RESUMO
Highly active antiretroviral therapy (HAART) has been shown to induce a major and durable viral load reduction accompanied by a stable CD4 increase. This process may evolve with adverse clinical phenomena, known as the immune reconstitution inflammatory syndrome (IRIS). In the HIV population, non-tuberculous mycobacteria are a common cause of IRIS. However, only a few cases of Mycobacterium xenopi associated IRIS have been described. This paper concerns a case of M. xenopi pulmonary infection resulting in self-limited immune reconstitution inflammatory syndrome in an HIV-1 infected patient.
Assuntos
Infecções por HIV/complicações , Síndrome Inflamatória da Reconstituição Imune/etiologia , Pneumopatias/complicações , Infecções por Mycobacterium não Tuberculosas/complicações , Mycobacterium xenopi , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Infecções Oportunistas Relacionadas com a AIDS/virologia , Adulto , Terapia Antirretroviral de Alta Atividade , Infecções por HIV/tratamento farmacológico , Infecções por HIV/imunologia , Infecções por HIV/virologia , HIV-1 , Humanos , Pneumopatias/imunologia , Pneumopatias/microbiologia , Masculino , Infecções por Mycobacterium não Tuberculosas/imunologia , Infecções por Mycobacterium não Tuberculosas/microbiologia , Mycobacterium xenopi/isolamento & purificaçãoRESUMO
Visceral Leishmaniasis (VL) is a vector-borne zoonosis endemic in Southern Italy whose usual clinical features include fever, splenomegaly, pancytopenia and hypergammaglobulinemia. The clinical and biochemical picture may be misleading in patients with immunodeficiency diseases hampering the diagnosis. We describe a VL case in a patient whose spleen had been removed and who had Common Variable Immunodeficiency and Evans syndrome.
Assuntos
Anemia Hemolítica Autoimune/complicações , Imunodeficiência de Variável Comum/complicações , Leishmaniose Visceral/etiologia , Trombocitopenia/complicações , Anfotericina B/administração & dosagem , Anemia Hemolítica Autoimune/tratamento farmacológico , Antiprotozoários/administração & dosagem , Imunodeficiência de Variável Comum/terapia , Febre , Glucocorticoides/administração & dosagem , Humanos , Imunização Passiva , Hospedeiro Imunocomprometido , Leishmaniose Visceral/tratamento farmacológico , Leishmaniose Visceral/fisiopatologia , Masculino , Pessoa de Meia-Idade , Prednisona/administração & dosagem , Esplenectomia , Trombocitopenia/cirurgiaRESUMO
Myxoma is the most common type of cardiac tumour in all age groups. It may simulate infective endocarditis but is rarely infected. We describe one case of infected left atrial myxoma caused by Enterococcus faecalis. Combined therapy, consisting of surgical management and antimicrobial therapy, was used. Histological examination of the excised tumour revealed a typical myxoma with infiltrates of neutrophils. Few cases of infected atrial myxomas have been reported in the literature.
Assuntos
Bacteriemia/complicações , Endocardite Bacteriana/etiologia , Enterococcus faecalis/isolamento & purificação , Infecções por Bactérias Gram-Positivas/etiologia , Átrios do Coração/microbiologia , Neoplasias Cardíacas/complicações , Mixoma/complicações , Idoso , Aminoglicosídeos/farmacologia , Antibacterianos/uso terapêutico , Bacteriemia/microbiologia , Farmacorresistência Bacteriana Múltipla , Enterococcus faecalis/efeitos dos fármacos , Feminino , Febre/etiologia , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Humanos , Mixoma/diagnóstico por imagem , Mixoma/cirurgia , UltrassonografiaRESUMO
In developing countries, tuberculosis (TBC) is commonly associated with inadequate socio-economic and sanitary conditions. Currently, in Western countries, TBC is often linked with HIV infection, an ageing population or trans-global migration. Approximately two out of ten TB cases worldwide are extra-pulmonary, of which abdominal tuberculosis accounts for 11%-16%. The Mycobacterium tuberculosis complex involves the abdomen as primary or secondary localization (hematogenous spread or from pulmonary foci or infected neighbouring organs). Abdominal TBC can infect the gastrointestinal tract, peritoneum, mesentery, abdominal lymph nodes, liver, spleen, and pancreas. Diagnosis of abdominal tuberculosis is difficult because of vague and non-specific clinical features and due to the differential diagnosis with other granulomatous diseases such as Crohn's Disease. It is of great importance for clinicians to pay great attention to tubercular aetiology as a possible cause of gastrointestinal symptoms. Here we describe the clinical case of a young immigrant patient with intestinal TB for whom the wrong initial diagnosis led to a delay in the correct diagnosis and a worsening of the already serious general conditions.