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1.
Medicine (Baltimore) ; 99(18): e20175, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32358406

RESUMO

RATIONALE: The cystic features of the novel coronavirus disease 2019 (COVID-19) found on computed tomography (CT) have not yet been reported in the published literature. We report the cystic chest CT findings of 2 patients confirmed to have COVID-19-related pneumonia. PATIENT CONCERNS: A 38-year-old man and a 35-year-old man diagnosed with severe COVID-19 pneumonia were admitted to the intensive care unit. DIAGNOSES: Chest CT findings showed multiple cysts in ground-glass opacities (bilaterally) with/without pneumothorax. The cysts had a smooth inner wall. INTERVENTIONS: The patients continued to be given oxygen by mask and received antitussive, phlegm-dispelling treatment. OUTCOMES: At follow up, there was a reduction in the number of multiple cystic lesions on CT. To date, 1 patient was discharged from hospital, while the other had been transferred to the rehabilitation department. LESSONS: COVID-19 may independently result in pulmonary cyst formation and pneumothorax; the application of a ventilator may be another causative factor.


Assuntos
Dor no Peito/etiologia , Infecções por Coronavirus/diagnóstico , Coronavirus , Cistos/diagnóstico por imagem , Dispneia/etiologia , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Adulto , Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico por imagem , Humanos , Pulmão/patologia , Masculino , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico por imagem , Pneumotórax/patologia , Tórax
4.
Medicine (Baltimore) ; 99(6): e19035, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32028418

RESUMO

RATIONALE: Nabothian cysts are mucus-filled cervical cysts that are usually asymptomatic unless they become very large. Chronic urinary retention is the persistent inability to empty the bladder despite maintaining an ability to urinate. Chronic urinary retention caused by a large, deep nabothian cyst has not been reported previously. PATIENT CONCERNS: A 46-year-old woman presented with chronic urinary retention and a cervical cyst that gradually increased in size. DIAGNOSIS: Based on histopathological evidence, our patient was diagnosed with a nabothian cyst. INTERVENTIONS: A hysterectomy was performed. OUTCOMES: The urinary symptoms of the patient resolved after she performed clean, intermittent self-catheterizations for 5 days after the operation. She was discharged on postoperative day 6. LESSONS: Large nabothian cysts are rare but may account for some unusual symptoms including unexplained urinary difficulties in women. We recommend treating symptomatic nabothian cysts with local cystectomies or hysterectomies.


Assuntos
Cistos/complicações , Retenção Urinária/etiologia , Doenças do Colo do Útero/complicações , Cistos/diagnóstico por imagem , Cistos/cirurgia , Feminino , Humanos , Histerectomia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Doenças do Colo do Útero/diagnóstico por imagem , Doenças do Colo do Útero/cirurgia
5.
Can Assoc Radiol J ; 71(2): 186-194, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32063011

RESUMO

The tectal plate comprises the posterior portion of the midbrain, borders the quadrigeminal cistern, and includes the superior and inferior colliculi. Benign and malignant pathologies occurring in this location may lead to aqueductal stenosis, obstructive hydrocephalus, and Parinaud syndrome. Both computed tomography and magnetic resonance imaging can be used to further characterize lesions involving the tectal plate. In this pictorial essay, we review various tectal plate lesions and their imaging features.


Assuntos
Fístula Arteriovenosa/diagnóstico por imagem , Neoplasias do Tronco Encefálico/diagnóstico por imagem , Cistos/diagnóstico por imagem , Glioma/diagnóstico por imagem , Hemangioma Cavernoso do Sistema Nervoso Central/diagnóstico por imagem , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Teto do Mesencéfalo/diagnóstico por imagem , Abscesso Encefálico/diagnóstico por imagem , Infartos do Tronco Encefálico/diagnóstico por imagem , Neoplasias do Tronco Encefálico/secundário , Lipoma/diagnóstico por imagem , Esclerose Múltipla/diagnóstico por imagem
6.
Cir. pediátr ; 33(1): 43-46, ene. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-186137

