Uma Apresentação Rara de COVID-19 com Embolia Pulmonar / A Rare Presentation of COVID-19 with Pulmonary Embolism

Resumo A doença de coronavírus 2019 (COVID-19) foi relatada em quase todos os países do mundo desde dezembro de 2019. A infecção por SARS-CoV-2 é frequentemente assintomática ou com sintomas leves, mas também pode levar à hipóxia, um estado hiperinflamatório e coagulopatia. Os parâmetros de coagulação anormais estão associados a complicações trombóticas, incluindo embolia pulmonar na COVID-19, mas pouco se sabe sobre os mecanismos. A semelhança dos sintomas iniciais de ambas as doenças também pode ser confusa, portanto, os médicos devem estar cientes do potencial para condições concomitantes. Apresentamos aqui um caso que não apresentava opacidades em vidro fosco nos pulmões, mas apresentava embolia pulmonar e derrame pleural em associação com infecção por COVID-19.

Abstract Coronavirus disease 2019 (COVID-19) has been reported in almost every country in the world since December 2019. Infection with SARS-CoV-2 is often asymptomatic or with mild symptoms, but it may also lead to hypoxia, a hyperinflammatory state, and coagulopathy. The abnormal coagulation parameters are associated with thrombotic complications, including pulmonary embolism in COVID-19, but little is known about the mechanisms. The similarity of initial symptoms of both diseases can also be confusing, therefore the physicians should be aware of the potential for concurrent conditions. Herein, we present a case who did not have ground-glass opacities in the lungs, yet presented with pulmonary embolism and pleural effusions in association with COVID-19 infection.

Asymptomatic IgE mediated food hypersensitivity in patients with nasal polyps.

The aim of this prospective study is to compare the prevalence of atopy in patients afflicted by nasal polyps with the atopy prevalence in healthy volunteers without nasal polyps, since systemic allergy and allergy in the nasal mucosa are still being debated as underlying causes for nasal polyps. Thirty-four cases with nasal polyposis without asthma and history of allergy or atopic disease were enrolled in the study and compared with 20 healthy volunteer controls in respect to asymptomatic food hypersensitivity. Hypersensitivity for 48 kinds of commonly consumed food in Turkey was investigated by an epicutaneuos prick test, Multi-Test II (Lincoln Diagnostic, Inc, USA), using a special applicator. The food allergy test was positive in 25 out of the 34 cases with nasal polyps and in 6 out of the 20 controls. The difference between the two groups was statistically significant (chi2 = 0.000, p < 0.001). The number of skin tests with positive results in patients with nasal polyps ranged from 1 to 37 (mean +/- S.D. = 10.0 +/- 7.9), whereas in the control subjects the range was 1 to 10 (mean +/- S.D. = 4.0 +/- 3.3). The difference in the number of food reactions was also statistically significant. Asymptomatic food hypersensitivity, being immunologically mediated, may be a triggering factor for the pathogenesis of nasal polyps. Therefore, treatment of asymptomatic food allergy in patients with nasal polyps may alleviate symptoms, slow the progress of nasal polyps and prolong the disease-free interval after polypectomy.

Molds in the homes of asthmatic patients in Isparta, Turkey.

This study was planned in order to determine the fungal spores in the air of inside the homes of asthmatic patients living in Isparta (from southwest region of Turkey). The seasonal properties of mold spores in the air of homes of 24 asthmatic and 14 control subjects living in the city of Isparta over a period of one year were investigated. Viable molds were recovered from all 38 houses. Twenty different molds were isolated and identified from the indoor air of the houses in which asthmatic patients and controls lived. The most common isolated genera were Penicillium spp. (27.9%), followed by Cladosporium spp. (26.3%), Aspergillus spp. (14.7%) and Alternaria spp. (13.1%) in the indoor air of the houses of asthmatic patients. No differences in colony numbers were observed between asthmatics and control groups. The percentage of molds was higher in kitchens than other parts of the houses such as living rooms and bedrooms (p < 0.05). A seasonal variety of the fungal flora in Isparta city region was observed. It is concluded that viable molds are common in houses in Isparta. Reducing indoor molds may improve the health of individuals with fungal-induced diseases like asthma.