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Cureus Dec 2022Mumps is an acute viral illness occurring in children and young adults transmitted via droplets. It is a vaccine-preventable illness caused by the mumps virus, an RNA...
Mumps is an acute viral illness occurring in children and young adults transmitted via droplets. It is a vaccine-preventable illness caused by the mumps virus, an RNA (ribonucleic acid) virus belonging to theParamyxoviridaefamily. It typically presents with fever, parotitis, epididymo-orchitis, oophoritis, meningitis, encephalitis, pancreatitis and arthritis. Although viremia with multiorgan involvement is known to be commonly seen in mumps, there have been no reported cases of splenic abscess in a case of mumps. Here we present the case of a 16-year-old girl with unknown vaccination history who presented with fever, rash, bilateral parotid swelling, myocarditis, pneumonitis with pleural effusion and shock. Enzyme-linked immunosorbent assay (ELISA) for mumps Immunoglobulin M (IgM) antibody was positive (ratio: 7.26, reference: 1.10). She was managed conservatively with parenteral antibiotics, oxygen, inotropic support and bronchodilators. As she complained of abdominal pain in the left hypochondrium on the 13th day since onset of symptoms, ultrasound scan of abdomen was done which showed a hypoechoic lesion with internal echoes in the inferior pole of spleen (2.9 cm x 2.2 cm) suggestive of splenic abscess. Computed tomography (CT) of abdomen confirmed similar findings. The splenic abscess completely regressed with parenteral antibiotics. Therefore, one must suspect splenic abscess in a case of mumps when the presentation includes abdominal pain and tenderness so that appropriate treatment may be provided for the best outcome for the patient.
PubMed: 36733790
DOI: 10.7759/cureus.33195 -
BMJ Case Reports Jan 2023Xanthogranulomatous endometritis (XGE) is a rare pathological entity which is characterised by sheets of foamy histiocytes and lymphoplasmacytic infiltrates. This...
Xanthogranulomatous endometritis (XGE) is a rare pathological entity which is characterised by sheets of foamy histiocytes and lymphoplasmacytic infiltrates. This condition can mimic endometrial carcinoma. We report a case, clinically suspected as carcinoma of the endometrium/ovary, which was diagnosed as XGE with left salpingo-oophoritis on histopathology.
Topics: Female; Humans; Oophoritis; Endometritis; Postmenopause; Salpingitis; Granuloma; Xanthomatosis; Endometrial Neoplasms
PubMed: 36657821
DOI: 10.1136/bcr-2021-247341 -
BMJ Case Reports Jan 2023Though there is no definite agreement on diagnostic criteria or definition of chronic ectopic pregnancy (CEP), it could be deemed to be a variant of pregnancy of unknown...
Though there is no definite agreement on diagnostic criteria or definition of chronic ectopic pregnancy (CEP), it could be deemed to be a variant of pregnancy of unknown location with non-specific clinical signs and symptoms. This was a case of a para 2+2 who presented with lower abdominal pain and bleeding per vaginum, and initial ultrasound was suggestive of a tubo-ovarian abscess/mass. With a further MRI scan and a diagnostic laparoscopy, she was found to have a CEP and had a laparoscopic salpingectomy for management. The diagnosis of CEP could be quite challenging as a result of the protracted symptoms, often negative/low serum B-HCG and ultrasound features mimicking a pelvic mass. A high index of suspicion is needed, and an MRI scan and diagnostic laparoscopy often aid in diagnosis and management.