RESUMO

Introducción: Los quistes ductales subglóticos adquiridos (QDSA) son una causa rara de obstrucción de la vía aérea, sin consenso en la literatura en cuanto al tratamiento más eficaz. Presentamos nuestra experiencia en el tratamiento de los QDSA. Material y métodos: Estudio retrospectivo de los pacientes trata-dos en nuestro centro por QDSA en los últimos 5 años. Se recogieron los antecedentes de intubación, la clínica presentada, el tratamiento realizado, la evolución postquirúrgica, el seguimiento en consulta y los controles endoscópicos. Resultados: Se identificaron 4 pacientes, con unas medianas de edad y peso de 6,5 meses (6-8) y 5,9 kg (3,6-7), respectivamente. Todos presentaron antecedentes de intubación por intervenciones quirúrgicas, siendo prematuros 2 de ellos. La mediana entre la última intubación y el diagnóstico fue de 119,5 días (71-171). La clínica consistió en estridor bifásico con mejoría postural presentando una ocupación de la luz traqueal de más del 50% en la endoscopia diagnóstica. Se realizó escisión endoscópica (EE) al diagnóstico en 3 de los pacientes y como técnica de rescate en el cuarto por recidiva tras tratamiento con drenaje y dilatación con balón. La mediana de tiempo de intubación postquirúrgico fue de 13,5 horas (0-48) y la estancia hospitalaria de 7 días (6-9). Tras un seguimiento mediano de 17,5 meses (6-42) no se ha presentado ninguna recidiva. Conclusión: Los QDSA son una causa poco frecuente de estridor post-extubación. La EE permite un tratamiento eficaz con baja tasa de recidiva


Introduction: Subglottic cyst is a rare cause of airway obstruction, and there is a lack of evidence about the best treatment in the literature. This report describes our experience with endoscopic removal. Materials and methods: A retrospective study of all patients un-dergoing endoscopic removal of subglottic cyst at our healthcare facility between 2014 and 2019 was performed. Clinic and demographic data regarding gestational age, intubation, comorbidities, surgical procedures, first symptoms, endoscopic findings, treatment, and follow-up were collected. Results: Four patients were identified. Two out of four (50%) were preterm, and all patients were intubated during their neonatal period. Median age and weight at diagnosis were 6.5 months (6-8) and 5.9 kg (3.6-7). Median time between last intubation and diagnosis was 119.5 days (71-171). Biphasic stridor and progressive respiratory distress were the most common clinical symptoms. Airway obstruction of at least 50% was found during upper airway endoscopy in all patients. Endoscopic removal was performed as a first-line treatment in 3 patients, and as a second-line treatment in 1 patient. Median intubation time after treatment and hospital stay were 13.5 hours (0-48) and 7 days (6-9). All four pa-tients are free of disease, with a median follow-up of 17.5 months (6-42). Conclusion: Subglottic cyst is a rare cause of post-extubation stri-dor. Endoscopic removal seems to be a feasible and effective treatment with a low recurrence rate


Assuntos
Humanos , Masculino , Feminino , Lactente , Cistos/diagnóstico por imagem , Cistos/cirurgia , Glote/cirurgia , Endoscopia , Estudos Retrospectivos , Glote/diagnóstico por imagem , Cistos/patologia , Intubação , Tempo de Internação , Traqueia/patologia , Traqueia/cirurgia , Tomografia de Coerência Óptica
7.
Ann Otol Rhinol Laryngol ; 129(3): 209-215, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31631672

RESUMO

OBJECTIVES: Preoperative maxillary sinus imaging findings have been suggested to be associated with complications and outcomes of sinus lift and dental implant procedures; nonetheless the evidence is controversial. The aim of this study was to examine the association between preoperative maxillary sinus imaging findings and outcomes of sinus lift and dental implant procedures in asymptomatic patients. METHODS: We included all patients who underwent maxillary sinus lift and dental implant procedures between 2014 and 2017. Maxillary sinus imaging findings were extracted from pre-procedural dental computed tomography scans, and outcomes of the procedures were assessed. RESULTS: A total of 145 procedures were included. No sinonasal symptoms were reported preoperatively. In 46% of cases maxillary sinus imaging was abnormal. The most common imaging finding was peripheral mucosal thickening (38%). Sinus floor cyst/polyp was identified in 13% of the cases, of which 47% occupied more than 50% of the sinus volume. Partial or complete opacification of the maxillary sinus was documented in 3% of cases. The sinus ostium and ostiomeatal complex were obstructed in 7% and 1%, respectively. Mucosal perforation was documented in 22% of cases and was inversely related to mucosal thickening (P = 0.011). Other minor post-operative complications did not correlate with radiological findings. Post-surgical sinusitis was not observed in any of the patients regardless of pre-surgical imaging findings. CONCLUSIONS: Incidental maxillary sinus imaging findings such as mucosal swelling, cysts or polyps, regardless of their severity or size, and maxillary ostial obstruction may not need to be addressed prior to sinus augmentation and dental implant procedures in asymptomatic patients. Patients with complete sinus opacification should be referred to an otolaryngologist prior to surgery. Further controlled trials, in larger cohorts, are needed to corroborate our findings.


