ABSTRACT
A 19-years-old male was admitted for left bilobar pneumonia. All microbiologic studies in blood and in several samples obtained by bronchoscopy were negative. The patient worsened progressively despite antibiotherapy of a wide spectrum. A fine needle transparietal puncture was performed. The cultures of the sample were positive for Nocardia asteroides, a positive catalase germ. Immunologic studies initiated after this time showed negative tetrazolium nitroblue test, the results of which led to the diagnosis of chronic granulomatous disease. This disease is very infrequent and the polymorphonuclear leukocytes are genetically incapable of producing peroxides whose absence impedes lysis of the positive phagocytic catalase germs with which a histologic reaction is produced in the form of granulomas from which the name of the disease is derived.
Subject(s)
Granulomatous Disease, Chronic/diagnosis , Nocardia Infections/diagnosis , Nocardia asteroides , Pneumonia/diagnosis , Adult , Biopsy , Drug Therapy, Combination , Granulomatous Disease, Chronic/drug therapy , Humans , Lung/diagnostic imaging , Lung/pathology , Male , Nocardia Infections/drug therapy , Nocardia asteroides/isolation & purification , Pneumonia/drug therapy , RadiographyABSTRACT
The authors present one clinical case of lung epidermoid carcinoma with several concurrent features which are uncommon in relation to this type of neoplasia. Consequently, the age of the patient (22), the lack of known risk factors, the histologic type (little differentiated squamous) and an aggressive biologic behaviour of the tumour, preceded of multiple cutaneous metastasis, are circumstances that make this clinical case exceptional. The more significative aspects present at lung carcinoma included in this age group respect to others are analyzed.