RESUMEN
Multiple thoracic hydatic disease involving a cardiac and pulmonary localization is exceptional and prognosis is poor. We report a case in a 21-year-old male who presented repeated episodes of hemoptysis. The chest x-ray showed multiple opacities. The thoracic computed tomography and echocardiography visualized cystic formations in the heart and the pulmonary arteries. Hydatic serology was strongly positive. Medical treatment with albendazole was given but the patient died from massive hemoptysis before the cardiac and pulmonary artery cysts could be removed surgically (a procedure which requires extracorporeal circulation). A hydatic cyst of the pulmonary artery is usually secondary to a cardiac localization. The risk is dissemination into the pulmonary and eventually systemic circulation. An arterial localization must be carefully ruled out in all patients with multiple or cardiac hydatidosis. Treatment is surgical to avoid dissemination.
Asunto(s)
Equinococosis/diagnóstico , Cardiopatías/parasitología , Enfermedades Pulmonares Parasitarias/etiología , Arteria Pulmonar/parasitología , Adulto , Resultado Fatal , Hemoptisis/etiología , Humanos , MasculinoRESUMEN
INTRODUCTION: The management of a first episode of spontaneous pneumothorax is controversial and the best technique to be used as an initial intervention, aspiration or intercostal drainage, is still debated. PATIENTS AND METHODS: We present a retrospective case series during two and a half consecutive years describing the immediate management of spontaneous pneumothoraces, comparing aspiration versus thoracic drainage. RESULTS: One hundred and thirty-three clinical files from patients with spontaneous pneumothoraces were analyzed (17 primary and 116 secondary). The pneumothoraces were of varying size and different etiologies. Patients were initially treated with simple aspiration in 68 cases, with an immediate success rate of 37.5%, intercostal drainage in 49 cases, and by rest alone in 16 cases. CONCLUSION: In case of secondary pneumothorax, aspiration appeared to offer advantages as an initial strategy over intercostal drainage in terms of hospital stay (11 versus 22 days), and with significant effectiveness (37.5%).
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Neumotórax/terapia , Adulto , Tubos Torácicos/estadística & datos numéricos , Drenaje/métodos , Drenaje/estadística & datos numéricos , Humanos , Tiempo de Internación/estadística & datos numéricos , Persona de Mediana Edad , Marruecos/epidemiología , Neumotórax/diagnóstico , Neumotórax/epidemiología , Neumotórax/patología , Recurrencia , Estudios Retrospectivos , Toracocentesis/estadística & datos numéricosRESUMEN
INTRODUCTION: Tuberculosis is a major public health problem in Morocco. Tuberculosis of the lung bases is a rare and atypical form and raises real diagnostic problems. PATIENTS AND METHODS: We report a retrospective study of 21 cases of basal pulmonary tuberculosis, collected at the service of respiratory diseases in Ibn Rushd hospital in Casablanca between 2004 and 2015 (11 years). RESULTS: From a total of 21 patients having basal pulmonary tuberculosis, 13 (62%) were women versus eight men (48%), the average age was 33 years. The average time of diagnosis was 25 days. The disease was unilateral in 20 cases (95%). The right lower lobe was the most frequently affected (71%). Inhomogeneous opacities (66%) and consolidation (28%) were the main radiological findings. Associated comorbidities were dominated by diabetes in six cases (28%). Bronchoscopy had recovered thickening spurs in eight cases, endobronchial granules in seven cases and bronchial inflammation in six cases. Bronchial biopsies had found a necrotizing granulomatous inflammation tuberculoide in seven cases (33%). The smear was positive in sputum in three cases (14%), in the bronchial aspirate in four cases (19%), in induced sputum in one case (4.7%) and in post-bronchoscopic sputum in six cases (28%). The antituberculous treatment was started in all patients with good clinical and radiological evolution. CONCLUSION: The basal localization of the pulmonary tuberculosis is misleading; source of diagnostic delay, hence the need to think about it especially in patients with comorbidities.
