February 1, 2009 Ali Lotfizadeh, MD and Dinesh K. Chhetri, MD
October 31, 2008 Enrique Palacios, MD, FACR, Wesley Jones, MD, and Jorge Alvernia, MD
October 31, 2008 Amy L. Rutt, DO and Robert T. Sataloff, MD, DMA
article
Abstract
Aspergillus niger, an opportunistic filamentous fungus, was identified as the cause of chronic unilateral otomycosis in a 55-year old, immunocompromised man who had been unresponsive to a variety of treatment regimens. The patient presented with intermittent otalgia and otorrhea and with a perforation of his left tympanic membrane. A niger was identified in a culture specimen obtained from the patient's left ear canal. In immunocompromised patients, it is important that the treatment of otomycosis be prompt and vigorous, to minimize the likelihood of hearing loss and invasive temporal bone infection.
July 31, 2008 Diana T. Albay, MD and Glenn E. Mathisen, MD
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Abstract
Lymphogranuloma venereum (LGV)—caused by Chlamydia trachomatis serovars L1, L2, or L3—rarely occurs in the United States. The disease clinically manifests in three stages: primary, secondary, and tertiary. The primary manifestation, a self-limited genital ulcer at the site of inoculation, often is absent by the time the patient seeks medical attention. The most common clinical manifestation of LGV is evident in its secondary stage: unilateral tender inguinal and/or femoral lymphadenopathy. However, proctocolitis or inflammatory involvement of perirectal or perianal lymphatic tissues resulting in fistulas and strictures may also occur. The diagnosis of LGV is usually made serologically and by exclusion of other causes of inguinal lymphadenopathy or genital ulcers. Doxycycline is the preferred treatment; it cures the infection and prevents ongoing tissue damage. This case highlights an unusual manifestation of LGV infection—cervical lymphadenopathy following suspected oropharyngeal infection with C trachomatis. Head and neck manifestations of LGV may become an increasing problem in the future if sexual practices such as orogenital contact become more widespread.
March 1, 2008 Kristine E. Johnson, MD, Kevin Leahy, MD, PhD, Christopher Owens, MD, Joel N. Blankson, MD, PhD, William G. Merz, PhD, and Bradley J. Goldstein, MD, PhD
article
Abstract
We describe what we believe is the first reported case of simultaneous highly invasive cutaneous and laryngopharyngeal zygomycosis in a non-neutropenic, nondiabetic but immunosuppressed patient with prostate cancer. An invasive fungal process was not suspected until late in the patient's hospital course; when it was, a tracheotomy and direct laryngoscopic biopsies were performed. Unresectable invasive zygomycosis with Rhizopus rhizopodiformis was diagnosed. The patient was managed with liposomal amphotericin B initially and later with palliative medical therapy until he died. This case emphasizes the need for a rapid and specific diagnosis with timely introduction of appropriate antifungal management, particularly now that voriconazole is frequently used as empiric prophy-laxis against aspergillosis in high-risk patients.
January 1, 2008 Subhaschandra Shetty, MS, DNB, Usha Kini, MD, DCP, DNB, and Rajeev Joy, MBBS, DLO
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Abstract
Mucormycosis is characterized by severe infection with rapid progression and a high mortality rate. In immunocompromised hosts, the most common type is the rhinocerebral form of mucormycosis. Invasive mucormycosis affecting only the tongue is extremely rare. We report one such case that occurred in an immunocompromised 4-month-old girl with Down syndrome who had been hospitalized for acute gastroenteritis. The infant had metabolic acidosis secondary to diarrhea. It was suspected that the infection had been contracted through the use of a wooden tongue depressor during oral examination. We present this case report in the hope that it will discourage clinicians from using wooden tongue depressors in vulnerable infants. We also wish to emphasize that mucormycosis should be considered in all patients—regardless of age—who pre-sent with localized bluish-black discolored mucosa of the oral mucosa and/or tongue.
October 31, 2007 Kenneth Le, MD, Philip J. Daroca Jr., MD, and Enrique Palacios, MD
October 31, 2007 Dewey A. Christmas Jr., MD, Joseph P. Mirante, MD, FACS, and Eiji Yanagisawa, MD, FACS
September 30, 2007 Brenda L. Nelson, DDS; Lester D.R. Thompson, MD, FASCP
article
Median rhomboid glossitis-also known as central papillary atrophy and posterior midline atrophic candidiasis-is a type of erythematous candidiasis unique to the midline posterior tongue. It occurs in as many as 1% of adults.
July 31, 2007
article
Bijan Khademi, MD;
Nika Niknejad, MD;
Behrooz Gandomi, MD;
Firoozeh Yeganeh, MD
Abstract
We conducted a prospective study to determine the correlation between the presence or absence of Helicobacter pylori on the tonsillar surface and in the tonsillar core as determined by the Campylobacter-like organism (CLO) rapid urease enzyme test. Our study population was made up of 55 patients who underwent adenoidectomy, tonsillectomy, or both from December 2002 through April 2003 at Khalili Hospital in Shiraz, Iran. Of these 55 patients, 45 (82%) were positive and 10 (18%) were negative for H pylori colonization as determined by CLO testing. Analysis of samples obtained from individual patients revealed differences in H pylori colonization between tonsillar surface samples and the core tissue samples. Of 106 tonsils obtained from 53 patients who underwent adenotonsillectomy or tonsillectomy, H pylori was found on 56 tonsillar surface samples (53%) and 24 tonsillar core samples (23%); only 13 tonsils (12%) contained H pylori both on the surface and in the core. We conclude that a surface swab is neither specific nor sensitive as an indicator of the presence or absence of H pylori colonization in tonsillar core tissue.
July 31, 2007 Gabriel Caponetti, MD; Liron Pantanowitz, MD
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Cat-scratch disease is an infectious disease caused primarily by the bacillus Bartonella henselae. Its manifestations can include self-limited regional lymphadenopathy, fever of unknown origin, and visceral organ, neurologic, and ocular involvement. In immunocompromised patients, cat-scratch disease can cause life-threatening systemic disease. This infection generally occurs in young immunocompetent individuals who have been scratched or bitten by a cat; it can also be caused by a flea bite.
March 31, 2007 Dewey A. Christmas Jr., MD; Joseph P. Mirante, MD, FACS; Eiji Yanagisawa, MD, FACS
