Botryomycosis.

As many as half of patients who have symptoms and objective evidence of gastroesophageal reflux disease (GERD) will have normal mucosa or only hyperemia at endoscopy. Because inflamed esophageal mucosa may appear normal endoscopically, and because hyperemia may or may not reflect histologic espophagitis, biopsy to document tissue injury in symptomatic patients with these minimal endoscopic findings may be helpful. Reflux may induce inflammation in the squamous mucosa of the esophagus, but in many patients only hyperplasia of the epithelium is seen. This hyperplasia is defined by a basal zone that exceeds 15% of the thickness of the mucosa and subepithelial papillae that exceed 67% of the thickness of the mucosa. Because these changes may be present normally in the distal 2.5 cm of the esophagus, and because they may be distributed over the distal 8 cm in a patchy fashion, multiple biopsies taken more than 2.5 cm above the esophagogastric junction are necessary to detect them reliably. Supraesophageal complications of GERD include posterior laryngitis, inflammatory polyp of the larynx (contact ulcer or laryngeal granuloma), subglottic stenosis and laryngeal squamous cell carcinoma.

Diagnosis, Differential↗

PubMed2000

[Simultaneous leptospirosis and hantavirus infection in the same patient].

The leptospirosis and the hantaviral infections are worldwide distributed zoonoses having the similar epidemiology and clinical symptoms. Both in Europe and Asia those hantaviral serotypes are common which are responsible for the haemorrhagic fever with renal syndrome, while on the American continent the hantaviral pulmonary syndrome has also been diagnosed. Authors describe a patient who had simultaneous leptospira and hantaviral infections with haemorrhagic fever as well as with mild, transient renal insufficiency and liver damage. The dual infection was proved by serology.

Diagnosis, Differential↗