ABSTRACT
Abstract: Background: Erythema nodosum leprosum may appear before, during or after treatment of leprosy and is one of the main factors for nerve damage in patients. When it occurs or continues to occur after treatment, it may indicate disease recurrence and a new treatment may be instituted again. Objective: To evaluate the retreatment of patients with multibacillary leprosy who underwent standard treatment with multidrug therapy, but developed or continued to present reactions of erythema nodosum leprosum and/or neuritis 3-5 years after its end. Method: For this objective, a new treatment was performed in 29 patients with multibacillary leprosy who maintained episodes of erythema nodosum and/or neuritis 3-5 years after conventional treatment. Results: In general, we observed that 27 (93.10%) had no more new episodes after a follow up period of eight months to five years. In five of these patients the reason for the retreatment was the occurrence of difficult-to-control neuritis, and that has ceased to occur in all of them. Study limitations: Small number of patients.. Conclusion: In the cases observed, retreatment was an effective measure to prevent the occurrence of erythema nodosum leprosum and/or persistent neuritis.
Subject(s)
Humans , Male , Female , Leprosy, Lepromatous/drug therapy , Erythema Nodosum/drug therapy , Leprosy, Multibacillary/drug therapy , Neuritis/drug therapy , Recurrence , Time Factors , Leprosy, Lepromatous/microbiology , Treatment Outcome , Retreatment , Erythema Nodosum/microbiology , Leprosy, Multibacillary/microbiology , Leprostatic Agents/therapeutic use , Neuritis/microbiologyABSTRACT
Establecer el diagnóstico de tuberculosis (TBC) en niños no es fácil. Muchas de sus manifestaciones son inespecíficas, por lo que requiere alto índice de sospecha. Mas aún, en nuestro medio, la TBC es una condición infrecuente. Este artículo brinda una revisión en torno a los conceptos contacto y primoinfección, ilustrando de manera breve algunos escenarios clínicos como TBC pulmonar primaria progresiva, TBC ósea y eritema nodoso de nuestra práctica diaria.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/transmission , Erythema Nodosum/diagnosis , Erythema Nodosum/microbiology , Mycobacterium tuberculosis , Tuberculosis, Osteoarticular/diagnosis , Tuberculosis, Osteoarticular/microbiology , Tuberculosis, Pulmonary/microbiologyABSTRACT
We encountered a case of tuberculous lymphadenitis with erythema nodosum presenting with an unusual manifestation as subungual erythema in all the digits. Relevant literature and the possible explanation for the subungual erythema have been discussed.
Subject(s)
Adolescent , Arthritis, Reactive/microbiology , Erythema Nodosum/microbiology , Female , Humans , Nail Diseases/microbiology , Tuberculosis, Lymph Node/diagnosisABSTRACT
O eritema nodoso hansênico é evento inflamatório agudo no curso crônico da hanseníase. É considerado evento de base imunológica e importante causa de morbidade e incapacidade física. Avaliou-se o perfil clínico, sorológico e histopatológico de 58 pacientes com eritema nodoso hansênico recrutados sequencialmente entre julho-dezembro de 2000, em área urbana hiperendêmica do Brasil Central (Estado de Goiás). A metade dos pacientes apresentava quadro reacional grave, e em 66 por cento dos casos o primeiro episódio reacional ocorreu durante tratamento específico. A maioria dos casos com eritema nodoso hansênico e dos controles apresentaram reatividade para IgM anti-PGL I. Os achados histopatológicos mais freqüentes no eritema nodoso hansênico foram infiltrado neutrofílico, paniculite, vasculite e agressão neural. Dos pacientes com eritema nodoso hansênico, 96 por cento usaram corticosteróide sistêmico no primeiro episódio. Os casos de eritema nodoso hansênico estavam associados à neurite e raramente usaram talidomida como medicação isolada nos serviços de saúde.