Asunto(s)
Pulmón/patología , Tuberculosis Pulmonar/patología , Adolescente , Adulto , Anciano , Femenino , Humanos , Pulmón/diagnóstico por imagen , Pulmón/microbiología , Masculino , Persona de Mediana Edad , Radiografía Torácica , Estudios Retrospectivos , Tuberculosis Pulmonar/diagnóstico por imagen , Tuberculosis Pulmonar/epidemiología , Adulto JovenRESUMEN
OBJECTIVE: Tuberculosis is a serious and common complication of silicosis. The aim of this study is to describe the epidemiological, clinical, radiological and progressive aspects of this pathological entity. PATIENTS AND METHODS: The study concerns 23 cases of silicotuberculosis which were collected at the service of respiratory diseases at CHU Ibn Rochd of Casablanca, Morocco during 12years (2003-2015). RESULTS: All patients were men. They were 7 diggers, 5 rock crushers, 7 miners and 4 masons. The mean duration of silica exposure was 11years. The symptomatology was dominated by dyspnea and persistent bronchial syndrome. Imagery showed tumor-like opacities in all cases, associated with mediastinal calcified lymphadenopathy in 9 cases, with micronodules in 8 cases and an excavated opacity in 2 cases. The diagnosis of tuberculosis was confirmed by isolation of the Koch's bacillus in sputum in 13% of cases in the bronchial aspirate in 52% and culture in sputum post-bronchoscopy in 13%. The bronchial biopsies confirmed the diagnosis in 2 cases. Tuberculosis had complicated silicosis 9years on average after the cessation of exposure to silica in 65% of cases. The antituberculous treatment was started in all patients with good clinical outcome in 22 cases. We had deplored a case of death by acute respiratory failure. CONCLUSION: Silicosis increases the risk of tuberculosis, hence the importance of TB screening in all patients with silicosis.
Asunto(s)
Silicosis/epidemiología , Silicotuberculosis/epidemiología , Anciano , Progresión de la Enfermedad , Humanos , Masculino , Persona de Mediana Edad , Marruecos/epidemiología , Exposición Profesional/estadística & datos numéricos , Radiografía Torácica , Estudios Retrospectivos , Factores de Riesgo , Silicosis/diagnóstico por imagen , Silicosis/patología , Silicotuberculosis/diagnóstico por imagen , Silicotuberculosis/etiología , Silicotuberculosis/patologíaRESUMEN
Chlamydia pneumoniae infection has been often associated with several chronic diseases including asthma and chronic obstructive pulmonary diseases (COPD). The spectrum of Chlamydia pneumoniae infection has been expanded to the association with coronary heart disease (CHD). In Morocco, the implication of Chlamydia pneumoniae infection in these pathologies is unknown. The aim of our study was to determine the relationship between infection with Chlamydia pneumoniae and respiratory pathology and atherosclerosis. The patients were from two departments (department of respiratory disease and of cardiology), and presented exacerbation of COPD and asthma or atherosclerosis. The mean age was 45 years a with a 1.7 sex ratio for the first population and 61 years with a 1.4 sex ratio for the second population. Serological diagnosis of Chlamydia pneumoniae infection has been determined by microimmunofluorescence (MIF). All samples were tested for anti-Chlamydia pneumoniae IgG, IgA and IgM. In the first group, we found 42 % positive for IgG, 11 % for IgA, and no case for IgM. In the second group the presence of anti-Chlamydia pneumoniae IgG was observed in 67.5 % cases, IgA in 16.5 % cases and IgM in 2 % cases, 14 % of patients had negative serology for IgA, IgG, and IgM. Our results are in accord to those reported by other studies. According to these results, it seems that a certain degree of association exists between Chlamydia pneumoniae infection and exacerbation of COPD, asthma and atherosclerosis which should be of importance on a therapeutic point of view.
