disease skin ulcers Cervical lymphadenitis adjacent to mucosal surfaces (lung abscesses) extra-pulmonary Tuberculoid leprosy Disseminated (cervicofacial actinomycosis), Cutaneous infections (disseminated: kidneys, Lepromatous leprosy infection in the lungs (pulmonary) or such as: mycetoma, bones, spleen, meninges) Skin infections in the abdominal cavity lymphocutaneous (peritonitis, abscesses in infections, ulcerative appendix and ileocecal lesions, abscesses, regions) cellulitis; Dissemination: brain abscesses Distribution All over the world India, Brazil, Tropical disease All over the world All humans Tropical disease * Africa Indonesia, Africa (e.g. Africa, Asia, (e.g.
    [Show full text]
  • 17110-Disseminated-Nocardiosis-A-Case-Report.Pdf
    Open Access Case Report DOI: 10.7759/cureus.5294 Disseminated Nocardiosis: A Case Report Ines M. Leite 1 , Frederico Trigueiros 1 , André M. Martins 1 , Marina Fonseca 1 , Tiago Marques 2 1. Serviço De Medicina 2, Hospital De Santa Maria, Lisboa, PRT 2. Serviço De Doenças Infecciosas, Hospital De Santa Maria, Lisboa, PRT Corresponding author: Ines M. Leite, [email protected] Abstract Disseminated nocardiosis is a rare infection associated with underlying immunosuppression, and patients usually have some identifiable risk factor affecting cellular immunity. Due to advances in taxonomy and microbiology identification methods, infections by Nocardia species are more frequent, making the discussion of its approach and choice of antibiotherapy increasingly relevant. A 77-year-old man presented to the emergency department with marked pain on the right lower limb, weakness, and upper leg edema. He had been diagnosed with organized cryptogenic pneumonia one year before and was chronically immunosuppressed with methylprednisolone 32 mg/day. Blood cultures isolated Nocardia cyriacigeorgica. Computed tomography revealed a gas collection in the region of the right iliacus muscle with involvement of the gluteal and obturator muscles upwardly and on the supragenicular plane inferiorly. Triple therapy with imipenem, amikacin, and cotrimoxazole was started, and the patient was submitted for emergent surgical decompression, fasciotomy, and drainage due to acute compartment syndrome. The patient had a good outcome and was discharged from the hospital after 30 days of intravenous therapy. This case illustrates the severity of Nocardia infection and highlights the need for a meticulous approach in the diagnosis and treatment of these patients. Categories: Internal Medicine, Infectious Disease Keywords: nocardia, nocardia infection, immunosuppression Introduction In the suborder of Corynebacterineae, three genera have strains that may be pathological to humans, with some characteristics similar to Fungi: Mycobacterium, Corynebacterium, and Nocardia.
    [Show full text]
  • Pediatric Nocardial Brain Abscesses in Acquired Immunodeficiency Syndrome
    C S & lini ID ca A l f R o e l Chotey et al., J AIDS Clin Res 2016, 7:11 s a e Journal of n a r r c DOI: 10.4172/2155-6113.1000628 u h o J ISSN: 2155-6113 AIDS & Clinical Research Case Report Open Access Pediatric Nocardial Brain Abscesses in Acquired Immunodeficiency Syndrome Chotey NA1, Ramdial PK1*, Miles E1, Nargan K2 and Mubaiwa L3 1Department of Anatomical Pathology, National Health Laboratory Service & University of KwaZulu-Natal, Durban, South Africa 2KwaZulu-Natal Research Institute for Tuberculosis and HIV, Durban, KwaZulu-Natal, South Africa 3Paediatrics and Child Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa Abstract Nocardiosis is relatively uncommon in children and adults with acquired immunodeficiency syndrome (AIDS), despite the profound associated cellular immunodeficiency. Acquired most often by inhalation and less commonly by percutaneous inoculation, subsequent hematogenous dissemination may lead to infection of almost any organ, with a particular predilection for the central nervous system. Nocardial brain abscesses are rare. To the best of our knowledge, pediatric Nocardial brain abscesses have not been documented in Human Immunodeficiency Virus (HIV)-infected children in the English-language literature, to date. In reporting two Nocardial brain abscesses in a 9 year old AIDS patient with intermittent seizures, we highlight the difficulty associated with the ante-mortem diagnosis of Nocardial brain abscesses, and the need for cognizance of rare entities occurring in HIV-infected children. Furthermore, we emphasize the pivotal role of the autopsy in finalizing the nature of the cerebral pathology, the cause of the seizures albeit post-mortem, a cause of death and in providing a platform for continued learning in the AIDS era.
