RESUMO
We present a 3-patient case series that support the use of ultrasound guided minimally invasive autopsy (MIA). This technique has a high diagnostic accuracy in specific clinical settings. It makes easier to diagnose pathologies once the patient has died, avoiding body deformation, with a notable reduction in sample processing time compared to the open autopsy study and, therefore, a shorter overall diagnostic response time. MIA shows some similarities with point of care ultrasound (POCUS), like examination protocols or that they can be performed at the bedside.
Assuntos
Testes Imediatos , Ultrassonografia de Intervenção , Humanos , Autopsia/métodos , Ultrassonografia/métodos , Sistemas Automatizados de Assistência Junto ao LeitoRESUMO
Staphylococcus lugdunensis is a coagulase-negative staphylococcus of growing importance and atypical behavior. The infections caused by this microorganism are becoming more frequent, having a broader spectrum. Psoas abscesses caused by this germ are rare, with few cases reported in the literature. In this work, we present a case of a psoas abscess caused by S. lugdunensis in a patient suffering from diabetes mellitus and rheumatoid arthritis, which was treated with intravenous cloxacillin with a good outcome.
Assuntos
Abscesso do Psoas/microbiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus lugdunensis/isolamento & purificação , Antibacterianos/uso terapêutico , Artrite Reumatoide/complicações , Técnicas de Tipagem Bacteriana , Cloxacilina/uso terapêutico , Diabetes Mellitus Tipo 2/complicações , Abscesso Epidural/tratamento farmacológico , Abscesso Epidural/microbiologia , Feminino , Humanos , Hospedeiro Imunocomprometido , Pessoa de Meia-Idade , Abscesso do Psoas/tratamento farmacológico , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus lugdunensis/patogenicidadeRESUMO
A 43-year-old man with a history of severe extrinsic allergic asthma treated with once-monthly omalizumab (600 mg) for the last 15 months. He presented to the emergency room with a 2-week history of right lower limb pain and chest pleuritic pain. Computed tomography pulmonary angiography showed bilateral pulmonary embolism with right-sided pulmonary infarction and ultrasound of right lower limb confirmed distal deep vein thrombosis. No other known risk factors were identified. Treatment with omalizumab was stopped during hospitalization. The Naranjo Adverse Drug Reaction (ADR) Probability Scale classifies this as a probable ADR (score of 6). Omalizumab is a humanized monoclonal anti-IgE antibody indicated for the treatment of persistent moderate-to-severe asthma and certain chronic refractory urticaria. The EXCELS study (The Epidemiologic Study of Xolair (omalizumab): Evaluating Clinical Effectiveness and Long-term Safety in Patients with Moderate-to-Severe Asthma), a postmarketing observational cohort study to assess clinical safety profile of omalizumab, showed a significant increase in venous thromboembolism. In conclusion, omalizumab has been associated with arterial and venous thromboembolic events, although the evidence is not definitive.