Assuntos
Implantação Dentária , Seio Maxilar/diagnóstico por imagem , Levantamento do Assoalho do Seio Maxilar , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Assintomáticas , Cistos/diagnóstico por imagem , Feminino , Humanos , Achados Incidentais , Masculino , Pessoa de Meia-Idade , Mucosa Nasal/diagnóstico por imagem , Mucosa Nasal/lesões , Obstrução Nasal/diagnóstico por imagem , Pólipos Nasais/diagnóstico por imagem , Osseointegração , Doenças dos Seios Paranasais/diagnóstico por imagem , Cuidados Pré-Operatórios , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
8.
Radiologe ; 60(2): 154-161, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-31828384

RESUMO

BACKGROUND: Cystic abdominal masses are a common main or incidental finding in daily radiological practice; however, differentiation is not always trivial. OBJECTIVES: In children, cystic abdominal masses represent a special feature compared to adults, since the spectrum of congenital lesions must be taken into consideration. The article gives a structured overview of the most common entities. MATERIALS AND METHODS: The standard methods in abdominal imaging in pediatric radiology are ultrasound and MRI. Based on a literature review, the most important differential diagnoses with their characteristics in ultrasound and MRI were compiled. RESULTS AND DISCUSSION: With anatomical classification, presence or absence of solid components as well as the contrast agent behavior in the MRI, the cystic masses can be well differentiated and classified into three groups: congenital and acquired cysts as well as neoplasms.


Assuntos
Cistos , Abdome/diagnóstico por imagem , Adulto , Criança , Cistos/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Radiografia , Ultrassonografia
9.
Clin Nephrol ; 93(1): 34-49, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31746731

RESUMO

BACKGROUND: To determine the role of E-selectin gene S128R polymorphism on the enlargement of renal cysts in patients with polycystic kidney disease (PKD). MATERIALS AND METHODS: 76 PKD patients with no comorbidity were enrolled in the study. Serum E-selectin levels were analyzed by enzyme-linked immunoabsorbent assay (ELISA). E-selectin gene S128R (561 A>C, rs: 5361) polymorphism was examined by polymerase chain reaction restriction fragment length (PCR-RFLP). Magnetic resonance imaging was performed at baseline evaluation and at the end of the 1st year to determine cyst enlargement and total kidney volume (TKV). RESULTS: No significant difference was identified between AA genotype and AC or CC variants of E-selectin gene S128R polymorphism in terms of age, disease duration, baseline cyst volume, cyst volume at the 12th month, baseline dominant cyst volume, and dominant cyst volume at the 12th month. In contrast, a significant difference was determined between the groups with regard to the change of TKV (2.9 ± 13.4 vs. 5.2 ± 16.3 mm3; respectively, p = 0.01). In the correlation analysis, the serum E-selectin level was significantly correlated to glucose, alanine transaminase, creatinine, calcium, phosphorus, total protein, albumin, and end diastolic volume (p = 0.0001, p = 0.001, p = 0.03, p = 0.021, p = 0.023, p = 0.002, p = 0.003, and p = 0.047, respectively). Multivariate logistic regression analysis demonstrated a 1.32-fold higher risk of cyst enlargement in patients with CC polymorphism when compared to AA genotype (p = 0.052), but not between AA and AC genotypes or CC and AC genotypes. CONCLUSION: PKD patients with CC variants of the E-selectin gene S128R polymorphism are at greater risk of cyst enlargement. The results of the present study should be confirmed with further studies with large sample size and longer duration of follow-up.