Topics: Pregnancy; Female; Humans; Abscess; Pregnancy, Ectopic; Oophoritis; Salpingitis; Abdominal Abscess; Laparoscopy
PubMed: 36599488
DOI: 10.1136/bcr-2022-253396 -
Medicine Dec 2022Primary ovarian insufficiency (POI) is a complicated clinical syndrome characterized by progressive deterioration of ovarian function. Autoimmunity is one of the main... (Review)
Review
Primary ovarian insufficiency (POI) is a complicated clinical syndrome characterized by progressive deterioration of ovarian function. Autoimmunity is one of the main pathogenic factors affecting approximately 10% to 55% of POI cases. This review mainly focuses on the role of autoimmunity in the pathophysiology of POI and the potential therapies for autoimmunity-related POI. This review concluded that various markers of ovarian reserve, principally anti-Müllerian hormone, could be negatively affected by autoimmune diseases. The presence of lymphocytic oophoritis, anti-ovarian autoantibodies, and concurrent autoimmune diseases, are the main characteristics of autoimmune POI. T lymphocytes play the most important role in the immune pathogenesis of POI, followed by disorders of other immune cells and the imbalance between pro-inflammatory and anti-inflammatory cytokines. A comprehensive understanding of immune characteristics of patients with autoimmune POI and the underlying mechanisms is essential for novel approaches of treatment and intervention for autoimmune POI.
Topics: Female; Humans; Autoimmunity; Primary Ovarian Insufficiency; Autoimmune Diseases; Autoantibodies
PubMed: 36595863
DOI: 10.1097/MD.0000000000032500 -
Frontiers in Medicine 2022We present the case of a female patient with a heterozygous somatic BLNK mutation, a T-cell LGL (large granular lymphocyte) leukemia, and multiple autoimmune diseases....
We present the case of a female patient with a heterozygous somatic BLNK mutation, a T-cell LGL (large granular lymphocyte) leukemia, and multiple autoimmune diseases. Although this mutation seems uncommon especially in this kind of clinical observation, it could represent a new mechanism for autoimmune diseases associated with LGL leukemia. The patient developed several autoimmune diseases: pure red blood cell apalsia, thyroiditis, oophoritis, and alopecia areata. She also presented a T-cell LGL leukemia which required treatment with corticosteroids and cyclophosphamide, with good efficacy. Interestingly, she had no notable infectious history. The erythroblastopenia also resolved, the alopecia evolves by flare-ups, and the patient is still under hormonal supplementation for thyroiditis and oophoritis. We wanted to try to understand the unusual clinical picture presented by this patient. We therefore performed whole-genome sequencing, identifying a heterozygous somatic BLNK mutation. Her total gamma globulin level was slightly decreased. Regarding the lymphocyte subpopulations, she presented a B-cell deficiency with increased autoreactive B-cells and a CD4+ and Treg deficiency. This B-cell deficiency persisted after complete remission of erythroblastopenia and LGL leukemia. We propose that the persistent B-cell deficiency linked to the BLNK mutation can explain her clinical phenotype.
PubMed: 36465938
DOI: 10.3389/fmed.2022.997161 -
Emergency Medicine Practice Dec 2022Pelvic inflammatory disease is associated with complications that include infertility, chronic pelvic pain, ruptured tubo-ovarian abscess, and ectopic pregnancy. The... (Review)
Review
Pelvic inflammatory disease is associated with complications that include infertility, chronic pelvic pain, ruptured tubo-ovarian abscess, and ectopic pregnancy. The diagnosis may be delayed when the presentation has nonspecific signs and symptoms. Even when properly diagnosed, pelvic inflammatory disease is often treated suboptimally. This review provides evidence-based recommendations for the diagnosis, treatment, disposition, and follow-up of patients with pelvic inflammatory disease. Arranging follow-up of patients within 48 to 72 hours and providing clear patient education are fundamental to ensuring good patient outcomes. Emerging issues, including new pathogens and\ evolving resistance patterns among pelvic inflammatory disease pathogens, are reviewed.
