RESUMO
A 25-year-old female with transfusion-associated acquired immunodeficiency syndrome (AIDS) treated with zidovudine (AZT) developed cervical lymph node enlargement. The histological study disclosed granulomas and the culture revealed M. tuberculosis. The patient was treated with isoniazid, rifampicin and pirazynamide and the lymphadenomegaly resolved. Five years later, with a CD4 cell count of 245, the lymph node enlargement reappeared, the biopsy and special studies confirming tuberculosis (TB). She was then given cirpofloxacin, azithromicin, ethambutol, amikacin and pirazyn amide without success. In two instances the enlarged nodes were surgically removed. Facing progressive osbtruction of both the airway and the esophagus, localized radiotheraphy (1800 cGy in nine fractions) to the right aspect of the neck was delivered with dramatic resolution of the node elargement; however, dissemination of the infection leading to a severe lung infiltration and respiratory failure ended the life of the patient
Assuntos
Adulto , Humanos , Feminino , Amicacina/uso terapêutico , Azitromicina/uso terapêutico , Western Blotting , Linfócitos T CD4-Positivos/imunologia , Ciprofloxacina/uso terapêutico , Etambutol/uso terapêutico , Anticorpos Anti-HIV/imunologia , Pirazinamida/uso terapêutico , Radioterapia , Síndrome da Imunodeficiência Adquirida/complicações , Tuberculose Resistente a Múltiplos Medicamentos/etiologia , Zidovudina/uso terapêuticoRESUMO
Se comentan las dificultades para establecer un diagnóstico específico de las alteraciones hipofisarias según las manifestaciones clínicas; se propone una serie de modalidades radiológicas diagnósticas disponibles en la actualidad, con insistencia particular en las ventajas de cada una de ellas, y se hace hincapié en la necesidad de establecer una relación estrecha entre radiólogos y clínicos para la aplicación y la interpretación de estos estudios de obtención de imágenes