RESUMO
Extra-intestinal infections due to Clostridium difficile have been reported rarely. Herein we report a case of pyogenic liver abscess from toxigenic C. difficile in an 80-year-old non-hospitalized woman with diabetes mellitus, cerebrovascular and cardiovascular diseases. The patient was admitted to the emergency department with fever and abdominal pain. There was no history of diarrhea or use of antibiotics. Laboratory parameters revealed signs of inflammation and elevated AST and ALT levels. Abdominal ultrasound and computer tomography showed multiple focal lesions in the bilateral liver lobes and hydropic gallbladder with stones. The patient underwent cholecystectomy and the liver abscesses were drained. Toxigenic C. difficile strains were isolated from the drained pus and also from the stool sample. According to repetitive-element PCR (rep-PCR) analyses both organisms were the same. The organisms were susceptible to antibiotics. Despite proper antibiotic therapy and surgical drainage, the patient succumbed to her illness.
Assuntos
Doenças Cardiovasculares/diagnóstico , Transtornos Cerebrovasculares/diagnóstico , Clostridioides difficile/isolamento & purificação , Infecções por Clostridium/diagnóstico , Diabetes Mellitus/diagnóstico , Cálculos Biliares/diagnóstico , Abscesso Hepático Piogênico/diagnóstico , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/patologia , Doenças Cardiovasculares/cirurgia , Transtornos Cerebrovasculares/complicações , Transtornos Cerebrovasculares/patologia , Transtornos Cerebrovasculares/cirurgia , Colecistectomia , Clostridioides difficile/genética , Infecções por Clostridium/complicações , Infecções por Clostridium/patologia , Infecções por Clostridium/cirurgia , Complicações do Diabetes , Diabetes Mellitus/patologia , Diabetes Mellitus/cirurgia , Evolução Fatal , Feminino , Cálculos Biliares/complicações , Cálculos Biliares/patologia , Cálculos Biliares/cirurgia , Humanos , Abscesso Hepático Piogênico/complicações , Abscesso Hepático Piogênico/patologia , Abscesso Hepático Piogênico/cirurgiaRESUMO
OBJECTIVE: Our study aimed to evaluate the seropositivity for syphilis in non- immigrant and immigrant populations and compare the results regarding demographic data. METHODS: In accordance with the reverse algorithm, syphilis tests were performed between May 2014 and December 2018 in hospitals in our service zone for syphilis screening or symptomatic disease. RESULTS: A total of 135.328 non- immigrant and 6.641 immigrant were screened for syphilis. Seropositivity rates were 1.3% in the non- immigrant and 3.8% in immigrant groups (p=0.0001). There was a statistically significant difference in terms of seropositivity rates between the various age groups in the local group and immigrant groups (except 18 25 age group) (p<0.05). Syphilis seropositivity rates were found to be lower in indigenous population than immigrant groups according to the years tested (p=0.0001). The seropositivity rates were 2.4% and 3.2% among the males (p=0.025) and 0.6% and 4.0% among females (p=0.0001) in non-immigrantand immigrant groups, respectively. Whereas, 0.6% of pregnant women in the local group and 3.7% of pregnant women in immigrant groups were seropositive for syphilis (p=0.0001). Among the HIV positive group, syphilis seropositivity was only observed in the non-immigrant group with a rate of 23.0% (p=0.0001). CONCLUSION: The antibodies against syphilis were found more frequently in immigrants than non-immigrant. Among the HIV positive individuals syphilis seropositivity was only observed in the non-immigrant group.