RESUMO
Henoch-Schonlein purpura (HSP) is a vasculitis of the small vessels of the skin, joints, gastrointestinal tract, and kidneys characterized by immunoglobulin A deposits in the involved organs. HSP is typified by the classic tetrad of purpura, arthralgia, abdominal pain, and renal involvement. It is common in childhood, but may also occur in adults and can be accompanied by severe complications. Gastrointestinal symptoms occur in up to 85% of patients, and gastrointestinal involvement can manifest as severe problems including intussusception, obstruction, and perforation. The disease course is often self-limited, but severe manifestations occasionally require surgical intervention. We report the case of a 24-year-old man with HSP who presented with abdominal pain and vomiting. Computerized tomography revealed thickening of the ileal wall and multifocal disrupted prominent mucosal enhancement. These findings suggested hemorrhagic enteritis and mucosal necrosis. After treatment with high dose corticosteroids, the lesion improved and surgical intervention was avoided. Our experience suggests that corticosteroid therapy may help in controlling HSP with suspicious small bowel necrosis.
Assuntos
Adulto , Humanos , Adulto Jovem , Dor Abdominal , Corticosteroides , Artralgia , Enterite , Trato Gastrointestinal , Imunoglobulina A , Intussuscepção , Articulações , Rim , Necrose , Púrpura , Vasculite por IgA , Pele , Esteroides , Vasculite , Vasculite Leucocitoclástica Cutânea , VômitoRESUMO
The epidemiology of Group B streptococcal disease has been changing. Since the 1990s, early-onset neonatal and maternal peripartum infections have decreased, due to the administration of prophylactic intrapartum antibiotics. On the other hand, invasive Group B streptococcal infections have increased in nonpregnant adults, especially in elderly persons and in those with chronic immunosuppressive diseases, such as diabetes mellitus, liver cirrhosis, and malignancies. Although infective endocarditis is an uncommon manifestation of invasive Streptococcus agalactiae infection, it usually leads to cardiac surgery, due to heart failure associated with rapid valve destruction and the formation of emboli. Several cases of endocarditis due to S. agalactiae have appeared in the literature, but there have been few reports in Korea. We present a case of S. agalactiae infective endocarditis in an elderly patient with advanced gastric cancer, successfully treated with intravenous antibiotics and cardiac surgery.
Assuntos
Adulto , Idoso , Humanos , Antibacterianos , Diabetes Mellitus , Endocardite , Endocardite Bacteriana , Mãos , Insuficiência Cardíaca , Coreia (Geográfico) , Cirrose Hepática , Período Periparto , Neoplasias Gástricas , Infecções Estreptocócicas , Streptococcus , Streptococcus agalactiae , Cirurgia TorácicaRESUMO
The epidemiology of Group B streptococcal disease has been changing. Since the 1990s, early-onset neonatal and maternal peripartum infections have decreased, due to the administration of prophylactic intrapartum antibiotics. On the other hand, invasive Group B streptococcal infections have increased in nonpregnant adults, especially in elderly persons and in those with chronic immunosuppressive diseases, such as diabetes mellitus, liver cirrhosis, and malignancies. Although infective endocarditis is an uncommon manifestation of invasive Streptococcus agalactiae infection, it usually leads to cardiac surgery, due to heart failure associated with rapid valve destruction and the formation of emboli. Several cases of endocarditis due to S. agalactiae have appeared in the literature, but there have been few reports in Korea. We present a case of S. agalactiae infective endocarditis in an elderly patient with advanced gastric cancer, successfully treated with intravenous antibiotics and cardiac surgery.
Assuntos
Adulto , Idoso , Humanos , Antibacterianos , Diabetes Mellitus , Endocardite , Endocardite Bacteriana , Mãos , Insuficiência Cardíaca , Coreia (Geográfico) , Cirrose Hepática , Período Periparto , Neoplasias Gástricas , Infecções Estreptocócicas , Streptococcus , Streptococcus agalactiae , Cirurgia TorácicaRESUMO
Acute human immunodeficiency virus (HIV) syndrome develops in 40 to 90% of new HIV-1 infections. In Korea, recent increases in HIV-1 infection rates suggest that the number of patients experiencing acute HIV syndrome will also increase. Furthermore, it has been reported that aseptic meningitis occurs in 24% of patients with acute HIV syndrome. The inclusion of acute HIV syndrome in the differential diagnosis of aseptic meningitis is crucial; however, few reports of acute HIV syndrome presenting as aseptic meningitis in Korea exist. Here we report a case of aseptic meningitis in a patient who received early antiretroviral therapy after a diagnosis of acute HIV syndrome.
Assuntos
Humanos , Diagnóstico Diferencial , HIV , Infecções por HIV , HIV-1 , Coreia (Geográfico) , Meningite , Meningite AssépticaRESUMO
Acute human immunodeficiency virus (HIV) syndrome develops in 40 to 90% of new HIV-1 infections. In Korea, recent increases in HIV-1 infection rates suggest that the number of patients experiencing acute HIV syndrome will also increase. Furthermore, it has been reported that aseptic meningitis occurs in 24% of patients with acute HIV syndrome. The inclusion of acute HIV syndrome in the differential diagnosis of aseptic meningitis is crucial; however, few reports of acute HIV syndrome presenting as aseptic meningitis in Korea exist. Here we report a case of aseptic meningitis in a patient who received early antiretroviral therapy after a diagnosis of acute HIV syndrome.
Assuntos
Humanos , Diagnóstico Diferencial , HIV , Infecções por HIV , HIV-1 , Coreia (Geográfico) , Meningite , Meningite AssépticaRESUMO
Catamenial hemoptysis is a rare condition that's characterized by recurrent hemoptysis occurring in association with menstruation, and this is associated with the presence of intrapulmonary or endobronchial endometrial tissue. The diagnosis of pulmonary endometriosis can be made according to a typical clinical history and with exclusion of other causes of recurrent hemoptysis. Treatment of pulmonary endometriosis can be medical or surgical; however, the optimal management of this condition is still a matter of debate. Medical therapy may be problematic, due to recurrence of symptoms despite hormonal ablation, and adverse effects from long-term hormone therapy can also be a problem. We report here on a case of pulmonary endometriosis in a 23-year-old woman who presented with hemoptysis that occurred during the first 3 days of menstruation, and this happened over a 4 month period. She was successfully treated by video-assisted thoracoscopic surgery (VATS). No more hemoptysis was noted during 12 months of follow-up.