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1.
Medisan ; 25(5)2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1346545

ABSTRACT

Se presenta el caso clínico de un paciente de 21 años de edad, con antecedente de herniorrafia inguinal derecha, quien asistió a consulta de control y refirió presentar una induración y dolor en la región dorsal del pene con 4 días de evolución, que había comenzado después de una relación sexual en la cual consumió marihuana. En el examen físico se encontró la vena dorsal del pene engrosada, dura y dolorosa a la palpación. Se le diagnosticó una enfermedad de Mondor del pene. La ecografía Doppler confirmó la tromboflebitis de esta vena. El paciente recibió tratamiento médico y evolucionó satisfactoriamente.


The case report of a 21 years patient with history of right inguinal herniorrhaphy is presented, who attended control visit and he made reference to an induration and pain in the dorsal region of the penis with 4 days of evolution that had begun after a sexual relationship in which he consumed marihuana. In the physical exam the penis dorsal vein was found thicken, hard and painful to the palpation. He was diagnosed a Mondor disease of the penis. The Doppler scanning confirmed the thrombophlebitis of this vein. The patient received medical treatment and had a favorable clinical course.


Subject(s)
Penis/injuries , Thrombophlebitis/diagnostic imaging , Ultrasonography, Doppler , Herniorrhaphy
2.
Medicina (B.Aires) ; 81(3): 454-457, jun. 2021. graf
Article in Spanish | LILACS | ID: biblio-1346484

ABSTRACT

Resumen La flegmasia cerulea dolens es una complicación rara y poco frecuente de la trombosis venos a profunda. Los principales factores predisponentes son los procesos neoformativos, estados de hiper coagulabilidad, insuficiencia cardíaca congestiva, embarazo, inmovilización prolongada y cirugías. Se caracteriza por edema masivo, dolor intenso y cianosis. Sin tratamiento evoluciona con isquemia, necrosis y amputación del miembro comprometido. No existe consenso en su tratamiento, pero éste debe ser rápido, multidisciplinario y agresivo. La anticoagulación con heparina, la fibrinólisis sistémica, la trombectomía percutánea con fibrinólisis local, la trombectomía quirúrgica, la fasciotomía, la colocación de filtro de vena cava inferior y la amputación son algunos de los tratamientos propuestos.


Abstract Phlegmasia cerulea dolens (FCD) is a rare complication of deep vein thrombosis. Its cause is unknown. The main predisposing factors for the disease are neoformative processes, hypercoagulable states, congestive heart failure, pregnancy, prolonged immobilization, and surgeries on the affected limb. FCD is characterized by massive edema, severe pain, and cyanosis. The diagnosis is clinical. It is associated in most cases with pulmonary embolism and can lead to loss of the compromised limb if not treated in time. So far there is no consensus on its treatment. In clinical practice the use of anticoagulation with heparin, local thrombolysis, systemic fibrinolysis, surgical thrombectomy, fasciotomy, and inferior vena cava filter are described. In irreversible cases amputation is required. We present the case of a patient with FCD, the treatment performed and the evolution.


Subject(s)
Humans , Thrombophlebitis/drug therapy , Thrombophlebitis/diagnostic imaging , Venous Thrombosis/drug therapy , Venous Thrombosis/diagnostic imaging , Heparin , Thrombectomy , Fibrinolysis
3.
J. vasc. bras ; 20: e20200036, 2021. graf
Article in English | LILACS | ID: biblio-1250235

ABSTRACT

Abstract Our study describes a fatal case of phlegmasia cerulea dolens and massive venous thrombosis in a patient taking rivaroxaban regularly to treat cerebral venous sinus thrombosis. Blood tests samples were positive for lupus anticoagulant. The unique evolution of the case, as well as the positivity for lupus anticoagulant, raises the possibility of an acquired hypercoagulation syndrome. We highlight the fact that the test recommended as the first line for lupus anticoagulant diagnosis (dilute Russell viper venom time) is the most affected by rivaroxaban, leading to a high prevalence of false-positive results. We also discuss potential diagnoses for the current case and review the current state-of-the-art of use of the novel oral anticoagulation agents in this unusual situation. So far, there are no recommendations to use such agents as first options in cerebral venous sinus thrombosis or in hypercoagulation syndromes.


