ABSTRACT
Primary cutaneous infections with MAC are extremely rare. We report a case of primary cutaneous infection with MAC, in a 69 year-old HIV-negative male. Idiopathic CD4+ T-lymphocytopenia was diagnosed.
Subject(s)
Mycobacterium avium-intracellulare Infection/pathology , T-Lymphocytopenia, Idiopathic CD4-Positive/diagnosis , Tuberculosis, Cutaneous/pathology , Aged , Diagnosis, Differential , Humans , Male , Mycobacterium avium-intracellulare Infection/diagnosis , Mycobacterium avium-intracellulare Infection/immunology , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/immunologyABSTRACT
A 38-year-old woman with systemic lupus erythematosus and the phospholipid antibody syndrome was admitted because of rapidly evolving symptoms consistent with a transverse myelopathy at the TH9/10 level. Magnetic resonance imaging (MRI) showed slight diffuse swelling and increased signal intensity of the spinal cord. She was treated with high dose methylprednisolone plus azathioprine and aspirin. Four months later she had achieved almost complete remission with minimal residual sphincter disturbances. Despite the clinical recovery, repeated MRI at 4 months and 4 years showed diffuse and irreversible atrophy of the entire spinal cord.
Subject(s)
Antiphospholipid Syndrome/complications , Lupus Erythematosus, Systemic/complications , Myelitis, Transverse/complications , Spinal Cord/pathology , Adult , Atrophy/etiology , Female , Humans , Magnetic Resonance ImagingABSTRACT
A secondary aortoenteric fistula (SAIF) is a direct communication between the gastrointestinal (GI) tract and the aorta in a patient who has undergone major surgery on the aorta, often an aortic graft operation. The cardinal symptoms of a SAIF are septicaemia and/or GI-haemorrhage. In this case, a 40 year old man was admitted to the hospital because of repeated episodes of fever, chills and malaise. The patient had undergone an aortofemoral by-pass graft operation five years previously. Blood cultures showed repeated growth of different enteric-related microorganisms. None of the used diagnostic investigations revealed any signs of infection or fistulation near the aortic graft. After five months of hospitalization an endoscopy revealed the aortic graft protuding into the duodenal lumen, verifying the fistula. If GI-haemorrhage and/or septicaemia arise in a patient who has undergone major surgery on the aorta, one must suspect a secondary aortoenteric fistula and not hesitate too long to perform an explorative laporatomy. If untreated, the mortality rate of the condition is 100%.
