RESUMO
Bacillary angiomatosis is a vasculoproliferative infectious disease mostly recorded in patients with human immunodeficiency virus and rarely in organ transplant recipients. We report the first case of bacillary angiomatosis due to Bartonella quintana in a paediatric renal transplant patient with skin, lymph node and bone involvement with excellent response to doxycycline. Click here for the corresponding questions to this CME article.
Assuntos
Angiomatose Bacilar , Bartonella quintana , Transplante de Rim , Dermatopatias , Criança , Doxiciclina , Humanos , Transplante de Rim/efeitos adversos , Dermatopatias/tratamento farmacológico , TransplantadosRESUMO
BACKGROUND: Kikuchi-Fujimoto's disease (KFD), also called histiocytic necrotizing lymphadenitis, is a rare, idiopathic and self-limited condition usually characterized by cervical lymphadenopathy and fever, most often affecting young patients. Aetiology is unknown. Differential diagnosis includes mainly malignant lymphoma, tuberculous lymphadenitis and systemic lupus erythematosus (SLE), so early diagnosis is crucial. Pleuropulmonary involvement due to isolated KFD has been seldom reported. CASE PRESENTATION: a 32-year-old man, on treatment for iatrogenic hypothyroidism, was admitted due to high grade fever and painful cervical lymphadenopathies. KFD was diagnosed by lymph node biopsy. Some days after admission the patient got worse, he developed generalized lymphadenopathy, bilateral pleural effusion and interstitial lung disease. All of them resolved with prednisone and after two years of following up he remains asymptomatic and without evidence of any other associated disease. CONCLUSION: Pleural effusion and interstitial lung disease are very uncommon manifestations of KFD. In our experience, treatment with oral prednisone was effective.