A case of tuberculous involvement of the esophagus was studied in an adult with mediastinal lymphadenopathy unrecognized by roentgenography of the chest. The roentgenographic and endoscopic features in this case were more consistent with malignancy than with tuberculosis. Nineteen additional cases from the English-language literature were reviewed. Although esophageal tuberculosis is a rare disease, it should be strongly suspected in a patient with dysphagia who has a positive tuberculin skin test, active pulmonary disease, or mediastinal adenopathy.

Aged↗

PubMedDate not supplied

A case of chronic meningococcemia with unusual features.

A patient with chronic meningococcemia with the unusual features of subungual splinter hemorrhages, a pericardial friction rub, and a culture positive skin lesion is presented. Group specific and homologous antibody responses were absent and the nitroblue tetrazolium test for infection was negative. The clinical features and the difficulty in explaining the mechanism of the relatively benign course that characterizes this disease are discussed.

Adult↗

PubMedDate not supplied

Case report: comparative response of fever to corticosteroids in tuberculosis and in connective tissue disease.

A young woman with fever and pleural effusion eventually was found to have both primary tuberculosis and systemic lupus erythematosus. Before either diagnosis was confirmed, the patient had a dramatic defervescence in response to prednisone; her condition had not improved initially after anti-tuberculous therapy. Uncertainty regarding the clinical significance of this remarkable temperature response led us to review our experience with febrile tuberculous patients who had received corticosteroids. Of 14 such patients, nine had rapid declines of body temperature to below 36.5C. In a comparable group of 14 patients with a variety of connective tissue disease, 12 showed an equally dramatic defervescence after corticosteroid administration. The data suggest that a prompt temperature decline following corticosteroid therapy is a nonspecific response that cannot be used to differentiate between fever of infectious or noninfectious origin.

Adrenal Cortex Hormones↗