growing several inches below the surface of desert soil in the San Joaquim valley in southernArizona and central California is well documented in the literature. Most infections resolve quickly with minimal symptoms,1 although some individuals develop a subacute process called “Valley Fever”, which is characterized by shortness of breath, chest pain, cough and fevers lasting from weeks to month...

Palatal perforation can be defined as a communication between the nasal cavities and the oral cavity. There are various potential causes of palatal perforation. Failure of the palatal shelves to close during the sixth week of prenatal period results in cleft palate. Maternal alcohol consumption and cigarette smoking, folic acid deficiency, teratogenic drugs, certain viruses, corticosteroid use ...

BACKGROUND Disseminated coccidiomycosis during pregnancy can lead to both maternal and neonatal mortality. Placentitis is an uncommon sequelae and its effect on placental function remains speculative. The present report describes our management of such a case and describes serial umbilical artery velocimetry of an affected placenta. CASE A pregnant woman with coccidioidal placentitis confirme...

The question of whether the initial eosinophilia in case 2 of our report could have been due to Aspergillus infection, perhaps allergic bronchopulmonary Aspergillus (ABPA), can be answered with reasonable certainty. In our opinion the patient did not have specific evidence for the diagnosis of an Aspergillus infection. Cultures for clinically significant Aspergillus are identified in two to six...

Background. Invasive fungal infections (IFI) are a significant source of morbidity and mortality in neutropenic patients. Risk based prophylaxis or pre-emptive therapy are debated clinical approaches. Since 2009, IPC at our tertiary care institution has collected the IFI rate per 1,000 neutropenic patient days. We examine IFI per neutropenic episode by patient characterictics and duration of ne...

This case report presents an unusual and challenging diagnostic scenario involving a 72-year-old man who recently returned from trip to Maui, Hawaii. While in the patient presented with fever fatigue that resolved spontaneously. However, he had observable rash on his head was given steroid injection resolve rash. Later trip, experienced dry, nonproductive cough which five-day course of predniso...

BACKGROUND Coccidioidomycosis is an endemic fungal infection in the southwestern of United States. Most infections are asymptomatic or manifest with mild respiratory complaints. Rare cases may cause extrapulmonary or disseminated disease. We report two cases of knee involvement that presented as isolated lytic lesions of the patella mimicking neoplasms. CASE PRESENTATION The first case, a 27 ...

CMAJ • JUNE 15, 2010 • 182(9) © 2010 Canadian Medical Association or its licensors E382 Twenty days after getting a tattoo on his arm, a 30-year-old immunocompetent man de veloped peculiar lesions at the tattoo site. He presented to our dermatology clinic three months later with umbilicated, skin-coloured, papular lesions that were asymptomatic (Figure 1A). His physical examination was otherwis...

The Langhans’ giant cell described in 1868 is a large cell with numerous nuclei arranged in a ring around the periphery of an eosinophilic cytoplasm.1’ 2 The cytoplasm is homogeneous or granular and may contain inclusions such as Mycobacterium tuberculosis. The foreign body type giant cell can be distinguished by the presence of nuclei throughout the substance of the cytoplasm rather than at th...