Asunto(s)
Arteriosclerosis/microbiología , Asma/microbiología , Infecciones por Chlamydophila/complicaciones , Chlamydophila pneumoniae , Enfermedad Pulmonar Obstructiva Crónica/microbiología , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Antibacterianos/sangre , Arteriosclerosis/complicaciones , Asma/complicaciones , Distribución de Chi-Cuadrado , Infecciones por Chlamydophila/diagnóstico , Chlamydophila pneumoniae/inmunología , Femenino , Técnica del Anticuerpo Fluorescente , Humanos , Inmunoglobulina A/sangre , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Persona de Mediana Edad , Marruecos , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Factores de RiesgoRESUMEN
INTRODUCTION: Pleuropulmonary involvement is the second most common extra-intestinal manifestation of entamoeba histolytica infection after liver abscess. CASE REPORT: We report 2 cases of pleuropulmonary disease occurring in two men aged 32 and 48 years following an episode of dysentery. Purulent pleural infection was noted in one case. In the other both lung and liver abscesses occurred. CONCLUSION: The diagnosis was confirmed by strongly positive serology in both cases. Treatment with metronidazole (1.5 g per day) for 15 days combined with pleural drainage led to a satisfactory outcome in both cases.
Asunto(s)
Entamoeba histolytica , Entamebiasis , Absceso Hepático Amebiano , Absceso Pulmonar/parasitología , Enfermedades Pulmonares/parasitología , Enfermedades Pleurales/parasitología , Adulto , Animales , Antiprotozoarios/administración & dosificación , Antiprotozoarios/uso terapéutico , Drenaje , Entamebiasis/diagnóstico , Entamebiasis/tratamiento farmacológico , Humanos , Absceso Hepático Amebiano/diagnóstico , Absceso Hepático Amebiano/tratamiento farmacológico , Absceso Pulmonar/tratamiento farmacológico , Enfermedades Pulmonares/diagnóstico por imagen , Enfermedades Pulmonares/tratamiento farmacológico , Masculino , Metronidazol/administración & dosificación , Metronidazol/uso terapéutico , Persona de Mediana Edad , Enfermedades Pleurales/diagnóstico por imagen , Enfermedades Pleurales/tratamiento farmacológico , Radiografía Abdominal , Radiografía Torácica , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Paraganglioma is rare tumor arising from chromaffine cells. We report a 39-year-old man who was diagnosed with anterior mediastinal paraganglioma. Computed tomography (CT) revealed a solid mass in the anterior mediastinum. Surgical biopsies obtained by sternotomy confirmed histologic and immunohistochemical features of paraganglioma. Surgical removal of this vascularized and invasive tumor was not possible to. External radiotherapy was performed. Three years later, the patient developed chest pain. CT findings showed right nodular pleural masses. Transparietal biopsy confirmed the same pathological aspect of paraganglioma. Chemotherapy was proposed without significant response. This observation confirmed the rare course of paraganglioma to pleural metastases. Treatment of paraganglioma is mainly surgery if the mass is resectable.
Asunto(s)
Neoplasias del Mediastino/patología , Paraganglioma/secundario , Neoplasias Pleurales/secundario , Adulto , Humanos , Masculino , Neoplasias del Mediastino/diagnóstico , Paraganglioma/diagnóstico , Neoplasias Pleurales/diagnósticoRESUMEN
INTRODUCTION: Chronic pulmonary aspergillosis is a pulmonary fungal infection with various presentations that can occur on a pre-existing cavity, often a sequel of tuberculosis. The objective of our study was to report the diagnostic and therapeutic management of pulmonary aspergilloma in our structure. PATIENTS AND METHODS: We retrospectively studied 81 cases of pulmonary aspergilloma having occurred in the respiratory diseases unit of the Casablanca Ibn Rochd hospital, over 11 years. RESULTS: We included 48 male and 33 female non-immunocompromised patients, with an average age of 51 years (27-75). A history of tuberculosis was recorded in 78 cases. Hemoptysis was the revealing symptom in 73 cases. A characteristic "bell-like" image was observed in 25 cases. The serological results were positive for aspergillus in 54 cases. The treatment was surgical in 50 cases and medical in 24 cases. Five patients died. DISCUSSION: A significant number of pulmonary aspergilloma cases were recorded in our study, occurring most frequently on sequels of tuberculosis. This disease is currently common in countries highly endemic for tuberculosis; early and adequate management is required. CONCLUSION: Aspergillosis is a frequent and potentially severe disease occurring on pre-existing lesions, most often in our context sequels of tuberculosis. Surgical resection is the reference treatment but is the cause of a significant morbidity and mortality. Preventive measures are mandatory.
