RESUMO
A chronic septic process developed in the right knee of an elderly man with advanced degenerative arthritis of both knees. Open exploration, culture, and biopsy of the joint found that the pathogen was Corynebacterium pyogenes and that the synovium was involved with a remarkable perivascular infiltrate of plasma cells. Serum protein electrophoresis demonstrated a prominent M component. Following antimicrobial therapy, the M protein level has gradually declined, and no evolution of multiple myeloma has become apparent. The findings are consistent with a benign monoclonal gammopathy and localized plasmacytic reaction in the knee associated with infection by an unusual diphtheroid organism.
Assuntos
Artrite Infecciosa/patologia , Infecções por Corynebacterium/patologia , Articulação do Joelho/patologia , Idoso , Artrite Infecciosa/complicações , Infecções por Corynebacterium/complicações , Corynebacterium pyogenes , Humanos , Masculino , Osteoartrite/complicações , Plasmócitos/patologia , Membrana Sinovial/patologiaRESUMO
A case of fracture of the disc occluder of a Bjork-Shiley mitral prosthesis with embolization of the disc fragments to distal aorta is presented. The possibility of valve dysfunction and the diagnostic value of echocardiography should be considered whenever acute heart failure occurs in a patient with an artificial valve.
Assuntos
Aorta Abdominal , Embolia/etiologia , Próteses Valvulares Cardíacas/efeitos adversos , Valva Mitral/cirurgia , Ponte de Artéria Coronária , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/cirurgiaRESUMO
The source of hemorrhage in a young woman who required emergency laparotomy for intraabdominal bleeding was found to be a very early primary pregnancy implanted on the undersurface of the right diaphragm, far behind the dome of the liver. Immediately adjacent to this lesion were three tiny foci of endometriosis. This coincidence suggests that the site of nidation may have been a focus of ectopic endometrium rather than peritoneum.