1,033 results on '"Lymphadenitis etiology"'
Search Results
2. The spectrum of cytological findings in patients with BCG lymphadenitis: A series of 13 cases.
- Author
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Vaghasiya VL, Nasit JG, Rupavatiya B, Bambhaniya DD, and Kaka R
- Subjects
- Humans, Infant, Biopsy, Fine-Needle, Cytodiagnosis, Granuloma, BCG Vaccine adverse effects, Lymphadenitis etiology, Lymphadenitis pathology, Tuberculosis, Lymph Node diagnosis, Tuberculosis, Lymph Node complications, Tuberculosis, Lymph Node pathology
- Abstract
Context: Bacillus Calmette-Guérin (BCG) vaccine has been used to prevent tuberculosis and/or its severe complications for long. BCG lymphadenitis is a common complication of the vaccine, which is sometimes subjected to cytological examination. The aim of the study is to describe the cytological findings of BCG lymphadenitis., Settings: The study was conducted in a tertiary care hospital in the western part of India from January 2021 to December 2022., Design: The study was performed on archived material of all patients who were referred to the fine needle aspiration clinic for cytology examination. Clinical and pathological data of cases were retrieved, and cases of BCG lymphadenitis were selected in the study based on these data. Slides of cases were retrieved, and cytological findings were studied., Materials and Methods: Papanicolaou, Giemsa, and Hematoxylin & eosin-stained smears, as well as Ziehl-Neelson stain (Z.N. stain) smears of all BCG lymphadenitis cases, were retrieved. Cases were reviewed for individual cytological features and overall cytological diagnostic categories. Z.N. stain smears were evaluated for acid-fast bacilli., Results and Conclusions: Diagnostic categories observed in BCG lymphadenitis include suppurative lymphadenitis/abscess (15 %), necrotizing lymphadenitis (23 %), necrotizing granulomatous lymphadenitis (46 %), suppurative granulomatous lymphadenitis (8 %), non-necrotizing granulomatous lymphadenitis (8 %). Acid-fast bacilli were detected by Z.N. stain in 8 cases (62 %). The cytological findings of BCG lymphadenitis closely overlap with those of tuberculous lymphadenitis. So, clinical context is very important while reporting isolated axillary lymphadenopathy, specifically in recently vaccinated infants, to avoid misdiagnosis as tuberculous lymphadenitis., Competing Interests: Declaration of competing interest None., (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Published
- 2024
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3. Extensive Bilateral Cervicofacial Lymphadenitis Caused by Atypical Mycobacterium.
- Author
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Nuss S, Vishwanath N, Hayward A, and Groblewski JC
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- Child, Humans, Nontuberculous Mycobacteria, Mycobacterium avium Complex, Immunocompromised Host, Mycobacterium Infections, Nontuberculous diagnosis, Mycobacterium Infections, Nontuberculous drug therapy, Mycobacterium Infections, Nontuberculous complications, Lymphadenitis etiology, Lymphadenitis microbiology
- Abstract
Non-tuberculous mycobacterial (NTM) lymphadenitis typically presents as a unilateral, non-tender, slowly enlarging cervical, submandibular, or pre-auricular lymph node in children. Disseminated NTM infection is most often seen in immunocompromised children. Here, we present an unusual case of extensive bilateral cervical and retropharyngeal lymphadenitis caused by Mycobacterium Avium Complex (MAC) in an ostensibly immunocompetent pediatric patient.
- Published
- 2024
4. Necrotizing herpes simplex lymphadenitis in a patient with chronic lymphocytic leukaemia/small lymphocytic lymphoma, clinically masquerading as Richter transformation.
- Author
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Carlsen ED, Cook N, and Aggarwal N
- Subjects
- Humans, Leukemia, Lymphocytic, Chronic, B-Cell complications, Leukemia, Lymphocytic, Chronic, B-Cell diagnosis, Leukemia, Lymphocytic, Chronic, B-Cell pathology, Herpes Simplex diagnosis, Herpes Simplex pathology, Lymphoma, Large B-Cell, Diffuse pathology, Lymphadenitis diagnosis, Lymphadenitis etiology, Lymphadenitis pathology
- Published
- 2022
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5. Clinical, Microbiological Profile and Treatment Outcomes of Infants with BCG Adenitis: A Retrospective Study.
- Author
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Dash N, Verghese VP, Rose W, Michael JS, Rebekah G, Venkatesan M, and Chacko A
- Subjects
- Infant, Child, Humans, Retrospective Studies, BCG Vaccine adverse effects, Isoniazid, Treatment Outcome, Tuberculosis diagnosis, Lymphadenitis diagnosis, Lymphadenitis drug therapy, Lymphadenitis etiology, Mycobacterium bovis
- Abstract
Background: Bacille Calmette-Guérin (BCG) adenitis is an uncommon complication following BCG vaccination. In rare cases, infants can develop other complications. Controversy exists regarding the diagnosis and management of these cases. Not much information is available in literature regarding their microbiological and immunological characteristics., Methods: Electronic medical records of children presenting to the Pediatric Infectious Diseases clinic in a tertiary care hospital from January 2011-December 2020 with a diagnosis of BCG adenitis were retrospectively reviewed. Their clinical, microbiological, treatment and follow-up data were noted and analyzed., Findings: During the study period, 40 infants presented with a probable diagnosis of BCG adenitis with or without disseminated BCG. Median age at symptom onset was 4(2.5-5.9) months. Nine infants had disseminated disease at presentation. Fifteen infants were suspected to have underlying immune deficiency of whom 12 had proven defects in immune function. On multivariable logistic regression analysis, presence of disseminated disease was the only factor predictive of underlying immunodeficiency. Isoniazid monoresistance was seen in seven cases (32%) of the 22 samples sent for TB cultures., Conclusions: Though BCG adenitis runs a benign course, it could rarely be the first manifestation of an underlying immune defect. There is sizable isoniazid monoresistance, hence sending tissue samples for microbiologic evaluation is necessary to guide anti-tubercular therapy., (© The Author(s) [2022]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2022
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6. Incidence of lymphadenitis following Bacillus Calmette-Guérin (BCG) vaccination in north Indian children.
- Author
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Rangesh S, Vaidya PC, Mehra N, Gupta S, and Bharti B
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- Humans, Infant, Infant, Newborn, Incidence, Observational Studies as Topic, Prospective Studies, Vaccination adverse effects, BCG Vaccine adverse effects, Lymphadenitis epidemiology, Lymphadenitis etiology
- Abstract
Introduction: Bacillus Calmette-Guerin (BCG) vaccination is given as a part of the national immunization schedule in India and its most common complication is BCG lymphadenitis. The reported incidence of BCG lymphadenitis ranges from 0.1 to 9.9% in various studies. In our country, though most babies get BCG vaccination during the neonatal period, the incidence of BCG lymphadenitis is not studied well., Aims: To study the incidence of lymphadenitis following BCG vaccination at tertiary care hospital in North India., Methods: It was a prospective longitudinal observational study. All newborns weighing ≥1.5 kg at birth without any significant illness who received BCG vaccination at our institute were enrolled and followed up for 16 weeks after vaccination. Babies were examined at 6, 10 and 14 weeks for the development of lymphadenopathy. Meta-analysis of studies evaluating incidence of BCG adenitis in children was also performed., Results: Out of 817 babies vaccinated during the enrolment period, 605 babies could be followed up till 16.2 ± 0.9 weeks post BCG vaccination. One case of BCG lymphadenitis was detected at 14 weeks. Thus, the observed incidence of BCG lymphadenitis was 0.16% (95% CI of 0.004%-0.92%). Meta-analysis of 21 studies showed mean incidence estimate of 0.336% (95% CI: 0.315%-0.358%) using fixed effect model whereas random effect model showed mean incidence of 4.45% (95% CI: 3.02%-6.15%)., Conclusion: The lower incidence of lymphadenitis in our study can probably be attributed to a less immunogenic vaccine (Danish 1331), proper technique, experience of the vaccinator and good storage facilities available at our institute., Competing Interests: Conflicts of interest The authors have none to declare., (Copyright © 2021 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.)
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- 2022
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7. Intra-thoracic tuberculosis lymphadenitis in a child with rheumatic heart disease.
- Author
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Al Abdali K, Britton PN, Howard-Jones AR, Kesson AM, and Marais BJ
- Subjects
- Child, Humans, Lymph Nodes, Lymphadenitis diagnosis, Lymphadenitis etiology, Mycobacterium tuberculosis, Rheumatic Heart Disease complications, Rheumatic Heart Disease diagnosis, Tuberculosis, Lymph Node complications, Tuberculosis, Lymph Node diagnosis
- Published
- 2022
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8. A Woman with Painful Neck after COVID-19 Vaccination.
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Cheong KM and Tsai TY
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- Adult, Female, Humans, Pandemics, Point-of-Care Testing, SARS-CoV-2, Ultrasonography, COVID-19 Vaccines adverse effects, Lymphadenitis diagnostic imaging, Lymphadenitis etiology, Neck Pain diagnostic imaging, Neck Pain etiology
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- 2022
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9. Mycobacterial lymphadenitis without granuloma formation in a patient with anti-interferon-gamma antibodies.
- Author
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Asako M, Matsunaga H, Nakahara W, Ikeda M, Mima F, Minami R, Sekiguchi M, Oka K, Wada N, Suzuki K, Yoshizawa K, Sakagami T, and Ueda S
- Subjects
- Antibodies blood, Disease Management, Disease Susceptibility, Female, Humans, Immunohistochemistry, Middle Aged, Positron-Emission Tomography, Symptom Assessment, Antibodies immunology, Granuloma diagnosis, Granuloma etiology, Interferon-gamma immunology, Lymphadenitis diagnosis, Lymphadenitis etiology, Mycobacterium Infections, Nontuberculous diagnosis, Mycobacterium Infections, Nontuberculous microbiology
- Abstract
A previously healthy 49-year-old Japanese woman presented with cervical lymph node swelling and tenderness. Lymph node biopsy revealed reactive lymphadenitis without granulomas. No malignant cells were found, and no acid-fast positive bacilli were identified by Ziehl-Neelsen staining. She was treated unsuccessfully with various antibiotics, and it was very challenging to reach a diagnosis.
