DOCSLIB.ORG

Unusual Presentation of Rhinoscleroma Dehadaray A1, Patel M2, Kaushik M3, Agrawal D4

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Unusual Presentation of Rhinoscleroma Dehadaray A1, Patel M2, Kaushik M3, Agrawal D4 Case Report Unusual presentation of Rhinoscleroma Dehadaray A1, Patel M2, Kaushik M3, Agrawal D4 ABSTRACT Rhinoscleroma or respiratory scleroma is a chronic, slowly progressive, inflammatory disease of the upper respiratory tract. Here we present a 35 year old male presenting with unilateral orbital complaints and non- specific findings on radiological examination, diagnosed only by histopathology as Rhinoscleroma. Due to the low incidence of this disease and its rare presentation in this case, diagnosis was a challenge, but outcome was successful. Keywords- Rhinoscleroma, Orbit 1 MS ENT, Professor, 2 MS DNB ENT, Assistant Professor, 3 MS ENT, Professor and Head, 4 PG student, Department of ENT and HNS, Bharati Vidyapeeth Deemed University Medical College, Pune-411043. Corresponding Author: Dr. Monika Patel, Assistant Professor, Bharati Vidyapeeth Deemed University Medical College, Pune, Maharashtra. Mob: +919028738326 Email: [email protected] 32 The Indian Practitioner q Vol.70 No.11. November 2017 Case Report Introduction hinoscleroma is a chronic progressive, specific granulomatous infectious disease affecting the Rupper respiratory tract associated with Klebsiella rhinoscleromatis infection. It is endemic in Central and South America, Central Africa, Middle East, parts of Europe, India, and Indonesia [1]. It most commonly af- fects the nose [2]. Cases of Rhinoscleroma with invasion into the or- bits are rare, with very few cases reported in litera- ture. Ophthalmologists should also be aware of the Fig 1a Fig 1b disease and the problems in its management. We pres- ent a case of Rhinoscleroma which posed difficulty in with reduced movements in all directions, and vision diagnosing due to its clinical resemblance with other of 6/18. Anterior rhinoscopy revealed mucopurulent chronic granulomatous conditions, neoplastic diseas- discharge in the right nasal cavity. Rest of the cranial es and its unusual site of presentation. nerves were normal.(Fig. 1a) Case Report Microbiological examination of nasal discharge re- vealed Coagulase negative Staphylococcus, but no AFB A 35 year old male presented to ENT OPD with or fungus. Routine blood investigations were normal; chief complaints of excessive watering, redness and with cANCA negative (2.39 RU/ml). reduced movements of right eye since 4-5 months. He did not complain of nasal obstruction or epi- HRCT PNS and Orbit with contrast showed bilat- staxis. Patient was treated for pulmonary tuberculo- eral pansinusitis with destruction of medial wall of sis 3 years back. On examination, right eye propto- right maxillary sinus and a soft tissue mass in the right sis (4mm) and conjunctival congestion were present retrobulbar region, involving the inferior and medial recti muscles, suggestive of pseudo- tumor. (Fig. 2a, b, c, d, e) Biopsy taken from the hyper- trophied mucosa of right maxillary sinus showed polyps with inflam- matory cell infiltrate, suggestive of inflammatory polyp. Patient was given various intravenous antibiot- ics, like cefotaxime, metronidazole, piperacillin+tazobactam, gentamycin and levofloxacin during the course of Fig 2c hospitalisation but showed no symp- Fig 2a tomatic improvement. Excisional biopsy of the right peri-orbital mass Fig 2b Fig 2d Fig 2e The Indian Practitioner q Vol.70 No.11. November 2017 33 Case Report was done by lateral rhinotomy ap- serious complications like men- proach, where a soft, greyish-white ingitis and blindness by pressure mass was seen extending up to the on the optic nerve. Infection and orbital apex and was adherent to the haemorrhage are usually the cause nasolacrimal duct. Biopsy showed