Resumo Nosso estudo descreve um caso fatal de flegmasia cerúlea dolens e trombose venosa maciça em um paciente usando regularmente rivaroxabana para o tratamento de trombose de seio venoso cerebral. A investigação laboratorial foi positiva para o anticoagulante lúpico. A evolução única do caso aumenta a possibilidade de uma síndrome de hipercoagulabilidade adquirida, bem como a positividade para o anticoagulante lúpico. Destacamos o fato de que o teste recomendado como primeira linha para o diagnóstico de anticoagulante lúpico (veneno de víbora de Russel diluído) é o mais afetado pela rivaroxabana, levando a uma alta prevalência de resultados falso-positivos. Também discutimos os potenciais diagnósticos para o presente caso e revisamos o estado da arte atual dos novos agentes de anticoagulação oral usados nessa situação incomum. Até o presente momento, não há recomendações para o uso de tais agentes como primeira opção na trombose de seios venosos cerebrais ou nas síndromes de hipercoagulação.


Subject(s)
Humans , Female , Adult , Thrombophlebitis/complications , Venous Thrombosis/complications , Rivaroxaban/adverse effects , Anticoagulants/adverse effects , Sinus Thrombosis, Intracranial/drug therapy , Thrombophlebitis/diagnosis , Venous Thrombosis/diagnosis , Factor Xa Inhibitors
4.
Rev. chil. obstet. ginecol. (En línea) ; 85(3): 275-280, jun. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1126163

ABSTRACT

RESUMEN Presentamos caso clínico de puérpera de cesárea de noveno día con cuadro febril en espigas, asintomática, en que se plantea desde su ingreso el diagnóstico de tromboflebitis séptica pelviana y se inicia tratamiento con antibióticos parenterales de amplio espectro y heparina de bajo peso molecular en dosis terapéuticas. La respuesta es a la mejoría al tercer día de tratamiento. Se discuten los métodos diagnósticos, el diagnóstico diferencial y el tratamiento.


ABSTRACT A case of a woman on her 9th post-operative day after childbirth by cesarean section (CS) consulting with febrile spikes, otherwise asymptomatic, is presented. The diagnosis of a septic pelvic thrombophlebitis is proposed from the admission and treated with parenteral broad-spectrum antibiotics and low-molecular-weight heparin at therapeutic doses. Patient significantly improved on her third day of treatment. The diagnostic procedures, differential diagnosis and treatment are discussed.


Subject(s)
Humans , Female , Adult , Ovary/blood supply , Thrombophlebitis/etiology , Cesarean Section/adverse effects , Sepsis/etiology , Pelvis/blood supply , Thrombophlebitis/drug therapy , Thrombophlebitis/diagnostic imaging , Heparin/therapeutic use , Tomography, X-Ray Computed , Sepsis/drug therapy , Sepsis/diagnostic imaging , Diagnosis, Differential , Anti-Bacterial Agents/therapeutic use , Anticoagulants/therapeutic use
6.
Acta otorrinolaringol. cir. cabeza cuello ; 47(3): 178-182, 2019. ilus
Article in Spanish | LILACS, COLNAL | ID: biblio-1095195

ABSTRACT

El síndrome de Lemierre es una enfermedad rara, ocasionada por la complicación grave de una infección orofaringea que se manifiesta con una tromboflebitis séptica en la yugular interna y una embolización séptica a distancia. En principio, el síndrome cursa con fiebre, dolor en el área del ángulo de la mandíbula, inflamación de la región periamigdalina y un crecimiento unilateral del cuello luego de una infección en las estructuras de la cabeza y el cuello. En el artículo se presenta el caso de una mujer de 45 años quien consultó por una complicación infecciosa posterior a la realización de una exodoncia. El diagnóstico clínico se realizó con base en los signos y síntomas que indicaban tromboflebitis séptica del seno cavernoso. Se realiza antibióticoterapia con resultados positivos en la paciente y, como resultado, una mejoría total del estado de salud. Se presenta este caso por lo infrecuente de la entidad.


Lemierre syndrome is a disease caused by the serious complication of an oropharyngeal infection that manifests with septic thrombophlebitis in internal jugular and remote septic embolization. It presents with fever, pain in the area of the jaw angle, inflammation of the peritonsillar region and unilateral neck growth after an infection in the head and neck structures. We present the case of a 45-year-old woman who consulted due to an infectious complication after carrying out the extraction. The clinical diagnosis was made based on the signs and symptoms that indicated septic thrombophlebitis of the cavernous sinus. Antibiotic therapy is performed with positive results in the patient and total improvement of the state of health.


Subject(s)
Humans , Lemierre Syndrome , Thrombophlebitis , Fusobacterium
7.
Korean Journal of Medicine ; : 375-378, 2019.
Article in English | WPRIM | ID: wpr-759944

ABSTRACT

Pylephlebitis (septic thrombophlebitis of the portal venous system) is a rare but serious complication of intra-abdominal infections that drain into the portal venous system. Its diagnosis is based on imaging; computed tomography may reveal a thrombus in the portal vein. Bacteremia may also be evident. As the symptoms are nonspecific, early clinical diagnosis is difficult, and delayed treatment can compromise outcomes. We report a case with extensive pylephlebitis and a liver abscess associated with Streptococcus intermedius sepsis; the case was treated successfully with antibiotics and anticoagulants. Such cases have not been widely reported.


