Patient: Male, 48-year-old
Final Diagnosis: Hemophagocytic Lymphohistiocytosis • subcutaneous panniculitis-like T cell lymphoma
Symptoms: Chills • erythema • fever • night sweats • subcutaneous nodules
Medication: —
Clinical Procedure: Autologous stem cell transplantation • chemotherapy
Specialty: Dermatology • Hematology • Infectious Diseases • Medicine, General and Internal • Oncology • Pathology • Transplantology
Objective:
Rare disease
Background:
Subcutaneous panniculitis-like T cell lymphoma and primary cutaneous γδ T cell lymphoma are rare forms of non-Hodgkin lymphoma presenting as skin nodules or plaques.
Case Report:
Here, we present a case of a 48-year-old man with multiple subcutaneous, tender, erythematous nodules on his right thigh and left arm. Multiple courses of antibiotics were administered with no significant improvement in the patient’s lesions. The skin biopsy report showed CD3/CD8 lymphocytic rimming of the adipocytes and the patient was diagnosed with subcutaneous panniculitis-like T cell lymphoma. A subsequent bone marrow biopsy showed hemophagocytic lymphohistiocytosis. The patient underwent treatment with the cyclophosphamide, hydroxydaunorubicin, Oncovin, prednisone, and etoposide chemotherapy regimen and received an autologous peripheral blood stem cell transplant.
Conclusions:
Nodular skin lesions can result from a variety of noninfectious causes in addition to bacterial and fungal infections. This case highlights the importance of early biopsy of skin lesions that do not respond to standard therapy to establish an accurate diagnosis and start timely treatment to prevent poor outcomes.
Background:The COVID-19 vaccine pandemic is expected to control the pandemic. The vaccine acceptance in Africa is yet unknown. This survey was conducted to explore attitudes of healthcare workers towards COVID-19 vaccine and predictors of negative attitude.
Materials and methods:A cross sectional online survey was performed among 1110 healthcare workers to understand COVID-19 vaccine acceptability, encouragement of patients to take COVID-19 vaccine, encouragement of family members to take COVID-19 vaccine, and fears/concerns about COVID-19 vaccine. COVID-19 vaccine acceptance was compared across demographic variables and COVID-19 vaccine attitudes.
Results:The response rate was 60.2%. Out of the 668 respondents, substantial majority were physicians 49.4% and nurses 32.9 %. The vaccine acceptance rate was 72.2% (482/668). Only about 64 % reported that they would encourage their patients or families to get vaccinated. Those who reported they would accept the vaccination were highly likely to encourage their family members to be vaccinated (OR 58.13, 95 % CI 9.7 -348.32, P 0.001) over those who reported they would not encourage their family to be vaccinated. Majority (77%) had one or more fears/concerns about the COVID-19 vaccine. Among the fears/concerns were vaccine adverse reaction, effectiveness of the vaccine, vaccine was made too fast to be safe, and COVID-19 from the vaccine.
Conclusion:The high vaccine hesitancy rate (27.8%) among healthcare workers in Ethiopia is genuinely concerning. Healthcare workers are the main source of healthrelated information for their communities. Thus, we need to equip them with the most accurate and credible knowledge to increase COVID-19 acceptance in Ethiopia.
Cytomegalovirus (CMV) cholangitis is a rare manifestation of CMV infection that has previously been described only in HIV-infected patients and solid-organ-transplant recipients. Reported here is a case of CMV cholangitis that occurred in a patient on chronic corticosteroid therapy who presented with recurrent hemobilia and biliary obstruction and was successfully treated with ganciclovir and cholecystostomy. A search of the medical literature revealed no previous case of this kind.
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