RESUMEN
In the past, Mycobacterium avium complex (MAC) was considered a colonizing microbe in the immunocompetent host. Today it should be considered a potential pathogen. We present a case of MAC necrotizing pneumonia in a 27-year-old man who tested negatively for the human immunodeficiency virus, had no typical granulomas, and responded rapidly to antimicrobial therapy.
Asunto(s)
Seronegatividad para VIH , Infección por Mycobacterium avium-intracellulare/diagnóstico , Neumonía Bacteriana/diagnóstico , Adulto , Antibacterianos/uso terapéutico , Antiinfecciosos/uso terapéutico , Antibióticos Antituberculosos/uso terapéutico , Antituberculosos/uso terapéutico , Ciprofloxacina/uso terapéutico , Claritromicina/uso terapéutico , Quimioterapia Combinada/administración & dosificación , Quimioterapia Combinada/uso terapéutico , Etambutol/uso terapéutico , Humanos , Masculino , Necrosis , Atelectasia Pulmonar/microbiología , Rifampin/uso terapéuticoRESUMEN
This is the first case of cyclosporiasis in which the parasite was clearly demonstrated in a duodenal biopsy by light microscopy. Electron microscopy identified the stages of sporozoite, trophozoite, schizont, and merozoite. Although only asexual forms were identified in our case, the sexual cycle must have taken place in the human host, because oocysts were detected in stools of the patients. Therefore, it appears that Cyclospora species require only a single host to complete its entire life cycle. Despite the heavy infection, only enterocytes were invaded. The lamina propria and submucosa were not involved. The morphology of Cyclospora in the intestine is similar to that of Isospora, but differs from that of Cryptosporidium. The morphology of the oocyst of Cyclospora resembles that of Cryptosporidium, but differs from that of Isospora. Thus, a combined study of both stool and intestinal biopsy should readily distinguish Cyclospora from Cryptosporidium and Isospora.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/parasitología , Coccidiosis/parasitología , Duodeno/parasitología , Eucoccidiida/crecimiento & desarrollo , Parasitosis Intestinales/parasitología , Infecciones Oportunistas Relacionadas con el SIDA/patología , Adulto , Animales , Biopsia , Coccidiosis/patología , Duodeno/citología , Duodeno/patología , Duodeno/ultraestructura , Eucoccidiida/aislamiento & purificación , Eucoccidiida/ultraestructura , Heces/parasitología , Humanos , Parasitosis Intestinales/patología , Masculino , Microscopía Electrónica , Reproducción AsexuadaRESUMEN
An 88-year-old woman presented with fever, a neck ulcer, and multiple subcutaneous nodules on her upper extremities and thorax. Her condition was initially diagnosed as malignancy associated with metastatic disease to the skin. A subcutaneous nodule was aspirated. A gram stain of the aspirate revealed weakly gram-positive bacilli, and a stain for acid-fast bacilli was positive. Mycobacterium tuberculosis was isolated from a culture of a specimen of the skin lesion.