Mikuliez cell of death in fatal cases of this scle- chronic inflammatory cells, Russell rotic process. bodies and Mikulicz cells with no Russell body The first case of orbital involve- evidence of fungus or malignancy, ment by rhinoscleroma was re- using PAS and Silver methena- ported by Hara [5]. He postulated mine stains (Fig. 3). A diagnosis that the route of extension was of Rhinoscleroma was made and either through the lamina papy- patient was started on oral chlor- racea or by way of the nasolacri- amphenicol and prednisolone and mal tract into the orbit. Shaw and then septran and doxycycline. On 6 Martin [4] reported a case in their week follow up, patient’s right eye series which showed invasion of movements have improved, with both orbits and the skull base with no watering of eyes and reduced Fig 3 pressure atrophy of adjacent bone conjunctival congestion. (Fig. 1b) leading to proptosis and blindness. In our case naso- lacrimal duct appeared normal, hence the exact route Discussion of spread could not be found; although lamina papy- The route of transmission of this disease is not racea was found to be eroded intraoperatively; it could known as the organisms cannot survive outside, and have spread via the sinuses, as shown by computer- humans are the only identified host. Environmental ised axial tomography scan. Hsiung-Hsiang reported factors like overcrowding, poor hygiene and malnu- a similar case in 1958 as cited by Lubin JR in 1981[6]. trition is commonly associated with the acquisition of The mode of extension in that case was also through this disease. Rhinoscleroma is a diagnostic challenge, the sinuses. The possibility of intracranial spread of as it is an uncommon disease. infection is emphasised in these cases because of dif- The diagnosis can be established on the basis of his- ficulty in eradicating the organism since they are topathological, bacteriological and genetic examina- present within the macrophages are protected from tions. The disease can be divided into three sequential the host’s immune system, and hence remain viable but overlapping morphological stages: catarrhal or ex- even through prolonged courses of antibiotic therapy. udative, granulomatous or proliferative and sclerotic Hence prompt suspicion and treatment is required or cicatrical phase. During the catarrhal stage, there is when rare sites are involved. inflammation of the nasal mucosa giving rise to per- The presenting features and imaging tech- sistent rhinitis, mucopurulent discharge and atrophic niques usually provide a presumptive diagnosis of changes start occurring. In the second stage, inflamed Rhinoscleroma but histopathological examination mucosa coalesces to form granulomas. These granu- remains the mainstay for the definitive diagnosis. lomas may infiltrate other portions of the airway and Catarrhal stage shows a nonspecific sub-epithelial in- [3] cause scarring, giving rise to the cicatrical stage . In filtrate of polymorphonuclear leukocytes with granu- many cases of rhinoscleroma, the presence of all three lation tissue. The diagnostic histological changes of stages can be found at the time of diagnosis. rhinoscleroma are only seen during the proliferative Cases of rhinoscleroma with invasion into the or- phase, i.e. lymphocytes, plasma cells, Russell bodies bits are rare. The lesion usually starts as small granu- and the pathognomonic large Mikulicz cells; foamy lomas, which eventually coalesce to form obstructing macrophages with numerous cytoplasmic vacuoles masses and cause respiratory symptoms according containing viable and non-viable Klebsiella bacilli. to the site involved. Infiltration upwards through the Mikulicz cells are sparse or absent in the initial ca- sinuses and lacrimal apparatus is unusual but is be- tarrhal and final sclerotic stages. In the sclerotic phase, ing reported with increasing