Rhinosporodium: case report

This is the first reported case of rhinosporidiosis in Ibadan, Nigeria. A review of literature shows that the patient came from northern Nigeria where the first case was reported in the country. The organism is difficult to culture and the diagnosis was based on microscopy and histological examination of the polyp. We present the case of recurrent rhinosporidiosis in a 16 year old girl a year after polypectomy in Zaria, northern Nigeria.     

Primary cutaneous nocardiosis

A 37-year-old patient with systemic lupus erythematosus, who had been treated with oral corticosteroids for 10 years, developed primary cutaneous nocardiosis. Brown-violaceous, suppurative nodules and plaques arose on her right leg. Cultures of multiple biopsies on blood agar medium grew Nocardia. The patient received 500 mg of imipenem three times a day which resulted in complete regression of the lesions within two months. No relapse was observed 6 months later.     

Suprasellar osteolipoma: case report

BACKGROUND: Osteolipomas are distinguished from other intracranial lipomas by their arrangement of central adipose and peripheral osseous tissues and by characteristically arising in the suprasellar/interpeduncular region. METHODS: We report computed tomography (CT), magnetic resonance imaging (MRI), and pathology findings from this 34-year-old man who underwent surgical removal of this benign lesion. RESULTS: This case displays the distinctive histopathology that has been reported in 13 of 31 (42%) lipomas in this region. In contrast, ossification of lipomas at other intracranial sites is relatively rare. CONCLUSIONS: Ossification should be expected in many suprasellar/interpeduncular lipomas, and osteolipoma should be included in the radiologic differential diagnosis of fat-intensity masses with calcification in this region.     

Pseudopneumoperitoneum: a case report

A case of post-traumatic pseudocyst of the pancreas is presented. The elevated and compressed stomach showed an appearance on X-ray film which might be interpreted as free peritoneal air. The term pseudopneumoperitoneum is defined and other causes of this condition are mentioned.     

Hemangiopericytoma: a case report

We describe one case of hemangiopericytoma touching a 44-year-old man. It is a rare vascular tumor originating from pericytes surrounding capillaries. The main typical features of it are the difficulty in doing an histologic diagnosis and the impossibility to make out a reliable prognosis. The therapy of choice is a surgical procedure sometimes in combination with radio- and/or chemotherapy.     

Munchausen's syndrome: case report

A case report of a 31-year old butcher with haemorrhagica histrionica is presented. The patient went to great lengths to induce haematemesis and fake its symptoms to gain admission to hospital. The alarming frequency of admissions and dramatic behaviour of the patient prompted this report.     

Bilateral twinning: report of case

Twinning is an anomaly in which one tooth has combined with another or enlarged itself to the point of doubling its substance. A discussion of the nomenclature and a report of bilateral twinning are presented. A possible cause of the twinning events in this case include gemination of the maxillary right and mandibular left canines and fusion of the maxillary left and mandibular right canines with supernumerary teeth.     

Intercostal incisional hernia: case report

The authors report a case of intercostal incisional hernia following marsupialization of liver hydatid cyst stressing the considerable rarity of the pathology and describing the restorative procedure by intercostal plastic with polypropilene Mesh and rib's approach with stainless steel wires.     

Sneddon syndrome: a case report

Doxorubicin is cardiotoxic and its use must be monitored carefully. Incidence of refractory cardiac failure is shown to increase once the cumulative dose exceeds 450 mg/m2. However, significant decline of ejection fraction (EF) may occur even at lower dose levels. EF was monitored using Multigated Radionuclide Angiography (MUGA) scan of all consecutive lung cancer patients, treated with Doxorubicin based regimens. Thirteen of 82 patients showed a significant (more than 15%) decline of left ventricular EF. The dose of doxorubicin producing this decline ranged between 91-180 mg/m2. Actual decline in EF ranged between 16-45%. Only 5 of 13 patients developed symptoms attributable to the cardiac disease. Doxorubicin can alter EF significantly in lung cancer patients at levels well below which are considered 'safe'. The reason for massive decline in ejection fraction in these patients has been hypothesized.     