Assuntos
Cistos/patologia , Selectina E/genética , Rim/patologia , Doenças Renais Policísticas/genética , Doenças Renais Policísticas/patologia , Adulto , Cistos/sangue , Cistos/diagnóstico por imagem , Cistos/genética , Selectina E/sangue , Feminino , Patrimônio Genético , Genótipo , Humanos , Rim/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Doenças Renais Policísticas/sangue , Doenças Renais Policísticas/diagnóstico por imagem , Polimorfismo de Fragmento de Restrição
10.
Ann Vasc Surg ; 62: 498.e11-498.e13, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31449954

RESUMO

Spontaneous regression of cystic adventitial disease (CAD) of the popliteal artery is rare. In this report, we describe a 53-year-old woman who presented with left calf pain and was diagnosed with CAD with popliteal artery stenosis, which regressed without therapy. The disease was diagnosed via computed tomography, and a surgical intervention was planned at the time of diagnosis. However, her symptoms disappeared 2 months after the initial presentation. Ultrasonography and computed tomography revealed spontaneous regression of the cystic lesions and resolution of the popliteal artery stenosis. During the 29-month follow-up period, her symptoms did not recur. Although CAD often requires surgical intervention, it may be acceptable to carefully observe patients with spontaneous regression for some time to check for recurrence.


Assuntos
Túnica Adventícia , Cistos , Doença Arterial Periférica , Artéria Poplítea , Túnica Adventícia/diagnóstico por imagem , Constrição Patológica , Cistos/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Doença Arterial Periférica/diagnóstico por imagem , Artéria Poplítea/diagnóstico por imagem , Remissão Espontânea , Fatores de Tempo
11.
Medicine (Baltimore) ; 98(49): e18176, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31804334

RESUMO

INTRODUCTION: Choice of treatment in patients with symptomatic polycystic liver diseases (PLD) remains controversial. Various surgical procedures aiming at eliminating symptomatic cysts are widely used in mild and advanced PLD patients, but liver transplantation is currently recommended as the only curative treatment especially in severe cases. PATIENT CONCERNS: Case 1: A 51-year-old male was admitted for severe eating disorder and dyspnea for 2 months. He had been diagnosed as PLD, PKD, and hypertension for 9 years, with only antihypertensive drug therapy. No significant family history could be traced.Case 2: A 54-year-old female was admitted to our hospital for ventosity during nearly 5 years. She had been diagnosed as PLD and hypertension for 22 years, for which only aspiration-sclerotherapy therapy was performed for multiple times. Both her mother and sister were diagnosed with PLD previously. DIAGNOSIS: They were diagnosed as PLD by medical history, family history, and computed tomography scan (multiple cysts dispersively presenting in the liver). INTERVENTIONS: The 2 patients underwent hepatectomy with fenestration, and were well recovered with no mortality. OUTCOMES: While case 1 only experienced relief of symptoms, case 2 experienced massive growth of hepatic parenchyma, which indicated positive prognosis and showed the possibility to avoid or at least postpone liver transplantation for a long time, considering the lack of liver parenchyma is one of the main reason for urgency of liver transplantation. CONCLUSION: Here we described subradical polycystic hepatectomy, a special form of hepatectomy with fenestration modified by us, as a safe and effective treatment to potentially achieve long-term effects in PLD patients.


Assuntos
Cistos/cirurgia , Hepatectomia/métodos , Hepatopatias/cirurgia , Cistos/diagnóstico por imagem , Feminino , Humanos , Hepatopatias/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X
13.
Tech Vasc Interv Radiol ; 22(4): 100631, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31864533

RESUMO

The approach to treating common (cystic) lymphatic malformations (LMs) has evolved significantly over the last decade due to clinical research and recent developments in molecular biology. Surgery, sclerosing agents, and medical drugs with specific targets for biological therapy have been reported for the management of LMs. We will discuss the importance to standardize the location and imaging characterization of LMs to improve the knowledge about the outcome of the different therapeutic options. Our goal is to help the reader understand the different options for the management of LMs with the balance between risk and benefit for the patients.


Assuntos
Cistos/terapia , Anormalidades Linfáticas/cirurgia , Soluções Esclerosantes/administração & dosagem , Escleroterapia , Cistos/diagnóstico por imagem , Cistos/fisiopatologia , Humanos , Anormalidades Linfáticas/diagnóstico por imagem , Anormalidades Linfáticas/fisiopatologia , Soluções Esclerosantes/efeitos adversos , Escleroterapia/efeitos adversos , Resultado do Tratamento
14.
Medicine (Baltimore) ; 98(46): e17873, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725631

RESUMO

RATIONALE: We report a case of fetal lingual cyst that was diagnosed prenatally using 2-dimensional and 3-dimensional images during routine second trimester screening. To the best of our knowledge, this is the first description of a cystic lesion disappearing before birth. PATIENT CONCERNS: A 36-year-old woman at 22 weeks' gestation showed the presence of an oral cystic lesion in routine second trimester ultrasound screening. The lesion measured 18 × 15 × 15 mm. INTERVENTIONS: A follow-up ultrasound examination was performed every 4 to 6 weeks. OUTCOMES: The cyst disappeared in a follow-up ultrasound examination at 35 and 37 weeks of gestation. A male newborn who weighed 3480 g was delivered with no feeding difficulties. The boy was followed to 6 years after birth. The child had normal growth and development, and there was no recurrence of the cyst. LESSONS: Prenatally diagnosed lingual cysts are uncommon findings that can include many different pathologies with a wide spectrum of severity. Lingual cysts usually have a good prognosis.


