Introduction. Cutaneous actinomycosis of the buttocks is a rare granulomatous bacterial infection that usually starts in the perianal area. We present an exceptional case in the form of a pseudo-tumor. Case report. A ...Introduction. Cutaneous actinomycosis of the buttocks is a rare granulomatous bacterial infection that usually starts in the perianal area. We present an exceptional case in the form of a pseudo-tumor. Case report. A 69 year-old woman, in general good health, developed an indurate mass on the supra-external quadrant of the right buttock. The tumor was centered by an ulcerated nodule with a diameter of around 10 centimeters. Imaging showed invasion of the soft tissue of the skin in the internal psoas muscle, the adipose tonality of which was compatible with a liposarcoma.The skin biopsy revealed characteristic bacterial grain in the center of a cholesterol granuloma. Subsequent culture in aerobic milieu identified Actinomyces gerencseriae. Cure was obtained following complete exeresis of the fibrous tissue and 8 months of antibiotic amoxicillin-clavulanic acid therapy. Discussion. Otherthan the most unusual clinical aspect, the originality of this case of actinomycosis of the buttocks is based on its potential appendix origin, 4 years after acute appendicitis, with slow posterior fistulation. Other cases of actinomycosis of appendix origin have been reported and its delayed onset following the intervention has been documented. The pseudo-sarcomatous aspect was responsible for diagnostic wandering. The histological image and, subsequently, the results of the bacteriological culture confirmed the diagnosis.展开更多
Background. Zolpidem, a hypnotic drug, is occasionally taken in high doses by some drug addicts for its hallucinogenic properties. Case report. We report the original observation of a young female addict who developed...Background. Zolpidem, a hypnotic drug, is occasionally taken in high doses by some drug addicts for its hallucinogenic properties. Case report. We report the original observation of a young female addict who developed aseptic cutaneous abscesses on the forearms and feet induced by self injection of powdered zolpidem. Histopathological analysis revealed birefringent vegetal structures. Discussion. The shape and size of the birefringent structures are those of microcrystalline cellulose, an excipient used in zolpidempills. The same structures have been identified by microscopic examination of a zolpidem tablet dissolved in water.展开更多
文摘Introduction. Cutaneous actinomycosis of the buttocks is a rare granulomatous bacterial infection that usually starts in the perianal area. We present an exceptional case in the form of a pseudo-tumor. Case report. A 69 year-old woman, in general good health, developed an indurate mass on the supra-external quadrant of the right buttock. The tumor was centered by an ulcerated nodule with a diameter of around 10 centimeters. Imaging showed invasion of the soft tissue of the skin in the internal psoas muscle, the adipose tonality of which was compatible with a liposarcoma.The skin biopsy revealed characteristic bacterial grain in the center of a cholesterol granuloma. Subsequent culture in aerobic milieu identified Actinomyces gerencseriae. Cure was obtained following complete exeresis of the fibrous tissue and 8 months of antibiotic amoxicillin-clavulanic acid therapy. Discussion. Otherthan the most unusual clinical aspect, the originality of this case of actinomycosis of the buttocks is based on its potential appendix origin, 4 years after acute appendicitis, with slow posterior fistulation. Other cases of actinomycosis of appendix origin have been reported and its delayed onset following the intervention has been documented. The pseudo-sarcomatous aspect was responsible for diagnostic wandering. The histological image and, subsequently, the results of the bacteriological culture confirmed the diagnosis.
文摘Background. Zolpidem, a hypnotic drug, is occasionally taken in high doses by some drug addicts for its hallucinogenic properties. Case report. We report the original observation of a young female addict who developed aseptic cutaneous abscesses on the forearms and feet induced by self injection of powdered zolpidem. Histopathological analysis revealed birefringent vegetal structures. Discussion. The shape and size of the birefringent structures are those of microcrystalline cellulose, an excipient used in zolpidempills. The same structures have been identified by microscopic examination of a zolpidem tablet dissolved in water.