    [Show full text]
  • Case Report Widespread Nocardiosis in a Patient with Refractory ANCA-Associated Vasculitides: Relapse Or Mimics? a Case Report and Literature Review
    Int J Clin Exp Med 2019;12(6):7878-7886 www.ijcem.com /ISSN:1940-5901/IJCEM0089770 Case Report Widespread nocardiosis in a patient with refractory ANCA-associated vasculitides: relapse or mimics? A case report and literature review Wo Yao1, Jing Xue2 Departments of 1Allergy, 2Rheumatology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, P.R. China Received December 13, 2018; Accepted April 9, 2019; Epub June 15, 2019; Published June 30, 2019 Abstract: Immunocompromised patients are at high risk of Nocardia, however infection in these patients can also mimic relapsed or refractory autoimmune disease and that make diagnosis difficult. Herein is described a 60-year- old male diagnosed with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) who presented with fever, short of breath, cough, headache, and a subcutaneous mass in his right forearm after 3 months therapy with full-dose oral corticosteroid and intravenous cyclophosphamide. Given that the currently available laboratory tests and associated imaging features are nonspecific, it was quite difficult to differentiate between a recurrence of the patient’s AVV and infection as a complication. The patient was finally diagnosed with systemic nocardiosis base on a subcutaneous abscess puncture fluid culture after 3 weeks of hospitalization. Trimethoprim-sulfamethoxazole (TMP-SMX) was administered while the steroid was tapered, after which the patient’s systemic manifestations grad- ually resolved. A literature review identified 24 cases of nocardiosis as a complication of systemic vasculitis was performed. Male patients with systemic vasculitis (especially AAV or Behcet’s disease) aged ≥ 60 years who were treated with corticosteroid in conjunction with or without immunosuppressant therapy were at high risk of Nocardia infection.
    [Show full text]
  • Mycobacterium Marinum Infection: a Case Report and Review of the Literature
    CONTINUING MEDICAL EDUCATION Mycobacterium marinum Infection: A Case Report and Review of the Literature CPT Ryan P. Johnson, MC, USA; CPT Yang Xia, MC, USA; CPT Sunghun Cho, MC, USA; MAJ Richard F. Burroughs, MC, USA; COL Stephen J. Krivda, MC, USA GOAL To understand Mycobacterium marinum infection to better manage patients with the condition OBJECTIVES Upon completion of this activity, dermatologists and general practitioners should be able to: 1. Identify causes of M marinum infection. 2. Describe methods for diagnosing M marinum infection. 3. Discuss treatment options for M marinum infection. CME Test on page 50. This article has been peer reviewed and approved Einstein College of Medicine is accredited by by Michael Fisher, MD, Professor of Medicine, the ACCME to provide continuing medical edu- Albert Einstein College of Medicine. Review date: cation for physicians. December 2006. Albert Einstein College of Medicine designates This activity has been planned and imple- this educational activity for a maximum of 1 AMA mented in accordance with the Essential Areas PRA Category 1 CreditTM. Physicians should only and Policies of the Accreditation Council for claim credit commensurate with the extent of their Continuing Medical Education through the participation in the activity. joint sponsorship of Albert Einstein College of This activity has been planned and produced in Medicine and Quadrant HealthCom, Inc. Albert accordance with ACCME Essentials. Drs. Johnson, Xia, Cho, Burroughs, and Krivda report no conflict of interest. The authors report no discussion of off-label use. Dr. Fisher reports no conflict of interest. Mycobacterium marinum is a nontuberculous findings, the differential diagnosis, the diagnostic mycobacteria that is often acquired via contact methods, and the various treatment options.