18 F-Fluorodeoxyglucose (18 F-FDG) uptake in bones was evaluated using positron emission tomography-computed tomography (PET-CT), and disseminated mycobacterial infection was suspected. The interferon-gamma (IFN-γ) release assays QuantiFERON (QFT) and T-SPOT were used to diagnose tuberculosis infection. On testing, a difference in mitogen response was found between these assays. The response was low for QFT but adequate for T-SPOT, suggesting the presence of anti-IFN-γ antibodies. This difference depended on whether the patient's plasma (including anti-IFN-γ antibodies) was used within the assay system. Mycobacterium abscessus was isolated from lymph node cultures, and plasma anti-IFN-γ antibodies were confirmed. The patient was diagnosed with disseminated M. abscessus infection with underlying adult-onset immunodeficiency caused by anti-IFN-γ antibodies. Granulomas are a pathological hallmark of mycobacterial infection, but may not fully form in immunodeficient patients. Clinicians should be aware of the possibility of mycobacterial infection without granuloma formation due to anti-IFN-γ antibodies., (© 2021. Japanese Society of Hematology.)- Published
- 2021
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10. Management of Bacille Calmette-Guérin Lymphadenitis and Abscess in Immunocompetent Children: A Systematic Review.
- Author
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Villanueva P, Pittet LF, and Curtis N
- Subjects
- Humans, Lymphadenitis physiopathology, Randomized Controlled Trials as Topic, Abscess etiology, BCG Vaccine adverse effects, Disease Management, Immunocompetence, Lymphadenitis etiology
- Abstract
Background: There is no consensus on managing common adverse reactions to Bacille Calmette-Guérin (BCG) vaccination. We systematically reviewed the management of BCG-associated regional lymphadenitis and injection site abscess in immunocompetent individuals., Methods: Searches of Medline, Embase and PubMed were done until November 2020. Randomized controlled trials (RCTs) and cohort studies that compared management strategies for complications of intradermal BCG vaccination were included., Results: Of 1338 individual articles, 15 met inclusion criteria. Six RCTs, 4 prospective and 4 retrospective cohort studies compared management in 1022 children with BCG-associated lymphadenitis. For nonsuppurative lymphadenitis, no antimicrobial was found to significantly impact on time to resolution or prevention of suppuration. For suppurative lymphadenitis, there was some evidence that needle aspiration shortens time to resolution and prevents sinus tract formation. Surgical excision (mainly offered for persistent suppurative lymphadenitis) generally had favorable outcome. Two cohort studies (including 1 aforementioned) compared management strategies in up to 36 children with BCG injection site abscess; one showed no difference in outcome in children treated with antibiotics and the other reported complete resolution without treatment., Conclusions: Evidence does not support a role for antimicrobial therapy in the management of localized reactions to BCG vaccination in immunocompetent children. Needle aspiration may shorten the recovery period for BCG-associated suppurative lymphadenitis. BCG injection site abscess usually heals without treatment. However, studies are limited and cases are not well defined. Growing research into novel BCG applications provides opportunities to investigate optimal management strategies for adverse reactions in a prospective manner using active safety surveillance., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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11. Severe Fever with Thrombocytopenia Syndrome with Necrotizing Lymphadenitis in a Patient who Underwent 18 F-FDG PET/CT: A Case Report.
- Author
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Kim AR, Kim T, Shin DH, Lee S, and Lim S
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- Fluorodeoxyglucose F18, Humans, Positron Emission Tomography Computed Tomography, Lymphadenitis diagnostic imaging, Lymphadenitis etiology, Phlebovirus, Severe Fever with Thrombocytopenia Syndrome
- Abstract
Severe fever with thrombocytopenia syndrome (SFTS), also known as fever, thrombocytopenia, and leukopenia syndrome, is an emerging tick-borne infectious disease in Asian countries. SFTS should be suspected in patients presenting with fever, thrombocytopenia, and leukopenia and have a history of tick exposure in an endemic area. Since SFTS can be accompanied by lymphadenopathy, particularly generalized lymphadenopathy, it can be confused with a primary malignancy, such as lymphoma. The study reports a case of SFTS accompanied by multiple lymphadenopathies, which mimicked malignant lymphoma on F-18 fluorodeoxyglucose positron emission tomography/computed tomography.
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- 2021
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12. Tularemia: A rare cause of pediatric lymph nodes adenitis.
- Author
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Cognard J, Falque L, Zimmermann B, and Pietrement C
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- Anti-Bacterial Agents therapeutic use, Child, Female, Humans, Lymph Nodes abnormalities, Lymph Nodes physiopathology, Lymphadenitis physiopathology, Tularemia physiopathology, Lymphadenitis etiology, Tularemia complications
- Abstract
Adenopathy in pediatrics can have many different causes: infectious, tumoral, and inflammatory. We report the case of an 8-year-old patient with a febrile popliteal ulceration associated with an inflammatory satellite inguinal lymph node adenitis. Serological tests and polymerase chain reaction analyses confirmed the diagnosis of ulceroglandular tularemia. An appropriate antimicrobial therapy led to a full recovery. This case reminds us to consider tularemia as a potential emergent disease in children presenting with subacute to chronic lymphadenopathy and thereby to choose the correct diagnostic tool and appropriate antimicrobial therapy., Competing Interests: Conflicts of interest None., (Copyright © 2021 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2021
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13. Tuberculosis Lymphadenitis and Human Immunodeficiency Virus Co-infections among Lymphadenitis Patients in Northwest Ethiopia.
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Zenebe Y, Adem Y, Tulu B, Mekonnen D, Derbie A, Mekonnen Z, and Biadglegne F
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- Cross-Sectional Studies, Ethiopia epidemiology, HIV, Humans, Coinfection epidemiology, HIV Infections complications, HIV Infections epidemiology, Lymphadenitis epidemiology, Lymphadenitis etiology, Mycobacterium tuberculosis, Tuberculosis, Lymph Node epidemiology
- Abstract
Background: Tuberculosis and human immunodeficiency virus (HIV) are among the major health problems in Ethiopia. This study assessed the proportion of tuberculosis lymphadenitis (TBLN), HIV infection and their co-infection among TBLN presumptive individuals at the selected hospitals in Northwest Ethiopia., Methods: Institution based cross sectional study was carried out. Data on demographic and clinical variables were collected with standardized questionnaire. Microbiological culture was done on specimen obtained by fine needle aspirates. The HIV status was determined by rapid anti-HIV antibody test. Data was entered and scrutinized using SPSS version 20 statistical packages. A stepwise logistic regression model was used. The result was considered as statistically significant at P<0. 05., Results: A total of 381 lymphadenitis patients were included in the study. The overall prevalence of TBLN and HIV were at 250(65.6%) and 9(2.4%), respectively and their co-infection was at 6(2.4%). Based on the cytological examination, 301(79.0%) of them were diagnosed as TBLN. The age group, (P=0.01) and residency, (P=0.01) were found significantly associated with TBLN. Similarly, unsafe sex was also statistically significant for HIV infection (P=0.007)., Conclusion: Tuberculosis lymphadenitis is the leading cause of TB and lymphadenitis in the region. However, TBLN-HIV coinfection was promisingly low. High rate of discrepancy was noticed between cytological and culture results. Hence, the TBLN diagnostic criteria shall pursue revision., (© 2021 Yohannes Zenebe, et al.)
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- 2021
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14. Vestibular involvement of PFAPA syndrome.
- Author
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Kuzu S, Günebakan Ç, Yıldız E, Kahveci OK, and Bucak A
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- Age Factors, Child, Child, Preschool, Electromyography, Female, Fever physiopathology, Humans, Lymphadenitis physiopathology, Male, Pharyngitis physiopathology, Prospective Studies, Stomatitis, Aphthous physiopathology, Syndrome, Vestibular Diseases physiopathology, Fever etiology, Lymphadenitis etiology, Periodicity, Pharyngitis etiology, Stomatitis, Aphthous etiology, Vestibular Diseases complications, Vestibular Diseases diagnosis, Vestibular Function Tests methods, Vestibule, Labyrinth physiopathology
- Abstract
Objective: PFAPA syndrome is derived from the initials of the English words of the findings that make up the syndrome ("Periodic Fever", "Aphthous Stomatitis", "Pharyngitis", "Adenitis"). This study aims to evaluate the vestibular system in patients with PFAPA syndrome by the cVEMP test and to give a general review of PFAPA syndrome in light of current literature., Methods: In this prospective study, 30 patients aged 4-6 who were diagnosed with PFAPA in a tertiary pediatrics clinic, between January 2016 and February 2020 and 30 children of the same age group who applied to a tertiary otorhinolaryngology clinic for other reasons and proven to have no hearing or vestibular problems were included and in addition to routine physical examination, electromyographic activity of the sternocleidomastoid muscle surface was measured., Results: We found that the amplitude difference between cVEMP p1-n1 in patients with PFAPA syndrome in both ears decreased compared to the healthy control group., Conclusion: Our study proves there is a vestibular system involvement of PFAPA syndrome. This study is the first in the literature to search the relationship between PFAPA and the vestibular system., (Copyright © 2021 Elsevier Inc. All rights reserved.)
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- 2021
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15. COVID-19 myocarditis and postinfection Bell's palsy.
