ABSTRACT
Subcutaneous fungal infections are relatively uncommon in the lower extremity. Mycetoma begins as painless papules or nodules that increase in size and progresses to involve the connective tissue. Diagnosis is based on biopsy, with definitive identification of the organism needed for effective treatment. Treatment consists of antifungal medications and surgical debridement. This article provides an overview of this disorder and reports on a case of recurrent mycetoma in a 70-year-old woman.
Subject(s)
Mycetoma , Aged , Antifungal Agents/therapeutic use , Combined Modality Therapy , Debridement , Female , Follow-Up Studies , Fusarium/isolation & purification , Humans , Mycetoma/therapy , RecurrenceSubject(s)
Spider Bites/diagnosis , Adult , Animals , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Skin/pathology , Spider Bites/pathology , Spider Bites/therapy , SpidersABSTRACT
We compared the presentation of abdominal tuberculosis in 43 patients infected with the human immunodeficiency virus (HIV) and in 35 patients without HIV infection. Fever, weight loss, and extraabdominal lymphadenopathy were more common in HIV-infected patients, whereas ascites and jaundice were more frequent in patients without HIV infection. Intraabdominal lymphadenopathy and visceral lesions, visualized on computed tomography scans, were more common in HIV-infected patients, whereas ascites and omental thickening were more frequent in patients without HIV infection. Aspirates of abdominal lymph nodes were the only samples revealing acid-fast bacilli in eight HIV-infected patients, yielding a rapid diagnosis. Disseminated tuberculosis was present in 93% of the HIV-infected patients, compared with 31% of those without HIV infection; tuberculosis contributed to death in 23% of HIV-infected patients and in 31% of those without HIV infection. We conclude that abdominal tuberculosis in HIV-infected patients is almost invariably a manifestation of disseminated disease and results in significant mortality.
