ABSTRACT
La Aspergilosis es una infección micótica oportunista que afecta principalmente a pacientes inmunodeprimidos con neutropenia, en quienes produce a menudo enfermedad invasiva de curso fulminante. Las manifestaciones cutáneas de la Aspergilosis son infrecuentes, apareciendo en el 5 a 10% de los casos diseminados. Comunicamos un caso de Aspergilosis en una mujer adulta con neutropenia severa por enfermedad hematológica, con afectación pulmonar y sinusal, que presenta múltiples lesiones ulceronecróticas en piel y mucosas, con evolución fatal. Las lesiones mucocutáneas de la Aspergilosis no son específicas, obligan a varios diagnósticos diferenciales y, como en este caso, la biopsia para estudio histopatológico y micológico es necesaria para el diagnóstico.
Aspergillosis is an opportunistic fungal infection that primarily affects immunocompromised patients with neutropenia, in whom invasive disease often results in fulminant course. Cutaneous manifestations of aspergillosis are rare, occurring in 5-10% of cases scattered. We report a case of aspergillosis in an adult woman with severe neutropenia for hematologic disease, lung and sinus disease, having multiple ulceronecróticas skin lesions and mucous membranes, with fatal outcome. The mucocutaneous lesions of aspergillosis are nonspecific, forcing several differential diagnoses, and as in this case, the biopsy for histopathological and mycological study is required for diagnosis.
Subject(s)
Humans , Female , Middle Aged , Aspergillosis/complications , Aspergillosis/diagnosis , Skin Ulcer/diagnosis , Skin Ulcer/microbiology , Dermatomycoses/diagnosis , Dermatomycoses/microbiology , Skin/pathology , Fatal Outcome , Necrosis/diagnosis , Necrosis/microbiologyABSTRACT
We describe three cases of community-acquired necrotizing pneumonia which were caused by Panton-Valentine leucocidin-producing strains of Staphylococcus aureus (one of them methicillin sensitive). All cases were successfully treated without any sequelae for the patients due to the prompt initiation of adequate antimicrobial therapy. High suspicion toward this fatal pathogen was the key to the successful outcome of the patients.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Bacterial Toxins/biosynthesis , Exotoxins/biosynthesis , Leukocidins/biosynthesis , Pneumonia, Staphylococcal/diagnosis , Staphylococcus aureus/metabolism , Community-Acquired Infections/diagnosis , Community-Acquired Infections/microbiology , Community-Acquired Infections/pathology , Necrosis/microbiology , Necrosis/pathology , Pneumonia, Staphylococcal/microbiology , Pneumonia, Staphylococcal/pathology , Severity of Illness IndexABSTRACT
The objective of this study was to describe the first report involving a case of equine acute myonecrosis caused by C. novyi type A with an emphasis on clinical signs, the pathological and bacteriological analysis, and molecular identification of the microorganisms as the key of the definitive diagnosis.
Subject(s)
Animals , Clostridium Infections/veterinary , Clostridium/classification , Clostridium/isolation & purification , Horse Diseases/diagnosis , Horse Diseases/pathology , Myositis/veterinary , Necrosis/veterinary , Cluster Analysis , Clostridium Infections/diagnosis , Clostridium Infections/microbiology , Clostridium Infections/pathology , DNA, Bacterial/chemistry , DNA, Bacterial/genetics , DNA, Ribosomal/chemistry , DNA, Ribosomal/genetics , Histocytochemistry , Horses , Horse Diseases/microbiology , Myositis/diagnosis , Myositis/microbiology , Myositis/pathology , Necrosis/diagnosis , Necrosis/microbiology , Necrosis/pathology , Phylogeny , /genetics , Sequence Analysis, DNAABSTRACT
The purpose of this study was to investigate the influence of serum and necrotic soft tissue on the antimicrobial activity of intracanal medicaments. The medicaments tested were: calcium hydroxyde/glycerin paste, calcium hydroxide/chlorhexidine paste, calcium hydroxide/camphorated paramonochlorophenol/glycerin paste, and chlorhexidine/zinc oxide paste. Survival of Enterococcus faecalis and Candida albicans exposed to the medicaments tested in the presence or absence of serum or necrotic tissue was monitored in three in vitro experiments where samples for culturing were taken at different time periods. The overall results demonstrated that the antimicrobial activity of all intracanal medicaments tested was slowed down in the presence of necrotic tissue. Calcium hydroxide pastes in glycerin or chlorhexidine were significantly affected by serum. Of the medicaments tested in this study, the least affected was the calcium hydroxide/camphorated paramonochlorophenol/glycerin paste.