Asunto(s)
Aspergilosis Pulmonar/epidemiología , Adulto , Anciano , Antifúngicos/uso terapéutico , Enfermedad Crónica , Terapia Combinada , Comorbilidad , Femenino , Hemoptisis/etiología , Humanos , Masculino , Persona de Mediana Edad , Marruecos/epidemiología , Infecciones Oportunistas/diagnóstico por imagen , Infecciones Oportunistas/tratamiento farmacológico , Infecciones Oportunistas/epidemiología , Infecciones Oportunistas/cirugía , Neumonectomía , Aspergilosis Pulmonar/diagnóstico por imagen , Aspergilosis Pulmonar/tratamiento farmacológico , Aspergilosis Pulmonar/cirugía , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Radiografía , Estudios Retrospectivos , Fumar/epidemiología , Tuberculosis Pulmonar/epidemiologíaRESUMEN
Smoking is a serious public health problem. In Morocco, the number of smokers varies from 24% to 52% depending on different social categories (school children, university students, public health workers, industrial workers, civil servants). The aim of our descriptive study was to analyze knowledge about smoking and smoking habits in patients hospitalized or followed by two units in the Ibn Rochd Hospital, cardiology and respiratory diseases. A questionnaire was given to a consecutive series of 200 patients between January and March 1997 (100 patients in each unit). Twenty percent of the patients were smokers and 23% were former smokers. The most well known health risks of smoking in the two groups of patients were respiratory and cardiovascular risks (88% and 71% respectively). Smokers and former smokers were more aware of these health risks. 86% of the smokers and former smokers had attempted to stop smoking at least once, mainly for a "health" reasons. 60% of smokers and former smokers decided to never smoke or never take a cigarette again. 66% of the patients said they had not been advised at the hospital about the risk of smoking. Our study provides a basis for further studies. It points out the importance of the smoking phenomena and the minimal role played by health personnel in advising patients. Health care workers should participate in antismoking activities during their consultation activities at the hospital in order to help patients stop smoking and also help implement rigorous antismoking laws in Morocco.
Asunto(s)
Actitud Frente a la Salud , Conocimientos, Actitudes y Práctica en Salud , Pacientes Internos/educación , Pacientes Internos/psicología , Fumar/psicología , Adulto , Estudios de Casos y Controles , Femenino , Conductas Relacionadas con la Salud , Humanos , Masculino , Persona de Mediana Edad , Marruecos/epidemiología , Evaluación de Necesidades , Ocupaciones , Educación del Paciente como Asunto , Factores de Riesgo , Fumar/efectos adversos , Fumar/epidemiología , Cese del Hábito de Fumar/psicología , Cese del Hábito de Fumar/estadística & datos numéricos , Clase Social , Encuestas y CuestionariosRESUMEN
The etiology of the respiratory distress syndrome is dominated by pulmonary edema and the septic shock. We report a rare etiology of a respiratory distress secondary to a rupture of a well treated tuberculous latero-tracheal adenopathy. A 24-year-old woman was treated a year ago for a peripheral and mediastinal lymph node tuberculosis confirmed by the biopsy of a left supra clavicular adenopathy, by two months of isoniazid-rifampicin-pyrazinamide-ethambutol and seven months of isoniazid-rifampicin. The patient completed 9 month treatment with a good clinical and radiology course. Two months after stopping the antibacillary treatment, the patient was admitted to an intensive care unit with a respiratory distress syndrome requiring both intubation and artificial ventilation. The bronchial aspiration brought back plain pus. The telethorax from admission was normal and the retrospective history suggested the diagnostic of a ganglio-bronchial fistula which was confirmed by bronchial fibroscopy demonstrating right latero-tracheal fistula. The course was good with recovery of consciousness on the seventh day. Direct bacilloscopies and culture were negative. The digestive fibroscopy was normal. Finally, fistulization of a tuberculous adenopathy must be considered among the etiologies of respiratory distress even in a patient appropriately treated for mediastinal lymph node tuberculosis.