Subject(s)
Anti-Bacterial Agents , Anticoagulants , Bacteremia , Diagnosis , Intraabdominal Infections , Liver Abscess , Liver , Portal Vein , Sepsis , Streptococcus intermedius , Streptococcus , Thrombophlebitis , Thrombosis
8.
Article in Korean | WPRIM | ID: wpr-787534

ABSTRACT

Lemierre's syndrome is rare disease characterized by anaerobic sepsis, internal jugular vein thrombosis, septic emboli that resulted from head and neck infection. Lemierre's syndrome has significant morbidity, so immediate, accurate diagnosis and treatment is needed. It is necessary to perform contrast-enhanced computed tomography (CT) for diagnosis. Systemic antibiotics is recommended, and surgical interventions, anticoagulation may beis considered for treatment. We report misdiagnosed case as a simple deep neck infection on initial ultrasonography with simultaneous abscess aspiration but finally diagnosed and treated internal jugular vein thrombophlebitis (Lemierre's syndrome) on CT scan.We report a case of a 45-year-old patient, who was diagnosed with a simple deep neck infection and treated with simultaneous abscess aspiration, but finally diagnosed and treated internal jugular vein thrombophlebitis (Lemierre's syndrome) on CT scan.


Subject(s)
Abscess , Anti-Bacterial Agents , Diagnosis , Head , Humans , Jugular Veins , Lemierre Syndrome , Middle Aged , Neck , Rare Diseases , Sepsis , Thrombophlebitis , Thrombosis , Tomography, X-Ray Computed , Ultrasonography
9.
Revista Digital de Postgrado ; 8(3): e167, 2019. graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1087875

ABSTRACT

La utilización de catéter venoso central produce, en ocasiones, infecciones de tipo local o sistémico, como la bacteriemia no complicada o complicada (bacteriemia persistente, tromboflebitis séptica, endocarditis y otras complicaciones metastásicas). En este estudio se dan a conocer las infecciones ocasionadas por el uso de Catéter Venoso Central (CVC), así como los microorganismos presentes en los pacientes. Métodos: La investigación fue de tipo retrospectivo, descriptivo y de corte transversal, con un diseño de investigación no experimental y tuvo la finalidad de conocer, en forma directa, la realidad de la problemática. Las unidades de observación fueron (188) historias clínicas de los pacientes que ingresaron en el servicio de medicina interna en el hospital Miguel Pérez Carreño en el periodo comprendido entre enero y abril de 2017. Resultados: En 30 de los pacientes se realizó el cultivo de la punta del catéter venoso central. En el 67% no hubo crecimiento de microorganismos, mientras que el 33% crecieron microorganismos a las 24 horas. El 80% de las muestras cultivadas reportan la presencia de Cocos Gram positivos. Un 10% reportaron enterobacterias y un 10% reportan levaduras, finalmente con menor frecuencia pseudomona con un 0%. Conclusiones: Solo 78 pacientes ameritaron la colocación de un catéter venoso central, de los cuales se cultivaron 30 puntas de catéter, encontrándose que solo 10 de las puntas de catéteres dieron positivas para infección con crecimiento bacteriano a las 24 horas, siendo los cocos Gram positivos la principal bacteria aislada en los pacientes con CVC seguidos de enterobacterias(AU)


Intravascular catheterization is used for hemodynamic monitoring, hemodialysis, metabolic and nutritional support, fluid administration, chemotherapy and prolonged antibiotic therapy, blood and derivatives, among others. In this study, infections caused by the use of (CVC) central venous catheter are reported, as well as the microorganisms present in patients. Methods: The research was of a retrospective, descriptive and cross-sectional type, with a non-experimental research design and aimed to know, in a direct way, the reality of the problem. The observation units were (188) clinical records of the patients admitted to the internal medicine service at the Miguel Pérez Carreño Hospital in the period between January and April 2017. Results In 30 of the patients, the culture of the tip of the central venous catheter. In 67% there was no growth of microorganisms, while 33% grew microorganisms at 24 hours. 80% of the cultivated samples report the presence of Gram-positive cocci. 10% reported enterobacteria and 10% reported yeast, finally with less frequency pseudomonas with 0%. Conclusions: Only 78 patients required placement of a central venous catheter, of which 30 catheter tips were cultured, finding that only 10 of the catheter tips were positive for infection with bacterial growth at 24 hours, with Gram-positive cocci. the main bacteria isolated in patients with CVCfollowed by enterobacteria(AU)