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Dahl EH, Mosevoll KA, Cramariuc D, Vedeler CA, and Blomberg B
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- Adult, Alkalosis, Respiratory etiology, Blood Gas Analysis, C-Reactive Protein metabolism, COVID-19 blood, COVID-19 therapy, Echocardiography, Edema etiology, Electrocardiography, Humans, Hypotension etiology, Hypotension physiopathology, Lymphadenitis etiology, Lymphadenitis physiopathology, Magnetic Resonance Imaging, Male, Myocarditis blood, Myocarditis diagnostic imaging, Myocarditis therapy, Natriuretic Peptide, Brain blood, Neck, Oxygen Inhalation Therapy, Peptide Fragments blood, Procalcitonin blood, Recovery of Function, SARS-CoV-2, Troponin T blood, Vasoconstrictor Agents therapeutic use, Alkalosis, Respiratory blood, Bell Palsy physiopathology, COVID-19 physiopathology, Myocarditis physiopathology
- Abstract
Here we present the case of a 37-year-old previously healthy man who developed fever, headache and a unilateral, painful neck swelling while working offshore. He had no known contact with anyone with COVID-19; however, due to the ongoing pandemic, a nasopharyngeal swab was performed, which was positive for the virus. After transfer to hospital for assessment his condition rapidly deteriorated, requiring admission to intensive care for COVID-19 myocarditis. One week after discharge he re-presented with unilateral facial nerve palsy. Our case highlights an atypical presentation of COVID-19 and the multifaceted clinical course of this still poorly understood disease., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2021
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16. IL-1β blockade in periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome: case-based review.
- Author
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Soylu A, Yıldız G, Torun Bayram M, and Kavukçu S
- Subjects
- Female, Fever etiology, Humans, Infant, Inflammation Mediators, Interleukin-1beta antagonists & inhibitors, Lymphadenitis etiology, Pharyngitis etiology, Stomatitis etiology, Syndrome, Antibodies, Monoclonal, Humanized therapeutic use, Fever drug therapy, Interleukin 1 Receptor Antagonist Protein therapeutic use, Lymphadenitis drug therapy, Pharyngitis drug therapy, Stomatitis drug therapy
- Abstract
Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome and familial Mediterranean fever (FMF) are considered as inflammasome disorders associated with uncontrolled interleukin (IL)-1β production. Anti-IL1 agents are used in colchicine-resistant cases of FMF. Increase in pro-inflammatory mediators even between febrile attacks in PFAPA suggests that anti-IL1 treatment might be beneficial in these patients. We describe a child presenting with recurrent, self-limited febrile attacks at 1 year of age who was diagnosed as FMF being heterozygous for M694 V mutation. Her clinical findings were only controlled by the addition of canakinumab (2 mg/kg/8 week) to colchicine treatment. However, she developed typical PFAPA attacks during this treatment at 3 years of age. We conducted a literature search focusing on English articles with keywords including PFAPA, anakinra, canakinumab, and rilonacept. Five children and one adult patient with PFAPA were found and evaluated. Anakinra was reported to abort PFAPA attacks in children, while the adult patient first responded and then became resistant to anakinra. Canakinumab was effective in preventing febrile attacks in this patient. Failure of canakinumab to prevent PFAPA attacks in our case may arise from the differences in the pathophysiology of PFAPA and FMF. Thus, further experience with higher doses or shorter intervals of canakinumab is needed in children with PFAPA.
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- 2021
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17. Suppurative lymphadenitis caused by hypermucoid-variant Klebsiella in a Polynesian woman: a case report.
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Sun B, Singhal S, and Winslow DL
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- Female, Humans, Jugular Veins diagnostic imaging, Klebsiella Infections diagnosis, Klebsiella pneumoniae isolation & purification, Lymphadenitis diagnosis, Middle Aged, Venous Thrombosis diagnosis, Venous Thrombosis etiology, Klebsiella Infections complications, Klebsiella pneumoniae pathogenicity, Lymphadenitis etiology
- Abstract
Hypermucoid Klebsiella pneumoniae, known for its association with multiple-organ infection, has gradually increased in prevalence beyond where it was first characterized in East Asia. Here we describe a unique presentation of suppurative lymphadenitis due to hypermucoid Klebsiella in a patient from Tonga, a country with few reported cases., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2020
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18. A Teenager With Leg Rash, Fevers, and Positional Dyspnea.
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Georgette N and Kumar M
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- Adolescent, Antifungal Agents therapeutic use, Diagnosis, Differential, Erythema Nodosum diagnosis, Erythema Nodosum drug therapy, Glucocorticoids therapeutic use, Humans, Hyalohyphomycosis diagnosis, Hyalohyphomycosis drug therapy, Itraconazole therapeutic use, Leg, Lung diagnostic imaging, Lymph Nodes, Lymphadenitis diagnosis, Male, Mediastinal Diseases diagnosis, Mediastinal Diseases drug therapy, Mediastinum, Posture, Prednisone therapeutic use, Tomography, X-Ray Computed, Dyspnea etiology, Erythema Nodosum etiology, Fever etiology, Hyalohyphomycosis complications, Lymphadenitis etiology, Mediastinal Diseases etiology
- Published
- 2020
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19. Mediastinal Lymphadenitis Due to Nocardia Infection.
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Dawood W, Evans SE, and Grosu H
- Subjects
- Aftercare, Anti-Bacterial Agents administration & dosage, Anti-Bacterial Agents therapeutic use, Drug Therapy, Combination, Endoscopic Ultrasound-Guided Fine Needle Aspiration methods, Humans, Linezolid administration & dosage, Linezolid therapeutic use, Lymphadenitis pathology, Male, Mediastinal Diseases diagnostic imaging, Middle Aged, Nocardia isolation & purification, Nocardia Infections drug therapy, Positron Emission Tomography Computed Tomography methods, Treatment Outcome, Trimethoprim, Sulfamethoxazole Drug Combination administration & dosage, Trimethoprim, Sulfamethoxazole Drug Combination therapeutic use, Lymphadenitis etiology, Mediastinal Diseases microbiology, Mediastinum pathology, Nocardia Infections complications
- Published
- 2020
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20. POPS case: A 30-year-old Filipino woman with fevers, lymphadenopathy, painful scalp lesions, and a neck mass.
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Daley AS, Naro GR, Craig TJ, Hussein RHA, Banjade R, Jacobs JB, and Ross IR
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- Adult, Female, Fever etiology, Hip, Humans, Immunologic Deficiency Syndromes complications, Immunologic Deficiency Syndromes immunology, Lymphadenitis diagnosis, Lymphadenitis etiology, Meningitis, Aseptic diagnosis, Meningitis, Aseptic etiology, Mycobacterium avium-intracellulare Infection etiology, Mycobacterium avium-intracellulare Infection immunology, Osteolysis etiology, Philippines ethnology, Tracheoesophageal Fistula etiology, Autoantibodies immunology, Immunologic Deficiency Syndromes diagnosis, Interferon-gamma immunology, Mycobacterium avium-intracellulare Infection diagnosis, Osteolysis diagnostic imaging, Tracheoesophageal Fistula diagnostic imaging
- Abstract
We described a case of a 30-year-old Filipino woman who presented with fevers, night sweats, left hip pain, painful scalp lesions, and a neck mass. Symptoms began 6 months earlier, with nasal drainage, fever, cough, and occasional hemoptysis, which did not resolve with outpatient antibiotics. A further workup revealed lymphadenopathy and several lytic bone lesions. Her hospital course was later further complicated by the development of a tracheoesophageal fistula secondary to an esophageal mass and, then later, aseptic meningitis. Extensive diagnostic workup and immunologic tests were performed and finally led to the diagnosis. Here, we discussed the diagnostic workup and pathophysiology of the underlying condition. This case illustrated the importance of appropriate immunologic workup to make the diagnosis of a rare condition that proves to be clinically significant and presents challenges in management.
- Published
- 2020
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21. Cluster of Lymphadenitis due to Nontuberculous Mycobacterium in Children and Adolescents 8-15 Years of Age.
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Park SG, Kim H, Paik JH, Park KU, Park JS, Jeong WJ, Jung YH, Na JI, Sung KH, Kim JY, Lee H, and Lee H
- Subjects
- Adolescent, Anti-Bacterial Agents therapeutic use, Child, Humans, Lymphadenitis drug therapy, Lymphadenitis etiology, Male, Mycobacterium Infections, Nontuberculous complications, Mycobacterium Infections, Nontuberculous drug therapy, Mycobacterium haemophilum genetics, Mycobacterium haemophilum isolation & purification, Nontuberculous Mycobacteria genetics, Nontuberculous Mycobacteria isolation & purification, RNA, Bacterial metabolism, Lymphadenitis diagnosis, Mycobacterium Infections, Nontuberculous pathology
- Abstract
Background: Nontuberculous mycobacteria (NTM) lymphadenitis is an under-recognized entity, and data of the true burden in children are limited. Without a high index of suspicion, diagnosis may be delayed and microbiological detection is challenging. Here, we report a cluster of NTM lymphadenitis experienced in Korean children., Methods: Subjects under 19 years of age diagnosed with NTM lymphadenitis during November 2016-April 2017 and April 2018 were included. Electronic medical records were reviewed for clinical, laboratory and pathological findings. Information regarding underlying health conditions and environmental exposure factors was obtained through interview and questionnaires., Results: A total of ten subjects were diagnosed during 18 months. All subjects were 8-15 years of age, previously healthy, male and had unilateral, nontender, cervicofacial lymphadenitis for more than 3 weeks with no significant systemic symptoms and no response to empirical antibiotics. Lymph nodes involved were submandibular (n = 8), preauricular (n = 6) and submental (n = 1). Five patients had two infected nodes and violaceous discoloration was seen in seven subjects. Biopsy specimens revealed chronic granulomatous inflammation and acid-fast bacteria culture identified Mycobacterium haemophilum in two cases and NTM polymerase chain reaction was positive in two cases. Survey revealed various common exposure sources., Conclusion: NTM lymphadenitis is rare but increasing in detection and it may occur in children and adolescents. Diagnosis requires high index of suspicion and communication between clinicians and the laboratory is essential for identification of NTM., Competing Interests: The authors have no potential conflicts of interest to disclose., (© 2019 The Korean Academy of Medical Sciences.)
