Pseudomonas aeruginosa causing inflammatory mass of the nasopharynx in an immunocompromised HIV infected patient: A mimic of malignancy

Head and neck manifestations of acquired immunodeficiency syndrome are among the most common complications of this disease. The sinonasal and oral manifestations are more common that the otologic and range from malignancies to infectious processes caused by both opportunistic and nonopportunistic or...

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Main Authors: Gale, Michael John, Maritato, Maria Susana, Chen, Yaw-Ling, Abdulateef, Saif S., Ruiz, Jose E.
Format: Online
Language:English
Published: Elsevier 2015
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4672612/
id pubmed-4672612
recordtype oai_dc
spelling pubmed-46726122016-01-20 Pseudomonas aeruginosa causing inflammatory mass of the nasopharynx in an immunocompromised HIV infected patient: A mimic of malignancy Gale, Michael John Maritato, Maria Susana Chen, Yaw-Ling Abdulateef, Saif S. Ruiz, Jose E. Case Report Head and neck manifestations of acquired immunodeficiency syndrome are among the most common complications of this disease. The sinonasal and oral manifestations are more common that the otologic and range from malignancies to infectious processes caused by both opportunistic and nonopportunistic organisms. We report the case of a nasopharyngeal mass of infectious etiology in a severely immunocompromised HIV infected patient. The patient was admitted with a presumptive diagnosis of infectious gastroenteritis and was found to have a nasopharyngeal mass. The mass was extending into the oropharynx and paravertebral soft tissues and was associated with extensive secretions causing near complete occlusion of the oropharynx. CT scan findings favored malignant verses infectious etiology. The surgical biopsy performed twice ruled out malignancy and the bacterial culture proved to be a pure growth of Pseudomonas aeruginosa. Pseudomonas can inhabit the nasopharynx and lower digestive tract, and is only occasionally associated with causing disease in non-susceptible patients but is a common infection in immunocompromised patients. To the best of our knowledge, and after considering the current literature, we believe this case is unique. We discuss this rare entity and its management. Clinicians should be aware of this potential life threatening condition in the HIV population and add P. aeruginosa infection to the differential diagnosis of an acute inflammatory nasopharyngeal mass. Elsevier 2015-02-11 /pmc/articles/PMC4672612/ /pubmed/26793451 http://dx.doi.org/10.1016/j.idcr.2015.01.004 Text en © 2015 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
repository_type Open Access Journal
institution_category Foreign Institution
institution US National Center for Biotechnology Information
building NCBI PubMed
collection Online Access
language English
format Online
author Gale, Michael John
Maritato, Maria Susana
Chen, Yaw-Ling
Abdulateef, Saif S.
Ruiz, Jose E.
spellingShingle Gale, Michael John
Maritato, Maria Susana
Chen, Yaw-Ling
Abdulateef, Saif S.
Ruiz, Jose E.
Pseudomonas aeruginosa causing inflammatory mass of the nasopharynx in an immunocompromised HIV infected patient: A mimic of malignancy
author_facet Gale, Michael John
Maritato, Maria Susana
Chen, Yaw-Ling
Abdulateef, Saif S.
Ruiz, Jose E.
author_sort Gale, Michael John
title Pseudomonas aeruginosa causing inflammatory mass of the nasopharynx in an immunocompromised HIV infected patient: A mimic of malignancy
title_short Pseudomonas aeruginosa causing inflammatory mass of the nasopharynx in an immunocompromised HIV infected patient: A mimic of malignancy
title_full Pseudomonas aeruginosa causing inflammatory mass of the nasopharynx in an immunocompromised HIV infected patient: A mimic of malignancy
title_fullStr Pseudomonas aeruginosa causing inflammatory mass of the nasopharynx in an immunocompromised HIV infected patient: A mimic of malignancy
title_full_unstemmed Pseudomonas aeruginosa causing inflammatory mass of the nasopharynx in an immunocompromised HIV infected patient: A mimic of malignancy
title_sort pseudomonas aeruginosa causing inflammatory mass of the nasopharynx in an immunocompromised hiv infected patient: a mimic of malignancy
description Head and neck manifestations of acquired immunodeficiency syndrome are among the most common complications of this disease. The sinonasal and oral manifestations are more common that the otologic and range from malignancies to infectious processes caused by both opportunistic and nonopportunistic organisms. We report the case of a nasopharyngeal mass of infectious etiology in a severely immunocompromised HIV infected patient. The patient was admitted with a presumptive diagnosis of infectious gastroenteritis and was found to have a nasopharyngeal mass. The mass was extending into the oropharynx and paravertebral soft tissues and was associated with extensive secretions causing near complete occlusion of the oropharynx. CT scan findings favored malignant verses infectious etiology. The surgical biopsy performed twice ruled out malignancy and the bacterial culture proved to be a pure growth of Pseudomonas aeruginosa. Pseudomonas can inhabit the nasopharynx and lower digestive tract, and is only occasionally associated with causing disease in non-susceptible patients but is a common infection in immunocompromised patients. To the best of our knowledge, and after considering the current literature, we believe this case is unique. We discuss this rare entity and its management. Clinicians should be aware of this potential life threatening condition in the HIV population and add P. aeruginosa infection to the differential diagnosis of an acute inflammatory nasopharyngeal mass.
publisher Elsevier
publishDate 2015
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4672612/
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