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Fístula Bronquial/diagnóstico , Fístula/diagnóstico , Enfermedades Linfáticas/diagnóstico , Síndrome de Dificultad Respiratoria del Recién Nacido/etiología , Tuberculosis Ganglionar/complicaciones , Enfermedad Aguda , Adulto , Fístula Bronquial/etiología , Femenino , Fístula/etiología , Humanos , Recién Nacido , Enfermedades Linfáticas/etiología , Radiografía TorácicaRESUMEN
This cross sectional study took place with a self administered questionnaire between June and September 1999 and involved 1,388 subjects of whom 62.4% were men and 37.6% women. The total prevalence of smoking was 14.9%, ranging from 12.5% in paramedical staff to 15.5% in manual workers, 16.2% in doctors, 17.1% in laboratory staff, and 22.2% in administrators. The prevalence was 35.9% among men as against 2.2% among women. The study of smokers showed that 51.5% had started before the age of 21. The most common motive for starting smoking was "pleasure". Among the 45.5% who smoked at the workplace 60.5% felt concerned about it. Evaluation of the degree of nicotine dependence using the Fagerstrom score found high dependence in 21.3% of subjects. Only 24.5% of doctors warned patients against smoking in the absence of smoking related diseases or symptoms. In more than 75% of cases doctors advised against smoking in the workplace and in the home. 66.8% of staff were aware of the anti-smoking law but the legislative measures were poorly understood. Only 9% of those interviewed had taken part in an anti-smoking campaign. In conclusion, the prevalence of smoking in the hospitals of Casablanca has definitely diminished in the past 10 years but it remains relatively high in men. Hospital staff should be more involved in the fight against smoking.
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Actitud del Personal de Salud , Conocimientos, Actitudes y Práctica en Salud , Personal de Hospital/educación , Personal de Hospital/psicología , Fumar/epidemiología , Fumar/psicología , Adolescente , Adulto , Distribución por Edad , Actitud Frente a la Salud , Estudios Transversales , Femenino , Hospitales Urbanos/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Marruecos/epidemiología , Motivación , Ocupaciones/estadística & datos numéricos , Prevalencia , Factores de Riesgo , Distribución por Sexo , Encuestas y Cuestionarios , Lugar de TrabajoRESUMEN
We report two cases of pulmonary actinomycosis in two young men. These observations are an opportunity to review the usual difficulties of diagnosis and the clinical, radiological and therapeutic characteristics in patients with this rare disease. Pulmonary actinomycosis often appears in a debilitated patient with significant disease of the teeth and gingival margins. High-dose penicillin G which is the standard treatment generally provides cure.
Asunto(s)
Actinomicosis , Enfermedades Pulmonares , Actinomicosis/diagnóstico por imagen , Humanos , Enfermedades Pulmonares/diagnóstico por imagen , Masculino , Persona de Mediana Edad , RadiografíaRESUMEN
OBJECTIVE: Inhalation of foreign bodies is rare in adults. Inhalation of scarf pin is a phenomenon more frequent in the female population in Morocco. The aim of our study was to describe the characteristics of this particular foreign body and illustrate the circumstances and consequences of its inhalation. PATIENTS AND METHODS: Twenty-six young patients, all veiled, were hospitalized in the service of Respiratory Diseases University Hospital Ibn Rushd of Casablanca between January 2005 and July 2011 for inhaled scarf pin. RESULTS: The mean age was 16 years. Inhalation was accidental in all cases, whereas patients initiated to wear the veil. The penetration syndrome was found in all cases. Clinical examination was normal in all patients. The chest X-ray showed the foreign body as a linear opacity, located right in 18 cases and left in eight cases. Flexible bronchoscopy was able to extract the pin in 21 cases. The pin was released spontaneously in three cases and two patients were operated on. CONCLUSION: The scarf pin is a foreign body especially more common in women who wear the Islamic veil. Flexible bronchoscopy is an essential means of therapy, but the best preventive treatment is avoiding to put in the mouth sharp objects.