    [Show full text]
  • Infectious Diseases of the Philippines
    INFECTIOUS DISEASES OF THE PHILIPPINES Stephen Berger, MD Infectious Diseases of the Philippines - 2013 edition Infectious Diseases of the Philippines - 2013 edition Stephen Berger, MD Copyright © 2013 by GIDEON Informatics, Inc. All rights reserved. Published by GIDEON Informatics, Inc, Los Angeles, California, USA. www.gideononline.com Cover design by GIDEON Informatics, Inc No part of this book may be reproduced or transmitted in any form or by any means without written permission from the publisher. Contact GIDEON Informatics at [email protected]. ISBN-13: 978-1-61755-582-4 ISBN-10: 1-61755-582-7 Visit http://www.gideononline.com/ebooks/ for the up to date list of GIDEON ebooks. DISCLAIMER: Publisher assumes no liability to patients with respect to the actions of physicians, health care facilities and other users, and is not responsible for any injury, death or damage resulting from the use, misuse or interpretation of information obtained through this book. Therapeutic options listed are limited to published studies and reviews. Therapy should not be undertaken without a thorough assessment of the indications, contraindications and side effects of any prospective drug or intervention. Furthermore, the data for the book are largely derived from incidence and prevalence statistics whose accuracy will vary widely for individual diseases and countries. Changes in endemicity, incidence, and drugs of choice may occur. The list of drugs, infectious diseases and even country names will vary with time. Scope of Content: Disease designations may reflect a specific pathogen (ie, Adenovirus infection), generic pathology (Pneumonia - bacterial) or etiologic grouping (Coltiviruses - Old world). Such classification reflects the clinical approach to disease allocation in the Infectious Diseases Module of the GIDEON web application.
    [Show full text]
  • Non-Commercial Use Only
    Infectious Disease Reports 2014; volume 6:5327 A complicated case Introduction Correspondence: Chad J. Cooper, Department of of an immunocompetent Internal Medicine, Texas Tech University Health patient with disseminated Nocardia species are aerobic, gram positive Sciences Center, 4800 Alberta Ave, El Paso, TX nocardiosis filamentous branching bacteria that have the 79905, USA. potential to cause localized or disseminated Tel. +1.915.543.1009. E-mail: [email protected] Chad J. Cooper, Sarmad Said, infection. Nocardia species are ubiquitous in the environment as saprophytic components in Maryna Popp, Haider Alkhateeb, Key words: nocardia, lung abscess, brain abscess, dust, soil, water, decaying vegetation and stag- Carlos Rodriguez, septic emboli. nant matter.1 Nocardiosis mainly affects Mateo Porres Aguilar, Ogechika Alozie immunocompromised patients, although Contributions: the authors contributed equally. Department of Internal Medicine, Texas rarely immunocompetent individuals could Tech University Health Sciences Center, also be affected. The predominant form of Conflict of interests: the authors declare no El Paso, TX, USA nocardiosis is dependent on the species and potential conflict of interests. the geographical location.2 The majority of nocardiosis cases are caused by the N. aster- Received for publication: 28 January 2014. oides complex and N. brasiliensis. In the tropi- Revision received: 17 February 2014. Accepted for publication: 25 February 2014. Abstract cal climate cutaneous and lymphocutaneous infections caused by N. brasiliensis (myce- This work is licensed under a Creative Commons toma) predominate. In the temperate climate Nocardia species are aerobic, gram positive Attribution NonCommercial 3.0 License (CC BY- zone, pulmonary infections with N. asteroides NC 3.0). filamentous branching bacteria that have the complex will be more prevalent.2 The major potential to cause localized or disseminated risk factor for nocardia infection is being ©Copyright C.J.
