RESUMO
ABSTRACT: Filling materials are used to correct soft tissue deficits. Local and systemic complications are described when these substances are applied. The polyalkylamide gel (Bio-alcamid) used as filler material has been associated with complications at the facial level, while at the pulmonary level they have not been reported in the literature. We present the case of a patient who consulted due to sudden progressive dyspnea hours after the subcutaneous injection of Bio-alcamid in the breasts. After the clinical evaluation and the result of auxiliary tests, the diagnosis of acute pneumonitis secondary to the injection of this substance is concluded. Follow-up of the case was carried out with favorable evolution and resolution of symptoms after three months. We conclude that Bio-alcamid can generate complications at the pulmonary level, therefore, the intervention of public policies that regulate its use, commercialization and application by non-medical personnel is necessary.
RESUMEN: Los materiales de relleno son utilizados para la corrección de déficit de tejido blando. Se describen complicaciones locales y sistémicas cuando se aplican estas sustancias. El gel de polialquilamida (Bio-alcamid) empleado como material de relleno ha sido asociado a complicaciones a nivel facial, mientras que a nivel pulmonar no han sido informadas en la literatura. Presentamos el caso de una paciente que consultó por presentar disnea súbita progresiva horas después de la inyección subcutánea de Bio-alcamid en mamas. Luego de la evaluación clínica y el resultado de exámenes auxiliares se concluye el diagnóstico de neumonitis aguda secundaria a la inyección de esta sustancia. Se realiza seguimiento del caso con evolución favorable y resolución de síntomas a los tres meses. Concluimos que el Bio-alcamid puede generar complicaciones a nivel pulmonar, por tanto, es necesario la intervención de políticas públicas que regulen su uso, comercialización y la aplicación por personal no médico.
RESUMO
Tuberculosis is the most frequent granulomatous disease but the involvement of the larynx is rare. Immunosuppressed patients have a higher risk of developing this clinical form due to primoinfection or reactivation of latent tuberculosis. It is common to confuse the diagnosis of laryngeal tuberculosis with laryngeal cancer because they have similar macroscopic lesions and both produce dysphonia of chronic evolution. We present the case of a pregnant woman with chronic dysphonia, dysphagia, and odynophagia, diagnosed initially with laryngeal cancer after the first laryngoscopy. However, the patient also presented with fever, productive cough, weight loss, and dyspnea. The sputum sample showed a positive result for acid-fast bacilli (AFB) test; chest X-ray was showed bibasal nodular lesions with a predominance of right hemithorax and reticular opacities in left apex. A new laryngoscopy revealed a mamelonated tumor in the arytenoid cartilage, which led to the initiation of the antituberculous treatment without confirming the diagnosis by biopsy, with clinical improvement and no serious sequelae at the end of treatment. The reason for presenting this case is to consider the possibility of tuberculosis in areas of high endemicity, in patients who have a laryngeal tumor of probable neoplastic etiology, and that a biopsy is not necessary for the diagnosis of laryngeal tuberculosis in cases associated with pulmonary symptomatology.