RESUMO
Influenza virus-associated encephalopathy/encephalitis is a rare entity in adults that can lead to severe neurological sequelae and even death. The clinical presentation can be quite diverse. This absence of a typical presentation along with the difficulty detecting the virus in the cerebrospinal fluid represents a diagnostic challenge. We present the case of a 79-year-old male with sudden onset of decreased consciousness and signs of right hemisphere damage. The presence of influenza A (H3N2) virus in respiratory sample along with compatible findings in cranial magnetic resonance led to the diagnosis. The patient died without responding to treatment with antivirals and immunomodulators and the anatomopathological study did not detect infectious agent. Early diagnostic suspicion is essential to establish adequate treatment and improve the prognosis.
Assuntos
Córtex Cerebral/diagnóstico por imagem , Encefalite Viral/diagnóstico por imagem , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Influenza Humana/diagnóstico por imagem , Idoso , Córtex Cerebral/virologia , Humanos , Imageamento por Ressonância Magnética , MasculinoRESUMO
No disponible
Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Trombose Venosa , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/instrumentação , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/tendências , Adenocarcinoma , Neoplasias Retais , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Medicina Nuclear/métodos , Medicina Nuclear/tendênciasAssuntos
Fluordesoxiglucose F18 , Oclusão Vascular Mesentérica/diagnóstico , Veias Mesentéricas , Imagem Multimodal , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Tomografia Computadorizada por Raios X , Trombose Venosa/diagnóstico , Idoso de 80 Anos ou mais , Humanos , MasculinoRESUMO
The combination of positron emission tomography (PET) and computed tomography (CT) in a single scanner (PET/CT) allows anatomic and metabolic images to be fused and correlated with a high degree of accuracy; this represents a very important landmark in the history of medicine and especially in the area of diagnostic imaging. Nevertheless, the implementation, startup, and operation of a PET/CT scanner presents particularly interesting challenges, because it involves the integration of two well-established and consolidated techniques (CT and PET, which provide complementary information) that have traditionally been carried out in the context of two different specialties (radiology and nuclear medicine). The rapid diffusion of this new integrated technology raises a series of questions related to the optimal protocols for image acquisition, the supervision of the examinations, image interpretation, and reporting, as well as questions related to the legal competence and responsibility of the specialists involved in a PET/CT study. The objective of this article is to approach these aspects from a constructive perspective and to stimulate the dialog between the specialties of radiology and nuclear medicine, with the aim of maximizing the diagnostic potential of PET/CT and thus of providing better care for patients.
Assuntos
Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Protocolos Clínicos , Humanos , Legislação MédicaRESUMO
La combinación de una tomografía por emisión de positrones (PET) y de una tomografía computarizada (TC) en un único equipo (PET/TC) permite fusionar y correlacionar con un elevado grado de precisión imágenes anatómicas y metabólicas, y ha supuesto un hito reciente muy importante en la historia de la Medicina, y especialmente en el área del diagnóstico por la imagen. No obstante, la implementación, puesta en marcha y desarrollo de un equipo de PET/TC presenta desafíos particularmente interesantes, ya que supone la integración de dos técnicas diagnósticas reconocidas y consolidadas (la TC y la PET, que proporcionan información complementaria), pero que se han desarrollado tradicionalmente al amparo de dos especialidades diferentes (Radiología y Medicina Nuclear). La rápida difusión de esta nueva tecnología integrada plantea una serie de cuestiones relacionadas con los protocolos óptimos de adquisición de las imágenes, supervisión de los estudios, interpretación de las mismas, elaboración de informes y, especialmente, con la competencia y responsabilidad de los especialistas responsables de un estudio de PET/TC. El objetivo de este artículo es abordar estos aspectos desde una perspectiva constructiva, y estimular el diálogo entre las especialidades de Radiología y Medicina Nuclear, en un intento de maximizar el potencial diagnóstico de la PET/TC y así ofrecer una mejor atención a los pacientes (AU)
The combination of positron emission tomography (PET) and computed tomography (CT) in a single scanner (PET/CT) allows anatomic and metabolic images to be fused and correlated with a high degree of accuracy; this represents a very important landmark in the history of medicine and especially in the area of diagnostic imaging. Nevertheless, the implementation, startup, and operation of a PET/CT scanner presents particularly interesting challenges, because it involves the integration of two well-established and consolidated techniques (CT and PET, which provide complementary information) that have traditionally been carried out in the context of two different specialties (radiology and nuclear medicine). The rapid diffusion of this new integrated technology raises a series of questions related to the optimal protocols for image acquisition, the supervision of the examinations, image interpretation, and reporting, as well as questions related to the legal competence and responsibility of the specialists involved in a PET/CT study. The objective of this article is to approach these aspects from a constructive perspective and to stimulate the dialog between the specialties of radiology and nuclear medicine, with the aim of maximizing the diagnostic potential of PET/CT and thus of providing better care for patients (AU)
