RESUMO
Sarcoidosis is a systemic disease of unknown origin. We describe a case of sputum smear-and culture-negative tuberculosis that was diagnosed with histological examination of a surgical lung biopsy, as other entities such as sarcoidosis could not be excluded after extended investigation. Even a typical lambda sign on gallium scintigraphy proved to be misleading.
Assuntos
Gálio/administração & dosagem , Pulmão/diagnóstico por imagem , Cintilografia/métodos , Sarcoidose/diagnóstico por imagem , Tuberculose/diagnóstico , Adulto , Biópsia/métodos , Diagnóstico Diferencial , Erros de Diagnóstico/prevenção & controle , Erros de Diagnóstico/estatística & dados numéricos , Eritema Nodoso/diagnóstico , Eritema Nodoso/etiologia , Humanos , Pulmão/patologia , Pulmão/fisiopatologia , Linfonodos/diagnóstico por imagem , Masculino , Mediastino/patologia , Radiografia Torácica/métodosRESUMO
Severe leptospirosis can be a rare cause of acute respiratory distress syndrome (ARDS) and multiorgan failure. A patient who made an impact on how I practice was a case of severe leptospirosis (Weil's disease) that presented as ARDS in the ICU. Leptospirosis is an under-reported infectious disease worldwide and should be considered as a cause of ARDS especially in patients with exposure history complicated with diffuse alveolar bleeding (DAH), icteric hepatitis and renal deterioration. Empiric treatment should be recommended before confirmation of laboratory tests as serological diagnosis is time consuming.