Microcephaly caused by congenital Zika virus infection and viral detection in maternal urine during pregnancy.

Currently Latin America is undergoing a major epidemic of Zika virus, which is transmitted by Aedes mosquitoes. Concern for Zika virus infection has been increasing as it is suspected of causing brain defects in newborns such as microcephaly and, more recently, potential neurological and autoimmune complications including Guillian-Barré syndrome and acute disseminated encephalomyelitis. We describe a case of virus infection in a 25-year-old woman during the first trimester of her pregnancy, confirmed by laboratory tests only for the detection of viral particles in maternal urine, with imaging studies demonstrating the progression of cranial and encephalic changes in the fetus and later in the newborn, such as head circumference reduction, cerebral calcifications and ventriculomegaly.

Microcephaly caused by congenital Zika virus infection and viral detection in maternal urine during pregnancy / Microcefalia causada por infecção congênita pelo Zika virus e detecção viral na urina materna durante a gestação

Summary Currently Latin America is undergoing a major epidemic of Zika virus, which is transmitted by Aedes mosquitoes. Concern for Zika virus infection has been increasing as it is suspected of causing brain defects in newborns such as microcephaly and, more recently, potential neurological and autoimmune complications including Guillian-Barré syndrome and acute disseminated encephalomyelitis. We describe a case of virus infection in a 25-year-old woman during the first trimester of her pregnancy, confirmed by laboratory tests only for the detection of viral particles in maternal urine, with imaging studies demonstrating the progression of cranial and encephalic changes in the fetus and later in the newborn, such as head circumference reduction, cerebral calcifications and ventriculomegaly.

Resumo Atualmente, a América Latina está passando por uma grande epidemia de Zika vírus, transmitido por mosquitos Aedes. A preocupação pela infecção pelo Zika vírus vem aumentando, uma vez que é suspeita de causar defeitos cerebrais em recém-nascidos, como a microcefalia e, mais recentemente, potenciais complicações neurológicas e autoimunes, como síndrome de Guillian-Barré e encefalomielite disseminada aguda. Descrevemos um caso de infecção pelo vírus em uma mulher de 25 anos durante o primeiro trimestre de gestação, confirmado dentre os exames laboratoriais apenas pela detecção de partículas virais na urina materna, com estudos de imagens demonstrando a evolução das alterações cranianas e encefálicas no feto e no recém-nascido, como redução do perímetro cefálico, calcificações cerebrais e ventriculomegalia.

Chronic recurrent multifocal osteomyelitis exhibiting predominance of periosteal reaction.

Chronic recurrent multifocal osteomyelitis is an idiopathic nonpyogenic autoinflammatory bone disorder involving multiple sites, with clinical progression persisting for more than 6 months and which may have episodes of remission and exacerbation in the long term. It represents up to 2-5% of the cases of osteomyelitis, with an approximate incidence of up to 4/1,000,000 individuals, and average age of disease onset estimated between 8-11 years, predominantly in females. The legs are the most affected, with a predilection for metaphyseal regions along the growth plate. We describe the case of a female patient, aged 2 years and 5 months, with involvement of the left ulna, right jaw and left tibia, showing a predominance of periosteal reaction as main finding.

Schwannoma celular retroperitoneal / Retroperitoneal cellular schwannoma

Apresentamos o caso de paciente do gênero feminino, 35 anos, atendida com queixa de dores esporá- dicas no flanco esquerdo por 5 anos. Negou comorbidades. Exames laboratoriais sem anormalidades. Ultrassonografias prévias do aparelho urinário (sem o uso de Doppler colorido) descreveram possível cisto simples póstero-inferiormente a pelve renal esquerda. Em ultrassonografia recente observou-se, nessa topografia, volumosa formação ovalada, acentuadamente hipoecóica, com discreto fluxo de permeio. Tomografia computadorizada e ressonância magnética abdominais subsequentes caracterizaram massa retroperitoneal junto ao hilo do rim esquerdo, associada à redução dimensional renal e hidronefrose ipsilaterais. Diagnóstico histológico pós-exérese tumoral: schwannoma celular (somente padrão histológico Antoni A). (AU)

We present the case of a female patient, 35 years old, who had a complaint of sporadic left flank pain for 5 years. She said she had no comorbidities. The results of the laboratory tests did not show abnormalities. Previous ultrasonography of the urinary tract (without the use of color Doppler) described a possible single cyst postero-inferiorly to the left renal pelvis. In recent ultrasound we observed that topography massive oval formation markedly hypoechoic with discrete intermingled flow. Subsequent abdominal computed tomography and magnetic resonance imaging characterized retroperitoneal mass along the hilum of the left kidney, associated with renal dimensional reduction and ipsilateral hydronephrosis. Histological diagnosis after tumor excision: cell schwannoma (Antoni A histological standard only) (AU)

Chronic recurrent multifocal osteomyelitis exhibiting predominance of periosteal reaction / Osteomielite crônica multifocal recorrente exibindo predomínio de reação periosteal

Summary Chronic recurrent multifocal osteomyelitis is an idiopathic nonpyogenic autoinflammatory bone disorder involving multiple sites, with clinical progression persisting for more than 6 months and which may have episodes of remission and exacerbation in the long term. It represents up to 2-5% of the cases of osteomyelitis, with an approximate incidence of up to 4/1,000,000 individuals, and average age of disease onset estimated between 8-11 years, predominantly in females. The legs are the most affected, with a predilection for metaphyseal regions along the growth plate. We describe the case of a female patient, aged 2 years and 5 months, with involvement of the left ulna, right jaw and left tibia, showing a predominance of periosteal reaction as main finding.

Resumo Osteomielite crônica multifocal recorrente é uma desordem autoinflamatória óssea idiopática não piogênica, envolvendo vários sítios e com evolução clínica persistindo por mais de 6 meses, podendo apresentar episódios de remissão e exacerbação em longo prazo. Representa de 2 a 5% das osteomielites, com incidência aproximada de até 4/1.000.000, com idade média de apresentação estimada entre 8 e 11 anos, predominando no gênero feminino. Os membros inferiores são os mais afetados, com predileção para regiões metafisárias junto à fise. Descrevemos um caso da doença em uma menina de 2 anos e 5 meses de idade, com acometimento de ulna esquerda, mandíbula à direita e tíbia esquerda, exibindo predomínio de reação periosteal como achado principal.