    [Show full text]
  • 86A1bedb377096cf412d7e5f593
    Contents Gray..................................................................................... Section: Introduction and Diagnosis 1 Introduction to Skin Biology ̈ 1 2 Dermatologic Diagnosis ̈ 16 3 Other Diagnostic Methods ̈ 39 .....................................................................................Blue Section: Dermatologic Diseases 4 Viral Diseases ̈ 53 5 Bacterial Diseases ̈ 73 6 Fungal Diseases ̈ 106 7 Other Infectious Diseases ̈ 122 8 Sexually Transmitted Diseases ̈ 134 9 HIV Infection and AIDS ̈ 155 10 Allergic Diseases ̈ 166 11 Drug Reactions ̈ 179 12 Dermatitis ̈ 190 13 Collagen–Vascular Disorders ̈ 203 14 Autoimmune Bullous Diseases ̈ 229 15 Purpura and Vasculitis ̈ 245 16 Papulosquamous Disorders ̈ 262 17 Granulomatous and Necrobiotic Disorders ̈ 290 18 Dermatoses Caused by Physical and Chemical Agents ̈ 295 19 Metabolic Diseases ̈ 310 20 Pruritus and Prurigo ̈ 328 21 Genodermatoses ̈ 332 22 Disorders of Pigmentation ̈ 371 23 Melanocytic Tumors ̈ 384 24 Cysts and Epidermal Tumors ̈ 407 25 Adnexal Tumors ̈ 424 26 Soft Tissue Tumors ̈ 438 27 Other Cutaneous Tumors ̈ 465 28 Cutaneous Lymphomas and Leukemia ̈ 471 29 Paraneoplastic Disorders ̈ 485 30 Diseases of the Lips and Oral Mucosa ̈ 489 31 Diseases of the Hairs and Scalp ̈ 495 32 Diseases of the Nails ̈ 518 33 Disorders of Sweat Glands ̈ 528 34 Diseases of Sebaceous Glands ̈ 530 35 Diseases of Subcutaneous Fat ̈ 538 36 Anogenital Diseases ̈ 543 37 Phlebology ̈ 552 38 Occupational Dermatoses ̈ 565 39 Skin Diseases in Different Age Groups ̈ 569 40 Psychodermatology
    [Show full text]
  • Painful Red Nodule on the Right Hand
    THE CLINICAL PICTURE SALVADOR ARIAS-SANTIAGO, MD JO SÉ ANEIROS-FERNÁNDEZ, MD HU SEIN HUSEIN-EL Ahm ED, MD Department of Dermatology, San Cecilio Univer- Department of Pathology, San Cecilio University Department of Dermatology, San Cecilio University sity Hospital, Granada, Spain Hospital, Granada, Spain Hospital, Granada, Spain MARÍA SIERRA GIRÓN-PRIETO, MD LO E POLDO MUÑOZ-MEDINA, PhD R AMÓN NARANJO-SINTES, PhD Department of Dermatology, San Cecilio University Department of Internal Medicine, San Cecilio Department of Dermatology, San Cecilio University Hospital, Granada, Spain University Hospital, Granada, Spain Hospital, Granada, Spain The Clinical Picture Painful red nodule on the right hand FIGURE 1. A red nodule with central ulceration on FIGURE 2. A nodule on the patient’s forearm with the right hand. a sporotrichoid distribution. Locoregional lymph nodes were not palpable. 46-year-old healthy man presents with a 15- A day history of a tender subcutaneous nodule on the dorsum of the right hand that appeared after cleaning his aquarium. He has no fever or systemic symptoms. For 2 weeks he has been taking amoxi- cillin-clavulanate (Augmentin) and metronidazole (Flagyl), but without an adequate response. On physical examination, the nodule is painful and has central ulceration (FIGURE 1). Another two nodules are noted on the forearm, with a sporotri- choid distribution (FIGURE 2). Locoregional lymph nodes are not palpable. Laboratory testing (hemography, biochemis- try panel, coagulation test, and C-reactive protein) are normal. Routine bacterial cultures of blood and wound drainage are repeatedly negative. Histologic FIGURE 3. Histologic testing revealed a mixed infil- study (FIGURE 3) reveals signs of acute and chronic in- trate with lymphocytes, neutrophils, and histiocytes flammation (a mixed infiltrate with lymphocytes, (hematoxylin-eosin, × 40).