Topics: Pregnancy; Female; Humans; Pelvic Inflammatory Disease; Oophoritis; Abdominal Abscess; Emergency Service, Hospital; Pregnancy, Ectopic
PubMed: 36378827
DOI: No ID Found -
Internal Medicine (Tokyo, Japan) Jun 2023Cytomegalovirus (CMV) oophoritis is an extremely rare and fatal condition. We encountered a 63-year-old woman with CMV oophoritis who had been treated for Burkitt's... (Review)
Review
Cytomegalovirus (CMV) oophoritis is an extremely rare and fatal condition. We encountered a 63-year-old woman with CMV oophoritis who had been treated for Burkitt's lymphoma. Positron emission tomography/computed tomography performed after chemotherapy showed a high F-fluoro-2deoxy-D-glucose uptake in both ovaries, which required distinguishing relapse. CMV oophoritis was diagnosed on histology following bilateral salpingo-oophorectomy. Although the patient later developed recurrent episodes of CMV antigenemia, after which complications of CMV retinitis appeared, and she ultimately died of CMV meningitis, surgical resection with antiviral medication resolved her abdominal symptoms and cleared CMV antigenemia for several weeks. It is therefore worth considering surgical resection in combination with antiviral drugs as a treatment option.
Topics: Female; Humans; Middle Aged; Burkitt Lymphoma; Cytomegalovirus; Oophoritis; Neoplasm Recurrence, Local; Antiviral Agents; Cytomegalovirus Infections
PubMed: 36261376
DOI: 10.2169/internalmedicine.0517-22 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2022The aim: To determine the current prevalence of healthcare-associated tubo-ovarian infections in female and antimicrobial resistance of the responsible pathogens in...
OBJECTIVE
The aim: To determine the current prevalence of healthcare-associated tubo-ovarian infections in female and antimicrobial resistance of the responsible pathogens in Ukraine.
PATIENTS AND METHODS
Materials and methods: We performed a retrospective multicenter cohort study was based on healthcare-associated infections surveillance data. Definitions of health¬care-associated tubo-ovarian infections were used from the CDC/ NHSN. The susceptibility to antibiotics was determined by disk diffusion method according to the EUCAST.
RESULTS
Results: Among all the 1,528 of women in this study, the prevalence of healthcare-associated tubo-ovarian infections was 31.2%. Of these cases, Salpingitis, Oophoritis, and tubo-ovarian abscess were 47.5%, 34% and 18.5%, respectively. Of all cases tubo-ovarian infections in female, 74.7% were detected after hospital discharge. The predominant pathogens were: Escherichia coli (27.7%), Enterobacter spp. (12.2%), Klebsiella pneumoniae (9.6%), Staphylococcus aureus (8.2%), Pseudomonas aeruginosa (8.1%), and Enterococcus faecalis (7.5%), followed by Proteus mirabilis (5.1%), Streptococcus spp. (4.5%), Staphylococcus epidermidis (4.4%), and Acinetibacter spp. (4%). Methicillin-resistance was ob¬served in 16.8% of S. aureus (MRSA). No strains S.aureus and E. faecalis resistant to vancomycin. The overall proportion of extended spectrum beta-lactamases (ESBL) production among Enterobacteriaceae was 24.7%. The prevalence of ESBL production among E. coli isolates was 28.6% and among K. pneumoniae 12.8%. Resistance to third-generation cephalosporins was observed in 14.9% E.coli and 11.3% K. pneumoniae isolates. Carbapenem resistance was identified in 11.3% of P.aeruginosa isolates.
CONCLUSION
Conclusions: A healthcare-associated tubo-ovarian infections of the female in Ukraine is a common occurrence and many cases are caused by pathogens that are resistant to antibiotics.
Topics: Anti-Bacterial Agents; Carbapenems; Cephalosporins; Cohort Studies; Cross Infection; Delivery of Health Care; Drug Resistance, Bacterial; Escherichia coli; Female; Humans; Klebsiella pneumoniae; Methicillin; Pseudomonas aeruginosa; Staphylococcus aureus; Ukraine; Vancomycin; beta-Lactamases
PubMed: 36129086
DOI: 10.36740/WLek202208211 -
Taiwanese Journal of Obstetrics &... Sep 2022To present a rare case of xanthogranulomatous inflammation (XI) mimicking a uterine sarcoma and invading the ureter and colon. (Review)
Review
Xanthogranulomatous inflammation caused by K. pneumonia and nocardiosis mimicking a uterine tumor and invading the ureter and colon: A case report and review of the literature.
