RESUMO
A mycotic aneurysm is a localized, irreversible arterial dilatation resulting from destruction of the vessel wall by infection. Pathogens causing mycotic aneurysms include Gram-positive and -negative bacteria, mycobacteria, and fungi. Klebsiella pneumoniae is a common pathogen causing urinary tract infections, nosocomial pneumonia, soft tissue infection, pyogenic liver abscesses, and endophthalmitis, while mycotic aneurysms caused by K. pneumoniae are rare. Recently, the number of cases of endogenous K. pneumoniae endophthalmitis associated with K. pneumoniae-induced pyogenic liver abscesses has increased in Southern Asia, but there have been no reports of K. pneumoniae mycotic aneurysms accompanied by endophthalmitis. Here, we report the case of a man who had a K. pneumoniae mycotic aneurysm accompanied by endophthalmitis and, ultimately, lost sight in both eyes. The early diagnosis of associated endophthalmitis requires a high index of suspicion by the physician.
Assuntos
Aneurisma Infectado , Aorta , Ásia , Bactérias , Dilatação , Diagnóstico Precoce , Endoftalmite , Olho , Fungos , Glicosaminoglicanos , Klebsiella , Klebsiella pneumoniae , Abscesso Hepático Piogênico , Pneumonia , Infecções dos Tecidos Moles , Infecções UrináriasRESUMO
Hepatitis A is generally known as a mild, self-limiting disease of the liver, but in rare instances it can progress to fulminant hepatitis, which may require liver transplantation for recovery. Such cases are known to be related to old age and underlying liver disease. We report four cases of hepatitis A in which patients presented with fulminant hepatitis and acute renal failure and underwent liver transplantation. The following common features were observed in our cases: (1) occurrence in relatively old age (> or =39 years old), (2) association with acute renal failure, (3) presence of hepatomegaly, and (4) microscopic features of submassive hepatic necrosis.
Assuntos
Adulto , Feminino , Humanos , Masculino , Fatores Etários , Hepatite/complicações , Hepatite A/complicações , Hepatomegalia/diagnóstico , Injúria Renal Aguda/complicações , Fígado/patologia , Cirrose Hepática/diagnóstico , Transplante de Fígado , Tomografia Computadorizada por Raios XRESUMO
Papillary fibroelastomas are rare, benign primary heart neoplasms that mainly affect the heart valves. These neoplasms have the potential to cause serious, life threatening thromboembolic complications. Here we present the case of a 60-year-old asymptomatic woman with an aortic valve mass that was incidentally discovered via transthoracic echocardiography. There was no evidence of systemic thromboembolism. The mass was surgically excised and histologic examination led to a final diagnosis of papillary fibroelastoma.