frequency [4]. It does not extensive fibrosis and few inflammatory cells are seen invade bone itself, but continuous progression of the [7]. The Mikulicz cells [8] are characteristic of rhinoscle- process causes pressure atrophy of facial bones and roma but not pathognomonic. They are also seen in may invade the base of the skull and orbits, causing leprosy and bubonic plague and are thought to rep- 34 The Indian Practitioner q Vol.70 No.11. November 2017 Case Report resent the cells’ nonspecific response to toxins pro- challenging when Mikulicz cells are deficient. Our duced by the causative organism. Large numbers of case serves to highlight that rhinoscleroma can pres- Klebsiella rhinoscleromatis can sometimes be found ent with only orbital manifestations, and we hope to within the Mikulicz cells. They stain faintly with hae- raise awareness of this disease among physicians. matoxylin and eosin, but may require Gram’s stain or Giemsa to be seen. Although no bacilli were seen in References our specimen with special stains. 1. Kim NR, Han J, Kwon TY. Nasal rhinoscleroma in a nonen- demic area: A case report. J Korean Med Sci 2003;18:455-8. Treatment is challenging, as it is difficult to eradi- 2. Bailhache A, Dehesdin D, Francois A, Marie J P, Choussy cate the disease and recurrences are common. K. O.Rhinoscleroma of the sinuses. Rhinology 2008; 46: 338-341. rhinoscleromatis is an intracellular bacterium, hence 3. Stiernberg CM, Clark WD: Rhinoscleroma--a diagnostic Fluoroquinolones are recommended for their excellent challenge. Laryngoscope. 1983; 93(7): 866–70. activity against Gram negative bacilli, intracellular ef- 4. Shaw HJ, Martin H. Rhinoscleroma: A clinical perspective. J [9] ficacy and low toxicity profile . Recommended treat- Laryngol Otol 1961; 75: 1011-39. ment regime includes a combination of ciprofloxacin 5. Hara HJ. Scleroma. Laryngoscope 1957; 67: 695-708. and doxycycline for at least six months. Combination 6. Lubin JR, Jallow SE, Wilson WR, Grove AS, Albert DM. therapy is preferred due to the high relapse rates of Rhinoscleroma with exophthalmos: a case report. British the disease. Surgical debridement could also be con- Journal of Ophthalmology. 1981; 65(1):14-17. sidered if there is significant airway obstruction or 7. Zhong Q, Guo W, Chen X, Ni X, Fang J, Huang Z, Zhang cosmetic deformity S. Rhinoscleroma: a retrospective study of pathologic and clinical features. J Otolaryngol Head Neck Surg 2011; 40: 167- Conclusion 74. Rhinoscleroma is a diagnostic and therapeutic chal- 8. Mikulicz J. Ueber das Rhinosclerom. Arch Klin Chir 1877; 20: lenge due to its chronic course, need for prolonged 485-8. treatment and repeated relapses. Early diagnosis and 9. de Pontual L, Ovetchkine P, Rodriguez D, et al.
Load more

Recommended publications
  • Diagnostic Code Descriptions (ICD9)
    INFECTIONS AND PARASITIC DISEASES INTESTINAL AND INFECTIOUS DISEASES (001 – 009.3) 001 CHOLERA 001.0 DUE TO VIBRIO CHOLERAE 001.1 DUE TO VIBRIO CHOLERAE EL TOR 001.9 UNSPECIFIED 002 TYPHOID AND PARATYPHOID FEVERS 002.0 TYPHOID FEVER 002.1 PARATYPHOID FEVER 'A' 002.2 PARATYPHOID FEVER 'B' 002.3 PARATYPHOID FEVER 'C' 002.9 PARATYPHOID FEVER, UNSPECIFIED 003 OTHER SALMONELLA INFECTIONS 003.0 SALMONELLA GASTROENTERITIS 003.1 SALMONELLA SEPTICAEMIA 003.2 LOCALIZED SALMONELLA INFECTIONS 003.8 OTHER 003.9 UNSPECIFIED 004 SHIGELLOSIS 004.0 SHIGELLA DYSENTERIAE 004.1 SHIGELLA FLEXNERI 004.2 SHIGELLA BOYDII 004.3 SHIGELLA SONNEI 004.8 OTHER 004.9 UNSPECIFIED 005 OTHER FOOD POISONING (BACTERIAL) 005.0 STAPHYLOCOCCAL FOOD POISONING 005.1 BOTULISM 005.2 FOOD POISONING DUE TO CLOSTRIDIUM PERFRINGENS (CL.WELCHII) 005.3 FOOD POISONING DUE TO OTHER CLOSTRIDIA 005.4 FOOD POISONING DUE TO VIBRIO PARAHAEMOLYTICUS 005.8 OTHER BACTERIAL FOOD POISONING 005.9 FOOD POISONING, UNSPECIFIED 006 AMOEBIASIS 006.0 ACUTE AMOEBIC DYSENTERY WITHOUT MENTION OF ABSCESS 006.1 CHRONIC INTESTINAL AMOEBIASIS WITHOUT MENTION OF ABSCESS 006.2 AMOEBIC NONDYSENTERIC COLITIS 006.3 AMOEBIC LIVER ABSCESS 006.4 AMOEBIC LUNG ABSCESS 006.5 AMOEBIC BRAIN ABSCESS 006.6 AMOEBIC SKIN ULCERATION 006.8 AMOEBIC INFECTION OF OTHER SITES 006.9 AMOEBIASIS, UNSPECIFIED 007 OTHER PROTOZOAL INTESTINAL DISEASES 007.0 BALANTIDIASIS 007.1 GIARDIASIS 007.2 COCCIDIOSIS 007.3 INTESTINAL TRICHOMONIASIS 007.8 OTHER PROTOZOAL INTESTINAL DISEASES 007.9 UNSPECIFIED 008 INTESTINAL INFECTIONS DUE TO OTHER ORGANISMS