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Cuerpos Extraños/diagnóstico , Islamismo , Joyas , Tráquea , Adolescente , Broncoscopía , Femenino , Cuerpos Extraños/terapia , Hospitalización , Hospitales Universitarios , Humanos , Marruecos , Aspiración RespiratoriaRESUMEN
Chickenpox is a viral infection usually benign and practically mandatory of the childhood. In the adult, it may know multivisceral complications as pneumonia in relationship with chickenpox which is the most frequent. One case of varicella pneumonia with a bilateral pleurisy has been noticed in a 38-year-old adult. The definite diagnosis has been based on clinical, biological and radiological arguments. Under an antiviral treatment, the evolution is favourable.
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Varicela/complicaciones , Inmunocompetencia , Pleuresia/etiología , Adulto , Varicela/diagnóstico por imagen , Humanos , Masculino , Pleuresia/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/etiología , Radiografía TorácicaRESUMEN
OBJECTIVE: Smoking is a major public health problem. The doctor should be at the forefront in the fight against tobacco. Our study aims to determine the prevalence of smoking among medical students and to evaluate their attitudes towards this problem. PATIENTS AND METHODS: A cross-sectional survey was conducted among 736 medical students enrolled in the faculty of medicine and pharmacy of Casablanca in the academic year 2009/2010. RESULTS: The prevalence of smoking was 7.9%. It was significantly higher in men (16% against 3% in women) and varied little from one age group to another (7-8%). The average number of cigarettes smoked per day was eight. More than half of the students (58%) had attempted to quit smoking. The main motivation was the occurrence of certain symptoms (66%). Ex-smokers accounted for 10% of the total. Moroccan anti-smoking law was poorly understood by more than half of our students (72%). The majority was in favor of prohibition of tobacco sales to children (92%) and the training of health professionals to help patients who want to quit smoking (86%). CONCLUSION: Compared with previous years this study shows a marked decrease in the prevalence of smoking among medical students in Casablanca as well as a better understanding of its ill effects. This is due not only to greater awareness of this problem among medical students but also to the introduction of the teaching of the pathologies related to tobacco.
Asunto(s)
Actitud Frente a la Salud , Fumar/psicología , Estudiantes de Medicina/psicología , Adolescente , Adulto , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Marruecos/epidemiología , Prevalencia , Cese del Hábito de Fumar/legislación & jurisprudencia , Cese del Hábito de Fumar/psicología , Cese del Hábito de Fumar/estadística & datos numéricos , Encuestas y Cuestionarios , Industria del Tabaco/legislación & jurisprudencia , Tabaquismo/complicaciones , Tabaquismo/epidemiología , Tabaquismo/prevención & control , Tabaquismo/psicología , Adulto JovenRESUMEN
Intracardiac thrombosis is a rare complication of Behçet's disease. It may be isolated or associated with arterial disease. We report a case of a patient from northern Morocco, aged 23, without specific medical history. He consulted for recurrent hemoptysis of middle abundance, associated with bipolar aphthosis. Chest radiography showed a left basal opacity fuzzy and right paracardiac opacity. The thoracic CT objectified left segmental lower lobe embolism, an aneurysm of a segmental branch of the right lower lobe and right intraventricular thrombus. Echocardiography confirmed the intracardiac thrombus. The patient was treated by oral corticosteroids, azathioprine, colchicine, and anticoagulants. The outcome was favorable with complete resolution of intraventricular thrombus and the aneurysm.
