What is this neck mass? A 47-yo India-born male with chronic hep C, hepatocellular carcinoma, on tacrolimus and steroids s/p liver transplant, presents with fever, left lower lobe consolidation, pleural effusion. Ten days later, a submandibular mass developed.
Hepatocellular carcinoma
Posttransplant lymphoproliferation
Mycobacterium tuberculosis
Kaposi sarcoma
Non-Hodgkin lymphoma
You are correct. Liver biopsies show granulomata. A neck mass fine-needle aspirate showed acid-fast bacilli. Reactivated TB is the commonest cause of clinical TB after solid organ transplantation.
A 53-yo man noted an itchy, red rash on his ankle after a trip to Brazil. He was bitten while on a beach and covered the bite with a bandage. The bite mark extended itself 1 cm to 2 cm per day in a serpiginous pattern. He was otherwise well. What is it?
Tungiasis (burrowing flea)
Cutaneous larva migrans
Lymphatic filariasis (Brugia malayi)
Lyme erythema migrans
Chagas disease (T. cruzi)
You are correct. Cutaneous larva migrans is a common tropical/subtropical dermatosis caused by penetration and migration of hookworm larvae. The highly pruritic, advancing, serpiginous eruption is typically self-limiting.