    [Show full text]
  • WO 2014/134709 Al 12 September 2014 (12.09.2014) P O P C T
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2014/134709 Al 12 September 2014 (12.09.2014) P O P C T (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61K 31/05 (2006.01) A61P 31/02 (2006.01) kind of national protection available): AE, AG, AL, AM, AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, (21) International Application Number: BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, PCT/CA20 14/000 174 DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, (22) International Filing Date: HN, HR, HU, ID, IL, IN, IR, IS, JP, KE, KG, KN, KP, KR, 4 March 2014 (04.03.2014) KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, (25) Filing Language: English OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, (26) Publication Language: English SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, (30) Priority Data: ZW. 13/790,91 1 8 March 2013 (08.03.2013) US (84) Designated States (unless otherwise indicated, for every (71) Applicant: LABORATOIRE M2 [CA/CA]; 4005-A, rue kind of regional protection available): ARIPO (BW, GH, de la Garlock, Sherbrooke, Quebec J1L 1W9 (CA). GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, SZ, TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, TJ, (72) Inventors: LEMIRE, Gaetan; 6505, rue de la fougere, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, DK, Sherbrooke, Quebec JIN 3W3 (CA).
    [Show full text]
  • Rhinoscleroma in an Immigrant from Egypt: a Case Report
    387 BRIEF COMMUNICATION Rhinoscleroma in an Immigrant From Egypt: A Case Report Edgardo Bonacina, MD,∗ Leonardo Chianura, MD, DTM&H,† Maurizio Sberna, MD,‡ Giuseppe Ortisi, MD,§ Giovanna Gelosa, MD,|| Alberto Citterio, MD,‡ Giovanni Gesu, MD,§ and Massimo Puoti, MD† Downloaded from https://academic.oup.com/jtm/article/19/6/387/1795562 by guest on 23 September 2021 Departments of ∗Pathological Anatomy; †Infectious Diseases; ‡Neuroradiology; §Microbiology, and; ||Otorinolaringoiatry, Niguarda Ca` Granda Hospital, Milano, Italy DOI: 10.1111/j.1708-8305.2012.00659.x Rhinoscleroma is a chronic indolent granulomatous infection of the nose and the upper respiratory tract caused by Klebsiella rhinoscleromatis; this condition is endemic to many regions of the world including North Africa. We present a case of rhinoscleroma in a 51-year-old Egyptian immigrant with 1-month history of epistaxis. We would postulate that with increased travel from areas where rhinoscleroma is endemic to other non-endemic areas, diagnosis of this condition will become more common. hough rarely observed, rhinoscleroma has to be nasal fossae and ethmoid sinuses with complete bony T taken into consideration in travelers returning destruction of bilateral nasal turbinates (Figure 1). with ear, nose, and throat presentations, particularly Endoscopic biopsy was performed under local anesthe- after traveling to developing countries or regions where sia. Histopathologic examination revealed numerous this condition is endemic.1,2 foamy macrophages (Mikulicz cells) containing bacteria (Figure 2); no fungal hyphae were found.3 Staphylococcus Case Report aureus and Klebsiella rhinoscleromatis were isolated by culture of the tissue biopsy. A diagnosis of rhinoscle- A 51-year-old Egyptian male immigrant presented on roma was made.