Subject(s)
Humans , Adolescent , Adult , Thrombophlebitis/diagnosis , Catheterization, Central Venous/methods , Gram-Positive Cocci , Endocarditis/diagnosis , Catheter-Related Infections/microbiology , Central Venous Catheters/adverse effects , Bacterial Infections , Medical Records/statistics & numerical data , Cross Infection/epidemiology , Retrospective Studies
10.
J. vasc. bras ; 17(4): 337-340, out.-dez. 2018. ilus
Article in Portuguese | LILACS | ID: biblio-969179

ABSTRACT

síndrome de Lemierre caracteriza-se pela tromboflebite séptica da veia jugular interna, após uma orofaringite, com embolização séptica para o pulmão ou outros órgãos. Neste relato de caso, apresentamos uma paciente feminina, 37 anos de idade, com história de edema e dor em hemiface direita há três dias, associada a fadiga e dispneia progressiva há um dia. História de extração dentária do elemento 48 há três dias. No exame físico admissional, apresentava-se taquipneica, saturando 60% (em ar ambiente), com edema em ângulo da mandíbula direita, redução difusa do murmúrio vesicular e panturrilhas sem empastamento. Angiotomografia de tórax e exames laboratoriais foram compatíveis com quadro de embolia séptica, e tomografia computadorizada da cervical corroborou o diagnóstico de tromboflebite séptica da veia jugular interna. Foi tratada com antibióticos e sintomáticos. A síndrome de Lemierre afeta mais homens jovens e tem embolização para o pulmão em até 97% dos casos. Extrações dentárias raramente podem ser a etiologia dessa síndrome. A tomografia computadorizada é o método de imagem mais utilizado no diagnóstico, e o tratamento é, essencialmente, com antibióticos; portanto, a abordagem cirúrgica é raramente necessária


Lemierre syndrome is characterized by septic thrombophlebitis of the internal jugular vein, after an oropharyngeal infection, with septic embolization to the lungs or other organs. This case report describes a 37-year-old female patient who presented with edema and pain in the right hemiface with onset 3 days previously and progressive fatigue and dyspnea since the previous day. She had had tooth 48 extracted 3 days previously. Physical examination at admission found tachypnea, with 60% saturation (in room air), edema at the angle of the right mandible, diffuse reduction of vesicular murmur, and calves free from clubbing. Angiotomography of the chest and laboratory tests were compatible with septic emboli, and cervical computed tomography confirmed a diagnosis of septic thrombophlebitis of the internal jugular vein. She was managed with antibiotics and given treatment for her symptoms. Lemierre syndrome most often occurs in young men and there is embolization to the lungs in up to 97% of cases. Rarely, the etiology of this syndrome may be tooth extraction. Computed tomography is the imaging method most often used for diagnosis and treatment is basically antibiotic. Surgery is thus rarely necessary


Subject(s)
Humans , Female , Adult , Tooth Extraction/methods , Lemierre Syndrome , Thrombophlebitis , Diagnostic Imaging/methods , Pharyngitis/complications , Tomography, X-Ray Computed/methods , Jugular Veins/diagnostic imaging , Neck
11.
Rev. gastroenterol. Perú ; 38(3): 289-292, jul.-set. 2018. ilus, tab
Article in English | LILACS | ID: biblio-1014097

ABSTRACT

This case study describes a 71-year-old man with signet-ring cell gastric adenocarcinoma and malignant sigmoidal polyp; and typical features of Saint's triad and Heyde syndrome. He had digestive bleeding, two types of hernia, diverticulosis, arterial hypertension, malignant polyp, and antecedent of smoking, lung tuberculosis, and surgical correction of aortic valve stenosis. There is a hypothetical inverse relationship between herniosis and development of malignancy; however, the patient herein described presented gastric and sigmoidal cancers. Gastrointestinal malignancies are sometimes associated with paraneoplastic entities, isolated or manifested as syndromes, but neither Saint's triad or Heyde syndrome have been included. This patient persisted clinically stable during the preoperative period, but suddenly died; Trousseau's syndrome would be the most probable mechanism of sudden death in this setting. Case reports can stimulate further studies to get additional knowledge about unusual entities.


