A 16-year-old boy with a lesion of the left frontal lobe

Article Abstract:

A 16-year-old boy from Bombay, India had suffered repeated seizures and was admitted to the hospital. A computed tomographic (CT) scan showed swelling and a mass in the left frontal region of the brain. The three most common conditions which could cause lesions in the brain of a child from India are tumor, tuberculoma (a tumor-like mass in the brain caused by Mycobacterium tuberculosis, which causes tuberculosis), and cysticercosis (caused by tape worms). The clinical features did not indicate diagnosis of a cerebral glioma, a type of tumor which occurs in children and causes seizures. It was thought that the mass was a tuberculoma as tuberculosis is endemic in Bombay and the clinical features were compatible with the diagnosis of tuberculoma without manifestations outside the brain. The patient had been vaccinated against tuberculosis in childhood, but vaccination is not an assurance that the disease will not develop later in life. However, the patient was given drugs for the treatment of tuberculosis and still had the seizures. Cysticercosis was still a possible diagnosis. Abscesses caused by infectious agents such as bacteria, fungi and protozoa, or parasites were also considered. A brain biopsy was performed and examination of the tissue revealed that the patient had cysticercosis, which was manifested as a granulomatous abscess in the brain. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Causes of, Brain tumors, Cysticercosis, Seizures (Medicine), Tuberculosis in children, Pediatric respiratory diseases, Bombay, India, Bombay

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A 40-year-old man with headache, fever, rash, and thrombocytopenia after a caribbean trip, case 40-1989

Article Abstract:

A 40-year-old man who complained of headache, fever and a rash had been in good health until two days before his admission. At the end of a two-week visit to St. Thomas in the Virgin Islands he awoke with an itchy red rash on his extremities that rapidly spread to his thorax and abdomen, but did not develop on his face, palms and soles. While traveling home by plane he developed a pain around his waist, a headache on both sides of his head, fever and an aversion to bright lights. The physical findings and laboratory data are included in this case report. At the time of admission he was described as being mildly ill. On the third day of hospitalization his headache was gone, his rash had started to fade, and by evening his temperature was normal. The differential diagnosis from the various diseases that could produce these signs and symptoms is discussed. Ultimately a diagnosis of dengue fever was made. Classic dengue fever typically disappears within a week, as in this case, and in most cases it is benign, but more malignant forms of dengue have been reported. Dengue is endemic in the Caribbean area. It is caused by a virus that has an incubation period of two to eight days and is characterized by the symptoms seen in this case.

Diseases, Virus diseases, Dengue, Dengue fever, Caribbean Sea, Caribbean Area, Wyler, David J., Butterton, Joan R.

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A 24-year-old Haitian man with right flank pain and recent fever

Article Abstract:

A 24-year-old Haitian man with right lower back pain and fever was admitted to the hospital. Medical history included childhood skin infections, a seizure and confirmed brain lesion a year prior, a positive tuberculosis skin test, night sweats and weight loss. Ultrasound revealed enlarged abdominal lymph nodes. A small lesion on his spine and a mass in the psoas muscle in the loins was also noted. A recent HIV blood test had been negative. Even though there was no evidence of the lung involvement usually found with tuberculosis, the clinical and anatomical diagnosis of Mycobacterium tuberculosis infection with spinal, muscular and brain abscesses was made.

Analysis, Mycobacterium tuberculosis, Identification and classification, Muscles, Tomography, Abdomen, Abdominal muscles, Carpenter, Charles C.J.

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