Lethal Midline Granuloma of the Face

Resnick, Nolan; Skerrett, Philip V.

doi:10.1001/archinte.1959.00270010122016

Cited by 6 publications

(1 citation statement)

References 3 publications

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“…How far treatment contributed to healing is debatable, and it is not clear why the renal changes did not react correspondingly well: at least it may be said that the histological findings are an encouragement to continue to try the effect of steroids in future cases of Wegener's disease, in spite of the attendant risks. Wegener's granulomatosis is not to be confused with the so-called lethal midline granuloma of the face (" granuloma grangraenescens ") (see Resnick and Skerrett, 1959). Its kinship to polyarteritis, and, more remotely, to systemic lupus erythematosus, places it within the heterogeneous group of diseases primarily affecting the connective tissues (the so-called "collagen diseases ").…”

Section: Findings Reminiscent Of Systemic Lupusmentioning

confidence: 99%

Generalized Cytomegalic Inclusion-Body Disease Associated With Pneumocystis Pneumonia in Adults

Symmers

1960

J Clin Pathol

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Three cases of generalized cytomegalic inclusion-body disease (salivary virus disease) in adults are reported, bringing the number of published cases up to 34. The infection is very rare in adults although well known in infants. As is often found in infants with this disease, pneumonia due toPneumocystis cariniiwas also present in each case.The first patient had Wegener's granulomatosis, which presented with acute otitis media: a review of histological material obtained at mastoidectomy eight weeks before death showed that inclusion-body cytomegaly was already present then. Various antibiotics and prednisolone were given, and the lesions in the respiratory organs and the arteritis healed to a considerable extent. Renal failure, however, was progressive and led to death.The second patient had thrombotic purpura and died after a few weeks' illness, during which oxytetracycline and hydrocortisone were given. Congenital absence of the spleen was found at laparotomy, which was performed with the object of doing a splenectomy. Focal cryptococcal pneumonia was presentpost mortem: six years before death a solitary cryptococcal granuloma of one lung had been treated by lobectomy.The third patient had had Hodgkin's disease for 18 years. During the first 12 years the disease had the characteristics of the so-called indolent form (“Hodgkin's paragranuloma”) and it then passed into the typical form. Deepx-ray therapy and cytotoxic drugs were used during the course of the disease at various times, and streptomycin and tuberculostatic drugs were given because of intercurrent tuberculous meningitis which developed three months before death.In all three cases it seems likely that the underlying disease, or the drugs used in its treatment, predisposed to cytomegalic inclusion-body disease and concomitant pneumocystis pneumonia by lowering the patients' resistance. Just as some unusual types of fungal and bacterial infections have become less rare since the introduction of certain drugs, including antibiotics and steroids, it is possible that cytomegalic inclusion-body disease and pneumocystis infection may also be met with oftener in adults, perhaps particularly as a complication of the use of these drugs in the treatment of diseases which are specially liable to interfere with the body's defences.

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Section: Findings Reminiscent Of Systemic Lupusmentioning

confidence: 99%