Subject(s)
Antiprotozoal Agents , COVID-19 , Leishmaniasis, Visceral , Lymphohistiocytosis, Hemophagocytic , Humans , Leishmaniasis, Visceral/complications , Leishmaniasis, Visceral/diagnosis , Leishmaniasis, Visceral/drug therapy , Lymphohistiocytosis, Hemophagocytic/complications , Lymphohistiocytosis, Hemophagocytic/diagnosis , Lymphohistiocytosis, Hemophagocytic/drug therapy , COVID-19/complications , Antiprotozoal Agents/therapeutic useABSTRACT
We describe a 7-year-old child with multisystemic inflammatory syndrome that was temporarily associated with the novel coronavirus disease which evolved into serious illness, with coronary aneurysm, using human immunoglobulin and acetylsalicylic acid, in which clinical manifestations including hepatitis, convulsions, and coma were aggravated with Reye's syndrome. To date, there has been no report of the association of multisystemic inflammatory syndrome that is temporarily associated with the novel coronavirus disease and Reye's syndrome.
ABSTRACT
Congenital cytomegalovirus infection causes lethal diseases with neurological, visual, auditory and systemic injuries, including the hemophagocytic syndrome. Hemophagocytic lymphohistiocytosis (HLH) can be caused by primary hereditary immunological defects, as well as several infectious triggering factors, such as viruses, bacteria and fungus, among them the cytomegalovirus (CMV). Here we present the case report of a male newborn male, delivered by cesarean at term (gestation age of 39 weeks), weighing 3,250 g, with suffusion skin lesions spread throughout the body, anemia, generalized edema, hepatosplenomegaly, thrombocytopenia associated with grunts and difficulty breathing, treated with ganciclovir after receiving the diagnosis of congenital CMV infection. After a few days of hospitalization, the patient presented with high fever, persistent hepatosplenomegaly and pancytopenia, in addition to elevated ferritin and triglycerides, receiving the diagnosis of HLH treated with immunosuppressive therapy, corticosteroids and intravenous human immunoglobulin. The present case report highlights the importance for health professionals to carry out the investigation of congenital diseases, especially in developing countries, as well as their complications, such as HLH.
Subject(s)
Cytomegalovirus Infections/congenital , Cytomegalovirus/isolation & purification , Lymphohistiocytosis, Hemophagocytic/diagnosis , Administration, Intravenous , Adrenal Cortex Hormones/administration & dosage , Cesarean Section , Cytomegalovirus Infections/diagnosis , Cytomegalovirus Infections/drug therapy , Female , Humans , Immunoglobulins/administration & dosage , Infant , Infant, Newborn , Lymphohistiocytosis, Hemophagocytic/complications , Lymphohistiocytosis, Hemophagocytic/drug therapy , Male , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/drug therapy , Treatment OutcomeABSTRACT
O envelhecimento da população é hoje um fenômeno universal e a depressão é um problema de saúde frequente entre os idosos. Objetivos: Determinar a prevalência de depressão em idosos atendidos em ambulatório de geriatria e estabelecer os fatores associados. Metodologia: Foi realizado estudo transversal com aplicação de questionário contendo: variáveis clínicas e epidemiológicas, Escala de Depressão Geriátrica de Yesavage (EDG), WHOQOL-Old e WHOQOL-Abreviado em idosos atendidos no Setor de Geriatria do Programa de Ação Integrada para o Aposentado, de janeiro a abril de 2009, em São Luis-MA. Os dados foram analisados utilizando-se o programa SPSS for Windons 14.0, com aplicação dos testes não-paramétricos adequados, inclusive correlação de Spearman, considerando as diferenças significantes quando P < 0,05. Resultados: Foram avaliados 102 idosos com a idade variando de 60 a 91 anos e a média de 71,5 ± 6,7 anos. A maioria eram mulheres (71,6%), casados (64,8%) e aposentados (87,3%); 38,2% eram hipertensos; 11,8%, diabéticos; 20,6%, com hipertensão e diabetes; 40,2% procuraram atendimento por doença do sistema osteomuscular; 34,3%, do aparelho circulatório e 14,7%, por doenças endócrinas. A EGD variou de 0 a 13, com a média de 6,0 ± 3,9. A prevalência de depressão foi de 50%, sendo grave em 13,7%. Observou-se associação significante entre depressão e idade, sexo, raça e atividade física, refletindo na qualidade de vida dos idosos. Conclusão: A prevalência de depressão foi alta, afetando homens, negros e sedentários, com agravamento conforme avanço da idade e influenciando na piora da qualidade de vida.
