ABSTRACT
Amyotrophic lateral sclerosis is a progressive degenerative neuromuscular disease of insidious onset. It involves upper and lower motor neurons and causes both spastic and atrophic muscular symptoms. More than one fourth of patients have complaints relating to the head and neck (bulbar palsy); thus, the otolaryngologist may be the first physician to see them. In bulbar forms of Amyotrophic Lateral Sclerosis, voice and/or swallowing difficulties are often the initial signs of disturbance. Predominant symptoms are slurred speech, hoarseness, dysphagia, and dyspnea. Muscular weakness, atrophy, and fasciculation are noted on examination. We show a case and revise bibliography.
Subject(s)
Amyotrophic Lateral Sclerosis/complications , Deglutition Disorders/etiology , Voice Disorders/etiology , Female , Humans , Middle AgedABSTRACT
La esclerosis lateral amiotrófica es una enfermedad neuromuscular degenerativa de comienzo insidioso. Afecta a las neuronas superiores e inferiores y causa síntomas espásticos y atróficos. Más de un cuarto de los pacientes tienen sintomatología referida a cabeza y cuello (parálisis bulbar), por lo que el otorrinolaringólogo puede ser el primer médico en diagnosticarlo. En las formas bulbares de esclerosis lateral amiotrófica, las alteraciones en la voz y la deglución son a menudo los síntomas iniciales de la enfermedad. Los sín tomas predominantes son los trastornos del habla, disfonía, disfagia y disnea. Debilidad muscular, atrofia y fasciculaciones pueden encontrarse también en la exploración. Presentamos un caso y revisamos la bibliografía al respecto
Amyotrophic lateral sclerosis is a progressive degenerative neuromuscular disease of insidious onset. It involves upper and lower motor neurons and causes both spastic and atrophic muscular symptoms. More than one fourth of patients have complaints relating to the head and neck (bulbar palsy); thus, the otolaryngologist may be the first physician to see them. In bulbar forms of Amyotrophic Lateral Sclerosis, voice and/or swallowing difficulties are often the initial signs of disturbance. Predominant symptoms are slurred speech, hoarseness, dysphagia, and dyspnea. Muscular weakness, atrophy, and fasciculation are noted on examination
Subject(s)
Male , Middle Aged , Humans , Deglutition Disorders/etiology , Voice Disorders/etiology , Amyotrophic Lateral Sclerosis/diagnosis , Evoked PotentialsABSTRACT
Nasal tuberculosis represents a rare manifestation of infection by Mycobacterium tuberculosis. Clinically, it appeared to resemble cancer presenting as a nasopharyngeal mass with concomitant enlarged lymph nodes. It is important to consider tuberculosis in the differential diagnosis of all nasopharyngeal lesions and take biopsy samples for histological and bacteriological studies. Antituberculosis treatment is satisfactory with standard anti-tuberculous chemotherapy. Although this is a rare finding, it should be considered when a patient presents with nasal obstruction.
Subject(s)
Nasal Obstruction/etiology , Nasopharyngeal Diseases/diagnosis , Tuberculosis/diagnosis , Diagnosis, Differential , Female , Humans , Middle Aged , Nasopharyngeal Diseases/microbiologyABSTRACT
La tuberculosis nasal primaria es la afectación exclusiva nasal de la infección por el Micobacterium tuberculosis. La puerta de entrada es nasal ante el fracaso de las barreras defensivas nasales. Es muy infrecuente y variable clínicamente pudiendo confundirse con enfermedades granulomatosas nasales y con procesos neoplásicos, por lo que es importante la sospecha clínica y el diagnóstico diferencial. Su tratamiento es la misma quimioterapia antituberculosa que en la forma clásica pulmonar siendo excelente la respuesta al tratamiento (AU)
Nasal tuberculosis represents a rare manifestation of infection by Mycobacterium tuberculosis. Clinically, it appeared to resemble cancer presenting as a nasopharyngeal mass with concomitant enlarged lymph nodes. It is important to consider tuberculosis in the differential diagnosis of all nasopharyngeal lesions and take biopsy samples for histological and bacteriological studies. Antituberculosis treatment is satisfactory with standard anti-tuberculous chemotherapy. Although this is a rare finding, it should be considered when a patient presents with nasal obstruction (AU)
Subject(s)
Middle Aged , Female , Humans , Tuberculosis/diagnosis , Nasopharyngeal Diseases/diagnosis , Nasal Obstruction/etiology , Diagnosis, DifferentialABSTRACT
The Riedel's thyroiditis is a chronic inflammatory disease of the thyroid gland characterized by a process of fibrosis that destroys the gland partially, extending to the adjacent cervical structures. Its origin is unknown, although there are several theories in this respect. The clinical manifestations are not specific and it confuses frequently with neoplasia or infection, like a hard and painless thyroid mass that causes compressive symptoms. In this work, we report a case with lethal outcome.