Este estudio de caso describe un hombre de 71 años de edad, con adenocarcinoma gástrico con células en anillo de sello y un pólipo maligno sigmoideo; y características típicas de la tríada de Saint y del síndrome de Heyde. Tuvo una hemorragia digestiva, dos tipos de hernias, divertículos, hipertensión arterial, y pólipo maligno; con antecedente de tabaquismo, tuberculosis pulmonar, y corrección quirúrgica de estenosis de la válvula aórtica. Hay una hipotética relación inversa entre hernioses y el desarrollo de malignidades; sin embargo, el paciente que se describe en el presente documento presentó cánceres gástrico y sigmoideo. Neoplasias gastrointestinales se asocian a veces con entidades para neoplásicas aisladas o manifiestan síndromes, pero ni la tríada de Saint ni el síndrome de Heyde se ha incluido. Este paciente persistió clínicamente estable durante el período preoperatorio, pero de repente murió; síndrome de Trousseau sería el mecanismo más probable de muerte súbita en esta situación. Los informes de casos pueden estimular más estudios para obtener un conocimiento adicional sobre esas entidades inusuales.


Subject(s)
Aged , Humans , Male , Aortic Valve Stenosis/complications , Sigmoid Neoplasms/complications , Stomach Neoplasms/complications , Cholelithiasis/complications , Colonic Polyps/complications , Diverticulum/complications , Carcinoma, Signet Ring Cell/complications , Gastrointestinal Hemorrhage/etiology , Hernia, Hiatal/complications , Neoplasms, Multiple Primary/complications , Syndrome , Thrombophlebitis/etiology , Angiodysplasia/etiology , Fatal Outcome , Anemia, Iron-Deficiency/etiology , Death, Sudden , Models, Biological
12.
Rev. méd. hondur ; 86(1/2): 52-55, ene-. jul. 2018. ilus
Article in Spanish | LILACS | ID: biblio-1008651

ABSTRACT

Introducción: El embolismo séptico es una enfermedad grave caracterizada por iniltrados pulmonares bilaterales aso-ciados a un foco infeccioso extrapulmonar. Se relaciona con endocarditis derecha, trombolebitis pelviana, accesos vasculares y a infecciones como osteomielitis, artritis séptica o piomiositis. El Staphylococcus aureus meticilino-resistente adquirido en la comunidad (SAMR-AC) es un patógeno virulento y emergente, que afecta a sujetos sin factores de riesgo conocidos. Casos clínicos: Primer caso; Masculino 17 años de edad, sano, antecedente de herida por clavo en pie izquierdo. Inicia 15 días después iebre, disnea y expectoración hemoptoica. Segundo caso; Masculino de 26 años sano, con antecedente de absceso submandibular el cual fue dre-nado por el servicio de Otorrinolaringología. Una semana después reiere iebre, disnea, dolor torácico y expectoración hemoptoica. Discusión; El embolismo séptico se produce con la llegada al pulmón de productos infectados, con microorganismos que general-mente son bacterias. En pacientes graves, que requieren tratamiento endovenoso, las drogas de elección son vancomicina, linezolid, tigeciclina o daptomicina...(AU)


Subject(s)
Humans , Male , Adolescent , Adult , Pulmonary Embolism , Thrombophlebitis , Endocarditis/complications , Lung Diseases, Fungal
13.
Pesqui. vet. bras ; 38(5): 862-869, May 2018. tab, graf
Article in Portuguese | LILACS, VETINDEX | ID: biblio-955414

ABSTRACT

Afecções do trato gastrointestinal de equinos podem causar distúrbios de coagulação devido à concentração elevada de mediadores inflamatórios que estimulam a hemostasia e inibem a fibrinólise, gerando um estado de hipercoagulação. Equinos submetidos à laparotomia no tratamento da síndrome cólica permanecem com cateter venoso durante vários dias para a administração de fluidos e fármacos no período pós-operatório e, a veia jugular é o principal local para a implantação de cateteres. Assim, o trauma vascular persistente causado pelo cateter, associado ao ambiente pró-trombótico induzido pela afecção gastrointestinal, aumenta o risco para o desenvolvimento de tromboflebite jugular. Objetivou-se avaliar as características físicas e ultrassonográficas da veia jugular canulada com cateter de poliuretano durante o período pós-operatório de equinos submetidos à laparotomia. O cateter foi inserido de forma asséptica à admissão e permaneceu por sete dias. A avaliação ultrassonográfica revelou o desenvolvimento de tromboflebite em um equino, 48 após o procedimento cirúrgico. Os demais equinos demonstraram espessamento da parede vascular no local de punção e pequenos trombos junto ao cateter. A monitoração ultrassonográfica demonstrou que a cateterização prolongada em equinos submetidos à laparotomia, seguindo o protocolo proposto, minimiza a lesão vascular e pode prevenir a tromboflebite jugular.(AU)


