RESUMO
We present a case of renal abscess caused by Capnocytophaga canimorsus infection in a previously healthy middle-aged man. He presented with sepsis and an acute kidney injury, and although not identified on his initial assessment, he had sustained a dog bite 5 days prior to hospital admission. The patient developed left loin pain and imaging investigation revealed a renal abscess. Gram stain showed a gram-negative bacillus and C. canimorsus was identified by 16S PCR from these samples along with aspirate from the abscess. The patient responded to treatment with carbapenems but required a prolonged course. His clinical condition was further complicated by a pleural effusion and the development of fatigue symptoms consistent with a post-infection chronic fatigue syndrome. We present this case which we believe to be the first documented case of C. canimorsus causing renal abscess. We discuss the challenges relating to investigation, management and the importance of detailed diagnostic exposure histories in sepsis of unknown origin.
Assuntos
Mordeduras e Picadas , Infecções por Bactérias Gram-Negativas , Sepse , Masculino , Animais , Humanos , Cães , Abscesso/diagnóstico , Abscesso/tratamento farmacológico , Abscesso/complicações , Sepse/diagnóstico , Sepse/complicações , Capnocytophaga , Infecções por Bactérias Gram-Negativas/diagnóstico , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/complicações , Mordeduras e Picadas/complicaçõesRESUMO
The identification of Schistosoma ova in the upper genital tract is well documented, but the extent to which this is related to morbidity and mortality is unknown. We describe a case of right fallopian tube carcinoma associated with evidence of granuloma formation and Schistosoma ova of the left fallopian tube. To our knowledge this is the first documented case of such an association.
Assuntos
Neoplasias das Tubas Uterinas/complicações , Esquistossomose/complicações , Feminino , Granuloma/patologia , Humanos , Pessoa de Meia-Idade , Ovário/parasitologia , Ovário/patologiaRESUMO
Polyarteritis nodosa (PAN) is a term that includes patients with necrotizing inflammation of medium sized arteries, and excludes those with microscopic vessel involvement. Its manifestations are protean and include constitutional symptoms such as fever, malaise, weight loss, myalgia, peripheral neuropathy, rash, and gut and renal involvement. Although gastrointestinal manifestations have been noted in up to a third of patients with PAN, clinical presentation with pancreatic involvement has been reported only rarely. We describe a patient with PAN who developed acute pancreatitis with pseudocyst formation as well as infarcts in the spleen and liver.