Unilateral Cysticercosis of the Parotid Gland: Case Report, Diagnosis, and Clinical Management.

Cysticercosis is a systemic parasitic infection caused by the establishment of the larval form of the parasitic cestode, Taenia solium. Cysticercosis is acquired via the fecal-oral route and is prevalent in low- and middle-income countries (LMICs). Patients typically manifest with skeletal muscle, subcutaneous, or central nervous system involvement. Though there are reports of oral mucosa involvement, solitary involvement of the parotid gland is rare. This is a rare case of a 57-year-old man diagnosed with parotid cysticercosis by imaging and FNA. He was successfully treated by anthelminthic therapy and needle aspiration. The patient has been seen back several times. The cyst is not palpable, and he is satisfied. Parotid cysticercosis should be considered in the differential of a parotid mass in patients who have traveled to endemic regions. Though prior reports have indicated the importance of surgical excision, this patient was treated medically.

Balamuthia mandrillaris Granulomatous Amebic Encephalitis With Renal Dissemination in a Previously Healthy Child: Case Report and Review of the Pediatric Literature.

Balamuthia mandrillaris is a recently described ameba known to cause a subacute to chronic central nervous system infection called granulomatous amebic encephalitis. Evidence suggests that apparently immunocompetent persons are at risk for disease and show a similar nonspecific presentation to that of immunodeficient persons. However, evidence of hematogenous dissemination, which has been found in immunodeficient patients, has been lacking in immunocompetent patients. Here, we describe a previously healthy patient with B mandrillaris-associated granulomatous amebic encephalitis in whom both central nervous system and renal disease were found during autopsy, which suggests hematogenous dissemination. We also provide a comprehensive review of the pediatric literature on this disease and its clinical presentation in children.

Cytologic diagnosis of coccidioidomycosis: Spectrum of findings in Southern Arizona patients over a 10 year period.

BACKGROUND: The largest series examining the cytological diagnosis of coccidioidomycosis was reported more than 20 years ago and only considered fine needle aspiration (FNA) specimens from pulmonary nodules. Since then, there has been a substantial increase in the incidence of the disease in endemic regions. The aims of this study were to examine the spectrum of Coccidioides in all cytologic specimens and detail their diagnostic and clinical features. The prevalence of infection is also examined against temperature and precipitation data. METHODS: The Department of Pathology database was retrospectively searched for cases diagnosed as coccidioidomycosis. Climate report was obtained from National Weather Service Forecast Office. Statistical analysis was carried out using JMP version 11.2.0. RESULTS: The presence of Coccidiodes was microscopically diverse with immature spherules, variably sized spherules, endosporulating spherules, empty spherules, and ruptured spherules being observed. Bronchoalveolar lavages demonstrated the greatest number of different forms of Coccidioides and were associated with acute inflammatory response. Granulomas were rare and mostly seen in lymph nodes and extra pulmonary sites. A necrotic background with paucity of inflammation was frequently seen in lung FNA. Immune competent patients outnumbered immunocompromised patients, illustrating the importance of considering the diagnosis in all patients. The reported association between rainfall and peak prevalence was not observed in our study. CONCLUSION: Coccidioides has diverse cytological appearance and varied host response depending on the site and type of preparation examined. In endemic areas, the disease should be considered in all patients, independent of immune status, and throughout the year.