Coagulation abnormalities are usually associated with equine gastrointestinal disease due to the increased levels of inflammatory mediators, which promotes hemostasis and inhibit fibrinolysis, creating a hypercoagulable state. Horses underwent laparotomy to treat colic usually require a venous catheter for several days to administrate fluids and drugs during the postoperative period, and the jugular vein is the most frequent site for catheterization. Therefore, the persistent vascular trauma caused by an implanted catheter, associated with the prothrombotic environment induced by the gastrointestinal disorder, increases the risk for the development of jugular thrombophlebitis. The purpose of the present investigation was to evaluate physical and ultrassonographic features of the jugular vein cannulated with a polyurethane catheter during the postoperative period of horses underwent colic surgery. The catheter was inserted aseptically on admission and dwell time was seven days. Upon ultrasound examination, one horse developed thrombophlebitis 48 hours after surgery and the other horses showed thickened venous wall at puncture site and small clots associated to the catheter. Ultrasound monitoration showed that long-term catheterization in horses underwent colic surgery following the present protocol minimizes vascular trauma and could prevent jugular thrombophlebitis.(AU)


Subject(s)
Thrombophlebitis/classification , Gastrointestinal Diseases/veterinary , Horses/abnormalities , Laparotomy/veterinary
14.
Geriatr., Gerontol. Aging (Impr.) ; 12(1): 50-53, jan,-mar.2018. ilus.
Article in English, Portuguese | LILACS | ID: biblio-904991

ABSTRACT

INTRODUÇÃO E OBJETIVO: O plasmocitoma é uma proliferação neoplásica de um clone de plasmócitos que produzem imunoglobulina monoclonal. O plasmocitoma solitário ósseo é definido pela presença de um plasmocitoma na ausência de múltiplas lesões osteolíticas ou outros achados compatíveis com mieloma múltiplo. O presente artigo relata o caso de uma paciente idosa que apresentou plasmocitoma ósseo solitário de esterno de difícil diagnóstico devido a manifestações clínicas atípicas e possível evolução para mieloma múltiplo. RELATO DO CASO: Paciente de 74 anos, do sexo feminino. Procurou atendimento médico por confusão mental, taquidispneia e dor torácica precordial em queimação, além de história de queda com trauma da região anterior do tórax. Na internação hospitalar evoluiu com hiponatremia refratária ao tratamento, tromboflebite superficial em membro superior esquerdo, celulite periorbitária, endoftalmite e osteomielite no esterno. A eletroforese de proteínas séricas teve como resultado o aumento policlonal na região das gamaglobulinas. A biópsia da lesão considerou achado compatível com plasmocitoma. Tomografia computadorizada de esqueleto não evidenciou lesões adicionais. Apresentou uma evolução ruim com insuficiência renal crônica agudizada por provável síndrome de lise tumoral, indo a óbito. CONCLUSÃO: O estudo vem ressaltar a importância da hipótese diagnóstica de plasmocitoma/mieloma múltiplo frente a um paciente idoso, com manifestação clínica diversificada, como anemia, insuficiência renal, fratura patológica e infecções de repetição, em vista de sua evolução e prognóstico.


INTRODUCTION AND OBJECTIVE: Plasmacytoma is a neoplastic proliferation of a plasma cell clone which produces monoclonal immunoglobulin. Solitary plasmacytoma of bone is defined by the presence of a single plasmacytoma in the absence of multiple osteolytic lesions or other findings compatible with multiple myeloma. We report an older patient with solitary plasmacytoma of the sternum associated with atypical clinical findings which complicated diagnosis and possible progression to multiple myeloma. CASE REPORT: A 74-year-old woman sought medical care due to mental confusion, tachydyspnea, and chest pain after a fall with blunt trauma to the anterior chest. During admission, the patient developed refractory hyponatremia, superficial thrombophlebitis in the left upper limb, periorbital cellulitis, endophthalmitis, and sternal osteomyelitis. Serum protein electrophoresis showed a polyclonal increase in gamma globulins. Biopsy result was compatible with plasmacytoma. A computed tomography scan showed no additional lesions. Progression was poor, with chronic renal failure exacerbated by probable tumor lysis syndrome, resulting in death. CONCLUSION: The present findings emphasize the importance of considering a diagnostic hypothesis of plasmacytoma/multiple myeloma in older patients with a set of varied clinical signs, such as anemia, renal failure, pathological fracture, and repetitive infections


Subject(s)
Humans , Female , Aged , Plasmacytoma/diagnosis , Thrombophlebitis , Multiple Myeloma , Tumor Lysis Syndrome/complications , Tomography, X-Ray Computed/instrumentation , Hyponatremia/blood
15.
Article in English | WPRIM | ID: wpr-715712

