RESUMO
In immunocompromised patients, visceral leishmaniasis (VL) can present with atypical clinical symptoms that include poor response to treatment. No optimal therapeutic regimen is available for such cases. In a splenectomized male patient, we observed a disseminated form of the disease in the liver, bone marrow, lymph nodes, and gastrointestinal tract. There was an apparent clinical improvement when he was initially treated with liposomal amphotericin B (L-AmB), but this was followed by a relapse involving severe clinical symptoms. He was finally treated successfully with a combination of L-AmB, meglumine antimoniate, and pentamidine isethionate. It is important to include asplenia as an immunosuppressive condition that induces exotic VL pathologies. In such cases, combination anti-Leishmania drug therapy should be considered.
Assuntos
Anfotericina B/uso terapêutico , Leishmaniose Visceral/tratamento farmacológico , Antimoniato de Meglumina/uso terapêutico , Pentamidina/uso terapêutico , Esplenectomia , Anfotericina B/administração & dosagem , Antiprotozoários/administração & dosagem , Antiprotozoários/uso terapêutico , Medula Óssea/parasitologia , Quimioterapia Combinada , Humanos , Hospedeiro Imunocomprometido , Mucosa Intestinal/parasitologia , Leishmaniose Visceral/imunologia , Linfonodos/parasitologia , Masculino , Antimoniato de Meglumina/administração & dosagem , Pessoa de Meia-Idade , Pentamidina/administração & dosagemRESUMO
Rhinocerebral zygomycosis is the most frequent form of fungal infection caused by members of the Zygomycetes class. A fatal case of rhinocerebral zygomycosis caused by Rhizopus (oryzae) arrhizus with histopathological and mycological diagnosis is reported in a diabetic patient.
Assuntos
Encefalopatias/microbiologia , Complicações do Diabetes/microbiologia , Doenças Nasais/microbiologia , Rhizopus/isolamento & purificação , Zigomicose/patologia , Adulto , Encefalopatias/patologia , Complicações do Diabetes/patologia , Evolução Fatal , Feminino , Humanos , Doenças Nasais/patologiaRESUMO
Rhinocerebral zygomycosis is the most frequent form of fungal infection caused by members of the Zygomycetes class. A fatal case of rhinocerebral zygomycosis caused by Rhizopus (oryzae) arrhizus with histopathological and mycological diagnosis is reported in a diabetic patient.
Zigomicose rinocerebral é a forma mais frequente das infecções fúngicas causadas por membros da classe Zygomicetes. É relatado um caso fatal de zigomicose rinocerebral por Rhizopus (oryzae) arrhizus com diagnóstico histopatológico e micológico, em paciente diabética.