ABSTRACT
A case of disseminated cryptococcosis in an HIV-negative patient presenting with cutaneous lesions is described for the first time in Egypt. The patient, a 16-year-old male, presented with cough, expectoration, loss of weight, and cutaneous lesions, mainly on the face and trunk. The lesions consisted of vegetating crusted plaques discharging purulent to sanguinous fluid and flattened, shiny, erythematous to brownish plaques. Anorexia, headache and personality changes soon followed. Histopathological examination of lesions was highly suggestive of a deep mycosis, particularly cryptococcosis. The fulminant disease advanced with central nervous system involvement. The progression was not arrested when systemic antifungal therapy was administered late in the disease course. Pathological examination of lungs, liver, pancreas and spleen revealed disseminated infection with no evidence of other underlying pathology. Disseminated cryptococcosis is a morbid infection, rare in an area where heightened awareness and raised index of suspicion will surely allow earlier diagnosis, management and better prognosis.
Subject(s)
Cryptococcosis/diagnosis , Dermatomycoses/diagnosis , Fungemia/diagnosis , Occupational Diseases/diagnosis , Adolescent , Agriculture , Antifungal Agents/therapeutic use , Biopsy, Needle , Cryptococcosis/physiopathology , Cryptococcosis/therapy , Dermatomycoses/physiopathology , Dermatomycoses/therapy , Fatal Outcome , Fungemia/physiopathology , Fungemia/therapy , Humans , MaleABSTRACT
Sperm antibodies were evaluated in serum and semen of 14 cases with bilateral congenital absence of the vas deferens, by agglutination and complement dependent tests. The level of the various immunoglobulin fractions were determined by the single radial immuno diffusion method. Sperm agglutinins were present in serum in 71% of cases and in 29% in semen. Immunoglobin (Ig) M was not detected in semen of both patient and control groups, while IgG and IgA were absent in the semen of patients.
Subject(s)
Autoantibodies/analysis , Infertility, Male/immunology , Semen/immunology , Spermatozoa/immunology , Vas Deferens/abnormalities , Adult , Humans , Immunoglobulin A/analysis , Immunoglobulin G/analysis , Immunoglobulin M/analysis , MaleABSTRACT
Fifteen children, 6-14 years old, who were heavily exposed to pigeon droppings, presented with cough, chills and breathlessnes on mild exertion. Twelve gave immediate positive skin test reactions to pigeon droppings. Ten of the fifteen also gave a late (Arthus) reaction, and seven gave a positive delayed reaction which was maximal at 24--72 hr. Nine children had precipitins against avian droppings. In ten patients who were tested for lymphocyte transformation, five gave positive responses to both serum and pigeon droppings. Radiological findings of the chest showed parenchymatous infiltrations and diffuse interstitial reticulations, suggestive of extrinsic allergic alveolitis. In a control group of fifteen heavily-exposed children who had no symptoms, immediate and late skin reactions occurred respectively in five and two. One only had a positive precipitin test, and one of five tested had a positive lymphoblastic transformation. In a non-exposed comparable group of children, all tests were negative except for one immediate positive skin response. Children heavily exposed to the inhalation of avian antigens can develop extrinsic allergic bronchiolo-alveolitis.
