Oana Maria PATRASCU, Monica CIRSTOIU, Anca Mihaela LAZAROIU, Adrian Vasile DUMITRU, Andreea Elena MIHAI, Manuela POPA, Anca DIMITRIU, Maria SAJIN, Mariana COSTACHE and Andreea ILIESIU

ABSTRACT

Associations of different pathologies are not uncommon in every day practice, but association of disseminated infections like cytomegalovirus infection and tuberculosis are quite rare and hard to diagnose. Both are infections which appear frequently in immunocompromised patients and have unfavorable prognosis. We present a case of a 62 year old male with a history of Crohn’s disease and tuberculosis which presented with symptoms of relapse and infection. He was treated with immunosuppressive medication and cortisol for the past 6 weeks. Cytomegalovirus (CMV) infection was serologically confirmed. In evolution, he suffered from gastrointestinal hemorrhage and died afterwards due to the hemorrhage and pulmonary infections. Histology confirmed the CMV modification in the lungs and intestines, but also highlighted active and disseminated tuberculosis (TB), bronchopneumonia, osseous metaplasia, hyaline membranes, numerous TB abscesses in the intestinal wall and specific CMV and TB modifications in the liver. The trigger for such important and serious infections remains unclear, for the cause can be represented by the Crohn’s disease per se or only by the immunosuppressive treatment. Also, CMV can trigger modifications in immune system and patients with immune-mediated diseases have an increased risk for TB reactivation.

Keywords: cytomegalovirus, tuberculosis, Crohn’s disease, osseous metaplasia, gastro-intestinal hemorrhage

Full text | PDF

Monica CIRSTOIU, Luminita Elena MITRACHE, Manuela POPA, Nicoleta Corina MEHOTIN, Maria SAJIN and Catalin CIRSTOIU

ABSTRACT

We report the case of a 44-year-old woman who presented with vaginal bleeding. Vaginal examination and colposcopy showed a tumor on the anterior lip of the cervix. Trans-vaginal sonography revealed a thickened endometrium with accentuated vascularization. Samples from the tumor and endometrium were collected by byopsic curettage. Histopathologic examination showed atypical hyperplasia of the endometrium and benign xanthogranuloma of the cervix. Therefore, surgical intervention was performed.

Full text | PDF