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Infectious Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Susanna J. Dunachie, Hanif Esmail, Ruth Corrigan, Maria Dudareva
Symptoms develop in about one-third following primary infection. Painful blistering and ulceration are typical, which may cause dysuria depending on location of lesion. This may also be associated with systemic symptoms of fever and myalgia. Lymphadenitis is common in primary infection.
Infection and immunology
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
5.25. Toxoplasmosis isa bacterial disease.a cause of lymphadenitis.usually lethal in man.due to an organism that can cross the placental barrier.resistant to treatment with sulphonamides.
Head and neck
Published in Spencer W. Beasley, John Hutson, Mark Stringer, Sebastian K. King, Warwick J. Teague, Paediatric Surgical Diagnosis, 2018
Spencer W. Beasley, John Hutson, Mark Stringer, Sebastian K. King, Warwick J. Teague
Acute lymphadenitis may progress to abscess formation in a few days. The presence of a fluctuant swelling suggests abscess formation, but when the cavity is beneath the investing cervical fascia, even a large abscess may be tense and not obviously fluctuant. Non-tuberculous mycobacterial lymphadenitis has a longer history with low-grade inflammatory signs, and after about 4-6 weeks produces a purple discoloration of the skin as the subcutaneous portion of the collar-stud abscess points. Untreated, a chronic discharging sinus will develop. Lymphatic malformations involving the neck or side of the face may present as non-tender swellings at birth. In the absence of haemorrhage into the cysts, they transilluminate. They may enlarge rapidly from both infection and haemorrhage. Surgery at birth is not necessary unless the lesion is enormous and causes obstruction of the airway, in which situation urgent provision of an airway may be required. Lymphatic malformations are often treated by interventional radiology.
Clinical manifestations, treatment and outcomes of patients infected with Mycobacterium haemophilum with a focus on immune reconstitution inflammatory syndrome: a retrospective multi-site study
Published in Infectious Diseases, 2023
Said El Zein, Omar M. Abu Saleh, Nancy L. Wengenack, John W. Wilson
Immunosuppressive therapy was discontinued or reduced in 14 out of 22 patients. The median duration between symptom onset and initiation of effective antimicrobials was 133 days (IQR 80 - 193 days). Two patients had isolated lymphadenitis with no evidence of infection elsewhere. One was immunocompetent (case 25), while the other one was on methotrexate for rheumatoid arthritis (case 21). They were treated with lymph node resection without concomitant antimicrobial therapy and had no evidence of infection recurrence. The remainder twenty-four patients received a multidrug, macrolide-based regimen, containing at least one companion drug with in vitro or expected activity against M. haemophilum. Fluoroquinolones were the most commonly used companion drugs (20 patients), followed by rifampin or rifabutin (18 patients). Only two patients received TMP-SMX as part of their multidrug regimen, although, 100% of the tested isolates were susceptible to this agent in vitro. One patient (case 7) developed multiple intolerances to antibiotics during therapy and received a short course of linezolid. The median duration of antibiotic therapy was 363 days (IQR 202–458 days). Surgical debridement of the skin lesions or affected joints was performed in 15 patients in conjunction with antibiotic therapy. The median duration between onset of symptoms and the first surgical debridement was 153 days (IQR 59–190 days), and patients underwent a median of two surgeries each (range 1–6 surgeries).
Orbital Mass as the Only Presenting Sign with Overlapping Features of Lupus Erythematosus Panniculitis and Subcutaneous Panniculitis-Like T-Cell Lymphoma
Published in Ocular Immunology and Inflammation, 2023
Mehmet Serhat Mangan, Ahmet Murat Sarici, Ozben Yalcin, Demet Aydin, Gulcin Yegen, Emire Seyahi
Panniculitis-like T-cell infiltration and the presence of accompanying atypical lymphoid cells are in favor of lymphoma.10 SPTCL typically has a dominance of CD8+ lymphocytes.10 In our case, 75% of T lymphocytes were CD4+, and 25% of T lymphocytes were CD8+, but also included B-lymphocyte aggregates (CD20+, Bcl2+). Distinct adipocyte rimming is in favor of lymphoma, but not specific to it.11,12 Even though the presence of atypical lymphocytes contravenes with LEP,7 the infiltrating cells in our case were mainly small lymphocytes with occasional atypical lymphocytes. The presence of plasma cells and CD20 + B-cells, as in our patient, is also in favor of LEP.3,12 Also, fat necrosis, commonly observed in SPTCL, was not present. The T-cell receptor clonality test is helpful in the distinction of SPTCL and benign panniculitis.1 We did not observe clonal T lymphocyte proliferation in our case. Bosisio et al. reported that granulomas containing areas of necrosis and histiocytic infiltration can be encountered in cases of SPTCL and LEP.3,8 We also observed abscess-forming necrotizing granulomatous lymphadenitis in the lymph node biopsy of our case. This mandated differential diagnosis with tuberculosis but the PPD test of our patient was negative.
Chapter 2: Transmission and pathogenesis of tuberculosis
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2022
Richard Long, Maziar Divangahi, Kevin Schwartzman
At 4-12 months after infection, early disease manifestations include complicated lymph node disease (airway compression, expansile caseating pneumonia, infiltration of adjacent anatomic structures), pleural disease (most commonly a lymphocyte-predominant exudative effusion) and peripheral lymphadenitis (usually in the cervical lymph nodes).61 In immunocompetent children and adolescents, early disease is more likely to manifest as intrathoracic adenopathy and in adults as a unilateral pleural effusion. In severely immunocompromised people of any age (e.g., those with advanced HIV or AIDS), early disease may manifest as intrathoracic adenopathy.66,67 Newly infected children who are 10 years of age or older (pubertal) or adolescents, may develop adult-type pulmonary disease (see below) or other types of extrapulmonary TB (for example bone and joint TB) within the first 8-24 months of infection.61,68