RESUMO
Neisseria meningitidis infection (meningococcemia) is very common throughout the world. It usually presents as meningitis or sometimes pharyngitis. A gastroenteritis-like syndrome, with diarrhea, vomiting and abdominal pain, may occur in children but is very rare in adults. Search of the medical literature revealed only 3 such cases, all in young adults. We report an 80-year-old woman who presented with fever, diarrhea and abdominal pain. Meningococcus infection was later suspected, and proved by culture. Although treatment was intensive and included ceftriaxone (Rocephin) and garamycin, she did not respond and died 40 hours after admission. We draw attention to the possibility that what is usually a common symptom can be the first presentation of a serious, often fatal condition.
Assuntos
Dor Abdominal/etiologia , Diarreia/etiologia , Gastroenterite/etiologia , Meningite Meningocócica/diagnóstico , Meningite Meningocócica/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ceftriaxona/uso terapêutico , Diagnóstico Diferencial , Quimioterapia Combinada/uso terapêutico , Evolução Fatal , Feminino , Gentamicinas/uso terapêutico , Humanos , Meningite Meningocócica/tratamento farmacológico , Neisseria meningitidisRESUMO
Nuchal fibroma was diagnosed in a 54-year-old diabetic woman with a two year history of increased skin thickness of her low-posterior neck and interscapular region, causing discomfort and limitation of neck and arm motion. Physical and laboratory examinations excluded further disorders. The patient was released, free from symptoms, after complete excision of the soft tissue tumor.
Assuntos
Dorso/patologia , Fibroma/patologia , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias Cutâneas/patologia , Tecido Adiposo/patologia , Colágeno , Diabetes Mellitus Tipo 1/complicações , Diagnóstico Diferencial , Tecido Elástico/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Esclerodermia Localizada/patologiaRESUMO
Rheumatoid arthritis is a clinical entity whose etiology is unknown, although an infectious cause has been suggested. We describe three patients diagnosed to have a rheumatoid arthritis-like disease that was chronic but nonerosive and unresponsive to nonsteroidal anti-inflammatory drugs. The patients were females aged 30, 69 and 70 years who had morning stiffness of more than 30 minutes and symmetric polyarthritis for periods of 4, 6, and 20 months, respectively. A laboratory screening revealed minunal liver enzyme elevations, whereas acute phase reactants were consistent with systemic inflammation, and the presence of rheumatoid factor and cryoglobulins was detected. Serology was positive for hepatitis C virus antigens. Liver biopsies revealed hepatitis and early cirrhosis. Alpha-interferon therapy was associated with clinical improvement of arthritis in two cases. It is suggested that hepatitis C infection may be associated with rheumatoid-like arthritis.