RESUMO
Cryptococcal infection is not frequent in immunocompetent patients. The most commonly involved sites are the lungs and the central nervous system. Cryptococcal osteomyelitis occurs in 5-10 percent of patients with disseminated cryptococcosis with few reports of cryptococcal arthritis in elderly adults. We describe the case of a 92-year-old woman with a Cryptococcus neoformans knee joint infection associated to osteomyelitis.
La infección por Cryptococcus neoformans es infrecuente, los sitios más comunes de presentación son pulmón y SNC. La osteomielitis criptococóccica ocurre en 5 a 10 por ciento de los pacientes con criptococcosis diseminada. La mayoría de casos ocurre entre 21 y 59 años de edad, hay pocos reportes de artritis criptococóccica en adultos mayores.
Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Artrite Infecciosa/microbiologia , Criptococose/diagnóstico , Cryptococcus neoformans/isolamento & purificação , Antifúngicos/uso terapêutico , Artrite Infecciosa/diagnóstico , Artrite Infecciosa/tratamento farmacológico , Criptococose/tratamento farmacológico , Fluconazol/uso terapêuticoRESUMO
Anti-endothelial cell autoantibodies (AECA), first described more then 30 years ago, represent a heterogeneous group of autoantibodies directed against poorly characterized antigens located in endothelial cell membranes, and have been reported in a variety of sistemic diseases. Although most of the target antigens for AECA are still not well identified, and AECA have been considered an epiphenomenon of vascular injury, new evidence suggests a pathogenic role, specially by inducing endothelial cell activation and apoptosis. The presence of AECA has been correlated with disease activity in SLE and systemic vasculitis such as Wegener's granulomatosis, Takayasu arteritis, and behçet's disease, and they could be valuable markers of disease activity. Other potential areas of clinical interest in diseases associated to AECA could be the serum thrombomodulin level, as marker of endothelial cell injury in neuropsychiatric lupus, and other vasculitides; and the determination of anti-heat shock protein antibodies including the Hsp60, as a new, non traditional risk factor for atherosclerosis in patient with lupus.