RESUMO
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was firstly identified in China and has been declared a global pandemic. Several serious extrapulmonary manifestations due to SARS-CoV-2 infection have also been reported and associated with hypercoagulability thrombotic vasculopathy. In addition, cases of Mycobacterium-leprae infection have also been known associated with blood coagulation abnormality. Methods: Here, we report a 56-year-old male with coronavirus disease-19 (COVID-19) with concomitant leprosy infection with manifestation of glans penile necrosis, presented to the emergency department with acute penile pain. This case is unique because no occlusion blood flow to the penile was observed in the radiographic imaging. We described the potential pathophysiology in this case through a literature review. Results: The patient received treatment according to the COVID-19 protocol and was given low molecular weight heparin (LMWH) therapy for 4 days. During the follow up, the clinical and functional condition of the penis showed significant improvement. Conclusions: Microthrombus involvement, platelet abnormalities and impaired hemostasis due to SARS-CoV-2 and leprosy co-infection are the hypothesis in this case report.
Assuntos
COVID-19 , Hanseníase , Necrose , Pênis , SARS-CoV-2 , Humanos , Masculino , COVID-19/complicações , Pessoa de Meia-Idade , Pênis/patologia , Pênis/irrigação sanguínea , Hanseníase/complicações , Hanseníase/patologia , Hanseníase/tratamento farmacológico , Coinfecção , Doenças do Pênis/patologia , Doenças do Pênis/tratamento farmacológico , Doenças do Pênis/virologia , Doenças do Pênis/complicações , Heparina de Baixo Peso Molecular/uso terapêuticoRESUMO
CASE PRESENTATION: A case of a 57 years old woman came with the chief complaint of urinary incontinence since 20 years ago. After labor, she complained of urinary incontinence and left untreated. Physical examination and urethrocystoscopy revealed vaginal stone sized 90 × 70 mm and urethrovaginal fistula. We performed hysterectomy and vaginal stone removal, continued with fistula closure and vaginal repair. Up to 2 months follow up, no sign of urinary leakage and incontinence was found. CONCLUSION: Vaginal stone is a rare Case that might be present in a case of long term urethrovaginal fistula with neglected contraceptive device.