RESUMEN
Some solid cancers (such as lung, breast, and esophageal cancer, and melanoma) can lead to pericardial effusion by metastatic spread, potentially provoking hemodynamic instability. Detection by echocardiography is therefore essential. Pericardiocentesis can help restore cardiac function and provide fluid for establishing an etiology through cytological, microbiological, and cellularity analysis. A 60-year-old woman with metabolic syndrome and obesity hypoventilation syndrome presented to the emergency department with dyspnea at rest. A chest X-ray showed cardiomegaly and massive left pleural effusion. Ultrasound findings were pericardial effusion with signs of cardiac tamponade. We performed pericardiocentesis, extracting 1000 mL of exudate, and thoracentesis, which confirmed the diagnosis of lymphocytic exudative effusion. A CAT (computerized tomography) scan of the chest, abdomen, and pelvis revealed a left kidney mass. A biopsy of the mass confirmed the diagnosis of clear cell renal cell carcinoma and a pleural biopsy revealed metastatic involvement. This report describes a rare presentation of cardiac tamponade due to clear cell renal cell carcinoma and discusses the pathogenesis, mechanisms, and prognosis of this condition.
RESUMEN
Three cases of pleural empyema caused by Gemella species--2 caused by Gemella morbillorum and 1 caused by G haemolysansare reported. Microbiological characteristics, predisposing factors, and treatment are reviewed and all cases published in the literature are analyzed.
Asunto(s)
Empiema Pleural/microbiología , Infecciones por Bacterias Grampositivas/complicaciones , Staphylococcaceae , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Se describen 3 casos de empiema pleural por microorganismosdel género Gemella, 2 por la especie G. morbillorum yuno por G. haemolysans. Se revisan las características microbiológicas,los factores predisponentes y las pautas detratamiento, y se exponen los casos publicados en la literatura médica (AU)
Three cases of pleural empyema caused by Gemellaspecies-2 caused by Gemella morbillorum and 1 caused byG haemolysans-are reported. Microbiological characteristics,predisposing factors, and treatment are reviewed and all cases published in the literature are analyzed (AU)