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PubMed2005

Malignant mimickers: chronic bacterial and fungal infections of the larynx.

Chronic infections of the larynx are notorious "copycats" of squamous cell carcinoma. Patients typically present with a historical picture and symptoms identical to those seen in a neoplastic setting: dyspnea, hoarseness, odynophagia, weight loss, and a history of tobacco and alcohol abuse. Historically, these patients were subject to an extensive resection for what was in reality a benign disease. A better understanding and awareness of these conditions has reinforced the need for a direct laryngoscopy, biopsy, and culture in the evaluation of long-lasting laryngeal lesions; this has led to more appropriate and focused treatment. The clinical mimicry of chronic laryngeal infections will be illustrated in two recent case reports, histoplasmosis and botryomycosis of the larynx, which will lead into a discussion on the differential diagnosis of bacterial and fungal laryngeal infections, their evaluation, and treatment options.

Adult↗
PubMedDate not supplied

Endocarditis due to enteric bacilli other than Salmonellae: case reports and literature review.

The clinical and pathological findings in two recent patients with non-salmonella enterobacterial endocarditis are described, and those of 42 patients in the literature are summarized. Most of the patients acquired their endocarditis secondary to urinary tract infection and had an acute clinical course characterized by high fever and chills. Thirty-two of these patients died, and all except one had a postmortem examination. The most frequent pathological finding was the occurrence of very large vegetations which caused relatively little destruction of the underlying valve. Prompt diagnosis and antibiotic therapy chosen on the basis of bactericidal as well as bacteriostatic activity against the individual bacterium may improve the prognosis in this disease. Results of tricuspid and pulmonic valvulectomies for bacteriologic failure in pseudomonas and in a few cases of enterobacterial endocarditis appear to warrant a surgical approach in patients with right-sided enterobacterial endocarditis who fail to respond to vigorous medical therapy.

Aged↗