O objetivo deste estudo foi avaliar a influência do soro e de tecido mole necrosado na atividade antimicrobiana de medicamentos intra-canais. Os medicamentos testados foram pastas de hidróxido de cálcio/glicerina, hidróxido de cálcio/clorexidina, hidróxido de cálcio/paramonoclorofenol canforado/glicerina e clorexidina/óxido de zinco. A sobrevivência de Enterococcus faecalis e Candida albicans expostos aos medicamentos na presença ou ausência de soro ou tecido necrosado foi monitorada em três experimentos in vitro nos quais amostras para cultura foram avaliadas em diferentes períodos de tempo. No geral, os resultados demonstraram que a atividade antimicrobiana de todos os medicamentos testados foi retardada na presença de soro ou de tecido necrosado. As pastas de hidróxido de cálcio em glicerina ou clorexidina foram significativamente afetadas pelo soro. Dos medicamentos testados, o menos afetado foi a pasta de hidróxido de cálcio/paramonoclorofenol canforado/glicerina.
Subject(s)
Animals , Cattle , Anti-Infective Agents, Local/pharmacology , Candida albicans/drug effects , Dental Pulp Cavity/microbiology , Enterococcus faecalis/drug effects , Root Canal Irrigants/pharmacology , Anti-Infective Agents, Local/chemistry , Colony Count, Microbial , Calcium Hydroxide/chemistry , Calcium Hydroxide/pharmacology , Camphor/chemistry , Camphor/pharmacology , Chlorhexidine/chemistry , Chlorhexidine/pharmacology , Chlorophenols/chemistry , Chlorophenols/pharmacology , Drug Combinations , Glycerol/chemistry , Glycerol/pharmacology , Microbial Sensitivity Tests , Necrosis/microbiology , Root Canal Irrigants/chemistry , Serum , Smear Layer , Zinc Oxide/chemistry , Zinc Oxide/pharmacologyABSTRACT
En las últimas décadas ha sido reportado en varios países un aumento en el número de hospitalizaciones por neumonía bacteriana y también por complicaciones supurativas en niños. Se ha señalado al Streptococcus pneumoniae como el principal agente causal y también se ha advertido un aumento en la resistencia de éste a penicilina; sin embargo, no se ha logrado establecer una relación de causalidad. Se postula que el fenómeno de resistencia no tiene incidencia en la mayor frecuencia de complicaciones observadas y que éstas si podrían tener relación con el serotipo de S. pneumoniae (principalmente serotipos 1, 3 y 14). La neumonía necrotizante o excavada es considerada una complicación grave de la neumonía bacteriana, se asocia a fiebre prolongada, más días de hospitalización y mayor frecuencia de complicaciones (insuficiencia respiratoria, síndrome séptico). En su diagnóstico la radiografía de tórax ha demostrado ser menos sensible que la tomografía. La disminución de la impregnación del medio de contraste del parénquima pulmonar observada por hipoperfusión pueden ir posteriormente a la necrosis. El mecanismo de la necrosis está relacionado con la oclusión trombótica de los capilares alveolares. A pesar que la necrosis y la formación de cavidades pueden comprometer extensas zonas de lóbulos del pulmón, la indicación de resección quirúrgica en niños es excepcional y el seguimiento radiológico muestra resolución completa.