ABSTRACT
Whipple's disease is a rare systemic infectious disease caused by the bacterium Tropheryma whippelii. Early diagnosis is essential. Whipple's disease is potentially fatal but responds dramatically to antibiotic treatment. The diagnosis is confirmed by means of polymerase chain reaction (PCR) technology. This analysis may be useful for monitoring the efficacy of therapy. The recommended treatment al present is administration of cotrimoxazole twice daily for one year. When CNS involvement occurs, it is recommended initial treatment with daily parenteral administration of streptomycin 1 g and 1.2 million units of benzyl penicillin (Penicillin G) over a period of 14 days.
Subject(s)
Whipple Disease/diagnosis , Aged , Anemia/etiology , Arthritis, Infectious/diagnosis , Arthritis, Infectious/etiology , Biopsy , DNA, Bacterial/isolation & purification , Diarrhea/etiology , Duodenal Diseases/etiology , Duodenal Diseases/microbiology , Duodenal Diseases/pathology , Female , Folic Acid/therapeutic use , Gastrointestinal Hemorrhage/etiology , Gram-Positive Bacteria/genetics , Gram-Positive Bacteria/isolation & purification , Heart Failure/etiology , Heart Valve Diseases/etiology , Heart Valve Diseases/surgery , Humans , Laparotomy , Male , Penicillin G/therapeutic use , Polymerase Chain Reaction , Streptomycin/therapeutic use , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use , Weight Loss , Whipple Disease/drug therapyABSTRACT
La enfermedad de Whipple, también conocida como lipodistrofia intestinal, es un proceso infeccioso, multisistémico y poco frecuente, causado por la bacteria Tropheryma whippelii. El diagnóstico precoz es fundamental porque esta enfermedad es potencialmente letal, pero responde espectacularmente al tratamiento antibiótico. El diagnóstico se confirma con la reacción en cadena de la polimerasa (PCR) que también es útil para monitorizar la respuesta al tratamiento. Actualmente el tratamiento recomendado consiste en la administración de cotrimoxazol oral dos veces al día durante un año. Cuando hay afectación del SNC se aconseja iniciar el tratamiento con la administración intramuscular de 1 gramo de estreptomicina asociado a 1,2 MU de bencil penicilina (penicilina G) de forma diaria durante 14 días
Whipples disease is a rare systemic infectious disease caused by the bacterium Tropheryma whippelii. Early diagnosis is essential. Whipples disease is potentially fatal but responds dramatically to antibiotic treatment. The diagnosis is confirmed by means of polymerase chain reaction (PCR) technology. This analysis may be useful for monitoring the efficacy of therapy. The recommended treatment al present is administration of cotrimoxazole twice daily for one year. When CNS involvement occurs, it is recommended initial treatment with daily parenteral administration of streptomycin 1 g and 1,2 million units of benzyl penicillin (Penicillin G) over a period of 14 days
Subject(s)
Adult , Humans , Whipple Disease/diagnosis , Whipple Disease/pathology , Trimethoprim, Sulfamethoxazole Drug Combination/chemical synthesis , Trimethoprim, Sulfamethoxazole Drug Combination , Macrophages/classification , Whipple Disease/etiology , Polymerase Chain Reaction , Macrophages/physiology , Tomography, X-Ray Computed/methodsABSTRACT
Infestation in soft tissue by Echinococcus granulosus is not a common disease, and its diagnosis is based on clinical, laboratory data and radiological findings. The aim of our retrospective study is to give an overview of the different signs and patterns shown by MRI that can be useful in characterizing soft tissue hydatid disease. The MRI images obtained in seven patients with soft tissue and subcutaneous hydatidosis were reviewed. Typical signs of hydatidosis were multivesicular lesions with or without hypointense peripheral ring ("rim sign"). Related to the presence and absence, respectively,of viable scolices in the microscopic exam, daughter cysts were presented either as high signal intensity or low signal intensity on T2-weighted images. Low-intensity detached layers within the cyst and peripheral enhancement with gadolinium-DTPA were also presented. Atypical signs were presented in an infected muscular cyst, a subcutaneous unilocular cyst and several unilocular cysts. Knowledge of the different patterns in MRI of soft tissue hydatid disease can be useful in diagnosing this entity. We observed that the "rim sign" is not as common as in other locations, and in addition, MRI seems to be of assistance when evaluating the vitality of the cysts.
Subject(s)
Connective Tissue Diseases/diagnosis , Connective Tissue/pathology , Echinococcosis/diagnosis , Magnetic Resonance Imaging , Muscle, Skeletal/pathology , Muscular Diseases/diagnosis , Connective Tissue/parasitology , Connective Tissue Diseases/parasitology , Contrast Media/administration & dosage , Diagnosis, Differential , Gadolinium DTPA/administration & dosage , Humans , Injections, Intravenous , Magnetic Resonance Imaging/methods , Muscle, Skeletal/parasitology , Muscular Diseases/parasitology , Retrospective StudiesABSTRACT
Pseudoaneurism in renal grafts is a well known complication of the percutaneous biopsy. Colour Doppler has been shown to be the choice technique for their diagnosis and subsequent control, the most effective treatment being embolization. This paper presents an unusual form of pseudoaneurism in terms of its size (up to 8 cm diameter) in a renal graft, following performance of a percutaneous biopsy with automatic needle. The findings of the colour Doppler study and the angiography are shown and discussed, as well as the treatment by embolization with metal spirals which achieved the stable, complete occlusion of the lesion after six months control.