- Published
- 2019
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22. [PFAPA syndrome - An important differential diagnosis in children with recurrent fever].
- Author
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Rydenman K, Berg S, Karlsson-Bengtsson A, Fasth A, and Wekell P
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- Biomarkers blood, Child, Preschool, Diagnosis, Differential, Female, Fever diagnosis, Fever drug therapy, Fever etiology, Hereditary Autoinflammatory Diseases classification, Hereditary Autoinflammatory Diseases complications, Hereditary Autoinflammatory Diseases drug therapy, Humans, Inflammation blood, Lymphadenitis diagnosis, Lymphadenitis drug therapy, Lymphadenitis etiology, Male, Pharyngitis diagnosis, Pharyngitis drug therapy, Pharyngitis etiology, Stomatitis, Aphthous diagnosis, Stomatitis, Aphthous drug therapy, Stomatitis, Aphthous etiology, Syndrome, Hereditary Autoinflammatory Diseases diagnosis
- Abstract
Periodic Fever, Aphthous Stomatitis, Pharyngitis and Cervical Adenitis (PFAPA) syndrome is the most common autoinflammatory disorder among children in many parts of the world and an important differential diagnosis in children presenting with recurrent fever episodes. Commonly, PFAPA has an onset under the age of 5 years. Fever episodes in PFAPA usually last 3-6 days and are associated with one or more of the cardinal symptoms aphthous stomatitis, pharyngitis and cervical adenitis. The fever episodes typically recur with an interval of 3-6 weeks, often with a striking regularity. During the episodes, the patient has elevated inflammatory variables such as CRP and serum amyloid A (SAA) and may sometimes have additional symptoms such as abdominal pain, nausea and leg pain. Between the fever episodes, the patient is typically free of symptoms with normalized inflammatory variables and grows normally. Awareness and recognition of PFAPA is key to providing the patient with adequate treatment and avoiding misdiagnosis.
- Published
- 2019
23. A 19-month-old Boy With Refractory Cervical Adenitis.
- Author
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Schneider A, Ranza E, Diana A, Laurent M, Rougemont AL, Hauri M, Reichenbach J, and Blanchard-Rohner G
- Subjects
- Cervix Uteri diagnostic imaging, Cervix Uteri pathology, Female, Humans, Infant, Liver diagnostic imaging, Liver pathology, Male, Mutant Proteins genetics, NADPH Oxidase 2 genetics, Point Mutation, Tomography, X-Ray Computed, Ultrasonography, Granulomatous Disease, Chronic diagnosis, Granulomatous Disease, Chronic pathology, Liver Abscess etiology, Liver Abscess pathology, Lymphadenitis etiology, Lymphadenitis pathology
- Published
- 2019
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24. Cervical syphilitic lymphadenitis causing fever of unknown origin followed by rash of secondary syphilis.
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Mahapatra R, Clarke G, Lobo Z, and Psevdos G
- Subjects
- Aged, Cervix Uteri diagnostic imaging, Cervix Uteri pathology, Exanthema pathology, Female, Fever of Unknown Origin pathology, Histocytochemistry, Humans, Lymph Nodes diagnostic imaging, Lymph Nodes pathology, Lymphadenitis pathology, Male, Microscopy, Tomography, X-Ray Computed, Treponema pallidum isolation & purification, Exanthema etiology, Fever of Unknown Origin etiology, Lymphadenitis etiology, Syphilis diagnosis, Syphilis pathology
- Abstract
Competing Interests: None
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- 2019
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25. Lymph-node-first Kawasaki disease and giant coronary artery aneurysm.
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Ramly B
- Subjects
- Child, Coronary Aneurysm diagnosis, Coronary Aneurysm pathology, Coronary Vessels pathology, Diagnosis, Differential, Female, Humans, Lymph Nodes pathology, Lymphadenitis diagnosis, Lymphadenitis pathology, Mucocutaneous Lymph Node Syndrome diagnosis, Mucocutaneous Lymph Node Syndrome pathology, Neck pathology, Thrombosis diagnosis, Thrombosis pathology, Tonsillitis diagnosis, Coronary Aneurysm etiology, Lymphadenitis etiology, Mucocutaneous Lymph Node Syndrome complications, Thrombosis etiology
- Abstract
A 8-year-old Irish ethnicity girl presented with 3 days of fever with right-sided neck swelling which was first thought as acute tonsillitis with right-sided lymphadenitis. She was started on intravenous antibiotics. At day 7 of illness, she was diagnosed to have Kawasaki disease with clinical and biochemical evidence. Echocardiogram at day 9 of illness and subsequently CT cardiac angiogram performed revealed giant aneurysm at the right coronary artery with non-obstructing thrombus seen. The patient then commenced on clopidogrel and continued with a regular dose of aspirin. Due to the evidence of thrombus with a giant coronary aneurysm, she was also put on long-term warfarin therapy with regular monitoring of her international normalised ratio to be kept at the range of 2.0-3.0., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2019
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26. A novel evaluation of genetic polymorphism in BCG adenitis.
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Hassanzad M, Farnia P, Darougar S, and Velayati AA
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- Cytokines metabolism, Female, Humans, Infant, Lymphadenitis etiology, Lymphadenitis metabolism, Male, Mutation, Tuberculosis diagnosis, Ultrasonography, BCG Vaccine adverse effects, Cytokines genetics, Lymphadenitis genetics, Polymorphism, Genetic, Tuberculosis prevention & control, Vaccination adverse effects
- Abstract
Hassanzad M, Farnia P, Darougar S, Velayati AA. A novel evaluation of genetic polymorphism in BCG adenitis. Turk J Pediatr 2019; 61: 466-470. Bacillus Calmette-Guerin (BCG) is a live attenuated vaccine which has been used to prevent tuberculosis, according to the World Health Organization (WHO) recommendation in parts of the world with an incidence of tuberculosis infection more than 1%. The incidence of BCG adverse reactions differs between regions with regional lymphadenitis as the most common presentation. The aim of this study was to detect the impact of polymorphisms causing BCG lymphadenitis in children receiving BCG vaccination at birth. Eight healthy infants with BCG adenitis from 4 to 12 months old were enrolled. All these patients underwent a thorough physical examination, abdominopelvic ultrasound evaluation to detect distant lymphadenopathies and immunodeficiency screening tests for any possible underlying immunodeficiency disorders. Then genotyping for known mutations was performed using restriction fragments length polymorphism (PCR-RFLP) assays. Sequencing was performed for IL-12 Rβ1, IFN-ϒ receptor 1, IL-10, TNF-α and P2X7. The mean age of onset of the adenitis was 6.5 months. TNF-857, IL-12Rβ1 705, IL-10 1082, and IFN-ϒ- 56 single nucleotide polymorphisms (SNPs) were common in the children studied. The most frequent polymorphism found in the patients with BCG adenitis except one, was the P2X7 -762 polymorphism. To conclude, these polymorphisms are more common in some ethnic populations but not others and make the genetic basis of immunity to BCG strains and the occurrence of post-BCG lymphadenitis in otherwise healthy children.
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- 2019
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27. A Case of Retinal Vessel Occlusion Caused by Bartonella Infection.
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Woo M, Ahn S, Song JY, and Kim SW
- Subjects
- Adult, Anti-Bacterial Agents therapeutic use, Antibodies, Bacterial blood, Anticoagulants therapeutic use, Bartonella immunology, Bartonella Infections complications, Bartonella Infections drug therapy, Female, Fluorescein Angiography, Humans, Lymph Nodes pathology, Lymphadenitis diagnosis, Lymphadenitis etiology, Retinal Artery Occlusion etiology, Rifampin therapeutic use, Visual Acuity, Bartonella Infections diagnosis, Retinal Artery Occlusion diagnosis
- Abstract
Competing Interests: The authors have no potential conflicts of interest to disclose.
- Published
- 2018
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28. Granulomatous lymphadenitis mimicking metastatic lymphadenopathy in the neck after lymphatic embolization of chyle leakage: A case report.
- Author
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Ryu KH, Baek HJ, Cho SB, An HJ, and Kim JP
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- Adult, Carcinoma, Papillary complications, Carcinoma, Papillary surgery, Chyle, Diagnosis, Differential, Granulomatous Disease, Chronic etiology, Humans, Lymph Nodes diagnostic imaging, Lymphadenitis etiology, Lymphadenopathy etiology, Lymphatic Diseases diagnostic imaging, Lymphatic Diseases etiology, Male, Neck Dissection adverse effects, Postoperative Complications diagnostic imaging, Postoperative Complications etiology, Thyroid Cancer, Papillary, Thyroid Neoplasms complications, Thyroid Neoplasms surgery, Thyroidectomy adverse effects, Embolization, Therapeutic adverse effects, Granulomatous Disease, Chronic diagnosis, Lymphadenitis diagnosis, Lymphadenopathy diagnosis, Lymphatic Diseases therapy, Postoperative Complications therapy
- Abstract
Rationale: Lymphatic embolization is a minimally invasive treatment option for managing chyle leakage after nodal dissection in the neck. After the procedure, the embolic material may cause foreign body granulomatous lymphadenitis and can be a diagnostic challenge for radiologists because of sonographic similarity to metastatic lymph node. Herein, we describe a clinical case of granulomatous lymphadenitis due to embolic material mimicking nodal metastasis detected on ultrasonography (US) with cytologic findings in a patient with thyroid cancer who underwent lymphatic embolization to treat chyle leakage after total thyroidectomy and neck dissection. We also review the relevant literature regarding this disease with technical background of the procedure and suggest the importance of clinical suspicion in diagnosing the granulomatous lymphadenitis in patients with a history of lymphatic embolization., Patient Concerns: A 40-year-old man who underwent total thyroidectomy and bilateral modified radical neck dissection due to papillary thyroid carcinoma had suspicious cervical lymph node on US after lymphatic embolization of chyle leakage., Diagnoses: The suspicious cervical lymph node proved to be foreign body granulomatous lymphadenitis due to embolic material by US-guided fine-needle aspiration., Interventions: The patient did not undergone additional surgery because the pathologic cervical lymph node was confirmed to be foreign body granulomatous lymphadenitis., Outcomes: The patient is being followed up regularly at the outpatient department., Lessons: Clinical awareness of the technical background of lymphatic embolization and possible sonographic features of granulomatous lymphadenitis is important for an accurate diagnosis and the appropriate management in patients who underwent lymphatic embolization.
