Internal medicine
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Case Reports
Sepsis and meningoencephalitis caused by Bacillus cereus in a patient with myelodysplastic syndrome.
We herein report the findings of a case of myelodysplastic syndrome that was complicated by septicemia and meningoencephalitis, both of which were caused by Bacillus cereus. In contrast to all of the previous cases of B. cereus that have been seen at our institution, this patient did not have any invasive devices, such as a central venous catheter, that could have acted as a conduit for a B. cereus infection. Although B. cereus-induced meningoencephalitis is often lethal, the immediate treatment with a regimen of antibiotics including vancomycin was effective in eradicating the infection and, therefore, in reversing both the septicemia and the meningoencephalitis.
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Obtaining an accurate histopathological diagnosis is mandatory for the optimal treatment of patients who are suspected of having recurrent lung cancer. The purpose of this retrospective study was to investigate the usefulness of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for the diagnosis of recurrent non-small cell lung cancer (NSCLC) among patients who undergo curative surgical resection. ⋯ Convex probe EBUS-TBNA is a sensitive method for diagnosing recurrent NSCLC in patients with lymph node and peribronchial lung parenchymal lesions. Therefore, EBUS-TBNA should be considered first for the cytopathological diagnosis of recurrent NSCLC.
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Case Reports
Autoimmune polyglandular syndrome III in a patient with idiopathic portal hypertension.
A 42-year-old woman with a history of idiopathic portal hypertension (IPH) developed type 1A diabetes and was found to have chronic thyroiditis. The concurrence of IPH and type 1A diabetes has been previously reported in only one case. This is the second known case, and our patient was classified as having autoimmune polyglandular syndrome (APS) III. The patient's HLA DR and DQ alleles were determined to be susceptible to autoimmune thyroid diseases but resistant to type 1A diabetes.
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We herein report the first Japanese case of vertebral sarcoidosis diagnosed using multiple imaging modalities and a biopsy. CT, MRI and (18)F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) detected multiple vertebral lesions, and a vertebral biopsy guided by the PET findings confirmed the diagnosis of vertebral sarcoidosis. Although the disease was refractory to corticosteroids, treatment with methotrexate (MTX) achieved a good response. Our case suggests that MRI and 18F-FDG PET are useful for determining the site for a biopsy and that MTX is effective for treating vertebral sarcoidosis.