Síndrome antisintetasa con buena respuesta a micofenolato mofetilo / Antisynthetase syndrome with good response to mycophenolate mofetil

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[Multifocal inflammatory pseudotumor of the lung with good response to corticoids]. / Seudotumor inflamatorio multifocal del pulmón con buena respuesta a corticoides.

A 75-year-old woman was admitted to our hospital with persistent fever, productive cough and systemic symptoms of two months' duration. A chest film showed bilateral infiltration in the form of subpleural plaques with multiple satellite nodules in both lung fields. The biopsy specimens taken by thoracoscopy were compatible with inflammatory pulmonary pseudotumor. Lung resection was ruled out because the lesions were bilateral and corticosteroid treatment was instated. The clinical and radiologic response was excellent and the patient was asymptomatic after 30 months of low-dose corticoid therapy.

Nontyphoidal salmonella intracranial infections in HIV-infected patients.

Salmonella focal intracranial infections are unusual in human immunodeficiency virus (HIV)-infected patients. Six such infections have been reported in the world literature. We report a case of salmonella subdural and epidural cerebral empyema with concomitant osteomyelitis of the frontal bone. Such a complication in the course of salmonellosis is reported for the first time. In previously published case reports, four patients had brain abscess and two had subdural empyema. Salmonella typhimurium was isolated from two patients, and different serotypes were recovered from the others. All patients had advanced HIV disease, and all but two had had opportunistic infections before the diagnosis of salmonella intracranial infection. Surgical drainage combined with systemic antibiotic therapy resulted in the recovery of four of five patients. No regression of the lesions occurred in one patient treated only with antibiotics for multiple cerebral abscesses.