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- 2018
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29. Risk factors for periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome: a case-control study.
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Kettunen S, Lantto U, Koivunen P, Tapiainen T, Uhari M, and Renko M
- Subjects
- Adolescent, Bottle Feeding adverse effects, Breast Feeding, Case-Control Studies, Child, Child, Preschool, Female, Humans, Infant, Logistic Models, Male, Risk Factors, Smoking adverse effects, Syndrome, Fever etiology, Lymphadenitis etiology, Pharyngitis etiology, Stomatitis, Aphthous etiology
- Abstract
The etiology and pathogenesis of periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome are unclear. We performed a case-control study to evaluate potential environmental or lifestyle factors associated with PFAPA morbidity. We enrolled 119 patients with PFAPA syndrome who had undergone tonsillectomy in Oulu University Hospital between 1987 and 2007. We recruited 230 controls, matched for sex, birth date, and place from the database of the Population Register Center of Finland. All the patients and controls completed a questionnaire regarding exposure to environmental triggers during early childhood. Maternal smoking was more common among PFAPA syndrome patients than controls (23 vs. 14%; P = 0.005). PFAPA patients had lower breastfeeding rates than controls (94 vs. 99%; P = 0.006). No other environmental factors were associated with PFAPA syndrome, except having an aquarium at home (P = 0.007). The patient group also used natural or herbal medicines more often than the controls (P = 0.01)., Conclusion: Maternal smoking and lack of breastfeeding, known risk factors for common childhood infections, were more common in patients with PFAPA syndrome than in matched controls. Environmental factors may be important in the pathogenesis of PFAPA syndrome and should be evaluated in future studies. What is Known: • The pathogenesis and genetics of periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome remain unsolved. • PFAPA syndrome has been shown to cluster in families. What is New: • Maternal smoking and lack of breastfeeding are more common in patients with PFAPA syndrome than in the controls. • Environmental risk factors may be important in the pathogenesis of the syndrome.
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- 2018
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30. Atypical presentation of cat scratch disease: Parinaud's oculoglandular syndrome with facial nerve paresis.
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Valor C and Huber K
- Subjects
- Adult, Animals, Anti-Bacterial Agents administration & dosage, Azithromycin administration & dosage, Bartonella henselae isolation & purification, Cat-Scratch Disease complications, Cat-Scratch Disease drug therapy, Cats, Conjunctivitis, Bacterial etiology, Facial Nerve Diseases etiology, Humans, Lymphadenitis diagnostic imaging, Male, Ocular Motility Disorders etiology, Tomography, X-Ray Computed, Cat-Scratch Disease diagnosis, Lymphadenitis etiology
- Abstract
A 28-year-old man presented to our clinic over the course of 3 weeks with symptoms that progressed from mild headaches to fever, fatigue, myalgia and an enlarged right preauricular lymph node with ipsilateral conjunctivitis and upper eyelid weakness. Our differential included Epstein Barr Virus/Cytomegalovirus mononucleosis, bacterial conjunctivitis and lymphoma. We evaluated with CBC, EBV IgM Ab, lactate dehydrogenase level and a CMV IgG Ab which were all within normal limits. During his third visit, we discovered our patient had been scratched by two stray kittens he had adopted 2 months prior. We confirmed the diagnosis with a positive Bartonella henselae IgG level and diagnosed him with cat scratch disease presenting as Parinaud's oculoglandular syndrome. He was treated with a 5-day course of Azithromycin 250 mg with definitive improvement., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
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- 2018
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31. Clinical features and outcomes of Bacille Calmette-Guérin (BCG)-induced diseases following neonatal BCG Tokyo-172 strain immunization.
- Author
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Rermruay R, Rungmaitree S, Chatpornvorarux S, Brukesawan C, Wittawatmongkol O, Lapphra K, Phongsamart W, Kongstan N, Khumcha B, and Chokephaibulkit K
- Subjects
- Bacteremia etiology, Bacteremia pathology, Child, Preschool, Female, Humans, Infant, Lymphadenitis etiology, Lymphadenitis pathology, Male, Osteitis etiology, Osteitis pathology, Retrospective Studies, Tertiary Care Centers, Thailand, BCG Vaccine administration & dosage, BCG Vaccine adverse effects, Iatrogenic Disease, Tuberculosis etiology, Tuberculosis pathology
- Abstract
Background: Bacille Calmette-Guérin (BCG) vaccination at birth may cause mild and benign local adverse effects (AE). More serious AE are rarely reported., Objective: To describe clinical features and outcomes of BCG (Tokyo-172 strain)-induce diseases (BCG-ID) that required medical attention at a tertiary care center in Bangkok, Thailand., Method: We retrospectively reviewed medical records from January 2007 to December 2016 that were selected by ICD-10 codes. The inclusion criteria were the patients under 3 years of age who developed lymphadenitis, osteitis, or disseminated infections of which BCG was a possible pathogen. Cases were classified into suspected (clinically compatible without laboratory confirmation), probable (suspected cases with M. tuberculosis complex identified), and confirmed BCG-ID (probable cases with molecular confirmation of M. bovis BCG strain)., Results: 95 children were identified; 57 (60.0%) were male, and the median age at presenting symptom was 3.5 (range: 0.6-28.7) months. Of these, 25 (26.3%) were suspected, 49 (51.6%) were probable, and 21 (22.1%) were confirmed BCG-ID. Overall, 87 (92%) children had regional lymphadenitis corresponding to the BCG site, 5 (5%) had osteitis, and 3 (3%) had disseminated BCG. Of those with lymphadenitis, average size was 2.2 (range 0.7-5) cm. in diameter and 53% (46/87) had pulmonary involvement. Five children with immunodeficiency; three had disseminated BCG and two had lymphadenitis. Eight (9.2%) patients with lymphadenitis underwent needle aspiration; 57 (65.5%) had surgical excision. All children with BCG osteitis underwent surgical intervention in combination with anti-tuberculosis treatment. One patient with osteitis experienced long-term leg length discrepancy., Conclusion: Regional lymphadenitis was the most common feature of BCG-ID requiring medical attention. That none of the BCG osteitis were immunocompromised hosts suggested the potential virulence of BCG in neonates. A systematic national surveillance and reporting system is needed to develop accurate estimates of population incidence and support development of effective vaccine policy., (Copyright © 2018 Elsevier Ltd. All rights reserved.)
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- 2018
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32. Severe Disseminated Necrotizing and Granulomatous Lymphadenitis and Encephalitis in a Dog Due to Sporotrichum pruinosum (Teleomorph: Phanerochaete chrysosporium).
- Author
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Magstadt DR, Fales-Williams AJ, Palerme JS, Flaherty H, Lindquist T, and Miles KG
- Subjects
- Animals, Dog Diseases pathology, Dogs, Female, Granuloma veterinary, Lymphadenitis etiology, Lymphadenitis microbiology, Lymphadenitis pathology, Necrosis, Sporotrichosis complications, Sporotrichosis pathology, Dog Diseases microbiology, Lymphadenitis veterinary, Sporothrix, Sporotrichosis veterinary
- Abstract
A 9-year-old female mixed breed dog presented for an acute onset of anorexia, vomiting, and cough. Initial examination and diagnostics revealed a large multilobular cranial mediastinal mass with unidentified fungal organisms on cytology. The disease progressed in spite of therapy until the dog was euthanized 8 months later. Gross necropsy findings were a large multilobular intrathoracic mass, mild pleuritis, and generalized lymphadenopathy. Histologic evaluation showed granulomatous inflammation and necrosis with numerous 20- to 70-micron, periodic acid-Schiff- and Gomori methenamine silver-positive spherules effacing lymph node parenchyma, as well as severe inflammation within the midbrain. Endosporulation was a common finding, and large numbers of fungal hyphae were also present in affected areas. Ribosomal RNA gene sequencing found 100% identity to published sequences of Phanerochaete chrysosporium, the teleomorph form of Sporotrichum pruinosum. This is the first published report of disease caused by natural infection with this basidiomycete organism in animals.
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- 2018
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33. Nine patients with chronic granulomatous disease having selective neck dissection for severe cervical lymphadenitis.
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Wingfield LR, Liu J, Hu M, Bianchi D, Hauck K, Driscoll B, Gallin JI, Malech HL, Holland SM, and Van Waes C
- Subjects
- Adolescent, Adult, Child, Female, Humans, Male, Neck, Retrospective Studies, Treatment Outcome, Young Adult, Granulomatous Disease, Chronic complications, Granulomatous Disease, Chronic surgery, Lymph Node Excision, Lymphadenitis etiology, Lymphadenitis surgery, Neck Dissection
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- 2018
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34. The First International Conference on Periodic Fever, Aphthous Stomatitis, Pharyngitis, Adenitis Syndrome.
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Harel L, Hashkes PJ, Lapidus S, Edwards KM, Padeh S, Gattorno M, and Marshall GS
- Subjects
- Child, Child, Preschool, Congresses as Topic, Diagnosis, Differential, Fever etiology, Hereditary Autoinflammatory Diseases etiology, Hereditary Autoinflammatory Diseases therapy, Humans, Lymphadenitis etiology, Pharyngitis etiology, Stomatitis, Aphthous etiology, Hereditary Autoinflammatory Diseases diagnosis
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- 2018
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35. Do infections with disseminated Mycobacterium avium complex precede sweet's syndrome? A case report and literature review.