    [Show full text]
  • Coexistence of Cutaneous Tuberculosis (Scrofuloderma) and Hanseniasis-A Rare
    DOI: 10.7860/JCDR/2014/7050.4033 Case Report ection Coexistence of Cutaneous Tuberculosis S (Scrofuloderma) and Hanseniasis-A Rare icrobiology icrobiology M Presentation CHANDAN KUMAR DAS1, ASHOKA MAHAPATRA2, MANASI MANASWINI DAS3, DEBASISH SAHOO4, NIRUPAMA CHAYANI5 ABSTRACT Cutaneous tuberculosis, pulmonary tuberculosis and hanseniasis are all caused by different spp. of Mycobacterium, an intracellular pathogen whose development depends on impaired cell mediated immunity. Scrofuloderma is the most common variant of cutaneous tuberculosis, which is characterized by a direct extension of the skin which overlies the infected lymph gland, bone or joint, that breaks down to form an undermined ulcer. We are reporting a rare association of Scrofuloderma (cutaneous tuberculosis) with Hanseniasis (leprosy) in an adult male whose immune status was controversial. Keywords: Co-infection , M. tuberculosis, leprosy CASE REPORT Pus was drained out and it was sent for gram staining, Ziehl Neelsen A 65-year-old man, a farmer by occupation, got admitted to the staining, routine and mycobacterial cultures. Cutaneous biopsy was surgery OPD of S.C.B. Medical College, Cuttack,India with the sent for histopathological studies and blood was sent for routine complaint of a painless discharging ulcer over right inguinal region. tests as well as HIV and VDRL test. Three consecutive sputum The lesion had started as a pea sized papule [Table/Fig-1], that Ziehl Neelsen stainings and X-rays of chest were done for excluding had progressed to a nodule and a pustule, leading to draining pulmonary TB. X-ray of the right thigh was done to detect any bony sinus within a span of 6 months.
    [Show full text]
  • Zoonoses and Communicable Diseases Common to Man and Animals
    ZOONOSES AND COMMUNICABLE DISEASES COMMON TO MAN AND ANIMALS Third Edition Volume I Bacterioses and Mycoses Scientific and Technical Publication No. 580 PAN AMERICAN HEALTH ORGANIZATION Pan American Sanitary Bureau, Regional Office of the WORLD HEALTH ORGANIZATION 525 Twenty-third Street, N.W. Washington, D.C. 20037 U.S.A. 2001 Also published in Spanish (2001) with the title: Zoonosis y enfermedades transmisibles comunes al hombre a los animales ISBN 92 75 31580 9 PAHO Cataloguing-in-Publication Pan American Health Organization Zoonoses and communicable diseases common to man and animals 3rd ed. Washington, D.C.: PAHO, © 2001. 3 vol.—(Scientific and Technical Publication No. 580) ISBN 92 75 11580 X I. Title II. Series 1. ZOONOSES 2. BACTERIAL INFECTIONS AND MYCOSES 3. COMMUNICABLE DISEASE CONTROL 4. FOOD CONTAMINATION 5. PUBLIC HEALTH VETERINARY 6. DISEASE RESERVOIRS NLM WC950.P187 2001 En The Pan American Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. Applications and inquiries should be addressed to the Publications Program, Pan American Health Organization, Washington, D.C., U.S.A., which will be glad to provide the latest information on any changes made to the text, plans for new editions, and reprints and translations already available. ©Pan American Health Organization, 2001 Publications of the Pan American Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights are reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the Pan American Health Organization concerning the status of any country, ter- ritory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
    [Show full text]