RESUMO
RESUMEN La aspergilosis pulmonar, causada por el hongo oportunista Aspergillus, afecta principalmente a individuos inmunocomprometidos. Este reporte presenta tres casos: Una mujer de 18 años con leucemia aguda desarrolló dificultad respiratoria y patrones bilaterales de "árbol en brote" en la tomografía computarizada (TC). A pesar del tratamiento con voriconazol, falleció debido a insuficiencia respiratoria. Una mujer de 58 años con diabetes y EPOC presentó disnea y hemoptisis. Las imágenes revelaron una lesión cavitada, confirmando un aspergiloma. Se consideró la cirugía debido a la hemoptisis activa. Una mujer de 41 años con antecedentes de tuberculosis presentó fiebre y síntomas respiratorios. La TC mostró lesiones cavitadas y bronquiectasias, confirmando aspergilosis crónica. Respondió bien al voriconazol. Estos casos destacan la variabilidad en la aspergilosis pulmonar y subrayan la importancia de un diagnóstico y tratamiento oportunos para mejorar los resultados en los pacientes.
ABSTRACT Pulmonary aspergillosis, caused by the opportunistic fungus Aspergillus, primarily affects immunocompromised individuals. This report presents three cases: An 18-year-old female with acute leukemia developed respiratory distress and bilateral "tree-in-bud" patterns on CT. Despite voriconazole treatment, she succumbed to respiratory failure. A 58-year-old female with diabetes and COPD had dyspnea and hemoptysis. Imaging revealed a cavitated lesion, confirming aspergilloma. Surgery was considered due to active hemoptysis. A 41-year-old female with a history of tuberculosis presented with fever and respiratory symptoms. CT showed cavitated lesions and bronchiectasis, confirming chronic aspergillosis. She responded well to voriconazole. These cases highlight the variability in pulmonary aspergillosis and underscore the importance of timely diagnosis and treatment to improve patient outcomes.
RESUMO
OBJECTIVE: To determine the frequency of chronic joint pain and stiffness 3 years after infection with chikungunya virus (CHIKV) in a Latin American cohort. METHODS: A cross-sectional followup of 120 patients from an initial cohort of 500 patients who reported joint pain 2 years after infection from the Atlántico Department, Colombia. Patients were clinically diagnosed as having CHIKV during the 2014-2015 epidemic, and baseline and followup symptoms at 40 months were evaluated in serologically confirmed cases. RESULTS: Of the initial 500 patients enrolled in the study, 482 had serologically confirmed chikungunya infection. From this group, 123 patients reported joint pain 20 months after infection, and 54% of those patients reported continued joint pain 40 months after infection. Therefore, 1 out of every 8 people who tested serologically positive for CHIKV infection had persistent joint pain 3 years after infection. Participants who followed up in person were predominantly adult (mean ± SD age 51 ± 14 yrs) and female (86%). The most common type of pain reported in these patients at 40 months post-infection was pain with periods of relief and subsequent reoccurrence, and over 75% reported stiffness after immobility, with 39% experiencing morning stiffness. CONCLUSION: To our knowledge, this is the first report to describe persistent joint pain and stiffness 40 months after viral infection. The high frequency of chronic disease highlights the need to develop prevention and treatment methods. Further studies should be conducted to understand the similarities between post-chikungunya joint pain and rheumatoid arthritis.