ABSTRACT
We report a case of abdominal actinomycosis, a chronic suppurative infection caused by bacteria of the genus Actinomyces, simulating colon cancer, and presenting with abdominal pain and leukocytosis. Computed tomography revealed a mass lesion with irregular contours, infiltrative aspect, with extension to omental fat and abdominal wall, in the transverse colon. A surgical intervention was performed due to the suspicious of a colonic tumor. In the post-operative period, anatomopathological examination showed suppurative nodules associated with actinomycetes colonies, confirming the diagnosis of abdominal actinomycosis. After surgery, the patient was submitted to antibiotic treatment and no relapse was observed.
Reportamos un caso de actinomicosis abdominal, una infección supurativa crónica causada por bacterias del genero Actinomyces, que simula el cáncer de colon y se manifiesta con dolor abdominal y leucocitosis. La tomografía computada reveló una lesión sólida con contornos irregulares y aspecto infiltrativo en el colon transverso, con extensión al epiplón y la pared abdominal. La intervención quirúrgica fue realizada debido a la sospecha de un tumor de colon. En el posoperatorio, el examen anatomopatológico mostró la presencia de nódulos supurativos asociados con colonias de actinomicetos, lo que confirma el diagnóstico de actinomicosis abdominal. Posteriormente a la cirugía el paciente recibió antibioticoterapia y no presentó Recidivas.
Subject(s)
Abdominal Wall , Actinomycosis , Colonic Neoplasms , Abdominal Pain/etiology , Actinomycosis/diagnosis , Colonic Neoplasms/complications , Colonic Neoplasms/diagnosis , Humans , Neoplasm Recurrence, LocalABSTRACT
Neuronal nitric oxide synthase (nNOS) is expressed in the cardiovascular system and besides NO, generates H2O2. nNOS has been proposed to contribute to the control of blood pressure in healthy humans. The aim of this study was to verify the hypothesis that nNOS can contribute to the control of vascular relaxation and blood pressure in hypertensive patients undergoing drug treatment. The study was conducted in resistance mesenteric arteries from 63 individuals, as follows: 1) normotensive patients; 2) controlled hypertensive patients (patients on antihypertensive treatment with blood pressure normalized); 3) uncontrolled hypertensive patients (patients on antihypertensive treatment that remained hypertensive). Only mesenteric arteries from uncontrolled hypertensive patients showed impaired endothelium-dependent vasorelaxation in response to acetylcholine (ACh). Selective nNOS blockade with inhibitor 1 and catalase, which decomposes H2O2, decreased vasorelaxation in the three groups. However, the inhibitory effect was greater in controlled hypertensive patients. Decreased eNOS expression was detected in both uncontrolled and controlled hypertensive groups. Interestingly nNOS expression and ACh-stimulated H2O2 production were greater in controlled hypertensive patients, than in the other groups. ACh-stimulated NO production was lower in controlled hypertensive when compared to normotensive patients, while uncontrolled hypertensive patients showed the lowest levels. Catalase and nNOS blockade inhibited ACh-induced H2O2 production. In conclusion, nNOS-derived H2O2 contributes to the endothelium-dependent vascular relaxation in human resistance mesenteric arteries. The endothelial dysfunction observed in uncontrolled hypertensive patients involves decreased eNOS expression and NO production. The normalization of vascular relaxation and blood pressure in controlled hypertensive patients involves increased nNOS-derived H2O2 and NO production.
