Uznapredovala aktinomikoza larinksa

Izolirana laringealna aktinomikoza vrlo je rijetka bolest i najčešće je posljedica liječenja karcinoma larinksa. Pravovremena dijagnoza primarne laringealne aktinomikoze važna je kako bi se liječenje što ranije započelo. U radu je prikazan bolesnik kod kojeg je zbog gušenja učinjena hitna traheotomija, a potom zbog progresije procesa na larinksu i neuspjeha konzervativnog liječenja, i totalna laringketomija. Patohistološki nalaz pokazao je da promjena odgovara opsežnoj, dubokoj nekrozi larinksa s opisanim nakupinama uzročnika karakterističnim za aktinomikozu. Poslije operacije bolesnik je primao penicilinski antibiotik tijekom tri mjeseca. Osam godina nakon operacije bolesnik je bez znakova recidiva bolesti. Dijagnoza primarne aktinomikoze larinksa, ako se javlja bez značajnijih lokalnih simptoma, nije jednostavna. Zbog kasne dijagnoze liječenje bolesti ponekad, uz antibiotike, traži i agresivno kirurško liječenje, kako je bilo neophodno i kod prikazanog bolesnika

Laryngeal Leishmaniasis

INTRODUCTION: Leishmaniasis is classified into three clinical presentations: visceral, coetaneous and mucocutaneous. The latter is usually secondary to hematogenous spread after months or years of skin infection and can manifest as infiltrative lesions, ulcerated or vegetating in nose, pharynx, larynx and mouth, associated or not with ganglionics infarction. Laryngeal involvement is part of the differential diagnosis of lesions in this topography as nonspecific chronic laryngitis, granulomatosis and even tumors of the upper aerodigestive tract presenting atypical evolution. Sometimes it is difficult for the correct diagnosis of Leishmaniasis, with description of cases in the literature were conducted improperly. OBJECTIVE: The objective of this study is to report a case of laryngeal Leishmaniasis addressing the difficulty of diagnosis, complications and treatment applied. CASE REPORT: A patient with pain throat, dysphagia, odynophagia, dysphonia and weight loss, with no improvement with symptomatic medication. At telelaringoscopy, infiltrative lesion showed nodular supraglottis. He underwent a tracheotomy for airway obstruction and biopsy with immunohistochemical study for a definitive diagnosis of laryngeal Leishmaniasis. The patient was referred to the infectious diseases that initiated treatment with N-methylglucamine antimoniate with satisfactory response to therapy. FINAL COMMENTS: Faced with a clinical suspicion of granulomatous diseases, it is essential to follow protocol laboratory evaluation associated with histological injury, to get a precise definition etiological without prolonging the time of diagnosis. Medical treatment for mucosal Leishmaniasis, recommended by the World Health Organization, was adequate in the case of laryngeal disorders, with complete resolution of symptoms.INTRODUÇÃO: A leishmaniose é classificada em três apresentações clínicas: visceral, cutânea e mucocutânea. Esta última geralmente é secundária à disseminação hematogênica após meses ou anos de infecção cutânea e pode manifestar-se com lesões infiltrativas, ulceradas ou vegetantes em nariz, faringe, laringe e boca, associadas ou não à enfartamento ganglionar. O acometimento laríngeo faz parte do diagnóstico diferencial de lesões nesta topografia como laringites crônicas inespecíficas, granulomatoses e mesmo tumores das vias aerodigestivas superiores que apresentam evolução atípica. Por vezes, encontra-se dificuldade no diagnóstico correto da leishmaniose, com descrição de casos na literatura que foram conduzidos de forma inadequada. OBJETIVO: O objetivo deste trabalho é relatar um caso de leishmaniose laríngea abordando sua dificuldade diagnóstica, complicações e terapêutica aplicada. RELATO DE CASO: Paciente com quadro de dor de garganta, disfagia, odinofagia, disfonia e perda ponderal, sem melhora com medicação sintomática. À telelaringoscopia, apresentava lesão infiltrativa nodular em supraglote. Foi submetido à traqueostomia por obstrução de via aérea e biópsia da lesão com estudo imunohistoquímico para definição diagnóstica de leishmaniose laríngea. O paciente foi encaminhado à infectologia que iniciou tratamento com antimoniato de N-metilglucamina, com resposta satisfatória à terapêutica. COMENTÁRIOS FINAIS: Diante de quadros clínicos com suspeição de doenças granulomatosas, é fundamental seguir protocolo de avaliação laboratorial associado à estudo histológico da lesão, para conseguir uma definição etiológica precisa sem prolongar o tempo de diagnóstico. O tratamento medicamentoso para leishmaniose mucosa, preconizado pela Organização Mundial de Saúde, mostrou-se adequado no caso de afecção laríngea, com melhora completa dos sintomas.Universidade Federal de São Paulo (UNIFESP) Departamento de Otorrinolaringologia e Cirurgia de Cabeça e PescoçoUNIFESP, Depto. de Otorrinolaringologia e Cirurgia de Cabeça e PescoçoSciEL