Assuntos
Cistos/diagnóstico , Diagnóstico Pré-Natal/métodos , Doenças da Língua/diagnóstico , Adulto , Cistos/diagnóstico por imagem , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Segundo Trimestre da Gravidez , Doenças da Língua/diagnóstico por imagem , Ultrassonografia Pré-Natal
15.
Niger J Clin Pract ; 22(10): 1457-1458, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31607739

RESUMO

Among various reasons of swellings in the female inguinal region nuck canal cysts are rare entities. Abnormal persistence of procesus vaginalis opening cause this formation. Presentation at adults can lead misdiagnosis. Inguinal hernia, tumors (benign or malign), cysts, lymphadenopathies and endometriosis are other common reason for female groin swelling. Once diagnosed surgical excision is definitive treatment.


Assuntos
Cistos/diagnóstico por imagem , Edema/etiologia , Hérnia Inguinal/cirurgia , Canal Inguinal/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Cistos/cirurgia , Erros de Diagnóstico , Feminino , Hérnia Inguinal/diagnóstico , Humanos , Canal Inguinal/cirurgia , Resultado do Tratamento , Ultrassonografia
16.
BMJ Case Rep ; 12(9)2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31570355

RESUMO

Pheochromocytoma (PCC) may present as a cystic or solid tumour. Cystic PCCs are difficult to differentiate from simple cysts in the absence of classic symptoms of PCCs. Cystic nature develops due to intralesional bleeding and necrosis. We present a case of young man without any comorbidity who was diagnosed as a simple adrenal cyst and planned for laparoscopic excision but found to be functional PCC during the time of surgery only. The patient was managed with extensive monitoring and use of multiple drugs to control blood pressure. Surgery was completed without any complication laparoscopically and postoperative period was also uneventful. Histopathology confirmed the diagnosis of cystic PCC. Our case also shows the importance of functional imaging like metaiodobenzylguanidine (MIBG) scan in doubtful cases of adrenal cysts when other biochemical markers are unremarkable to diagnosis. We emphasise the importance of meticulous preparation for any intraoperative disasters even for apparently simple adrenal cyst.


Assuntos
Neoplasias das Glândulas Suprarrenais/patologia , Glândulas Suprarrenais/patologia , Cistos/patologia , Feocromocitoma/patologia , Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Neoplasias das Glândulas Suprarrenais/cirurgia , Glândulas Suprarrenais/diagnóstico por imagem , Adulto , Dor nas Costas , Cistos/diagnóstico por imagem , Diagnóstico Diferencial , Dor no Flanco , Humanos , Hipertensão , Laparoscopia , Masculino , Posicionamento do Paciente , Feocromocitoma/diagnóstico por imagem , Feocromocitoma/cirurgia , Radiografia Abdominal , Tomografia Computadorizada por Raios X , Resultado do Tratamento
17.
BMJ Case Rep ; 12(9)2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31570357

RESUMO

Vallecular cysts are a rare entity but can complicate the airway management due to the physical impediment and distortion of the laryngeal inlet. It can lead to fatal life-threatening airway obstruction postinduction of anaesthesia. Infancy compounds the risks due to lack of cooperation and physiological reserves. The literature review suggested most anaesthesiologists avoided muscle relaxants and aspiration of the cyst was used as a rescue technique. The present case report illustrates the successful airway management of an infant with a huge vallecular cyst using fibre-optic intubation by a 'three-person' technique after paraglossal videolaryngoscopy failed to secure the airway.


