RESUMO
A case of ventricular septal tumor diagnosed in 7-month-old boy is reported. An echocardiogram was performed for investigation of a heart murmur in an otherwise healthy infant. He remained asymptomatic, and the tumor had a very slow growth. When the boy was 9 years old, partial surgical excision was performed for right ventricular outflow tract obstruction. Histology showed a primary cardiac leiomyoma. To the authors' knowledge, a primary cardiac leiomyoma of the ventricular septum has not been reported previously.
Assuntos
Ecocardiografia/métodos , Neoplasias Cardíacas/diagnóstico , Leiomioma/diagnóstico , Imagem Cinética por Ressonância Magnética/métodos , Procedimentos Cirúrgicos Cardíacos/métodos , Diagnóstico Diferencial , Eletrocardiografia Ambulatorial , Seguimentos , Neoplasias Cardíacas/cirurgia , Humanos , Lactente , Leiomioma/cirurgia , Masculino , Fatores de Tempo , Septo InterventricularRESUMO
The authors present the case of an apparently immunocompetent 9-year-old child with probable cytomegalovirus encephalitis. The clinical picture was characterised by fever, frontal headache and behavioural changes, associated with visual and auditory hallucinations. Cerebrospinal fluid (CSF) biochemistry and brain CT were normal. Electroencephalography showed left temporal paroxysmal activity. Diagnosis was based on cytomegalovirus (CMV) DNA detection on the CSF by PCR. Acyclovir and ceftriaxone were given until herpes simplex virus (HSV) and bacterial encephalitis were ruled out. Rapid resolution of fever and complete clinical recovery was observed. Remarkably, anti-CMV serum antibodies were not detected on admission or until 6 months later. This discrepancy led us to question the presence of an impaired specific host humoral response, immune evasion by the virus or a false-positive result for CMV DNA in CSF.