ABSTRACT
In a tropical country like India, fevers are caused by different etiological agents. Rickettsial infections, which have a global distribution is one of the differential diagnosis in such cases and are reported from almost all parts of India. Rickettsial diseases widely vary in severity from self-limited mild illnesses to fulminating life-threatening infections. They are obligate intracellular gramnegative coccobacillary forms that multiply within eukaryotic cells which makes it difficult to culture them on artificial culture medium. With globalization there is rapid spread of disease across the continents and therefore, skills for diagnosis and management of the disease attains global importance. Rickettsial diseases can be clinically classified as Spotted Fever group, typhus group, distinctive clinical rickettsiae and emerging rickettsiae. The clinical course will have incubation period, stage non-specific clinical signs and symptoms followed by typical/classical features depending on the type of rickettsiae infecting a person. However the clinical manifestation varies from one geographical area to another area for same species. The rickettsial diseases once thought to have been eradicated from India are re-emerging in many parts of our country. Their presence has recently been documented in at least eleven states of our country. Greater clinical awareness, a higher index of suspicion, better use of available diagnostic tools would increase the frequency with which rickettsial diseases are diagnosed.
Subject(s)
Agglutination Tests/methods , Child , Doxycycline/therapeutic use , Rickettsia Infections/classification , Rickettsia Infections/diagnosis , Rickettsia Infections/drug therapy , Rickettsia Infections/epidemiology , Rickettsia Infections/etiology , Rickettsia Infections/therapySubject(s)
Atrophy , Blindness/congenital , Brain/pathology , Consanguinity , Deafness/congenital , Humans , Infant , Genetic Linkage/genetics , Magnesium/blood , Male , Intellectual Disability/genetics , Microphthalmos/genetics , Retinal Detachment/congenital , Vitreous Body/abnormalities , X Chromosome/geneticsABSTRACT
Objetive: To describe the local and regional anatomical spread and growing pattern of the sinonasal malignant tumors based on pretreatment CT and MRI findings. Material, patients and methods: The current study was performed as a retrospective clinical series that includes 21 patients studied and treated in MD Anderson Cancer Center, Houston, Texas. Anatomical analisis was performed based in CT and MRI findings. Results: Here is described in detail the growing pattern of sinonasal malignancies and the corresponding secondarily affected structures. Conclusion: The sinonasal malignancies mainly affects elderly people, corresponding to carcinomas, arising frequently from the maxilary sinus that compromises the suprastructure and secondarily involves the pterigopalatine fossa, orbits and nasal cavity. Imaging based anatomical mapping of the tumoral spread leads the desition of resectability and focuses the attention in possible areas of recurrence