    [Show full text]
  • Rhinoscleroma
    Eur J Rhinol Allergy 2020; 3(2): 53-4 Image of Interest Rhinoscleroma Seepana Ramesh , Satvinder Singh Bakshi Department of ENT and Head & Neck Surgery, AIIMS Mangalagiri, Guntur, India A 22-year-old man presented with a 6-month history of bilateral nasal obstruction and nasal discharge that was associated with intermittent mild episodes of blood-tinged nasal discharge since 2 months. On examination, a pinkish irregular mass was observed in both the nostrils with complete obstruction of the right nostril. Computed tomography revealed a non-en- hanced homogeneous mass in the left frontal, ethmoid, and maxillary sinuses that extended to both the nasal cavities (Figure 1). Histopathology revealed fragments of granulation tissue with inflammatory cells comprising several foamy to vacuolated histiocytes and plasma cells, suggestive of rhinoscleroma (Figure 2). The patient underwent surgical debridement of the mass and received ciprofloxacin 500 mg twice daily for 6 weeks. He was asymptomatic at 4 months of follow-up. Rhinoscleroma is a chronic granulomatous disease affecting the region between the nose and the subglottis. It is caused by the gram-negative bacillus Klebsiella rhinoscleromatis and spreads by inhalation of contaminated droplets (1). The symptoms depend on the stage of the disease. In the atrophic stage, patients present with fetid nasal dis- charge and crusting, followed by the granulomatous stage, wherein patients develop epistaxis and nasal deformity, secondary to the destruction of the nasal cartilages (1). The final stage is the sclerotic stage, in which patients present with thick dense scars in the nose and upper airway, leading to complete nasal obstruction and even stridor due to laryngeal stenosis (1).
    [Show full text]
  • A Novel Murine Model of Rhinoscleroma Identifies Mikulicz Cells, the Disease Signature, As IL-10 Dependent Derivatives of Inflammatory Monocytes
    OPEN TRANSPARENT Research Article ACCESS PROCESS IL-10 controls maturation of Mikulicz cells A novel murine model of rhinoscleroma identifies Mikulicz cells, the disease signature, as IL-10 dependent derivatives of inflammatory monocytes Cindy Fevre1y, Ana S. Almeida2,3y, Solenne Taront2,3, Thierry Pedron2,3, Michel Huerre4, Marie-Christine Prevost5, Aure´lie Kieusseian6,7, Ana Cumano6,7, Sylvain Brisse1, Philippe J. Sansonetti2,3,8,Re´gis Tournebize2,3* Keywords: IL-10; inflammatory Rhinoscleroma is a human specific chronic disease characterized by the monocytes; Klebsiella; Mikulicz cell; formation of granuloma in the airways, caused by the bacterium Klebsiella rhinoscleroma pneumoniae subspecies rhinoscleromatis, a species very closely related to K. pneumoniae subspecies pneumoniae. It is characterized by the appearance of specific foamy macrophages called Mikulicz cells. However, very little is known DOI 10.1002/emmm.201202023 about the pathophysiological processes underlying rhinoscleroma. Herein, we Received September 14, 2012 characterized a murine model recapitulating the formation of Mikulicz cells in Revised January 31, 2013 lungs and identified them as atypical inflammatory monocytes specifically Accepted February 14, 2013 recruited from the bone marrow upon K. rhinoscleromatis infection in a CCR2- independent manner. While K. pneumoniae and K. rhinoscleromatis infections induced a classical inflammatory reaction, K. rhinoscleromatis infection was characterized by a strong production of IL-10 concomitant to the appearance of Mikulicz cells. Strikingly, in the absence of IL-10, very few Mikulicz cells were observed, confirming a crucial role of IL-10 in the establishment of a proper environment leading to the maturation of these atypical monocytes. This is the first characterization of the environment leading to Mikulicz cells maturation and their identification as inflammatory monocytes.
