ABSTRACT
UNLABELLED: The superantigenic properties of Staphylococcus aureus have been implicated in increasing the inflammatory process in airway diseases. Local formation of IgE antibodies against staphylococcal enterotoxins by secondary lymphoid tissue in nasal polyps has been demonstrated. Staphylococcus aureus is known to colonize the nasal mucosa, and has been found invading the nasal submucosa and intracellularly. OBJECTIVE: To evaluate the limits of Staphylococcus aureus invasion in the upper airway. MATERIAL AND METHODS: Inferior turbinate samples from 3 patients without sinus disease, 6 ethmoid samples from patients with chronic rhinosinusitis with nasal polyposis, and 6 ethmoid samples from patients with chronic rhinosinusitis without nasal polyposis were studied. A fluorescein-labeled PNA probe against Staphylococcus aureus was used to test for the presence of the bacterium in bone (after decalcification) and mucosa. RESULTS: We found Staphylococcus aureus invading the nasal submucosa in patients with nasal polyposis, but no cases of Staphylococcus aureus positivity in bone. In conclusion, we cannot support the hypothesis of nasal bone as a reservoir for Staphylococcus aureus, releasing massive amounts of staphylococcal enterotoxins and eliciting an inflammatory reaction, as occurs with the nasal mucosa.
Subject(s)
Disease Reservoirs/microbiology , Ethmoid Bone/microbiology , Rhinitis/microbiology , Sinusitis/microbiology , Staphylococcus aureus/isolation & purification , Chronic Disease , Endotoxins/immunology , Humans , Immunohistochemistry , Nasal Mucosa/microbiology , Nasal Polyps/microbiology , Staphylococcus aureus/immunology , Superantigens/immunologyABSTRACT
O carcinoma basocelular metastático é raro, sua incidência varia de 0,0028 a 0,5 por cento. Os fatores de risco para metástases são: a) reoperações prévias; b) radioterapia prévia; c)diâmetro da lesão maior do que 5 cm; d) tempo de evolução maior do que cinco anos; e) tipo histológico metatípico ou esclerosante; f) grau acentuado de angiogênese. O prognóstico desses pacientes mostra-se reservado, principalmente quando a metástase ocorre a distância. Os autores descrevem um caso de carcinoma basocelular metástico que ilustra os fatores de risco acima descritos. Paciente de 46 anos, da raça branca, com tempo de evolução longo, várias intervenções cirúrgicas prévias, lesão extensa e submetido a radioterapia. Portanto, todo paciente com carcinoma basocelular deve ser avaliado quanto aos fatores de risco e ser seguido atendtamente após o tratamento cirúrgico da lesão primária com radicalidade oncológica