Intramedullary tuberculoma: a case report

A fifty-year-old Portuguese man presented with a six-month history of low back pain, which initially was mechanical and slowly became inflammatory. Secondarily, he complained of right atypical sciatalgia. He did not report any fever, loss of weight, cough nor personal or familial history of tuberculosis. General examination was normal. Neurologic examination showed weakness of the extensors of the right leg, with a symmetric increased reflexes of the lower extremities suggesting a pyramidal syndrome without Babinski's sign. Laboratory data were normal as well as chest radiographs. Dorsolumbar gadolinium enhanced MRI revealed an intramedullary ringlike enhancing mass at T12 level. Lumbar puncture showed 11 WBC/mm3 (95 p. 100 lymphocytes), a normal protein and glucose content. PCR and culture for Mycobacterium tuberculosis were negative. Within a few days, he developed meningoencephalitis with fever, CSF examination revealed then 360 WBC/mm3 (65 p. 100 lymphocytes and 17 p. 100 neutrophils), a protein content of 7 g/l and a glucose level of 1.7 mmol/l. The clinical picture was then suggestive of tuberculosis and a specific therapy with rifampin, izoniazid, pyrazinamid, ethambutol and steroids was started. Clinical improvement and a second CSF culture that revealed one month later Mycobacterium tuberculosis complex confirmed this diagnosis. Ten months later, the patient was asymptomatic with a normal MRI. To our knowledge, this is the first total recovery of an intramedullary tuberculoma on medical therapy alone, confirmed by MRI normalization. We reviewed also 19 recent cases of tuberculomas in the literature, intending a therapeutic attitude when discovering an intramedullary ringlike enhancing mass on MRI.     

Captopril-induced agranulocytosis: a case report

1,000 refugees living in Strasbourg have had a stoll parasitologic exam between 1986 and 1990. We have not retained results of South America and other areas of Asia subjects because of their scarce total number. Proportionally, the most numerous are the South East Asia Nationals (51.7%); followed by those from Middle East and Africa (20 and 15.5%) and more recently by those from East of Europe (5.2%). Their parasitic infestation's rate remains important (60.9%) but variable depending on their origin. Thus, people coming from Middle East and Africa are parasited mainly by protozoan, although those from South East Asia are parasited by helminths. It's interesant to notify that the prevalence of D. fragilis is ten times higher among East European people than in the common people.     

Intraspinal epidural sarcoidosis: case report

OBJECTIVE AND IMPORTANCE: A rare case of lumbar intraspinal epidural sarcoidosis is identified. The rarity of this condition and its clinical presentation are stressed. CLINICAL PRESENTATION: A young Caucasian man presented with the progressive onset of cauda equina syndrome as a result of an expanding mass in the lumbar epidural space compromising the lumbar dural tube from L1 to S1. The patient presented with motor, sensory, and sphincteric dysfunction as a result of this large intraspinal epidural mass. No evidence of systemic illness was noted concomitant with the patient's onset of neurological symptomatology. The patient underwent surgical extirpation of a lumbar intraspinal epidural mass, which was identified histopathologically as sarcoid granuloma. The postoperative work-up included the identification of a mediastinal adenopathy, which was subsequently biopsied and confirmed the diagnosis of sarcoid disease. The patient was treated postoperatively with oral prednisone over a 4-month period. At 7 months postoperatively, the patient had regained gainful employment, the results of his neurological examination were normal, and he was pain-free. INTERVENTION: The patient underwent a multilevel bilateral lumbar laminectomy with facet preservation, extending from L1 to S1, allowing for a gross total removal of the epidural mass. Postoperative oral prednisone was administered as adjuvant therapy for the treatment of multisystem sarcoid disease. CONCLUSION: Aggressive surgical management involving the removal of an extensive epidural mass of the lumbar canal, which was diagnosed as sarcoid disease, coupled with the adjuvant use of oral prednisone has resulted in an excellent outcome for the patient. The results of his clinical examination are now normal, and postoperative radiological imaging reveals no evidence of recurrent or residual disease in the lumbar epidural space. In the unusual case of intraspinal epidural sarcoidosis, the surgical resection of accessible intraspinal epidural masses is recommended, as is the use of oral prednisone postoperatively.     

Bacterial tracheitis: a case report

The SR Ca-ATPase in skeletal muscle SR vesicles isolated from young adult (5 months) and aged (28 months) rats was analyzed for nitrotyrosine. Only the SERCA2a isoform contained significant amounts with approximately one and four nitrotyrosine residues per young and old Ca-ATPase, respectively. The in vitro exposure of SR vesicles of young rats to peroxynitrite yielded selective nitration of the SERCA2a Ca-ATPase even in the presence of excess SERCA1a. No nitration was observed during the exposure of SR vesicles to nitric oxide in the presence of O2. These data suggest the vivo presence of peroxynitrite in skeletal muscle. The greater nitrotyrosine content of SERCA2a from aged tissue implies an age-associated increase in susceptibility to oxidation by this species.