RESUMEN
BACKGROUND AND IMPORTANCE: Cavernous malformations (CMs) are angiographically occult low-flow vascular malformations that infrequently involve the optic pathway and the hypothalamus (OPH). CLINICAL PRESENTATION: A 23-yr-old male presented with bitemporal hemianopia due to chaismal apoplexy. Imaging revealed a CM involving the OPH. The CM was resected by an extended endonasal approach. The patient had improvement in his visual field defects, and postoperative magnetic resonance imaging (MRI) revealed a gross total resection of the CM. CONCLUSION: This case demonstrates the surgical technique of endoscopic endonasal resection of a CM involving the optic pathway.
Asunto(s)
Neuroendoscopía , Hemianopsia , Humanos , Imagen por Resonancia Magnética , Masculino , Nariz/diagnóstico por imagen , Nariz/cirugía , Trastornos de la Visión/etiología , Trastornos de la Visión/cirugíaRESUMEN
A patient with human immunodeficiency virus (HIV) infection presented with multiple cutaneous lesions on upper extremities, trunk, face and with ulcers involving oral mucosa. Histoplasma capsulatum was isolated in culture from scrapings from both cutaneous as well as oral mucosal lesions. The patient responded well initially to the treatment with Amphotericin B followed by itraconazole; however, lesions recurred after three months with the further deterioration of immune status of the patient indicated by decline in CD4 counts. The same treatment was restarted and the patient is still being followed-up.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Dermatomicosis/complicaciones , Infecciones por VIH/complicaciones , Histoplasma/aislamiento & purificación , Histoplasmosis/complicaciones , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Infecciones Oportunistas Relacionadas con el SIDA/microbiología , Adulto , Dermatomicosis/diagnóstico , Dermatomicosis/microbiología , Histoplasmosis/diagnóstico , Histoplasmosis/microbiología , HumanosRESUMEN
Cutaneous infections is observed in 15% of patients with disseminated cryptococcosis with AIDS. We present here a case of a 34 years old female with AIDS. She presented with multiple skin coloured umbilicated over face, neck, trunk and limbs, which mimicked molluscum contagiosum and kaposi sarcoma. The tissue from cutaneous lesions was collected by excision biopsy and processed by standard mycological methods. Cryptococcus neoformans was isolated and identified. Cerebrospinal fluid (CSF) also yielded the growth of C. neoformans . Cryptococcal antigen was detected with a titre of 1024 by Latex agglutination, is serum and CSF. Her serum was reactive for HIVI and 2 antibodies. The CD4 lymphocytes count was 80/cmm. The HIV viral load was 2,48,084 copies/mL. She was treated with amphotericin B injectable and oral fluconazole. She responded well and lesions regressed.