Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Tuberculose da Coluna Vertebral , Tumor de Pott , Ilustração MédicaRESUMO
Un varón de 51 años de edad con antecedentes de tuberculosis (TB) pulmonar en el año 2000, tratado por régimen 2RHZE/4RH. Presentó una recurrencia de TB con baciloscopía positiva y sensible a la rifampicina (Figura 1). Recibió etambutol (15 mg/kg/día), isoniacida (300 mg/día), rifampicina (600 mg/día) y pirazinamida (25mg/Kg/ día), más piridoxina 150 mg/ día. Tres meses después, el paciente presentó pérdida de la agudeza visual (AV) en ambos ojos (AO): 1/10 ojo derecho y 2/10 ojo izquierdo.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Nervo Óptico/terapia , Etambutol/efeitos adversos , Ilustração MédicaRESUMO
Tuberculosis is a major global public health problem. Osteoarticular tuberculosis is very rare. In half of the cases it affects the vertebrae. Symptoms are insidious over a prolonged period and isolation of the pathogen is difficult, mostly leading to difficult and delayed diagnosis. We here report a new case of tuberculous arthritis of the knee in a teenager in whom the mean time between symtom onset and definitive diagnosis based on the detection of Mycobacterium tuberculosis genome by Xpert MTB/RIF test was eight months. This study emphasizes the importance of bacteriological sampling and diagnostic methods by molecular assay in early and definitive diagnosis of tuberculous arthritis.
Assuntos
Articulação do Joelho/patologia , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose Osteoarticular/diagnóstico , Diagnóstico Tardio , Feminino , Humanos , Articulação do Joelho/microbiologia , Mycobacterium tuberculosis/genética , Técnicas de Amplificação de Ácido Nucleico , Adulto JovemRESUMO
Hydatid disease is a zoonosis caused by Echinococcus granulosus, and represents a global public health problem. In children the pulmonary location is the most frequent. The hydatid cyst can be asymptomatic and present symptoms when breaking into the bronchial tree or pleura. We present a case of complicated pulmonary hydatid cyst in a 14-year-old girl from Morocco, where this disease is endemic. The initial clinical picture simulated a lung abscess. The management was surgical, associated with albendazole treatment, with a good clinical evolution.
La enfermedad hidatídica es una zoonosis producida por el Echinococcus granulosus, y representa un problema mundial de salud pública. En niños la localización pulmonar es la más frecuente. El quiste hidatídico puede ser asintomático y presentar síntomas al romperse hacia el árbol bronquial o pleura. Presentamos un caso de quiste hidatídico pulmonar complicado en una niña de 14 años residente en Marruecos, donde esta enfermedad es endémica. El cuadro clínico inicial simuló un absceso pulmonar. El manejo fue quirúrgico, asociado a tratamiento con albendazol, con una buena evolución clínica.
Assuntos
Humanos , Feminino , Adolescente , Equinococose Pulmonar/cirurgia , Equinococose Pulmonar/tratamento farmacológico , Equinococose Pulmonar/diagnóstico por imagem , Radiografia Torácica , Tomografia Computadorizada por Raios X , Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêuticoRESUMO
The association achalasia and non tuberculous Mycobacteria lung infection is described in the literature. Most of the time Mycobacterium Fortuitum is responsible of aspiration pneumonia that didn't respond to usual antibiotic therapy. We report a new case about a 15 year-old woman with Allgrove's syndrome history. The chest imaging showed a right pulmonary condensation and the diagnosis was bacteriological. Mycobacterium Fortuitum resistant to Rifampicin, isoniazid, Pyrazinamide and ethamabutol was isolated. She was treated by cotrimoxazole, ciprofloxacin and clarithromycin for 12 months, with a good clinical, radiological and bacteriological evolution. With the purpose to prevent the relapse the patient was treated by cardiomyotomy.
Assuntos
Insuficiência Adrenal/fisiopatologia , Antibacterianos/administração & dosagem , Acalasia Esofágica/fisiopatologia , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Mycobacterium fortuitum/isolamento & purificação , Adolescente , Farmacorresistência Bacteriana Múltipla , Feminino , Humanos , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Infecções por Mycobacterium não Tuberculosas/microbiologia , Mycobacterium fortuitum/efeitos dos fármacosRESUMO
The association between achalasia and no tuberculosis mycobacterial lung infection is well described in the literature. MycobactériumFortuitum is often responsible, and the clinical's presentation is an aspiration pneumonia resistant to usual antibiotic therapy. We report the case of a 15 year-old patient with the history of Allgrove syndrome. The chest imaging showed right lung congestion; the diagnosis was bacteriological and MycobactériumFortuitum resistant to rifampicin, isoniazid, pyrazinamide and ethambutol was isolated. The patient was treated by the association cotrimoxazole, ciprofloxacin and clarithromycin for 12 months and the clinical, radiological and bacteriological outcomes were favorable. To prevent the recurrence the patient benefited from a cardiomyotomy.