Asunto(s)
Aneurisma/etiología , Síndrome de Behçet/complicaciones , Cardiopatías/etiología , Arteria Pulmonar , Embolia Pulmonar/etiología , Trombosis/etiología , Aneurisma/diagnóstico , Aneurisma/diagnóstico por imagen , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/diagnóstico por imagen , Diagnóstico Diferencial , Cardiopatías/diagnóstico , Cardiopatías/diagnóstico por imagen , Humanos , Masculino , Arteria Pulmonar/diagnóstico por imagen , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/diagnóstico por imagen , Radiografía Torácica , Trombosis/diagnóstico , Trombosis/diagnóstico por imagen , Adulto JovenRESUMEN
The occurrence of invasive pulmonary aspergillosis is unusual during the course of AIDS. Patients at risk have a CD4 T-lymphocyte count under 50 cells/mm(3) combined with other risk factors in 50% of the cases. Positive diagnosis is based on chest CT scan imaging and isolation of Aspergillus in broncho-alveolar fluid. Detection of galactomannan antigen in serum and broncho-alveolar lavage fluid (BALF) is a reliable complementary tool in assessing the diagnosis. The first line therapy is Voriconazole. The prognosis, often severe, depends on prompt initiation of the appropriate antifungal treatment. We report two cases of invasive pulmonary aspergillosis in AIDS patients.
Asunto(s)
Antifúngicos/uso terapéutico , Aspergilosis/diagnóstico , Infecciones por VIH/complicaciones , Enfermedades Pulmonares Fúngicas/diagnóstico , Aspergilosis Pulmonar/complicaciones , Pirimidinas/uso terapéutico , Triazoles/uso terapéutico , Adulto , Aspergilosis/diagnóstico por imagen , Lavado Broncoalveolar , Infecciones por VIH/diagnóstico , Humanos , Enfermedades Pulmonares Fúngicas/diagnóstico por imagen , Enfermedades Pulmonares Fúngicas/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Pronóstico , Aspergilosis Pulmonar/diagnóstico , Radiografía , Factores de Riesgo , VoriconazolRESUMEN
Demons-Meigs syndrome is a benign tumor of the ovary. It is very rare and its physiopathology remains obscure. We report a case of Demons-Meigs syndrome in a woman aged 51 years. It was discovered following a right pleural effusion syndrome with ascites and an abdominopelvic mass. Rate of serum CA 125 was 412IU/mL. Surgical exploration revealed ascites of one litre with no suspicious peritoneal lesion and an ovarian fibrothecoma of 70 mm. There were no post-operative complications and three months later, the level of CA 125 was negative with a total drainage of effusions.
Asunto(s)
Síndrome de Meigs/diagnóstico , Ascitis/etiología , Antígeno Ca-125/sangre , Femenino , Humanos , Síndrome de Meigs/patología , Síndrome de Meigs/cirugía , Persona de Mediana Edad , Neoplasias Ováricas/diagnóstico , Neoplasias Ováricas/patología , Neoplasias Ováricas/cirugía , Ovariectomía , Ovario/patología , Derrame Pleural Maligno/etiología , Neoplasia Tecoma/diagnóstico , Neoplasia Tecoma/patología , Neoplasia Tecoma/cirugíaRESUMEN
Multiple lung hydatidosis associated with cardiac localization is rare, whereas large arterial localization is exceptional and involves a poor prognosis. The authors report the case of a 26-year-old man living in a rural area, without a past medical history. He presented chest pain, hydatidoptysis and syncope. A chest x-ray revealed multiple bilateral cysts. A chest CT scan detected multiple cysts in the heart, the pericardium and multiple pulmonary cysts. Echocardiography revealed cysts in the right and left auricle, the pulmonary artery as well as the pericardium. Medical three treatments were administered before surgical intervention on the heart cysts under extracorporeal circulation, revealing an enormous hydatid cyst at the beginning of the aorta. Unfortunately, the patient died during the immediate postoperative phase.