ABSTRACT

Inflammatory bowel disease (IBD) is a well-recognized risk factor for thrombotic events in adults but data on children are scarce. In the great majority of adult patients, thrombotic events are usually deep vein thrombosis and pulmonary embolism. Other sites such as jugular veins are extremely rare. We present a case of Lemierre syndrome in an adolescent girl with active ulcerative colitis and discuss possible risk factors. This is the first reported case of severe Lemierre syndrome with thrombus extension to cranial veins in a patient with ulcerative colitis. Early recognition of Lemierre syndrome in patients who present with rapidly worsening symptoms of neck pain, fever and signs of pharyngitis is imperative because it increases a chance of favorable prognosis. It is important for pediatricians treating IBD patients not to underestimate possible thrombotic events in children with IBD. Recognition of additional risk factors is crucial for prompt diagnosis and adequate treatment.


Subject(s)
Adolescent , Adult , Child , Colitis, Ulcerative , Diagnosis , Female , Fever , Humans , Inflammatory Bowel Diseases , Jugular Veins , Lemierre Syndrome , Neck Pain , Pharyngitis , Prognosis , Pulmonary Embolism , Risk Factors , Thrombophlebitis , Thrombosis , Ulcer , Veins , Venous Thrombosis
16.
Kosin Medical Journal ; : 110-116, 2018.
Article in English | WPRIM | ID: wpr-715142

ABSTRACT

Lemierre syndrome is characterized by anaerobic bacterial infection in the head and neck and clinical or radiological evidence of internal jugular vein thrombophlebitis. The most common pathogens are Fusobacterium species, particularly Fusobacterium necrophorum. Septic emboli resulting from infected thrombophlebitis of the internal jugular vein leads to metastatic infections involving lung, liver, kidney, bone and central nervous system. The accurate diagnosis and treatment is important because it may be associated with a high mortality rate if untreated. We present a case of 28-year-old man with an atypical history for the diagnosis of Lemierre syndrome, which showed no definite evidence of internal jugular thrombophlebitis.


Subject(s)
Adult , Bacterial Infections , Central Nervous System , Diagnosis , Empyema , Fusobacterium , Fusobacterium necrophorum , Head , Humans , Jugular Veins , Kidney , Lemierre Syndrome , Liver , Lung , Mortality , Neck , Thrombophlebitis
17.
Article in English | WPRIM | ID: wpr-742466

ABSTRACT

PURPOSE: To identify risk factors for recurrent thromboembolic events (RTEs) and define the optimum duration of treatment with tinzaparin in patients with superficial vein thrombosis (SVT) of the lower limbs. MATERIALS AND METHODS: A total of 147 consecutive patients with significant SVT were treated with subcutaneously administered tinzaparin. The composite primary endpoint of the study was RTE, deep-vein thrombosis (DVT) and/or pulmonary embolism (PE) at 120 days. Patients were stratified into group A, where patients received a variable dose of tinzaparin for up to 60 days (n=98), and a subsequent group B-ext, where patients received a standardized intermediate dose of tinzaparin (n=49) for 90 days. RESULTS: RTEs occurred in 15/147 patients (10.2%), including recurrent SVT (n=10), DVT (n=4) and fatal PE (n=1). RTEs were less frequent in group B-ext (0% vs. 15.3% for group A, P=0.004), a difference that remained significant at the one-year follow-up. Clinically extensive SVT was an independent predictor for RTEs (hazard ratio, 5.94; 95% confidence interval, 2.05–17.23; P=0.001, Cox regression). Predictors or DVT or PE in group A included clinically extensive SVT (P=0.004), absence of local pain (P=0.023) and the ultrasound findings of superficial axial vein thrombosis (any, P=0.006 or isolated, P=0.036) and multiple thrombosed superficial venous sites (P < 0.001). CONCLUSION: An extended three-month regimen of tinzaparin in patients with SVT of the lower limbs is more effective than a shorter course and may be desirable in patients with risk factors.


Subject(s)
Follow-Up Studies , Heparin , Humans , Lower Extremity , Pulmonary Embolism , Recurrence , Risk Factors , Thrombophlebitis , Thrombosis , Ultrasonography , Veins , Venous Thrombosis
18.
Article in English | WPRIM | ID: wpr-742318

ABSTRACT

Hughes-Stovin syndrome is a rare disorder of unknown etiology. Although the association between multiple pulmonary artery aneurysms and venous thrombosis of the lower limbs was reported by Beattie and Hall in 1911, it was not until 1962 that the eponym “Hughes-Stovin syndrome” was formally introduced in the medical literature. We describe 2 patients with Hughes-Stovin syndrome who presented with pulmonary artery aneurysm, thrombophlebitis, hemoptysis, and oral ulcers, review the manifestations of the disease, and compare its similarities with and differences from Behçet disease.