- Author
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Hibiya K, Miyagi K, Tamayose M, Nabeya D, Kinjo T, Takeshima S, Ikemiyagi N, Yamada K, Fujita A, Hashioka H, Kami W, Inamine M, Shibahara D, Nakamura H, Furugen M, Haranaga S, Higa F, Tateyama M, and Fujita J
- Subjects
- Aged, Anti-Bacterial Agents administration & dosage, Anti-Inflammatory Agents therapeutic use, Drug Therapy, Combination, Glucocorticoids therapeutic use, Humans, Immunocompromised Host, Lymphadenitis etiology, Male, Mycobacterium avium Complex growth & development, Mycobacterium avium-intracellulare Infection diagnosis, Mycobacterium avium-intracellulare Infection drug therapy, Sweet Syndrome diagnosis, Sweet Syndrome drug therapy, T-Lymphocytes, Helper-Inducer classification, Treatment Outcome, Glucocorticoids adverse effects, Mycobacterium avium Complex physiology, Mycobacterium avium-intracellulare Infection complications, Sweet Syndrome etiology, T-Lymphocytes, Helper-Inducer immunology
- Abstract
Sweet's syndrome is reportedly associated with preceding nontuberculous mycobacterial infections (NTMIs). Here, we report on a systemic Mycobacterium intracellulare infection in a patient on corticoid therapy for Sweet's syndrome. Literature searches show that 69.1% of patients with Sweet's syndrome and NTMIs developed this syndrome later than NTMIs and 89.3% of them developed during the clinical course of a rapidly growing mycobacterial infection. The residual cases were associated with slow-growing mycobacteria (14.3%), but only three cases of Mycobacterium avium complex (MAC) infections before the onset of Sweet's syndrome have been reported, and all of them were caused by disseminated MAC disease. One of these cases developed during corticoid therapy for Sweet's syndrome, while another case had underlying diabetes mellitus. Hence, the occurrence of systemic MAC disease may be an inevitable consequence of long-term steroid use and underlying diseases. Literature searches also show that cervical lymphadenitis was a predominant symptom in NTMIs (90.5%). The present case did not have cervical lymphadenitis although the previously reported MAC cases did experience it. Therefore, lymphadenitis from NTMIs may be related to the pathogenesis of Sweet's syndrome. Hence, should a patient have systemic infection without lymphadenitis, it will be more difficult to clinically confirm that MAC disease is a predisposing factor for Sweet's syndrome.
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- 2017
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36. Cernunnos deficiency associated with BCG adenitis and autoimmunity: First case from the national Iranian registry and review of the literature.
- Author
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Yazdani R, Abolhassani H, Tafaroji J, Azizi G, Hamidieh AA, Chou J, Geha RS, and Aghamohammadi A
- Subjects
- Child, Preschool, DNA Repair Enzymes deficiency, DNA Repair Enzymes genetics, DNA-Binding Proteins deficiency, DNA-Binding Proteins genetics, Female, Hematopoietic Stem Cell Transplantation, Humans, Iran, Severe Combined Immunodeficiency pathology, Severe Combined Immunodeficiency therapy, BCG Vaccine adverse effects, DNA Repair Enzymes metabolism, DNA-Binding Proteins metabolism, Lymphadenitis etiology, Severe Combined Immunodeficiency genetics
- Abstract
Non-homologous end-joining (NHEJ) is a pathway that repairs double-strand breaks (DSB) in DNA and plays a vital role in V(D)J recombination of immunoglobulin genes. Cernunnos is a DNA repair factor that is involved in nonhomologous end-joining (NHEJ) process. Impairment in Cernunnos leads to a genetic disease characterized by neural disorders, immunodeficiency and increased radiosensitivity. We herein describe a severe combined immunodeficiency (SCID) patient with T- B+ phenotype who had a mutation in Cernunnos gene and manifested recurrent infections, microcephaly and growth retardation with hypogammaglobulinemia. Furthermore, our patient was associated with BCG adenitis and autoimmunity that less is observed in patients with Cernunnos deficiency. In contrast to previous reported Cernunnos-deficient patients, our patient had normal B-cell number along with normal IgA and IgM, suggesting a leaky form of the Cernunnos deficiency due to residual count of B cells in our patient. Cernunnos deficiency should be considered in children with recurrent bacterial infections, microcephaly and growth retardation, in spite of having normal B-cell as well as normal IgM and IgA level., (Copyright © 2017. Published by Elsevier Inc.)
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- 2017
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37. Clinicopathological features of cryptococcal lymphadenitis and a review of literature.
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Kawamoto K, Miyoshi H, Suzuki T, Muto R, Yamada K, Yanagida E, Koshino M, Sasaki Y, Takizawa J, Sone H, Sugita Y, Seto M, and Ohshima K
- Subjects
- Adult, Aged, 80 and over, Biomarkers, Biopsy, CD4 Lymphocyte Count, Colony Count, Microbial, Cryptococcosis etiology, Female, HIV Infections complications, HTLV-I Infections complications, Humans, Immunocompromised Host, Lymph Nodes pathology, Lymphadenitis etiology, Male, Phenotype, Cryptococcosis diagnosis, Lymphadenitis diagnosis
- Abstract
Cryptococcosis is an invasive fungal infection in immunocompromised patients. The clinicopathological characteristics of cryptococcal lymphadenitis are not well known. We analyzed three cases of cryptococcal lymphadenitis and compared their characteristics with those in previous reports. Two patients were human immunodeficiency virus (HIV) carriers, and one patient was a human T-cell leukemia virus type-1 (HTLV-1) carrier. The age of the HTLV-1 carrier with cryptococcosis was much higher than that of the HIV-1 carriers. CD4-positive cell counts in peripheral blood were 5.8/μL (Case 1) and 79.9/μL (Case 2) in the HIV carriers and 3285/μL in the HTLV-1 carrier (Case 3). According to flow cytometric analysis of the lymph nodes of Cases 1, 2, and 3, 50.0%, 87.1%, and 85.9%, respectively, of the T-cells were CD3; 9.8%, 16.3%, and 75.8%, respectively, were CD4; and 35.5%, 77.3%, and 10.2%, respectively, were CD8. Cryptococcus neoformans was detected in tissue culture in all patients. Although gelatinous lesions and numerous fungal cocci were observed in the two HIV patients, the granuloma formation was small. Gelatinous formation and granuloma formation were observed in the HTLV-1 carrier. Necrosis was observed in all cases. In previous reports, granuloma formation, epithelioid cells, and necrotic lesions were observed in most cases. Most of the patients were also immunosuppressed. However, no HTLV-1 carrier was detected. In conclusion, lymphadenopathy in a HTLV-1 carrier may suggest the presence of cryptococcal lymphadenitis. The frequency of cryptococcosis in HTVL-1 carriers may increase with increase in the long-term survival rate of HTLV-1 carriers.
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- 2017
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38. Fine-needle aspiration cytology of leishmanial lymphadenitis in a HIV reactive patient.
- Author
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Biswas B and Pal S
- Subjects
- Adult, Humans, Male, Microscopy, Biopsy, Fine-Needle, Cytological Techniques methods, HIV Infections complications, Leishmaniasis diagnosis, Leishmaniasis pathology, Lymphadenitis etiology, Lymphadenitis pathology
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- 2017
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39. Far-infrared ray for treating chronic lower extremity lymphedema with dermatolymphangioadenitis: a postoperative complication of gynecological tumor resection.
- Author
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Li K, Xu H, Liu NF, Sadigh P, Evans V, and Zhang YX
- Subjects
- Adult, Aged, Cytokines metabolism, Female, Humans, Lymphadenitis etiology, Lymphedema etiology, Middle Aged, Quality of Life, Recurrence, Treatment Outcome, Genital Neoplasms, Female surgery, Infrared Rays, Lower Extremity pathology, Lymphadenitis radiotherapy, Lymphedema radiotherapy, Postoperative Complications radiotherapy
- Abstract
Purpose: Lower extremity lymphedema is regarded as a relatively common postoperative complication and is often accompanied with dermatolymphangioadenitis (DLA). This study combines clinical assessment and laboratory investigation to explore therapeutic effects of far-infrared radiation (FIR) therapy for chronic lower extremity lymphedema accompanied with DLA, occurring after gynecological tumor resection., Methods: Patients who met inclusion and exclusion criteria would be enrolled. They received regular sessions using the FIR therapy machine over the 4-week treatment course. Clinical and laboratory outcome measures were carried out before and after treatment. Clinical outcome measures included DLA seizure frequency (episodes/year), patients' subjective feedback for lymphedema-related symptoms and quality of life (QOL). Laboratory outcome measures included bacterial cultures and concentrations of inflammatory cytokines: IL-1β, IL-2, IL-4, IL-10, IL-12, IL-18, TNF-α, TNF-β, caspase-1 and INF-γ, detected in serum and local lymphedema tissue fluid samples using protein microarray and ELISA., Results: Between 2012 and 2016, a total of 120 female patients were screened for study enrollment. Sixty-four recruited patients underwent clinical evaluation both before FIR radiation therapy and 1 year after a single course of FIR radiation therapy. Eleven patients (17.2%), randomly chosen from the study group, underwent additional laboratory analysis of blood and local lymphedema tissue fluid samples. The frequency of DLA decreased following treatment (p < 0.001). Fifty patients (78%) did not experience a single episode of DLA recurrence in the year subsequent to treatment. The efficiency rate calculated using DLA frequencies was greater than 50% for 63 (98%) patients following treatment. Patients reported a subjective decrease in lymphedema-related symptoms (p < 0.05). Patients' QOL scores were higher after treatment (p < 0.001). Laboratory analysis showed an elevation in serum concentration of IL-1β after FIR therapy (p < 0.05) and reduced local tissue fluid concentrations of inflammatory cytokines IL-2, IL-10 and IL-18 (p < 0.05). Bacterial culture results before and after treatment were both negative., Conclusion: FIR radiation therapy provides an effective treatment modality for patients with chronic lymphedema accompanied with DLA that develops secondarily to treatment of gynecological malignancies, whose therapeutic effects may be due to reduced immune dysfunction within local lymphedema tissues.
