Résumé
Cytomegalovirus (CMV) colitis, which is rare in an immunocompetent patient, was encountered in a 67-year-old man who was admitted due to persistent diarrhea. The first diagnostic tool was colonoscopy, which showed multiple ulcers from cecum to rectum. The secondary tool was CMV polymerase chain reaction, and CMV colitis was diagnosed. Intravenous ganciclovir therapy was administered, which resulted in improvement of diarrhea and ulcers throughout the colon were healed. Asymptomatic colon perforation was detected during diagnostic testing, which improved over the conventional treatment. CMV colitis is rare in immunocompetent patients, but it is essential for the differential diagnosis.
Sujets)
Sujet âgé , Humains , Caecum , Colite , Côlon , Coloscopie , Cytomegalovirus , Diagnostic différentiel , Tests diagnostiques courants , Diarrhée , Ganciclovir , Immunocompétence , Réaction de polymérisation en chaîne , Rectum , UlcèreRésumé
Solitary renal metastasis of esophageal cancer is rarely encountered. Herein, we report the case of a 47-year-old man who developed a solitary renal metastasis after concurrent chemoradiotherapy followed by esophagectomy with esophagogastrostomy for esophageal squamous cell carcinoma, and treatment with nephrectomy and subsequent chemotherapy. Histopathological evaluation after operation revealed that the kidney mass was a metastatic lesion from esophageal cancer. He completed 15 cycles of palliative chemotherapy after nephrectomy and remained cancer-free for 36 months. Although lymph node metastasis occurred during regular follow-up, no evidence of lymph node metastasis was found on the imaging study after 9 cycles of chemotherapy with radiotherapy.
Sujets)
Humains , Mâle , Adulte d'âge moyen , Carcinome épidermoïde , Chimioradiothérapie , Traitement médicamenteux , Tumeurs de l'oesophage , Oesophagectomie , Études de suivi , Noeuds lymphatiques , Métastase tumorale , Néphrectomie , RadiothérapieRésumé
Cytomegalovirus (CMV) colitis, which is rare in an immunocompetent patient, was encountered in a 67-year-old man who was admitted due to persistent diarrhea. The first diagnostic tool was colonoscopy, which showed multiple ulcers from cecum to rectum. The secondary tool was CMV polymerase chain reaction, and CMV colitis was diagnosed. Intravenous ganciclovir therapy was administered, which resulted in improvement of diarrhea and ulcers throughout the colon were healed. Asymptomatic colon perforation was detected during diagnostic testing, which improved over the conventional treatment. CMV colitis is rare in immunocompetent patients, but it is essential for the differential diagnosis.
Sujets)
Sujet âgé , Humains , Caecum , Colite , Côlon , Coloscopie , Cytomegalovirus , Diagnostic différentiel , Tests diagnostiques courants , Diarrhée , Ganciclovir , Immunocompétence , Réaction de polymérisation en chaîne , Rectum , UlcèreRésumé
Thrombotic thrombocytopenic purpura (TTP) is a blood coagulation disorder that damages numerous organs, including the kidney, heart and brain. Features indicative of TTP include thrombocytopenia, microangiopathic hemolytic anemia, neurologic symptoms, kidney failure and fever. Infections, toxins, pregnancy and, rarely, autoimmune diseases are all known to be associated with TTP. We encountered a rare case of rheumatoid arthritis accompanied by TTP following tympanoplasty. The patient's confusion, thrombocytopenia and renal failure all improved after plasmapheresis and high-dose glucocorticoid therapy, but she eventually expired due to sepsis. We report on this case herein and also review the relevant literature.
Sujets)
Grossesse , Anémie hémolytique , Polyarthrite rhumatoïde , Maladies auto-immunes , Troubles de l'hémostase et de la coagulation , Encéphale , Fièvre , Coeur , Rein , Manifestations neurologiques , Plasmaphérèse , Purpura thrombotique thrombocytopénique , Insuffisance rénale , Sepsie , Thrombopénie , TympanoplastieRésumé
Diffuse idiopathic skeletal hyperostosis (DISH) is a condition characterized by the calcification and ossification of soft tissue, and can lead to severe cervical kyphosis, presenting with a spectrum of physical complaints including dysphagia, hoarseness, stridor, aspiration pneumonia, and dyspnea due to airway compromise. Restrictive ventilatory impairment is very rare. We encountered a 73-year-old man with DISH presenting with progressive dysphagia and dyspnea over a few months. The symptoms were evaluated with a video fluoroscopy swallowing study and pulmonary function tests (PFT). The PFT revealed restrictive ventilatory impairment. A neck magnetic resonance imaging (MRI) study showed anterior cervical osteophytes causing upper airway compromise and compression of the esophagus. Osteophytes were removed surgically and the patient improved clinically. Here, we describe the case with a literature review.