ABSTRACT
BACKGROUND: Mycobacterium welchii (Mycobacterium w) vaccine was one of the many strategies used to both treat and prevent coronavirus disease 2019 (COVID-19) infection. We report the results of a retrospective analysis of 15 cases with vaccine-site granulomas after administration of prophylactic Mycobacterium w vaccine as part of a trial for COVID-19 and our experience in managing those cases. METHODS: This was a retrospective analysis of 15 patients with vaccine-site granulomas who were given the vaccine as a prophylactic measure as part of a trial with informed consent. RESULTS: The mean average age of cases was 37 and the male-to-female ratio was 1:0.87. All of the patients developed erythematous tender nodules over the injection sites within a month of receiving the inoculations. Mycobacterial cultures and cartridge-based nucleic acid amplification tests yielded negative results. Skin biopsy revealed granulomatous dermatitis with acid-fast bacilli positivity. A diagnosis of noninfective granulomatous dermatitis was made. Treatment started with analgesics and anti-inflammatory agents. Systemic antibiotics were required in 9/15 patients. Patients are being followed up with no reported recurrence till date. CONCLUSION: The possibility of injection-site granuloma should be taken into the risk-benefit analysis for the administration of Mycobacterium w vaccine and the patients should be counseled as such. Patients with persistent ulceration respond to combinations of doxycycline, ofloxacin, and clarithromycin.
Subject(s)
Bacterial Vaccines , Granuloma , Humans , Female , Male , Retrospective Studies , Adult , Granuloma/microbiology , Granuloma/pathology , Middle Aged , Bacterial Vaccines/adverse effects , Bacterial Vaccines/administration & dosage , COVID-19/prevention & control , Injection Site Reaction/etiology , Young Adult , Anti-Bacterial Agents/therapeutic useABSTRACT
Systemic sclerosis is a connective tissue disorder of unknown etiology. Although it is a multisystemic disorder, skin thickening is considered as a hallmark of the disease. It usually involves the lungs, gastrointestinal, and musculoskeletal systems. However, a rare subset of systemic sclerosis, systemic sclerosis sine scleroderma, is characterized by internal organ involvement and positive serologic markers with the total or partial absence of cutaneous manifestations. We present a rare association of osteopetrosis in a case of systemic sclerosis sine scleroderma, in a 22-year-old male patient, who presented with pulmonary symptoms as his chief complaints, unreported so far in literature.
Subject(s)
Osteochondrodysplasias/diagnosis , Tracheal Diseases/diagnosis , Female , Hemoptysis/etiology , Humans , Middle Aged , Osteochondrodysplasias/complications , Osteochondrodysplasias/diagnostic imaging , Tomography, X-Ray Computed , Trachea/diagnostic imaging , Tracheal Diseases/complications , Tracheal Diseases/diagnostic imagingABSTRACT
An 8-year-old boy presented with recurrent chest pain and haemoptysis since 3 years of age. He had taken multiple courses of antitubercular treatment without any symptomatic relief. His chest x-ray showed opacity consistent with right sided lung collapse. Further detailed work-up including high-resolution CT scan of thorax, pulmonary angiogram and radionucleide study confirmed intrathoracic gastrogenic cyst. Complete control of symptoms was achieved with pantaprazole 40 mg once daily.
Subject(s)
Bronchitis/complications , Cysts/complications , Hemoptysis/etiology , Stomach Diseases/complications , Child , Humans , Male , RecurrenceABSTRACT
Tuberculosis (TB) of the maxillary sinus is rare. We describe the clinical presentation, management and outcome in two human immunodeficiency virus (HIV) seronegative patients with histopathologically confirmed maxillary sinus TB. One of the patients who presented earlier in the course of the disease could be managed with antituberculosis treatment alone, while the other who presented late required surgical intervention as well.
Subject(s)
Maxillary Sinus/microbiology , Mycobacterium tuberculosis/isolation & purification , Tuberculosis/diagnosis , Adult , Aged , Biopsy , Diagnosis, Differential , Female , Humans , Male , Tomography, X-Ray Computed , Tuberculosis/microbiologyABSTRACT
A 26 year-old lady presented with episodic breathlessness, chest tightness, recurrent nasal obstruction and excessive sneezing, mainly during change of season along with opacity of the right hemithorax on chest x-ray. Further detailed work-up including spirometry, high-resolution CT scan of the thorax and fibre-optic bronchoscopy confirmed complete right lung agenesis in patients with bronchial asthma and allergic rhinitis. Complete control of symptoms was achieved with formeterol 6 µg and mometasone 200 µg (via dry powder inhaler) and intranasal fluticasone 50 µg (nasal spray) 2 puffs twice daily and oral montelukast 10 mg with levocetirizine 5 mg once daily.
