RESUMEN
Chronic mucocutaneous candidiasis (CMC) is characterized by susceptibility to Candida infection of skin, nails, and mucous membranes. Autoimmune endocrinopathies are common in CMC patients, but there are no reports of the involvement of systemic autoimmune disorders. We present here the first case of this kind of association in a patient with an autosomal dominant variant of CMC. The individual had had this disorder since childhood and systemic lupus erythematosus with secondary antiphospholipid syndrome, as well as renal, articular and hepatic manifestations without thymoma.
Asunto(s)
Candidiasis Mucocutánea Crónica/complicaciones , Candidiasis Mucocutánea Crónica/patología , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/patología , Adulto , Esofagoscopía , Esófago/patología , Femenino , Pie/patología , Humanos , Cuero Cabelludo/patología , Piel/patologíaRESUMEN
We probably describe the first report of esophageal rupture in a patient with autoimmune polyendocrinopathy - candidiasis - ectodermal dystrophy (APECED, OMIM # 240300), who had candida esophagitis as the main feature for decades. Strong evidence shows that this rupture may have been caused directly and indirectly by chronic candidiasis. In this way, we demonstrate how severe and harmful the persistent esophageal candidiasis can cause in the esophagus, especially in immunodeficient patients.
Asunto(s)
Candidiasis Mucocutánea Crónica , Candidiasis , Poliendocrinopatías Autoinmunes , Candidiasis/complicaciones , Candidiasis/diagnóstico , Candidiasis Mucocutánea Crónica/complicaciones , Candidiasis Mucocutánea Crónica/diagnóstico , Humanos , Poliendocrinopatías Autoinmunes/complicaciones , Poliendocrinopatías Autoinmunes/diagnósticoRESUMEN
Myeloperoxidase (MOP) is present in monocyte and neutrophil lysosomes, catalyzing hydrogen peroxide and chloride ion conversion to hypochlorous acid. MOP seems to destroy pathogens during phagocytosis by neutrophils and is considered an important defense against innumerous bacteria. We present a patient who had MOP deficiency, who presented with a subacute form of paracoccidioidomycosis and later with peritoneal tuberculosis. MOP deficiency leads to the diminished destruction of phagocytized pathogens. This case gives important evidence of an association between MOP deficiency and increased susceptibility to infection by Paracoccidioides brasiliensis and Mycobacterium tuberculosis.
Asunto(s)
Errores Innatos del Metabolismo/microbiología , Paracoccidioidomicosis/complicaciones , Peritonitis Tuberculosa/complicaciones , Femenino , Humanos , Errores Innatos del Metabolismo/diagnóstico , Paracoccidioidomicosis/diagnóstico , Peritonitis Tuberculosa/diagnóstico , Adulto JovenAsunto(s)
Síndrome de Inmunodeficiencia Adquirida , Infecciones por VIH , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Brasil/epidemiología , Estudios de Cohortes , VIH , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Humanos , Población UrbanaRESUMEN
Abstract Myeloperoxidase (MOP) is present in monocyte and neutrophil lysosomes, catalyzing hydrogen peroxide and chloride ion conversion to hypochlorous acid. MOP seems to destroy pathogens during phagocytosis by neutrophils and is considered an important defense against innumerous bacteria. We present a patient who had MOP deficiency, who presented with a subacute form of paracoccidioidomycosis and later with peritoneal tuberculosis. MOP deficiency leads to the diminished destruction of phagocytized pathogens. This case gives important evidence of an association between MOP deficiency and increased susceptibility to infection by Paracoccidioides brasiliensis and Mycobacterium tuberculosis.
Asunto(s)
Humanos , Femenino , Adulto Joven , Paracoccidioidomicosis/complicaciones , Peritonitis Tuberculosa/complicaciones , Errores Innatos del Metabolismo/microbiología , Paracoccidioidomicosis/diagnóstico , Peritonitis Tuberculosa/diagnóstico , Errores Innatos del Metabolismo/diagnósticoRESUMEN
The general consensus is that appendicitis is basically provoked by fecaliths or lymphoid hyperplasic obstruction. Several studies based on histological diagnosis have not confirmed this hypothesis. On the contrary, obstruction has been proved in only a minority of cases. Diverse infections by parasites, bacteria, fungus, and noninfective agents have been associated with appendicitis in the medical literature. We describe a firefighter, who ingested a small quantity of leachate from decomposing corpses while working and developed enteritis a few hours later, which lasted several days and evolved to appendicitis. This case raises the possibility that the high quantity of bacteria concentration present in the leachate could have provoked enteritis and the subsequent appendicitis due to a direct effect of the bacteria on the appendix.
RESUMEN
Chronic mucocutaneous candidiasis (CMC) is a rare disease associated with immunodeficiency and characterized by persistent and refractory infections of the skin, appendages and mucous membranes caused by members of the genus Candida. Several different disorders are classified under this common denominator, including chronic and recurrent mucocutaneous infections due to Candida spp., which are sometimes linked to autoimmune endocrinopathies. These fungal infections are usually confined to the mucocutaneous surface, with little propensity for systemic disease or septicemia. We describe a patient with CMC who had an esophageal candidiasis refractory to treatment for decades and who developed an epidermoid esophageal cancer. No risk factors such as familiar susceptibility, smoking, alcohol drinking, or living in an endemic area were verified. This case report suggests the participation of nitrosamine compounds produced by chronic Candida infections as a risk factor for esophageal cancer in a patient with autosomal-dominant chronic mucocutaneous candidiasis.