ABSTRACT
This pictorial review aims to highlight the clinical and imaging features of melioidosis in various organ systems. The patients were from two centres: one in Thailand and one in Singapore. The annual average incidence of melioidosis is estimated to be 4.4 in 100 000 in north-eastern Thailand and 1.7 in 100 000 in Singapore. Melioidosis affects many different organs and produces a spectrum of imaging features. The lung is the most frequently involved organ and, on radiographs and computed tomography, melioidosis may manifest as acute pulmonary consolidation, multiple nodules and abscesses. The finding of multiple small discrete abscesses in both the liver and the spleen is highly suggestive of visceral melioidosis and is best diagnosed on ultrasonography and computed tomography. Bone and soft tissue musculoskeletal involvement is usually part of disseminated melioidosis, with changes being seen on radiographs and MRI. Although imaging findings of melioidosis are not specific, this infection requires a high index of clinical suspicion, particularly in patients with pre-disposing comorbidities, such as diabetes mellitus, chronic renal failure, alcoholism or malignancy, those who are immunosuppressed as the result of either diseases or drug treatment, and those living in or with a history of travel to endemic areas.
Subject(s)
Bone Diseases, Infectious/diagnosis , Brain Diseases/diagnosis , Central Nervous System Bacterial Infections/diagnosis , Lung Diseases/diagnosis , Melioidosis/diagnosis , Splenic Diseases/diagnosis , Adult , Aged , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Risk Factors , Tomography, X-Ray ComputedABSTRACT
A 58-year-old man presented with signs of obstructive jaundice for two weeks. Ultrasonography showed dilatation of the intrahepatic ducts and common bile duct, due to a distal common bile duct mass. ERCP showed a papillary mass. A Whipple's operation was done for the ampulla of Vater carcinoma. The role of imaging in the diagnosis and treatment of obstructive jaundice is reviewed. The common causes of distal extrahepatic obstructive lesions are also discussed.
Subject(s)
Ampulla of Vater , Carcinoma/diagnosis , Common Bile Duct Neoplasms/diagnosis , Diagnostic Imaging/methods , Humans , Jaundice/etiology , Male , Middle AgedABSTRACT
A 62-year-old man was incidentally found to have a palpable right paraumbillcal mass. Ultrasonography and intravenous urogram showed cross-fused renal ectopia. The embryology and clinical features of renal ectopia are discussed.
