ABSTRACT
Deep venus thrombosis may result in pulmonary embolism. In rare instances, embolization has occurred, not directly to the pulmonary arterial tree, but to the right heart chambers. Although the value of echocardiography in the diagnosis is well recognised, their is no consensus for the appropriate treatment. We report herein six cases of floating right atrial thrombi, diagnosed by echocardiography, in patients with pulmonary embolism, or unexplained shock or syncope. Surgical embolectomy was carried out in 4 patients, and thrombolytic therapy in 2, without in-hospital mortality. The high mortality associated to this entity may be improved by rapid echocardiographic recognition and emergency treatment with thrombolysis or surgery. Our data suggest the possible use of thrombolysis as a first-choice therapy in selected patients.
Subject(s)
Embolism/diagnosis , Heart Diseases/diagnosis , Adult , Aged , Drug Therapy, Combination , Echocardiography , Embolectomy/methods , Embolism/therapy , Female , Fibrinolytic Agents/administration & dosage , Heart Diseases/therapy , Heparin/administration & dosage , Humans , Lung/diagnostic imaging , Male , Radionuclide Imaging , Streptokinase/administration & dosage , Thrombolytic Therapy , Ventilation-Perfusion RatioABSTRACT
Two new cases of infection due to Listeria monocytogenes in two females with HIV are discussed, one of them with full blown AIDS and the other pregnant and without knowledge of her seropositivity until that moment. Its clinical manifestation as a meningeal manifestation and bacteremia, coincide with the few cases described until now; different hypothesis invoked until now are reviewed to justify this infrequent association HIV-Listeria.
Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , Listeriosis/diagnosis , AIDS-Related Opportunistic Infections/etiology , Acquired Immunodeficiency Syndrome/complications , Acquired Immunodeficiency Syndrome/diagnosis , Adult , Bacteremia/microbiology , Female , HIV Seropositivity/diagnosis , HIV-1/immunology , Humans , Listeria monocytogenes/isolation & purification , Listeriosis/etiology , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/etiology , Substance Abuse, Intravenous/complicationsABSTRACT
Anti-Jo 1 antibodies define a subgroup of patients with polymyositis, which are characterized by the presence of extra-muscular involvement as pulmonary fibrosis, although Raynaud's phenomena, arthritis, tenosynovitis, pleuritis and pericarditis may also be present. Given the fact that extra-muscular signs may precede the clinical diagnosis of polymyositis, as in the two cases that we present here, these antibodies may help us to diagnose the disease before the onset of myositis.