Subject(s)
Cochlea/abnormalities , Diseases in Twins/diagnosis , Diseases in Twins/genetics , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/genetics , Triplets/genetics , Vestibular Aqueduct/abnormalities , Abnormalities, Multiple/diagnosis , Abnormalities, Multiple/genetics , Audiometry, Pure-Tone , Child, Preschool , Cochlea/pathology , Developmental Disabilities/diagnosis , Developmental Disabilities/genetics , Endolymphatic Duct/abnormalities , Endolymphatic Duct/pathology , Humans , Language Development Disorders/diagnosis , Language Development Disorders/genetics , Magnetic Resonance Imaging , Otoacoustic Emissions, Spontaneous/genetics , Phenotype , Tomography, X-Ray Computed , Vestibular Aqueduct/pathologySubject(s)
Adenoma, Pleomorphic/diagnosis , Ear Neoplasms/secondary , Hearing Loss, Sensorineural/etiology , Parotid Neoplasms/diagnosis , Tinnitus/etiology , Adenoma, Pleomorphic/pathology , Adenoma, Pleomorphic/surgery , Cell Transformation, Neoplastic/pathology , Cranial Fossa, Posterior/pathology , Cranial Fossa, Posterior/surgery , Diagnosis, Differential , Ear Neoplasms/pathology , Ear Neoplasms/surgery , Earache/etiology , Facial Paralysis/etiology , Female , Humans , Magnetic Resonance Imaging , Mastoid/pathology , Mastoid/surgery , Neoplasm Invasiveness , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/surgery , Parotid Gland/pathology , Parotid Gland/surgery , Parotid Neoplasms/pathology , Parotid Neoplasms/surgery , Petrous Bone/pathology , Petrous Bone/surgery , Postoperative Complications/etiology , Reoperation , Skull Neoplasms/pathology , Skull Neoplasms/secondary , Skull Neoplasms/surgery , Tomography, X-Ray Computed , Young AdultABSTRACT
A 35-year-old man with HIV-infection presented with a progressive swelling of the left parotid gland lasting for 3 months. Physical examination revealed a firm mass on the tail of the parotid gland. Ultrasound examination of the left parotid showed a well-circumscribed round lesion. MR imaging demonstrated a 2 cm lesion in the ventral subcutaneous part of the parotid gland. Lateral parotidectomy was performed with suspected pleomorphic adenoma. Histologic analysis revealed a granulomatous necrotising inflammatory lesion of an intra- and extraparotideal lymph node. The patient had no family history of tuberculosis. Hematologic investigations were within normal limits. Chest X-ray was normal. Primary tuberculosis of the parotid gland in a patient with HIV-infection was diagnosed and anti-mycobacterial therapy was started. In HIV-patients with unilateral swelling of the parotid gland, tuberculosis should be considered in the differential diagnosis of pleomorphic adenoma and fine needle aspiration cytology should be performed to avoid unnecessary surgery.
Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , Parotid Diseases/diagnosis , Tuberculosis/diagnosis , AIDS-Related Opportunistic Infections/pathology , AIDS-Related Opportunistic Infections/surgery , Adult , Antitubercular Agents/therapeutic use , Combined Modality Therapy , Diagnosis, Differential , Humans , Magnetic Resonance Imaging , Male , Parotid Diseases/pathology , Parotid Diseases/surgery , Parotid Gland/pathology , Parotid Gland/surgery , Tuberculosis/pathology , Tuberculosis/surgery , UltrasonographyABSTRACT
We report the case of a 55 year old man with osteomyelitic destruction of the odontoid process and a parapharyngeal abscess. The patient was admitted with diagnosis of meningitis and degenerative cervical spine disease without compression of spinal cord or nerve roots but progressive impairment of cervical spine mobility. Inflammatory parameters in serum and cerebrospinal fluid were detected and antibiotic therapy was initiated resulting in subjective improvement of symptoms. When impairment of cervical spine motility persisted and gait disturbance developed, a parapharyngeal abscess and an osteomyelitic destruction of the odontoid process caused by infection with staphylococcus aureus was diagnosed. After cleavage of the abscess and four months of antibiotic therapy the gait disturbance disappeared and mild impairment of cervical spine motility persisted.
