ABSTRACT
Sarcoidosis is a multi-system disorder characterized by non-caseating granulomas. Depressed cellular immunity predisposes patients to infections with certain intracellular organisms, mostly fungi, Mycobacterium tuberculosis, and Nocardia species. Isolated liver tuberculosis is a rare condition, and atypical clinical presentation challenges the clinical acumen of the treating physician. Liver sarcoidosis is usually unsuspected and confused with primary or metastatic liver carcinoma. We describe a case of isolated tuberculous liver abscess without pulmonary spread in a patient with asymptomatic stage I sarcoidosis.
Subject(s)
Liver Abscess/diagnosis , Sarcoidosis/diagnosis , Tuberculosis, Hepatic/diagnosis , Adult , Humans , Liver Abscess/etiology , Liver Abscess/therapy , Male , Sarcoidosis/etiology , Sarcoidosis/therapy , Tuberculosis, Hepatic/etiology , Tuberculosis, Hepatic/therapyABSTRACT
We describe a case of a 15-year-old boy with vincristine-induced simultaneous isolated bilateral facial palsy. The boy presented with superior vena caval syndrome (SVC syndrome), right-sided pleural effusion and anterior mediastinal lymphadenopathy. Histopathological examination of left axillary lymph node was suggestive of lymphoblastic lymphoma. We started chemotherapy with cyclophosphamide, doxorubicin, vincristine and prednisolone. SVC syndrome disappeared completely after the 1st cycle, and he achieved remission after the 3rd cycle of chemotherapy. He noticed that he could not close his eyes. Neurological examination revealed bilateral lower motor neuron facial palsy. Findings from examination of other cranial nerves and peripheral nerves were normal. Results of MRI of brain and cerebrospinal fluid examination were normal. He received 6 mg vincristine before developing toxicity.