Pelvic actinimycosis

Actinomycosis is a chronic bacterial infection caused by Actinomyces, Gram-positive anaerobic bacteria. Its symptomatology imitates some malignant pelvic tumours, tuberculosis, or nocardiosis, causing abscesses and fistulas. Actinomycoses are opportunistic infections and require normal mucous barriers to be altered. No epidemiological studies have been conducted to determine prevalence or incidence of such infections. Objective. To analyse the clinical cases of pelvic actinomycosis reported worldwide, to update the information about the disease. Methods. A systematic review of worldwide pelvic actinomycosis cases between 1980 and 2014 was performed, utilising the PubMed, Scopus, and Google Scholar databases. The following information was analysed: year, country, type of study, number of cases, use of intrauterine device (IUD), final and initial diagnosis, andmethod of diagnosis. Results. 63 articles met the search criteria, of which 55 reported clinical cases and 8 reported cross-sectional studies. Conclusions. Pelvic actinomycosis is confusing to diagnose and should be considered in the differential diagnosis of pelvic chronic inflammatory lesions. It is commonly diagnosed through a histological report, obtained after a surgery subsequent to an erroneous initial diagnosis. A bacterial culture in anaerobic medium could be useful for the diagnosis but requires a controlled technique and should be performed using specialised equipment

A 6-year retrospective study of fine needle aspiration cytology pattern of otorhinolaryngological cases of patients referred to national ear care centre Kaduna (2013-2018)

Background: This study was carried out to obtain the retrospective study of FNAC cases referred to NECC; and review occurrences of ortorhinolaryngological swellings and demographic studies of patients for a period of 6 years (2013-2018). Records of FNAC were obtained from the laboratory department’s unit’s register alongside the biodata of patients for demographic studies. Methods: FNAC samples were treated for diagnosis according to the unit’s standard operating procedure for cytology. A total of three hundred and fifty-three 353 cases were reported and tables were then plotted to present the study cases using simple descriptive statistics. Results: Highest age distribution was between thirty to thirty-nine (30-39) years with a total of ninety-five cases 95(26.9%) followed by the range of forty to forty-nine (40-49) years with a value of eighty 80(22.6%). Females had the highest frequency of one hundred and thirty-three 133 (62.3%) compared to their male patient counterpart with a value of two hundred and twenty 220 (37.6%). The site of sample collection had ANS with the highest value of eighty-one 81 (42.4%) compared to other sites. The year 2016 had the highest number of FNAC cases and finally ninety 6 cases 96 (27.2%) of cases were inflammatory, two hundred and thirty-two 232 (65.7%) were benign while twenty five 25 (7.1%) were malignant. Conclusions: In conclusion; FNAC plays a vital role in managing otorhinolaryngology conditions and gives a way forward for effective treatment to patients and often at times is therapeutic as some patients come with fluid field swelling that get relieved after the procedure

Ward Round – Cough, painful throat and progressive hoarseness of voice for 1 year

No Abstrac

Volume 25, index

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research. Visit the journal website at http://canjsurg.ca/ for more.https://ir.lib.uwo.ca/cjs/1186/thumbnail.jp

Primary Tuberculosis of Tonsils: A Case Report

Tuberculosis is one of the major causes of ill health and death worldwide. Isolated tuberculosis of tonsil in the absence of active pulmonary tuberculosis is a very rare clinical entity. A 10-year-male child presented with recurrent episodes of upper respiratory tract infections, with 2-3 occurrences per month for the past 6 years. On general physical examination, bilateral tonsils showed grade III enlargement and congestion. Posterior pharyngeal wall was clear. Examination of the chest was within normal limits. Histopathological examination of bilateral tonsils revealed caseating and noncaseating epithelioid cell granulomas with Langhans giant cells. Ziehl-Neelsen stain for acid fast bacillus was positive. Features were consistent with a diagnosis of tuberculosis of tonsils. Tuberculosis of the oral cavity is uncommon and lesions may be either primary or secondary. Early detection and intervention is essential for cure. Isolated and primary tuberculosis of the tonsils in the absence of pulmonary tuberculosis is a rare entity, which prompted us to report this case

Rigid endoscope-assisted tracheal intubation in a case of epiglottic cyst

Epiglottic cysts are of particular interest to both surgeons and anaesthetists because of the way in which they encroach on the airway. An epiglottic cyst in a 29-year-old woman was scheduled for endoscopic excision. It was located at the vallecula, and measured around 3 x 4 cm. As a fibre-optic bronchoscope was not available in our institution, endotracheal intubation was achieved with the help of a rigid endoscope and video-camera system.Keywords: epiglottic cyst, 300 nasal endoscope, nasotracheal intubatio