Chromobacterium violaceum is a gram-negative bacterium of soil and water in tropical and subtropical environments. Typically,it is considered a bacterium of low virulence although,uncommonly, it causes human infection...Chromobacterium violaceum is a gram-negative bacterium of soil and water in tropical and subtropical environments. Typically,it is considered a bacterium of low virulence although,uncommonly, it causes human infection, particularly in persons with defects in host defenses. Infection generally follows exposure of broken skin to contaminated water and soil, and is often characterized by pustules, lymphadenitis, fever, and vomiting, as well as rapid dissemination and a high mortality rate. Unfortunately, because C violaceum is ubiquitous, it is often dismissed as a contaminant when cultured. Because rapid diagnosis (by taking appropriate specimens) and treatment are vital to a good prognosis, it is imperative that physicians be aware of this organism. In addition, patients with chromobacterial infections should have an immunologic workup because infections in immunocompetent individuals are rare. Here wereport an aggressive yet nonfatal case of Cviolaceum septicemia in an adolescent male, diagnosed through a punch biopsy of askin lesion, and resulting in a new diagnosis of chronic granulomatous disease.展开更多
Pancreatic panniculitis is a rare complication occurring in 0.3-3%of patients with pancreatic disease. Clinical features include erythematous painful subcutaneous nodules usually on the lower leg and foot. A 72-year-o...Pancreatic panniculitis is a rare complication occurring in 0.3-3%of patients with pancreatic disease. Clinical features include erythematous painful subcutaneous nodules usually on the lower leg and foot. A 72-year-old man was diagnosed in 2002 with a neuroendocrine carcinoma of the head of the pancreas. In 2003 following surgery and radiation therapy, he developed liver metastases and painful nodules on his legs. Lipase was found to be markedly elevated;amylase andα1-antitrypsin were in the normal range. Histopathologic examination of a nodule showed subcutaneous fat necrosis with ghost cells surrounded by an acute inflammatory infiltrate.The pathogenesis of pancreatic panniculitis is unclear. The pancreatic enzyme lipase may induce lipolysis and fat necrosis with secondary tissue inflammation.展开更多
文摘Chromobacterium violaceum is a gram-negative bacterium of soil and water in tropical and subtropical environments. Typically,it is considered a bacterium of low virulence although,uncommonly, it causes human infection, particularly in persons with defects in host defenses. Infection generally follows exposure of broken skin to contaminated water and soil, and is often characterized by pustules, lymphadenitis, fever, and vomiting, as well as rapid dissemination and a high mortality rate. Unfortunately, because C violaceum is ubiquitous, it is often dismissed as a contaminant when cultured. Because rapid diagnosis (by taking appropriate specimens) and treatment are vital to a good prognosis, it is imperative that physicians be aware of this organism. In addition, patients with chromobacterial infections should have an immunologic workup because infections in immunocompetent individuals are rare. Here wereport an aggressive yet nonfatal case of Cviolaceum septicemia in an adolescent male, diagnosed through a punch biopsy of askin lesion, and resulting in a new diagnosis of chronic granulomatous disease.
文摘Pancreatic panniculitis is a rare complication occurring in 0.3-3%of patients with pancreatic disease. Clinical features include erythematous painful subcutaneous nodules usually on the lower leg and foot. A 72-year-old man was diagnosed in 2002 with a neuroendocrine carcinoma of the head of the pancreas. In 2003 following surgery and radiation therapy, he developed liver metastases and painful nodules on his legs. Lipase was found to be markedly elevated;amylase andα1-antitrypsin were in the normal range. Histopathologic examination of a nodule showed subcutaneous fat necrosis with ghost cells surrounded by an acute inflammatory infiltrate.The pathogenesis of pancreatic panniculitis is unclear. The pancreatic enzyme lipase may induce lipolysis and fat necrosis with secondary tissue inflammation.