Subject(s)
Thyroiditis/diagnostic imaging , Thyroiditis/pathology , Aged , Fatal Outcome , Female , Humans , Radiography, Thoracic/methods , UltrasonographyABSTRACT
La tiroiditis de Riedel es una enfermedad inflamatoria crónica de la glándula tiroides caracterizada por un proceso de fibrosis invasiva que destruye parcialmente la glándula, extendiéndose a las estructuras cervicales adyacentes. Su origen es desconocido, aunque hay varias teorías al respecto. Las manifestaciones clínicas no son específicas y se confunde frecuentemente con neoplasia o infección, ya que aparece una masa tiroidea dura e indolora que produce síntomas compresivos. En este trabajo, presentamos un caso con evolución letal (AU)
The Riedel's thyroiditis is a chronic inflammatory disease of the thyroid gland characterized by a process of fibrosis that destroys the gland partially, extending to the adjacent cervical structures. Its origin is unknown, although there are several theories in this respect. The clinical manifestations are not specific and it confuses frequently with neoplasia or infection, like a hard and painless thyroid mass that causes compressive symptoms. In this work, we report a case with lethal outcome (AU)
Subject(s)
Aged , Female , Humans , Thyroiditis/pathology , Radiography, Thoracic/methods , Fatal Outcome , UltrasonographyABSTRACT
El Rhodococcus equies un bacilo aerobio gram positivo pleomórfico, que fue aislado por primera vez como productor de bronconeumonía en caballos jóvenes. Cada vez con mayor frecuencia, está siendo reconocido como patógeno en humanos, sobre todo en la población inmunocomprometida. Describimos un caso, hasta ahora excepcional, de infección laríngea por Rhodococcus equi en un paciente con serología positiva para el virus de la inmunodeficiencia humana (VIH), y revisamos algunas características clínicas y epidemiológicas de las infecciones por este germen. El tratamiento es rifampicina y/o eritromicina, siendo el pronóstico malo, pues suelen ser pacientes inmunocomprometidos (AU)
The Rhodococcus equi is an aerobic gram positive pleomorphic bacillus, that was isolated for the first time like a producer of bronchopneumonia in young horses. Every time more often, it is being recognized as a pathogen in humans, mainly in the immunodepressed population. We described a case, until now exceptional, of laryngeal infection by Rhodococcus equi in a patient with positive serology for the virus of the human immunodeficiency (HIV), and we reviewed some clinical and epidemiological characteristics of the infections by this germ. The treatment is riphampicine and/or erythromycin, being the prognosis bad, because usually they are immunodepressed patients (AU)
Subject(s)
Adult , Male , Humans , Rhodococcus equi/isolation & purification , Antibiotics, Antitubercular , Acquired Immunodeficiency Syndrome/complications , Actinomycetales Infections/microbiology , Laryngeal Mucosa , Laryngitis/complications , Rifampin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Erythromycin/therapeutic use , Drug Therapy, CombinationABSTRACT
The Rhodococcus equi is an aerobic gram positive pleomorphic bacillus, that was isolated for the first time like a producer of bronchopneumonia in young horses. Every time more often, it is being recognized as a pathogen in humans, mainly in the immunodepressed population. We described a case, until now exceptional, of laryngeal infection by Rhodococcus equi in a patient with positive serology for the virus of the human immunodeficiency (HIV), and we reviewed some clinical and epidemiological characteristics of the infections by this germ. The treatment is riphampicine and/or erythromycin, being the prognosis bad, because usually they are immunodepressed patients.
