Résumé
Abstract Snakebites were included by the World Health Organization in their list of neglected diseases. In Latin America, most snakebites are caused by species of the Viperidae family, notably by the genus Bothrops. Bothrops atrox accounts for 90% of the cases of envenoming in the Brazilian Amazon. In this report, we present a series of three cases of snakebites that evolved with hemorrhagic stroke due to delays in the access to antivenom in the Brazilian Amazon, being fundamental for diagnosis to validate the clinical suspicion and make decisions that would improve the treatment and prognosis of the patients.
Sujets)
Humains , Animaux , Mâle , Femelle , Adolescent , Adulte , Sujet âgé , Jeune adulte , Morsures de serpent/complications , Accident vasculaire cérébral/étiologie , Hémorragies intracrâniennes/étiologie , Venins de crotalidé/toxicité , Morsures de serpent/traitement médicamenteux , Brésil , Sérums antivenimeux/usage thérapeutique , BothropsRésumé
Here, we describe a case of acute disseminated encephalomyelitis (ADEM) that occurred during a plausible risk interval following inactivated influenza vaccination in a previously healthy 27-year-old man from Manaus, Brazil. He was treated with intravenous methylprednisolone and immunoglobulin. One-month follow-up revealed resolution of the brain lesions, but not of the spinal cord lesions. No recurrence or progression of the main neurological symptoms was observed. After two years of monitoring, the patient continues to experience weak lower limbs and urinary retention. Thus, we recommend that ADEM should be considered in a patient presenting with neurological symptoms after influenza vaccination.
.Sujets)
Adulte , Humains , Mâle , Encéphalomyélite aigüe disséminée/étiologie , Vaccins antigrippaux/effets indésirables , Encéphalomyélite aigüe disséminée/diagnostic , Imagerie par résonance magnétiqueRésumé
We present a patient with Paracoccidioidomycosis/HIV coinfection which has been investigated because of chronic monoarthritis and mucocutaneous lesions. A biopsy of the synovial membrane and skin revealed structures consistent with Paracoccidioides brasiliensis. At diagnosis, the count of CD4 + T cells was 44 cells/mm3. We emphasize the importance of clinical suspicion of Paracoccidioidomycosis in patients with HIV/AIDS who live in or are from risk areas.