RESUMO
Objective. To identify cases of malaria with unusual presentations. Methods. The medical record of all the cases of malaria admitted to PICU and pediatric general ward from Oct 2006 to Sep 2009, were reviewed and cases with unusual presentations were identified. The study design was retrospective descriptive study. Results. Sixteen (10%) out of 162 malaria cases had unusual presentations - three had hemiplegia, two each with viral hepatitis-like presentation, acute abdomen, gastrointestinal bleed, generalized edema and hyperglycemia and one each with ptosis, severe headache and subacute intestinal obstruction-like presentation. Eleven cases had mixed parasitemia and two each with P. vivax and P. falciparum. One case was diagnosed on clinical grounds. Conclusions. Malaria is a common disease, but both typical and atypical presentations deserve attention for early diagnosis and management.
Assuntos
Abdome Agudo/parasitologia , Adolescente , Criança , Pré-Escolar , Países em Desenvolvimento , Diagnóstico Precoce , Edema/parasitologia , Feminino , Hemorragia Gastrointestinal/parasitologia , Cefaleia/parasitologia , Hemiplegia/parasitologia , Hepatite/parasitologia , Hospitais Universitários , Humanos , Hiperglicemia/parasitologia , Índia , Lactente , Unidades de Terapia Intensiva Pediátrica , Obstrução Intestinal/parasitologia , Malária Falciparum/complicações , Malária Falciparum/diagnóstico , Malária Falciparum/tratamento farmacológico , Malária Vivax/complicações , Malária Vivax/diagnóstico , Malária Vivax/tratamento farmacológico , Masculino , Prontuários Médicos , Plasmodium falciparum/isolamento & purificação , Plasmodium vivax/isolamento & purificação , Estudos Retrospectivos , Hospitais PediátricosRESUMO
We report here a case of pentastomiasis infection in a 3-year-old girl who had high fever, abdominal pain, abdominal tension and anemia. Ultrasound scanning of the abdomen revealed disseminated hyperechoic nodules in the liver and a small amount of ascites. Abdominal MRI showed marked hepatomegaly with disseminated miliary nodules of high signal intensity throughout the hepatic parenchyma on T2-weighted images; retroperitoneal lymphadenopathy and disseminated miliary nodules on the peritoneum were also noted. Chest CT showed scattered small hyperdense nodules on both sides of the lungs. The laparoscopy demonstrated diffuse white nodules on the liver surface and the peritoneum. After the small intestinal wall and peritoneal biopsy, histological examination revealed parenchymal tubercles containing several larvae of pentastomids and a large amount of inflammatory cell infiltration around them. The pathological diagnosis was parasitic granuloma from pentastomiasis infection.
Assuntos
Animais , Pré-Escolar , Feminino , Humanos , Abdome Agudo/parasitologia , Biópsia , Diagnóstico Diferencial , Imageamento por Ressonância Magnética/métodos , Doenças Parasitárias/diagnóstico , Pentastomídeos , Tomografia Computadorizada por Raios X/métodosRESUMO
É relatado um caso de abdome agudo causado por angiostrongilíase abdominal. Um paciente de 42 anos, previamente hígido, apresentou queixa de nove dias de dor abdominal, constipação, disúria, febre e uma massa palpável na fossa ilíaca direita. Uma laparotomia exploradora foi realizada. Após o tratamento cirúrgico o paciente apresentou graves complicações.
Assuntos
Adulto , Animais , Humanos , Masculino , Abdome Agudo/parasitologia , Angiostrongylus cantonensis/imunologia , Anticorpos Anti-Helmínticos/análise , Infecções por Strongylida/complicações , Abdome Agudo/patologia , Abdome Agudo/cirurgia , Ensaio de Imunoadsorção Enzimática , Laparotomia , Infecções por Strongylida/diagnóstico , Infecções por Strongylida/patologia , Infecções por Strongylida/cirurgiaRESUMO
Infestation with Ascaris lumbricoides (roundworm) is very common in the tropics and subtropics. Patients with ascariasis can be asymptomatic or may present with different clinical features in the form of simple nausea, decreased appetite, abdominal pain or more severe bowel obstruction, perforation, intussusception, biliary colic etc. Ultrasonography (USG) can be quick, safe, noninvasive and relatively inexpensive tool in diagnosing the presence of worms and also evaluating response to treatment (1, 2, and 3). Here we present four cases of roundworm infestation presenting with acute abdomen in the emergency department, which were diagnosed by USG and further imaging features of ascariasis on USG is described.