RESUMO
Lemierre's syndrome is a rare and severe sepsis that can rapidly lead to a life-threatening condition in the absence of early management. This syndrome described at the beginning of the 20th century combines oropharyngeal infection complicated with septic thrombosis of the internal jugular vein and septic emboli predominantly pulmonary. Fusobacterium necrophorum, anaerobic germ, Gram negative bacillus is the main germ in this "necrobacillosis". The diagnosis is should be confirmed precociously with cervicothoracic CT-scan, reference exam, and bacteriological examinations (especially in atypical forms). Its management consists of an emergency antibiotic treatment, combining a third-generation cephalosporin or a betalactam with metronidazole, anticoagulant therapy to be reserved for high-risk situations related to thrombosis. Surgical treatment may be required.
Assuntos
Antibacterianos/uso terapêutico , Anticoagulantes/uso terapêutico , Fusobacterium necrophorum/isolamento & purificação , Síndrome de Lemierre/diagnóstico , Adulto , Feminino , Humanos , Síndrome de Lemierre/terapia , Tomografia Computadorizada por Raios XRESUMO
Eosinophilic pleural effusions have multiple aetiologies. We report on the case of a 40-year-old man who experienced an eosinophilic pleural effusion with blood hypereosinophilia that occurred nine weeks after a treatment with valproic acid was introduced. Usual aetiologies of eosinophilic pleural effusion were excluded. Once valproic acid was discontinued, both pleural effusion and blood eosinophilia decreased rapidly. The persistence of a residual pleural effusion required the introduction of oral corticosteroids, which resulted in the effusion disappearing completely and rapidly. Valproic acid is a rare cause of eosinophilic pleural effusion. The effusion usually regresses when treatment is discontinued but short-term oral corticotherapy may be necessary in order to heal the patient.
Assuntos
Eosinofilia/induzido quimicamente , Derrame Pleural/induzido quimicamente , Ácido Valproico/efeitos adversos , Adulto , Antimaníacos/efeitos adversos , Contagem de Células Sanguíneas , Eosinofilia/complicações , Eosinofilia/diagnóstico por imagem , Eosinófilos/patologia , Humanos , Masculino , Derrame Pleural/complicações , Derrame Pleural/diagnóstico por imagem , Radiografia TorácicaRESUMO
INTRODUCTION: Cardiac echinococcosis is rare and only represents around 0.5% of all hydatic locations. Right ventricular location is exceptional. OBSERVATION: We report the case of a 72 year-old man having a chronic obstructive pulmonary disease. During an acute respiratory failure, cardiac ultrasonography showed a right ventricular tumour. After respiratory stabilisation, surgical intervention found the tumour, the histopathological study of which concluded in a dead and calcified hydatic cyst. DISCUSSION: This case report demonstrates the limits of modern imaging and the difficulties in diagnosing a calcified right intra-ventricular hydatidosis. It is important to emphasize the exceptional nature of this form and the scarcity of its localisation. Surgical treatment is crucial in the majority of cases and helps to confirm the diagnosis. CONCLUSION: In endemic areas, the discovery of an intra-cardiac tumour must evoke and eliminate echinococcosis. Calcification of a cardiac location remains exceptional.