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- 2017
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40. Paracoccidioides brasiliensis-associated dermatitis and lymphadenitis in a dog.
- Author
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Headley SA, Pretto-Giordano LG, Di Santis GW, Gomes LA, Macagnan R, da Nóbrega DF, Leite KM, de Alcântara BK, Itano EN, Alfieri AA, and Ono MA
- Subjects
- Animals, Antigens, Fungal analysis, Biopsy, Fine-Needle, Brazil, Cluster Analysis, DNA, Fungal chemistry, DNA, Fungal genetics, DNA, Ribosomal Spacer chemistry, DNA, Ribosomal Spacer genetics, Dermatitis etiology, Dermatitis pathology, Dog Diseases microbiology, Dogs, Female, Histocytochemistry, Immunoassay, Lymph Nodes microbiology, Lymph Nodes pathology, Lymphadenitis etiology, Lymphadenitis pathology, Microbiological Techniques, Microscopy, Paracoccidioidomycosis etiology, Paracoccidioidomycosis pathology, Phylogeny, Sequence Analysis, DNA, Skin microbiology, Skin pathology, Dermatitis veterinary, Dog Diseases diagnosis, Dog Diseases pathology, Lymphadenitis veterinary, Paracoccidioides isolation & purification, Paracoccidioidomycosis veterinary
- Abstract
Paracoccidioidomycosis (PCM) is an endemic disease of humans from Latin America that is caused by Paracoccidioides brasiliensis and P. lutzii, with most cases of PCM in domestic animals being associated with P. brasiliensis. This study presents the clinical, cytological, mycological, serological, and molecular findings associated with P. brasiliensis in a dog from Southern Brazil. Fine needle biopsies were collected from the skin and several lymph nodes of a 5-year-old female Labrador dog that had enlargement of most superficial lymph nodes. Cytology of the skin and lymph nodes revealed pyogranulomatous dermatitis and lymphadenitis associated with fine-necked, budding fungal structures consistent with the Paracoccidioides genus of organisms; mycological culture derived from the lymph node aspirate demonstrated similar budding structures. Serological assays using exoantigens obtained from the fungal culture demonstrated that the fungal organisms derived from the lymph node were antigenically similar to P. brasiliensis by immunodiffusion and Western blot. A PCR assay, using the fungal culture as input, amplified a partial segment of the internal transcribed spacer 1 and 2 regions of P. brasiliensis; direct sequencing and phylogenetic analyses confirmed the PCR product as P. brasiliensis. The combined cytological, mycological, serological, and molecular findings confirmed a diagnosis of fungal dermatitis and lymphadenitis due to P. brasiliensis in this dog. This case represents the third description of clinical PCM in dogs and the first confirmation of mycotic dermatitis associated with P. brasiliensis in this species. The participation of dogs in the possible dissemination of PCM is reviewed, and it is proposed that dogs are probable accidental hosts in the epidemiological cycle associated with P. brasiliensis.
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- 2017
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41. Association of Arterial and Lymph Node Inflammation With Distinct Inflammatory Pathways in Human Immunodeficiency Virus Infection.
- Author
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Tawakol A, Ishai A, Li D, Takx RA, Hur S, Kaiser Y, Pampaloni M, Rupert A, Hsu D, Sereti I, Fromentin R, Chomont N, Ganz P, Deeks SG, and Hsue PY
- Subjects
- Arteritis diagnosis, Arteritis epidemiology, CD4 Lymphocyte Count, California epidemiology, Case-Control Studies, HIV Infections virology, Humans, Incidence, Lymphadenitis diagnosis, Lymphadenitis epidemiology, Male, Middle Aged, Positron-Emission Tomography, Viral Load, Arteritis etiology, DNA, Viral analysis, HIV genetics, HIV Infections complications, Lymph Nodes diagnostic imaging, Lymphadenitis etiology
- Abstract
Importance: Human immunodeficiency virus (HIV) infection is associated with a high risk of cardiovascular disease and increased arterial inflammation. In HIV, inflammation is also increased within lymph nodes (LNs), tissues known to harbor the virus even among treated and suppressed individuals., Objective: To test the hypothesis that arterial inflammation is linked to HIV disease activity and to inflammation within HIV-infected tissues (LNs)., Design, Setting, and Participants: For this case-control study, participants were recruited from the SCOPE (Observational Study of the Consequences of the Protease Inhibitor Era) cohort, a clinic-based cohort of individuals receiving care at San Francisco General Hospital and the San Francisco Veteran's Affairs Medical Center. Arterial and LN inflammation were measured using 18F-fluorodeoxyglucose positron emission tomography. Detailed immunophenotyping was performed, along with measurement of viral activity/persistence and of circulating inflammatory biomarkers., Main Outcomes and Measures: Arterial and LN inflammation., Results: A total of 74 men were studied (45 HIV-infected men with a median age of 53 years [interquartile range, 49-59 years] and 29 uninfected male controls with a median age of 52 years [interquartile range, 46-56 years]). Lymph node inflammation was higher in HIV-infected individuals and correlated with markers of viral disease activity (viral load, CD8+ T cells, and CD4/CD8 ratio) and CD4+ T-cell activation. Uninfected controls had the lowest LN activity (mean [SD] maximum axillary LN standardized uptake value, 1.53 [0.56]), the elite controller and ART-suppressed groups had intermediate levels of LN (mean [SD] maximum axillary LN standardized uptake value, 2.12 [0.87] and 2.32 [1.79], respectively), and the noncontrollers had the highest activity (mean [SD] maximum axillary LN standardized uptake value, 8.82 [3.08]). Arterial inflammation was modestly increased in HIV-infected individuals and was positively correlated with circulating inflammatory biomarkers (high-sensitivity C-reactive protein and IL-6) and activated monocytes (CD14dimCD16+; nonclassical) but not with markers of HIV. While LN and arterial inflammation were increased in HIV, inflammatory activity in these tissues was not related (r = 0.09, P = .56)., Conclusions and Relevance: While LNs and, to a lesser degree, the arterial wall are inflamed in HIV, inflammation in these tissues is not closely linked. Namely, measures of HIV disease activity are strongly associated with LN inflammation but not with arterial inflammation. These data suggest that LN and arterial inflammation do not share underlying pathways of immune activation and also that therapeutic interventions that reduce viral disease activity may not predictably reduce arterial inflammation in HIV or its downstream consequence (ie, cardiovascular disease).
- Published
- 2017
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42. Disseminated Cryptococcosis in an Immunocompetent Child.
- Author
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Jain BB, Bose D, Mondal R, and Chattopadhyay S
- Subjects
- Child, Cryptococcosis pathology, Diagnostic Errors, Humans, Lymphadenitis etiology, Lymphadenitis pathology, Male, Tuberculosis diagnosis, Cryptococcosis diagnosis
- Abstract
A case of disseminated cryptococcus infection in an immunocompetent host is described. The present case attests to the importance of using a cautious approach for the diagnosis of granulomatous lymphadenitis. The patient was initially misdiagnosed and treated as disseminated tuberculosis. Later the patient developed visual loss and skin lesions. Periodic Acid Schiff stained sections of lymph node biopsy and cerebrospinal fluid culture established the diagnosis.
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- 2017
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43. [CAUSES AND WAYS OF THE NECK PHLEGMON SPREADING ON MEDIASTINUM WITH A DESCENDING PURULENT MEDIASTINITIS OCCURRENCE].
- Author
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Shevchuk IM and Snizhko SS
- Subjects
- Adult, Aged, Aggressive Periodontitis complications, Aggressive Periodontitis mortality, Aggressive Periodontitis pathology, Cellulitis etiology, Cellulitis mortality, Cellulitis surgery, Female, Humans, Lymphadenitis etiology, Lymphadenitis mortality, Lymphadenitis surgery, Male, Mediastinitis etiology, Mediastinitis mortality, Mediastinitis surgery, Mediastinum pathology, Mediastinum surgery, Middle Aged, Neck pathology, Neck surgery, Necrosis etiology, Necrosis mortality, Necrosis surgery, Suppuration etiology, Suppuration mortality, Suppuration surgery, Survival Analysis, Tonsillitis complications, Tonsillitis mortality, Tonsillitis pathology, Cellulitis pathology, Lymphadenitis pathology, Mediastinitis pathology, Necrosis pathology, Suppuration pathology
- Abstract
Results of treatment in 2000-2016 yrs of 183 patients for the neck phlegmon were analyzed. In 60 (32.8%) of them a descending purulent mediastinitis (DPM) was diagnosed. The main causes of the DPM occurrence were tonsilogenic and odontogenous factors. Postoperative lethality in DPM have constituted 25%.
- Published
- 2017
44. CLINICAL MANAGEMENT OF LOCALIZED BCG ADVERSE EVENTS IN CHILDREN.
- Author
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Moreira TN, Moraes-Pinto MI, Costa-Carvalho BT, Grumach AS, and Weckx LY
- Subjects
- Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Lymphadenitis etiology, Male, BCG Vaccine adverse effects
- Abstract
BCG adverse events (BCG-AE) are rare conditions with no well-established treatment. This study aims to describe clinical characteristics and outcome of localized BCG-AE. Children with BCG-AEs who were treated at the Reference Center for Special Immunobiologicals of the Federal University of São Paulo from 2009 to 2011 were included. Patients were followed monthly until 3 months after healing. One hundred and twenty-seven patients with localized BCG-AE were followed: 67 (52.7%) had suppurative lymphadenitis; 30 (23.6%) injection-site abscess; five (3.9%) had enlarged lymph node > 3 cm; four (3.1%) had ulcer > 1 cm; and one (0.8%) had a local bacterial infection. Five patients (3.9%) had more than one BCG-AE simultaneously. Fifteen patients (11.8%) had atypical manifestations: seven wart-like lesions; five BCG reactivations; two other dermatologic lesions and one with vasomotor phenomenon. Isoniazid was used in 96 patients with typical BCG-AE (85.7%) until lesion resolution which took place 3.1 months later (in median); the healing rate was 90.6%. Patients with atypical manifestations had an individual approach. Regarding the outcome, 105/112 patients with typical AE and 13/15 patients with atypical AE had resolution of BCG-AE. Localized BCG-AE caused by BCG Moreau RJ had positive outcome when treated with a short course of isoniazid. Atypical BCG-AE are not infrequent.
