RESUMEN
Vasculitic midline destructive lesions can be a complication of cocaine use. We report a 44-year-old man who presented with a two months history of left facial pain associated with ipsilateral facial paralysis and a cheek phlegmon. Magnetic resonance imaging showed broad soft tissue destruction linked to important cranial nerve involvement. Antibiotic and antifungal therapy was started and multiple surgical debridement procedures were performed, with no clinical improvement. Microbiological analysis was negative. Finally, thanks to the histologic findings corresponding to vasculitis and granuloma formation and the history of cocaine abuse, a cocaine induced midline destructive lesion was diagnosed.
Asunto(s)
Humanos , Masculino , Adulto , Enfermedades Nasales/diagnóstico , Enfermedades Nasales/inducido químicamente , Trastornos Relacionados con Cocaína/complicaciones , Tabique Nasal/efectos de los fármacos , Imagen por Resonancia Magnética , Tomógrafos Computarizados por Rayos X , Granulomatosis con Poliangitis/diagnóstico , Enfermedades Nasales/terapia , Diagnóstico Diferencial , Antibacterianos/clasificación , Antibacterianos/uso terapéuticoRESUMEN
Although gastrointestinal symptoms are not rare in Systemic lupus erythematosus, enteritis is an atypical manifestation of the disease. We report a 54 year-old woman who presented acute symptoms of diarrhea, fever and abdominal pain, receiving empiric antibiotic therapy for bacterial enteritis with no response. Computed tomography showed diffuse small intestine inflammation and serositis. Antinuclear antibodies, anti-Ro and anti-La were positive on blood tests. A lupic enteropathy was diagnosed and steroid treatment was initiated, with subsequent clinical improvement.