Assuntos
Insuficiência Adrenal/complicações , Acalasia Esofágica/complicações , Infecções por Mycobacterium não Tuberculosas/complicações , Mycobacterium fortuitum/isolamento & purificação , Tuberculose Pulmonar/complicações , Adolescente , Insuficiência Adrenal/microbiologia , Insuficiência Adrenal/patologia , Acalasia Esofágica/microbiologia , Acalasia Esofágica/patologia , Feminino , Humanos , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/microbiologia , Pneumonia Aspirativa/complicações , Pneumonia Aspirativa/diagnóstico , Pneumonia Aspirativa/microbiologia , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/microbiologiaRESUMO
Leiomyoma is a benign smooth muscle tumor usually encountered in the uterus. Primary pulmonary localization is extremely rare in adults and children. However, it must be included in the differential diagnosis of any nodular lung lesion. Its treatment is surgical, with good long-term results. Here, we report a case of leiomyoma of lung parenchyma diagnosed in a 26-year-old man.
Assuntos
Leiomioma , Neoplasias Pulmonares , Adulto , Biópsia , Humanos , Leiomioma/diagnóstico por imagem , Leiomioma/patologia , Leiomioma/cirurgia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Imageamento por Ressonância Magnética , Masculino , Pneumonectomia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Lymph nodes tuberculosis represents 30 percent of extra pulmonary tuberculosis in Morocco. We report here the experience of the pulmonology unit of the Avicenne Military Hospital in Marrakech for a period of 4 years. Our study interested 30 patients (15 males and 15 females) with an average age of 29 years old (10 to 62 years old). Tuberculosis has interested a single site in 28 patients, the other two patients had multiple but unilateral involvement. For the single sites, locations were jugulo-carotidian (20 patients), supra-calvicular (2 patients), axillary (2 patients), sub-mandibular (2 patients), spinal (2 patients) and mediastinal (2 patients). For the multiple locations, the involvement was jugulo-carotidian, sub-mandibular, spinal and sub-clavicular for one patient; and jugulo-carotidian and sub-clavicular for the other. Diagnosis was made by surgical biopsy and histology for all the patients. A six-month anti-tuberculous treatment was given afterward, with relapses in two patients.
Assuntos
Antituberculosos/uso terapêutico , Tuberculose dos Linfonodos/epidemiologia , Adolescente , Adulto , Biópsia , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Recidiva , Estudos Retrospectivos , Tuberculose dos Linfonodos/diagnóstico , Tuberculose dos Linfonodos/tratamento farmacológico , Adulto JovemAssuntos
Doenças Nasofaríngeas/diagnóstico , Tuberculose/diagnóstico , Antituberculosos/uso terapêutico , Biópsia , Diagnóstico Diferencial , Quimioterapia Combinada , Humanos , Isoniazida/uso terapêutico , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Doenças Nasofaríngeas/tratamento farmacológico , Doenças Nasofaríngeas/patologia , Neoplasias Nasofaríngeas/diagnóstico , Pirazinamida/uso terapêutico , Rifampina/uso terapêutico , Fumar , Tuberculose/tratamento farmacológico , Tuberculose/patologia , Tuberculose dos Linfonodos/diagnóstico , Adulto JovemAssuntos
Sinusite Maxilar/diagnóstico , Tuberculose/diagnóstico , Idoso , Antituberculosos/uso terapêutico , Quimioterapia Combinada , Etambutol/uso terapêutico , Feminino , Humanos , Isoniazida/uso terapêutico , Sinusite Maxilar/complicações , Sinusite Maxilar/tratamento farmacológico , Sinusite Maxilar/microbiologia , Mycobacterium tuberculosis/isolamento & purificação , Obstrução Nasal/etiologia , Pólipos Nasais/complicações , Pirazinamida/uso terapêutico , Rifampina/uso terapêutico , Tuberculose/complicações , Tuberculose/tratamento farmacológicoRESUMO
We describe a rare case of retrosternal goiter that developed on the left side of the trachea, squeezing between the trachea and the left supra-aortic vessels, and causing signs of compression and acute left upper limb ischemia in a 35-year-old woman. Her symptoms disappeared after an emergency total thyroidectomy was performed.
