RESUMO
INTRODUCTION: Cerebral infarction secondary to Aspergillus arteritis or septic embolism is an exceptional finding. We present a case of multiple systemic embolism and cerebral infarction resulting from Aspergillus aortitis in an immunocompetent patient. PATIENT: A 65-year-old male with hypertension, hyperglycaemia and myocardial infarction with aorto-coronary by-pass surgery three years before admission, that suffered cerebral infarction in middle right cerebral artery territory and right cubital artery embolism. One month later he presented abrupt increase of his left hemiparesia and left central facial palsy associated with fever of unknown origin. Laboratory test, cranial CT and echocardiogram were performed. He died ten days later. RESULTS: Hemogram: leucocytes 34.700/microL (85% N, 4.8%L). Cranial CT: cerebral infarction in middle right cerebral artery territory. Transthoracic and transesophageal echocardiogram: moderate left ventricular hypertrophy and slight inferior hypokinesis. Arteriography: complete thrombosis of the left internal carotid. Necropsy: parietal aortic aspergillosis with generalized septic embolisms (brain, kidney, liver, fingers), cerebral infarction in middle right cerebral artery territory and thrombosis of the left carotid siphon with Aspergillus arteritis. CONCLUSIONS: Aspergillosis is an exceptional cause of cerebral infarction, especially in immunocompetent patients, and their diagnosis is complicated, being usually found at necropsy.
Assuntos
Aortite/complicações , Arteriopatias Oclusivas/etiologia , Aspergilose/complicações , Infarto da Artéria Cerebral Anterior/etiologia , Infarto da Artéria Cerebral Média/etiologia , Embolia Intracraniana/etiologia , Complicações Pós-Operatórias/etiologia , Tromboembolia/etiologia , Idoso , Aortite/microbiologia , Braço/irrigação sanguínea , Arterite/complicações , Arterite/microbiologia , Trombose das Artérias Carótidas/etiologia , Ponte de Artéria Coronária , Evolução Fatal , Humanos , Imunocompetência , Rim/irrigação sanguínea , Fígado/irrigação sanguínea , Masculino , Infarto do Miocárdio/cirurgia , Complicações Pós-Operatórias/microbiologiaRESUMO
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Assuntos
Humanos , Feminino , Gravidez , Adulto , Pneumocefalia/complicações , Punção Espinal/efeitos adversos , Cefaleia/etiologia , Morte FetalRESUMO
El objetivo del presente artículo es el de establecer la relación del tratamiento hormonal sustitutivo y la enfermedad de Alzheimer. Estudios previos avalaron que el uso de la terapia hormonal sustitutiva podría prevenir o disminuir la aparición de síntomas de Alzehimer, al combatir la deprivación estrogénica que se insinuó como un factor de riesgo. En el presente trabajo se revisa la bibliografía y se definen las nuevas consideraciones existentes en la actualidad sobre el tema
The aim of the present article is, of establishing the relation of the hormonal substitute treatment and Alzheimers disease. Previous studies supported, that the use of the hormonal substitute therapy might anticipate or diminish the appearance of Alzehimers symptoms, when the deprivation attacks estrogénica that was insinuated as a factor of risk. In the present work the bibliography is checked and the new existing considerations are defined at present on the topic
