ABSTRACT
Granuloma annulare (GA) is a reactive process in the dermis, related to degeneration of collagen. It may occur as an idiopathic phenomenon or in conjunction with a myriad of systemic conditions, including infectious disease. We report an interesting case of GA precipitated by pulmonary coccidioidomycosis.
Subject(s)
Coccidioidomycosis/diagnosis , Granuloma Annulare/diagnosis , Lung Diseases, Fungal/diagnosis , Antifungal Agents/therapeutic use , Coccidioidomycosis/diagnostic imaging , Coccidioidomycosis/drug therapy , Coccidioidomycosis/immunology , Coccidioidomycosis/pathology , Female , Fluconazole/therapeutic use , Granuloma Annulare/drug therapy , Granuloma Annulare/immunology , Granuloma Annulare/pathology , Humans , Immunoglobulin G/blood , Immunoglobulin G/immunology , Immunoglobulin M/blood , Immunoglobulin M/immunology , Lung Diseases, Fungal/diagnostic imaging , Lung Diseases, Fungal/drug therapy , Lung Diseases, Fungal/immunology , Middle Aged , Radiography , Treatment OutcomeABSTRACT
In a current publications, it has been suggested that hypoxia-triggered "good angiogenesis" involving hypoxic up-regulation of vascular endothelial growth factor (VEGF) molecules, genes, and receptors is likely responsible in a major way for the remarkable gut and patient salvage experience associated with use of the "patch, drain, and wait" (PD&W) surgical approach to perforated necrotizing enterocolitis and midgut volvulus (MGV) with extensive ischemia/necrosis. We report a case in which extensive ischemia/necrosis in a newborn with gastroschisis (likely MGV-induced) was managed successfully by PD&W with an associated marked (24-fold) elevation of VEGF in drainage fluid at 7 days post-initiation of PD&W.