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- 2016
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45. Nontuberculous mycobacterial adenitis outside of the head and neck region in children: A case report and systematic review of the literature.
- Author
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Heraud D, Carr RD, McKee J, and Dehority W
- Subjects
- Child, Preschool, Female, Humans, Lymphadenitis microbiology, Mycobacterium Infections, Nontuberculous microbiology, Lymphadenitis etiology, Lymphadenitis pathology, Mycobacterium Infections, Nontuberculous diagnosis, Mycobacterium Infections, Nontuberculous pathology, Nontuberculous Mycobacteria classification, Nontuberculous Mycobacteria isolation & purification
- Abstract
Nontuberculous mycobacterial (NTM) adenitis of the head and neck region is well-described in healthy children, most commonly presenting under the age of 5years. Extracervicofacial NTM adenitis is less common. We present a case of NTM inguinal adenitis in a 2-year-old girl, followed by a systematic review of the literature., (Copyright © 2016 Asian-African Society for Mycobacteriology. Published by Elsevier Ltd. All rights reserved.)
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- 2016
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46. Novel insights into the early histopathogenesis of immunodeficiency-associated Burkitt lymphoma: a case report of Burkitt microlymphoma arising within HIV lymphadenitis.
- Author
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Park D, Ozkaya N, and Hariharan A
- Subjects
- Female, Flow Cytometry, Humans, Immunohistochemistry, In Situ Hybridization, Fluorescence, Middle Aged, Positron Emission Tomography Computed Tomography, Burkitt Lymphoma complications, Burkitt Lymphoma diagnosis, HIV Infections complications, Lymphadenitis etiology
- Abstract
Aims: To report a case detailing the early histopathogenesis of Burkitt lymphoma (BL), Epstein-Barr virus (EBV) positive, in the clinical setting of HIV infection., Methods and Results: We describe a 57 year-old woman with newly diagnosed HIV infection who presented with unilateral localized axillary lymphadenopathy. Histopathological, immunohistochemical, and flow cytometric analyses were performed and showed EBV-positive nests of Burkitt cells, including rare nests also positive for cytomegalovirus, exclusively located within hyperplastic monocytoid B-cell areas of HIV lymphadenitis. Due to positron emission tomography/computed tomography findings of persistent localized lymphadenopathy with markedly increased fludeoxyglucose avidity a core needle biopsy was performed. Histopathological, immunohistochemical, fluorescence in situ hybridization, and flow cytometric analyses confirmed BL., Conclusions: Early histopathogenesis of HIV-associated BL occurred as nests of EBV-positive Burkitt cells within prominent monocytoid B-cell areas in our case. The results equip the pathologist to identify a very subtle Burkitt microlymphoma which would allow for prompt and appropriate chemotherapeutic intervention and may promote research into the possible relationship between monocytoid B cells and BL., (© 2016 John Wiley & Sons Ltd.)
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- 2016
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47. [Langerhans cell histiocytosis presenting as isolated adenitis in an infant: case report].
- Author
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Soriano-Ramos M, Salcedo Lobato E, Baro Fernández M, and Blázquez-Gamero D
- Subjects
- Female, Histiocytosis, Langerhans-Cell complications, Humans, Infant, Lymphadenitis etiology, Neck, Histiocytosis, Langerhans-Cell diagnosis
- Abstract
Langerhans cell histiocytosis in infants is a rare condition, and presentation as an isolated cervical adenitis is exceptional at this age. We describe the case of a 3-month-old female infant presenting with a neck mass in the right mandibular angle with poor response to antibiotic treatment. Fine needle aspiration was performed and confirmed the diagnosis of Langerhans cell histiocytosis with complementary tests showing no features of systemic involvement. Langerhans cell histiocytosis should be considered in the differential diagnosis of subacute neck masses with poor outcome in infants and physicians should consider performing a fine needle aspiration to establish the diagnosis., (Sociedad Argentina de Pediatría.)
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- 2016
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48. Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome.
- Author
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Ali NS, Sartori-Valinotti JC, and Bruce AJ
- Subjects
- C-Reactive Protein metabolism, Chemokine CXCL10 blood, Fever therapy, Humans, Lymphadenitis therapy, NLR Family, Pyrin Domain-Containing 3 Protein genetics, Pharyngitis therapy, Pyrin genetics, Receptors, IgG blood, Recurrence, Stomatitis, Aphthous therapy, Syndrome, Vitamin D blood, Fever diagnosis, Fever etiology, Lymphadenitis diagnosis, Lymphadenitis etiology, Pharyngitis diagnosis, Pharyngitis etiology, Stomatitis, Aphthous diagnosis, Stomatitis, Aphthous etiology
- Abstract
Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome, the most common periodic disorder of childhood, presents with the cardinal symptoms of periodic fever, aphthous stomatitis, pharyngitis, and adenitis typically before age 5. This review presents the recent literature on PFAPA and summarizes key findings in the pathogenesis, evaluation, and treatment of the disease. Theories surrounding the pathogenesis of PFAPA include a faulty innate immunologic response in conjunction with dysregulated T-cell activation. A potential genetic link is also under consideration. Mediterranean fever (MEFV) gene variants have been implicated and appear to modify disease severity. In individuals with the heterozygous variant, PFAPA episodes are milder and shorter in duration. Diagnostic criteria include the traditional clinical signs, in addition to the following biomarkers: elevated C-reactive protein in the absence of elevated procalcitonin, vitamin D, CD64, mean corpuscular volume, and other nonspecific inflammatory mediators in the absence of an infectious explanation for fever. Treatment of PFAPA includes tonsillectomy, a single dose of corticosteroids, and, most recently, interleukin 1 blockers such as anakinra, rilonacept, and canakinumab. Tonsillectomy remains the only permanent treatment modality., (Copyright © 2016 Elsevier Inc. All rights reserved.)
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- 2016
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49. Tonsillar microbiota in children with PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and adenitis) syndrome.
- Author
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Tejesvi MV, Uhari M, Tapiainen T, Pirttilä AM, Suokas M, Lantto U, Koivunen P, and Renko M
- Subjects
- Biodiversity, Case-Control Studies, Child, Child, Preschool, Computational Biology methods, Female, Humans, Infant, Infant, Newborn, Male, Metagenome, Metagenomics methods, Palatine Tonsil surgery, Syndrome, Tonsillectomy, Fever etiology, Lymphadenitis etiology, Microbiota, Palatine Tonsil microbiology, Pharyngitis etiology, Stomatitis, Aphthous etiology
- Abstract
Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) is a childhood febrile syndrome of unknown origin that is often cured with tonsillectomy. We aimed to compare the bacterial microbiota of the tonsils removed from PFAPA patients with those of controls. We used next-generation sequencing technology to investigate the bacterial microbiota of the tonsils of 30 PFAPA patients and 24 controls. We found significant differences in the presence and relative abundance of many bacteria between PFAPA cases and controls. For example, cyanobacteria, potential producers of microcystins and other toxins, were more common in the case samples (14/30, 47 %) than in the controls (4/24, 17 %, p = 0.02), and the mean relative abundance of cyanobacteria was higher in the case samples (0.2 %) than in the controls (0.01 %, p = 0.01). Streptococci were present in all samples in both groups, but their mean relative abundance was lower in the case samples (3.7 %) than in the controls (9.6 %, p = 0.01). Typical nasopharyngeal microbes such as fusobacteria, Prevotella, Tannerella, Porphyromonas, and Parvimonas dominated the microbiota of the tonsils in both groups. The microbiota of the tonsils removed from PFAPA patients differed significantly from those of the controls. Tonsillar microbiota may play a role in triggering the inflammatory processes that lead to symptoms of PFAPA.
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- 2016
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50. False-Positive Axillary Lymph Nodes Due to Silicone Adenitis on (18)F-FDG PET/CT in an Oncological Setting.
- Author
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D'hulst L, Nicolaij D, Beels L, Gheysens O, Alaerts H, Van de Wiele C, and Maes A
- Subjects
- Axilla, Carcinoma, Non-Small-Cell Lung diagnostic imaging, Carcinoma, Non-Small-Cell Lung surgery, Female, Fluorodeoxyglucose F18, Humans, Lung Neoplasms diagnostic imaging, Lung Neoplasms pathology, Lung Neoplasms surgery, Lymph Nodes diagnostic imaging, Lymphadenitis diagnostic imaging, Lymphadenitis etiology, Lymphatic Metastasis, Male, Middle Aged, Radiopharmaceuticals, Transgender Persons, Breast Implants adverse effects, Breast Neoplasms surgery, Carcinoma, Non-Small-Cell Lung pathology, Lymph Nodes pathology, Lymphadenitis pathology, Positron Emission Tomography Computed Tomography methods, Silicones adverse effects
- Abstract
The case of a 49-year-old transgender individual with a history of bilateral silicone breast implants and a right lung mass proven by biopsy to be a non-small cell lung cancer is presented. In addition to the primary malignancy, a positron emission tomography/computed tomography scan showed contralateral hypermetabolic adenopathy in the left axilla that was suggestive of nodal metastatic disease. Additional imaging and histological examination of the lymph nodes indicated silicone breast implant leakage and silicone adenitis as the underlying cause of the hypermetabolic axillary lymph node., (Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
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