    [Show full text]
  • Lecture 1 ― INTRODUCTION INTO MICROBIOLOGY
    МИНИСТЕРСТВО ЗДРАВООХРАНЕНИЯ РЕСПУБЛИКИ БЕЛАРУСЬ УЧРЕЖДЕНИЕ ОБРАЗОВАНИЯ «ГОМЕЛЬСКИЙ ГОСУДАРСТВЕННЫЙ МЕДИЦИНСКИЙ УНИВЕРСИТЕТ» Кафедра микробиологии, вирусологии и иммунологии А. И. КОЗЛОВА, Д. В. ТАПАЛЬСКИЙ МИКРОБИОЛОГИЯ, ВИРУСОЛОГИЯ И ИММУНОЛОГИЯ Учебно-методическое пособие для студентов 2 и 3 курсов факультета по подготовке специалистов для зарубежных стран медицинских вузов MICROBIOLOGY, VIROLOGY AND IMMUNOLOGY Teaching workbook for 2 and 3 year students of the Faculty on preparation of experts for foreign countries of medical higher educational institutions Гомель ГомГМУ 2015 УДК 579+578+612.017.1(072)=111 ББК 28.4+28.3+28.073(2Англ)я73 К 59 Рецензенты: доктор медицинских наук, профессор, заведующий кафедрой клинической микробиологии Витебского государственного ордена Дружбы народов медицинского университета И. И. Генералов; кандидат медицинских наук, доцент, доцент кафедры эпидемиологии и микробиологии Белорусской медицинской академии последипломного образования О. В. Тонко Козлова, А. И. К 59 Микробиология, вирусология и иммунология: учеб.-метод. пособие для студентов 2 и 3 курсов факультета по подготовке специалистов для зарубежных стран медицинских вузов = Microbiology, virology and immunology: teaching workbook for 2 and 3 year students of the Faculty on preparation of experts for foreign countries of medical higher educa- tional institutions / А. И. Козлова, Д. В. Тапальский. — Гомель: Гом- ГМУ, 2015. — 240 с. ISBN 978-985-506-698-0 В учебно-методическом пособии представлены тезисы лекций по микробиоло- гии, вирусологии и иммунологии, рассмотрены вопросы морфологии, физиологии и генетики микроорганизмов, приведены сведения об общих механизмах функциони- рования системы иммунитета и современных иммунологических методах диагности- ки инфекционных и неинфекционных заболеваний. Приведены сведения об этиоло- гии, патогенезе, микробиологической диагностике и профилактике основных бакте- риальных и вирусных инфекционных заболеваний человека. Может быть использовано для закрепления материала, изученного в курсе микро- биологии, вирусологии, иммунологии.
    [Show full text]
  • Diagnosis One To
    Diagnosis One-to-One I9cm I9 Long Desc I10cm I10 Long Desc 0010 Cholera due to vibrio cholerae A000 Cholera due to Vibrio cholerae 01, biovar cholerae 0011 Cholera due to vibrio cholerae el tor A001 Cholera due to Vibrio cholerae 01, biovar eltor 0019 Cholera, unspecified A009 Cholera, unspecified 0021 Paratyphoid fever A A011 Paratyphoid fever A 0022 Paratyphoid fever B A012 Paratyphoid fever B 0023 Paratyphoid fever C A013 Paratyphoid fever C 0029 Paratyphoid fever, unspecified A014 Paratyphoid fever, unspecified 0030 Salmonella gastroenteritis A020 Salmonella enteritis 0031 Salmonella septicemia A021 Salmonella sepsis 00320 Localized salmonella infection, unspecified A0220 Localized salmonella infection, unspecified 00321 Salmonella meningitis A0221 Salmonella meningitis 00322 Salmonella pneumonia A0222 Salmonella pneumonia 00323 Salmonella arthritis A0223 Salmonella arthritis 00324 Salmonella osteomyelitis A0224 Salmonella osteomyelitis 0038 Other specified salmonella infections A028 Other specified salmonella infections 0039 Salmonella infection, unspecified A029 Salmonella infection, unspecified 0040 Shigella dysenteriae A030 Shigellosis due to Shigella dysenteriae 0041 Shigella flexneri A031 Shigellosis due to Shigella flexneri 0042 Shigella boydii A032 Shigellosis due to Shigella boydii 0043 Shigella sonnei A033 Shigellosis due to Shigella sonnei 0048 Other specified shigella infections A038 Other shigellosis 0049 Shigellosis, unspecified A039 Shigellosis, unspecified 0050 Staphylococcal food poisoning A050 Foodborne staphylococcal
    [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]
  • PCR-Based Identification of Klebsiella Pneumoniae Subsp
    PCR-based identification of Klebsiella pneumoniae subsp. rhinoscleromatis, the agent of rhinoscleroma. Cindy Fevre, Virginie Passet, Alexis Deletoile, Valérie Barbe, Lionel Frangeul, Ana Almeida, Philippe Sansonetti, Régis Tournebize, Sylvain Brisse To cite this version: Cindy Fevre, Virginie Passet, Alexis Deletoile, Valérie Barbe, Lionel Frangeul, et al.. PCR-based identification of Klebsiella pneumoniae subsp. rhinoscleromatis, the agent of rhinoscleroma.. PLoS Neglected Tropical Diseases, Public Library of Science, 2011, 5 (5), pp.e1052. 10.1371/jour- nal.pntd.0001052. inserm-00691408 HAL Id: inserm-00691408 https://www.hal.inserm.fr/inserm-00691408 Submitted on 26 Apr 2012 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. PCR-Based Identification of Klebsiella pneumoniae subsp. rhinoscleromatis, the Agent of Rhinoscleroma Cindy Fevre1, Virginie Passet1, Alexis Deletoile1, Vale´ rie Barbe2, Lionel Frangeul3, Ana S. Almeida4,5, Philippe Sansonetti4,5,Re´gis Tournebize4,5, Sylvain Brisse1* 1 Institut Pasteur, Genotyping of Pathogens and Public Health, Paris, France, 2 CEA-IG, Genoscope, Evry, France, 3 Institut Pasteur, Inte´gration et Analyse Ge´nomique, Paris, France, 4 Institut Pasteur, Unite´ de Pathoge´nie Microbienne Mole´culaire, Paris, France, 5 Unite´ INSERM U786, Institut Pasteur, Paris, France Abstract Rhinoscleroma is a chronic granulomatous infection of the upper airways caused by the bacterium Klebsiella pneumoniae subsp.
