RESUMEN
A case of disseminated aspergillus fumigatus infection is reported in a 43 year old Ugandan female with no known immune system disorder(not neutropenic and HIV-1 sero negative). She presented with multiple cutaneous ulcers, recurrent empyema thoracis, a past history of intra-abdominal abscess and bowel infarction. Empirical treatment for tuberculosis was previously given without improvement. A diagnosis of aspergillus fumigatus based on a combination of tissue wet potassium hydroxide preparation, fungal culture and tissue histologic typing was made. Despite antifungal therapy with intravenous amphotericin B infusion in 5% dextrose, after a normal baseline renal function test, the patient died in the second week of admission. Autopsy showed disseminated aspergillosis involving the pleural space, pericardium, spleen, and meningitis in addition to the cutaneous sites. Disseminated aspergillus fumigatus infection in a non-immunocompromised is rare antemortem diagnosis. This case highlights the difficulty in making a diagnosis in the face of many endemic conditions with similar presentation.
Asunto(s)
Aspergilosis/diagnóstico , Aspergillus fumigatus , Cardiopatías/diagnóstico , Enfermedades Pulmonares Fúngicas/diagnóstico , Meningitis Fúngica/diagnóstico , Úlcera Cutánea/diagnóstico , Enfermedades del Bazo/diagnóstico , Adulto , Aspergilosis/tratamiento farmacológico , Resultado Fatal , Femenino , Cardiopatías/tratamiento farmacológico , Humanos , Inmunocompetencia , Enfermedades Pulmonares Fúngicas/tratamiento farmacológico , Meningitis Fúngica/tratamiento farmacológico , Úlcera Cutánea/tratamiento farmacológico , Enfermedades del Bazo/tratamiento farmacológicoRESUMEN
A case of renal glycosuria is reported. A 55 year old female was diagnosed and treated in an upcountry hospital for diabetes mellitus. She developed symptoms of hypoglycaemia while on an oral hypoglycaemic agent, leading to her admission in Mulago Hospital. Persistent glycosuria was noted despite treatment and normal serum glucose. Oral glucose tolerance test and timed urine glucose showed a normal curve but high urine sugar. A diagnosis of renal glycosuria was made, oral hypoglycaemic therapy was stopped, patient improved and was discharged. Though renal glycosuria is a benign condition, mistaken diagnosis for diabetes mellitus puts patients at risk of hypoglycaemia due to treatment. Diagnosis of the condition requires physicians' awareness of its existence in our community and the use of Marbles' criteria obviates confusion with diabetes mellitus though it does not absolutely exclude Fanconi syndrome.