Rosai-Dorfman disease (RDD) is a rare, benign histiocytic proliferative disorder primarily occurring in the lymph nodes. Extranodal disease can occur in skin and soft tissue, central nervous system, gastrointestinal tract, and breast. Here we present a case of a 55-year-old female with a history of hypertension, hyperlipidemia, and diabetes mellitus who presented with a fixed solid mass localized to the right medial thigh. Excision revealed S100 and CD 68 positive scattered lymphoid aggregates and emperipolesis, hallmark molecular and cytopathologic features of RDD. RDD is a nonmalignant, classically sporadic histiocytosis. Clinical outcome in terms of mortality seems to be favorable in most cases, however given the benign and slowly progressive nature of the disease, conservative management with observation is typical, with surgical excision recommended for larger lesions. Currently, therapy revolves around surgical and immunosuppressive treatments, but the optimal diagnostic and therapeutic management of RDD remains to be defined.
Endocarditis is a condition that is usually caused by an infection or inflammation of the endocardium. The disease is commonly seen among intravenous drug abusers, patients with intravenous catheters, and those who undergo cardiovascular and invasive dental procedures. Multiple different pathogens can cause endocarditis (bacterial, fungal, and viral) depending upon the patient's risk factors, epidemiology, and bacteria that are prevalent/endemic to the region. We present the case of a woman who had a history of polysubstance abuse, having presented to the hospital on multiple occasions with bacteremia with a previous admission for endocarditis, who developed a multi-bacterial infection at this presentation involving Pseudomonas aeruginosa and group C Streptococcus, which affected both the right and left side of the heart. In this paper, we reviewed common presentations of endocarditis caused by either bacteria, as well as recommendations for medical or surgical management of the condition.
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