Subject(s)
Aneurysm , Behcet Syndrome , Eponyms , Hemoptysis , Humans , Lower Extremity , Oral Ulcer , Pulmonary Artery , Thrombophlebitis , Thrombosis , Venous Thrombosis
19.
Cuarzo ; 24(2): 44-49, 2018. ilus.
Article in Spanish | LILACS, COLNAL | ID: biblio-980387

ABSTRACT

La Flegmasía Cerúlea Dolens es una complicación rara y severa de la trombosis venosa profunda, que se manifiesta clínicamente con edema profuso, dolor y cianosis del miembro inferior afectado. La obstrucción masiva del sistema venoso determina un aumento de la presión de los compartimentos de la extremidad, que finalmente compromete la circulación arterial. Su tratamiento debe ser agresivo para evitar la gangrena y/o la muerte. Presentamos el caso de una paciente atendida en la Clínica La Sagrada Familia, Armenia ­ Colombia, quien consultó por cuadro clínico de edema progresivo en miembro inferior izquierdo, encontrando cambios isquémicos en falanges distales y edema grado III en miembro inferior izquierdo, con reporte de dúplex venoso con trombosis venosa profunda iliofemoral extensa izquierda y dúplex arterial con reducción de los flujos arteriales secundario a edema severo de tejidos blandos, se indica flebografía con trombólisis venosa por catéter regional en miembro inferior izquierdo con infusión continua de trombolítico. Con respectivos controles angiográficos a las 24 y 48 horas con recanalización del 80% de las venas iliaca, femoral y poplítea, se suspendió infusión y se retiró catéter, continuó anticoagulación con heparina no fraccionada hasta lograr paso a anticoagulación oral con posterior egreso hospitalario dado su evolución satisfactoria.


The Flegmasia Cerulea Dolens is a rare and severe complication of deep venous thrombosis, which manifests clinically with profuse edema, pain and cyanosis of the affected lower limb. The massive obstruction of the venous system is an increase in the pressure of the limb compartments, which compromises the arterial circulation. Your treatment should be aggressive to avoid gangrene and / or death. We present the case of a patient treated at La Sagrada Familia Clinic, Armenia - Colombia, who consulted for clinical picture of progressive edema in left lower limb, finding ischemic changes in distal phalanges and grade III edema in left lower limb, with report of duplex venous with deep left iliofemoral venous thrombosis and arterial duplex with reduction of arterial flow secondary to severe soft tissue edema, phlebography with venous thrombolysis is indicated by regional catheter in left lower limb with continuous thrombolytic infusion. With the respective angiographic controls at 24 and 48 hours with 80% recanalization of the iliac, femoral and popliteal veins, the infusion was interrupted and the catheter was withdrawn, anticoagulation with unfractionated heparin was continued until oral anticoagulation was administered, the hospital discharge was performed given its satisfactory evolution.


Subject(s)
Thrombophlebitis/therapy , Thrombophlebitis/diagnosis , Thrombolytic Therapy/methods , Anticoagulants/therapeutic use
20.
Urol. colomb ; 27(3): 287-289, 2018. Ilus
Article in Spanish | LILACS, COLNAL | ID: biblio-981622

ABSTRACT

La linfangitis esclerosante no venérea del pene es una lesión benigna, en la mayoría delos casos autolimitada, que afecta a los hombres en su periodo de mayor actividad sexual, entre los 20 y 45 años de edad aproximadamente, aunque puede presentarse fuera de este rango de edad.1­3 A pesar de que se han reportado casos desde hace más de 60 años, no se ha esclarecido del todo su fisiopatología, siendo la teoría más aceptada la relacionada con traumatismos locales repetidos por relaciones sexualesvigorosas y/o masturbación con obstrucción linfática superficial secundaria.


Non-venereal sclerosing lymphangitis of the penis is a benign lesion, in most cases self-limited, affecting men in their period of greatest sexual activity, between approximately 20 and 45 years of age, although it may occur outside this age range.1-3 Although cases have been reported for more than 60 years, their physiopathology has not been fully clarified, with the most accepted theory being that related to repeated local trauma due to vigorous sexual intercourse and/or masturbation with secondary superficial lymphatic obstruction.


Subject(s)
Humans , Lymphangitis , Penile Diseases , Thrombophlebitis , Coitus
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