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Case reports

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Vol. 48, 2012

 

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Extrapulmonary tuberculosis with intestinal and peritoneal localization (Case report) - 48, 2012, 2, 67-70.
A. Kircheva(1), V. Kaludova(2), D. Paskalev(3) and E. Softova(3)

(1)MPHAT “Sv. Anna” -- Varna, (2)PPhHAT -- Varna, (3)Medical University -- Varna
Summary: After 1990, tuberculosis pandemic marked a new development stage presented by an increase of the number of diseased by more than 50 per 100 000 individuals in more than 27 countries round the world. Bulgaria is one of the seriously affected countries. According to the National Health Information Centre, in 2005, tuberculosis occurrence in Bulgaria was 40.1 per 100 000 individuals, with a mortality rate of 3.5 per 100 000 individuals, compared with the respective 12.6 per 100 000 individuals and 0.9 per 100 000 individuals, registered in the countries of the EU. Recurrent cases of extrapulmonary tuberculosis, frequently masked by other disease symptoms, are diagnosed late or remain unidentified. We present a case of tuberculosis infection of the intestinal tract, involving the female genitalia, appendix and peritoneum, which is rarely registered in our country. The 16-year old patient (Y. S.) was admitted to the Clinic of Gyneco­logy for surgical treatment. Following the echographic and CT verification of the initial diagnosis of an ovarian cyst, ovarian carcinoma and ascites, an operation by delayed emergency was performed. During the operation, the initial diagnosis was changed on the basis of intra-operative and histological findings, pathognomonic for tuberculosis of the intestines, right salpinx, right ovary, appendix and peritoneum. The microbiological examination of the peritoneal exudate supported the clinical diagnosis on the 36th post-discharge day through isolation of a Mycobacterium tuberculosis strain, susceptible to first-line tuberculostatics. Following the course of the performed surgical and conservative treatment, we subjected the risk contacts between the patient and the hospital staff and other patients to epidemiological analysis, as well as emphasized on the significance of clinical and histological diagnosis (preceding the micro­biological one) for undertaking fast and adequate anti-epidemic measures.
Key words: tuberculosis, intestinal tuberculosis, Mycobacterium tuberculosis
Address for correspondence: Anna Kircheva, M. D., Department of Epidemiology, MHAT “Sv. Anna”, 100, Tzar Osvoboditel Str., Bg -- 9000 Varna, tel. +359 52 6926-579, e-mail: kircheva@svetaanna-varna.com

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Valsalva retinopathy -- a case presentation – 48, 2012, №1, 62-64.
H. Blagoeva and R. Hristova
Clinic of Ophthalmology, University Hospital “Tsaritsa Ioanna” -- Sofia
Summary: Valsalva retinopathy presents with capillary rupture after performing Valsalva maneuver, because of intraocular venous pressure increase. This case is of a 32-year-old man complaining of sudden vision loss after vigorous laugh during a comedy on TV. Visual acuity of the eye was 0.05. The ophthalmoscopic observation showed preretinal hemorrhage in the macular area. After positioning the patient and conservative treatment the visual acuity was 1.0 two months later. Valsalva retinopathy is а rare condition and sometimes it resolves spontaneously, but often needs head positioning, conservative or laser treatment.
Key words: Valsalva retinopathy, preretinal hemorrhage
Address for correspondence: Hristina Blagoeva, M.D., Ph.D., Department of Ophthalmology, University Hospital “Tsaritsa Ioanna”, 8 “Bialo more” Str., Bg -- 1527 Sofia, tel. +359 2 818 46 23, e-mail: ch_blagoeva@abv.bg

 

Epidermal cyst of the mammary gland – 48, 2012, 1, 65-66.
V. Uzunova(1), A. Uchikov(1)), K. Murdzhev(1), G. Prisadov(1), E. Poryazova(2) and D. Manolova(3)
(1)Chest and Abdominal Surgery Department, (2)Department of Basic and Clinical Pathology, (3)Diagnostic Imaging Department, Medical University -- Plovdiv
Summary: Localization of epidermal cysts in the mammary glands is extremely rare. It is of great importance not to miss breast carcinomas. In the current article, we present a case of a 34-year-old woman with a formation in the left mammary gland. Mammographically, a round formation was evident and ultrasonographically, there was a hypoechogenic area in the left mammary gland. A sectoral excision was carried out and the following histological examination confirmed an epidermal cyst.
Key words: epidermal cyst, mammary gland, sectoral excision, mammography, immunohistochemistry
Address for correspondence: Vania Uzunova, М. D., 171, 6 septemvri Str., Bg -- 4000 Plovdiv,
е-mail: vani59@yahoo.com

Last update of the page: 29.03.2012


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