RESUMO
Fungal elements are frequently noted overlying the base of chronic peptic ulcers of the stomach and it has been suggested that the fungi enhance the degree of necrosis and that these cases have protracted disease and deeper ulcers with more perforations. It has also been postulated that the number of fungal elements might be increased in the stomach of patients who are receiving potent medications such as H2-receptor antagonists to reduce gastric acidity, but there have not been adequate control studies, and the deleterious effects from the presence of the fungi in these cases have not been substantiated. We present a very rare case of invasive mucormycosis (phycomycosis) occurring in the base of a chronic gastric ulcer in a 55 years old diabetic male. This case was clinically and radiologically been mistaken for a gastric carcinoma. In addition, the ulcer was complicated by perforation and fungal septicemia with subsequent fatal outcome. The clinical, radiological and histopathological features are described together with a literature review of other reported fungal gastric ulcers.
Assuntos
Mucormicose/complicações , Mucormicose/diagnóstico , Úlcera Péptica Perfurada/microbiologia , Úlcera Gástrica/microbiologia , Dor Abdominal/microbiologia , Anorexia/microbiologia , Antiulcerosos/uso terapêutico , Sulfato de Bário , Biópsia , Doença Crônica , Terapia Combinada , Meios de Contraste , Complicações do Diabetes , Evolução Fatal , Gastrectomia , Gastroscopia , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Péptica Perfurada/diagnóstico , Úlcera Péptica Perfurada/terapia , Úlcera Gástrica/diagnóstico , Úlcera Gástrica/terapia , Tomografia Computadorizada por Raios X , Redução de PesoRESUMO
The function of polymorphonuclear leucocytes (PMN) of patients with hydatidosis was investigated. The patients were divided into three categories according to the characteristics of the cyst (calcified, alive and dead cyst). Healthy blood donors were used as a control group. The oxidative activity of PMN was determined by chemiluminescence (CL) assay. Reduction of ferricytochrome C was used to measure the superoxide (O2-) production. Phagocytosis was monitored by opsonized yeast uptake. The results showed that the CL response, O2- production and phagocytic index of PMN, significantly increased in patients with dead cysts compared with healthy subjects while in patients with live cysts there was a marked reduction. No significant changes were noticed in patients with calcified cysts. These data indicate that the PMN of infected patients were in an activated state both functionally and metabolically.