OBJECTIVE
To present a rare case of xanthogranulomatous inflammation (XI) mimicking a uterine sarcoma and invading the ureter and colon.
CASE REPORT
A 66-year-old woman presented with lower abdominal pain. Pelvic examination showed tenderness over the lower abdominal region without cervical discharge. Per-rectal examination showed a hard tumor on the posterior uterine wall, while ultrasonography showed a tumor-like mass extending from the posterior uterine wall to the rectum. Magnetic resonance imaging showed signs of endometrial cancer invading the rectum. However, the tumor markers carbohydrate antigen (CA) 125, CA199, and carcinoembryonic antigen were in the normal range. Cystoscopy, panendoscopy, and colonoscopy showed no significant findings. On performing exploratory laparotomy, we observed pus and severe adhesion on the posterior uterine wall and rectum. Hysterectomy, bilateral adnexectomy, colectomy, and partial left ureter resection were performed. The final pathology showed XI. The pus culture revealed Klebsiella pneumonia and PCR revealed nocardiosis. The patient received 2 weeks of antibiotic treatment and was discharged thereafter.
CONCLUSION
XI in elderly women is rare, and hence, differential diagnoses should be carefully considered.
Topics: Aged; Colon; Female; Humans; Inflammation; Nocardia Infections; Pneumonia; Suppuration; Ureter; Uterine Neoplasms
PubMed: 36088063
DOI: 10.1016/j.tjog.2021.12.006 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2022The aim: To assess the role of surgical site infections types associated with obstetric and gynecological surgeries as a cause of infertility among women reproductive...
OBJECTIVE
The aim: To assess the role of surgical site infections types associated with obstetric and gynecological surgeries as a cause of infertility among women reproductive age in Ukraine.
PATIENTS AND METHODS
Materials and methods: We conducted a retrospective multicentre cohort study was based on reproductive health surveillance data among women reproductive age from 2019 to 2021. Definitions of infertility were used from the WHO and surgical site infections were used CDC/ NHSN.
RESULTS
Results: Among all the 3,825 of infertility women in this study, the prevalence of surgical site infection (SSI) was 67.9%. The prevalence of SSI among primary infertility group and secondary infertility group women was 67.5% and 71.4%, respectively. There were differences among SSI type associated with infertility, primary infertility and secondary infertility. In logistic multivariate regression analyses, infertility was associated history of induced abortion (p < 0.001), history of obstetric and gynecological surgeries (p < 0.001), Salpingitis (p < 0.001), Oophoritis (p < 0.001), Endometritis (p < 0.001), Adnexa utery (p=0.009), and Pelvic abscess or cellulitis (p=0.043). The main factors associated with primary infertility were history of Salpingitis (33.6%) and Oophoritis (28.2%) after gynecological surgery. A factors associated with secondary infertility were history of Endometritis (27.2%), Pelvic abscess or cellulitis (11.2%), Salpingitis (10.1%), Adnexa utery (9.4%), Oophoritis (4.8%), and Chorioamnionitis (3.9%).
CONCLUSION
Conclusions: One of the main causes of infertility in women of reproductive age in Ukraine are SSIs after obstetric and gynecological surgeries, and induced abortion. This applies to both primary and secondary infertility group women's in this cohort study.
Topics: Abscess; Cellulitis; Cohort Studies; Endometritis; Female; Gynecologic Surgical Procedures; Humans; Infertility, Female; Oophoritis; Pregnancy; Salpingitis; Surgical Wound Infection; Ukraine
PubMed: 35962672
DOI: 10.36740/WLek202207104