RESUMEN
Kaposi sarcoma (KS) is a multifocal systemic disease that originates in the vascular endothelium related to Human Herpes Virus 8 (HHV-8). In the early 1980s the first series of cases of disseminated Kaposi Sarcoma in HIV infected patients were reported. However, with the advent of highly active antiretroviral therapy (HAART) since 1997, these cases are less frequently observed by clinicians. We report the case of a 40-year-old woman, presenting with two asymptomatic purpuric nodules localized in the superior and inferior left eyelids, occluding the palpebral fissure, which were present for 4 months prior to presentation. The eyelid nodules were determined to represent KS, but there were no additional cutaneous lesions. Pulmonary and gastric KS involvement was documented. Antiretroviral therapy was initiated along with pegylated liposomal doxorubicin. The nodules gradually disappeared and her immune status eventually improved. Ocular and periorbital involvement of KS associated with HIV-1 infection as the initial clinical manifestations is a rare advent. This case is important as it illustrates that disseminated KS was not to be predicted by the number or the extension of cutaneous lesions.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Neoplasias de los Párpados/etiología , Neoplasias Pulmonares/etiología , Nódulos Pulmonares Múltiples/etiología , Sarcoma de Kaposi/etiología , Síndrome de Inmunodeficiencia Adquirida/diagnóstico , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Adulto , Antibióticos Antineoplásicos/uso terapéutico , Terapia Antirretroviral Altamente Activa , Doxorrubicina/análogos & derivados , Doxorrubicina/uso terapéutico , Neoplasias de los Párpados/diagnóstico , Neoplasias de los Párpados/tratamiento farmacológico , Neoplasias de los Párpados/patología , Femenino , VIH-1 , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/patología , Nódulos Pulmonares Múltiples/diagnóstico por imagen , Nódulos Pulmonares Múltiples/patología , Polietilenglicoles/uso terapéutico , Radiografía Torácica , Sarcoma de Kaposi/diagnóstico , Sarcoma de Kaposi/tratamiento farmacológico , Sarcoma de Kaposi/patología , Tomografía Computarizada por Rayos XRESUMEN
Listeria monocytogenes is a ubiquitous, rapidly growing, gram-positive bacterium causing infections in humans and animals. It is responsible for a variety of symptoms depending on the infection site and the integrity of the host's immune system. Case reports of skin and soft tissues infections by Listeria are rare. The authors present a case of a 65-year-old diabetic male with recurrent skin abscess diagnosed with a perianal abscess due to Listeria monocytogenes associated with lumbar spine osteitis. At the time of this publication and to our knowledge, this case represents the first Listeria monocytogenes infection involving skin and bone in a diabetic man with recurrent skin abscess.
RESUMEN
Neurocysticercosis (NCC) is the most common cause of acquired epilepsy in resource-poor countries. We report the case of a 24-year-old woman born and residing in Guinea-Bissau, who was transferred to Portugal two months after the onset of a possible meningitis (fever, headache, seizures, and coma) that did not respond to antibiotic treatment. The diagnosis of NCC was confirmed by MR imaging, which showed multiple lesions compatible with cysticercus, and by polymerase chain reaction (PCR) of the cerebrospinal fluid. After 28 days on albendazole and dexamethasone without improvement, she was started on praziquantel, which she completed in six weeks with progressive recovery.