    [Show full text]
  • Infectious Diseases of the Dominican Republic
    INFECTIOUS DISEASES OF THE DOMINICAN REPUBLIC Stephen Berger, MD 2018 Edition Infectious Diseases of the Dominican Republic Copyright Infectious Diseases of the Dominican Republic - 2018 edition Stephen Berger, MD Copyright © 2018 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: 978-1-4988-1759-2 Visit 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]
  • Report for the Hemodialysis Vascular Access: Standardized Fistula Rate
    ESRD Quality Measure Development, Maintenance, and Support Contract Number HHSM-500-2013-13017I Report for the Hemodialysis Vascular Access: Standardized Fistula Rate (SFR) NQF #2977 Submitted to CMS by the University of Michigan Kidney Epidemiology and Cost Center June 21, 2017 Produced by UM-KECC Submitted: 6.21.2017 1 ESRD Quality Measure Development, Maintenance, and Support Contract Number HHSM-500-2013-13017I Table of Contents Introduction .................................................................................................................................................. 3 Methods ........................................................................................................................................................ 3 Overview ................................................................................................................................................... 3 Data Sources ............................................................................................................................................. 4 Outcome Definition .................................................................................................................................. 4 Denominator Definition ............................................................................................................................ 5 Risk Adjustment ........................................................................................................................................ 5 Choosing Adjustment Factors
    [Show full text]
  • Meleshko Tamara, Liashyna Kateryna, Bati Viktoriya, Boyko Nadiya
    Meleshko Tamara, Liashyna Kateryna, Bati Viktoriya, Boyko Nadiya BACTERIOLOGY & MYCOLOGY for 2nd year students Faculty of Medicine UDК 579.61 Introduction Study Guide «BACTERIOLOGY & MYCOLOGY» for self-study and practical training of course «Mi- Medical Microbiology is one of the fundamental disciplines of modern science because its studying is crobiology, Virology and Immunology» for foreign students of 2nd year Medical Faculty. Meleshko Tamara, the basis of students’ knowledge of biological and medical specialities. Liashyna Kateryna, Bati Viktoriia, Boyko Nadiya. Infectious diseases - are group of diseases caused by different types of infectious agents, characterized by Uzhhorod: SHEE «Uzhhorod National University» - 2016. diverse mechanisms of infection transmission and differences in pathogenesis, which must be systematically and efficiently learned during the course of microbiology, virology and immunology for students of medical, УДК 579.61 stomatological, biological and pharmaceutical specialities at universities of Ukraine and the world. Навчальний посібник «БАКТЕРІОЛОГІЯ ТА МІКОЛОГІЯ» для самостійної роботи та практичних Over the past decade is marked a sharp increase of infectious diseases incidence caused by bacterial, занять з курсу «Мікробіологія, вірусологія та імунологія» для іноземних студентів 2 курсу медичного viral and fungal agents with different ways of transmission. To stop this is one of the primary problems of the факультету. Мелешко Т., Ляшина К., Баті В., Бойко Н. world health system. Ужгород: ДВНЗ «Ужгородський національний університет» - 2016. During the lessons students have opportunity to get acquainted with methods of infectious diseases diagnostics, particularly with the production of ELISA. Attention is paid to the definition of diagnostic markers Manual material submitted according to the requirements of typical teaching program of microbiology of bacterial, fungal and other infectious agents.
    [Show full text]