RESUMO
Tuberculous dactylitis is an uncommon condition which is particularly difficult to differentiate from other lesions, particularly tumors. Diagnosis must be confirmed by histology and/or bacteriology studies. We report the case of a 64-year-old diabetic woman who consulted for a painful tumefaction on her fourth finger of the left hand which had developed after minimal trauma. The x-ray of the hand visualized multiple bony defects involving the second phalanx of the fourth finger and a fracture. Pathology examination of a biopsy specimen revealed granulomatous osteitis with typical caseous necrosis. The clinical signs and radiographic images resolved after anti-tuberculosis treatment.
Assuntos
Traumatismos dos Dedos/microbiologia , Fraturas Ósseas/microbiologia , Tuberculose Osteoarticular/complicações , Tuberculose Osteoarticular/diagnóstico , Antituberculosos/uso terapêutico , Biópsia , Complicações do Diabetes , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Osteonecrose/microbiologia , Tuberculose Osteoarticular/tratamento farmacológicoRESUMO
Necrotizing sarcoid granulomatosis is a rare granulomatous pulmonary angeitis that was first described by Liebow in 1973. We report the case of a 36-year-old woman who was admitted for exploration of chest pain, cough and fever at 39 degrees which had progressed for more than 2 months. Chest X-ray showed several inconstant pulmonary opacities. The physical examination, the radiographic and endoscopic aspects were non-specific. The diagnosis was made only by open lung biopsy which showed histological findings of necrotizing sarcoid granulomatosis. The opacities disappeared with no recurrence spontaneously at one year.