Assuntos
Manuseio das Vias Aéreas/métodos , Obstrução das Vias Respiratórias/cirurgia , Cistos/cirurgia , Tecnologia de Fibra Óptica , Doenças da Laringe/cirurgia , Laringoscopia/instrumentação , Obstrução das Vias Respiratórias/diagnóstico por imagem , Cistos/complicações , Cistos/diagnóstico por imagem , Humanos , Lactente , Doenças da Laringe/complicações , Doenças da Laringe/diagnóstico por imagem , Masculino , Resultado do Tratamento
18.
BMC Infect Dis ; 19(1): 911, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664917

RESUMO

BACKGROUND: Cyst infection is a prevalent complication in autosomal dominant polycystic kidney disease (ADPKD) patients, however therapeutic and diagnostic approaches towards this condition remain unclear. The confirmation of a likely episode of cyst infection by isolating the pathogenic microorganism in a clinical scenario is possible only in the minority of cases. The available antimicrobial treatment guidelines, therefore, might not be appropriate to some patients. CASE PRESENTATION: We describe two unique cases of kidney cyst infection by Candida albicans, a condition that has not been previously described in literature. Both cases presented clear risk factors for Candida spp. infection. However, since there was no initial indication of cyst aspiration and culture, antifungal therapy was not immediately started and empirical treatment was initiated as recommended by the current guidelines. Antifungal treatment was instituted in both cases along the clinical course, according to their specificities. CONCLUSION: Our report highlights the possibility of Candida spp. cyst infection. Failure of clinical improvement with antibiotics should raise the suspicion of a fungal infection. Identification of infected cysts should be pursued in such cases, particularly with PET-CT, and when technically possible followed by cyst aspiration and culture to guide treatment. Risk factors for this condition, such as Candida spp. colonization, previous antimicrobial therapy, hemodialysis, necrotizing pancreatitis, gastrointestinal/hepatobiliary surgical procedure, central venous catheter, total parenteral nutrition, diabetes mellitus and immunodeficiency (neutropenia < 500 neutrophils/mL, hematologic malignancy, chemotherapy, immunosuppressant drugs), should be also considered accepted criteria for empirical antifungal therapy.


Assuntos
Candida albicans , Candidíase/diagnóstico por imagem , Candidíase/etiologia , Rim Policístico Autossômico Dominante/complicações , Adulto , Antibacterianos/uso terapêutico , Antifúngicos/uso terapêutico , Candidíase/tratamento farmacológico , Candidíase/microbiologia , Cistos/diagnóstico por imagem , Cistos/microbiologia , Cistos/terapia , Drenagem , Evolução Fatal , Feminino , Fluconazol/uso terapêutico , Humanos , Masculino , Nefrectomia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Diálise Renal , Insuficiência Renal/terapia , Resultado do Tratamento
19.
Head Face Med ; 15(1): 25, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640721

RESUMO

BACKGROUND: The purpose of the present study was to describe the CT imaging findings of normal incisive canals and incisive canal cysts and propose cut-off values to differentiate between them. METHODS: A total of 220 normal subjects and 40 patients with incisive canal cysts on multi-detector row computed tomography (MDCT) were retrospectively analyzed. The shapes, sizes, anatomic variations, Hounsfield scale values, and so on of maxillary incisive canals and the sizes and Hounsfield scale values of maxillary incisive canal cysts were analyzed. RESULTS: A significant difference in sizes of maxillary incisive canals in normal subjects was found between males and females. The sizes of maxillary incisive canals were significantly wider during aging, but shapes, anatomic variations, and Hounsfield scale values in the maxillary incisive canals were not significantly different with aging. A significant difference in sizes but not Hounsfield scale values was found between normal maxillary incisive canals and maxillary incisive canal cysts. Based on a cut-off of over 6 mm in the width of incisive canals, maxillary incisive canal cysts could not be appropriately diagnosed for subjects over 60 years of age. Over 60 years of age, maxillary incisive canal cysts could be appropriately diagnosed based on a cut-off of over 7.1 mm in width of incisive canals. When maxillary incisive canals of the hourglass types were seen on sagittal sections, significantly more patients had maxillary incisive canal cysts than other types. CONCLUSION: In coincidentally diagnosing asymptomatic incisive canal cysts on imaging, we should apply different cut-offs for the size of the maxillary incisive canal for patients over and under 60 years of age. Specifically, the cut-offs for the long axis of maxillary incisive canal cysts were 7.1 mm for patients over 60 years of age and 6.0 mm for those under 60 years of age. In addition, we should pay attention to wider canals with hourglass shapes as indicative of cystic change of maxillary incisive canals.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Cistos , Maxila , Cistos/diagnóstico por imagem , Feminino , Humanos , Japão , Masculino , Maxila/diagnóstico por imagem , Pessoa de Meia-Idade , Estudos Retrospectivos
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