ABSTRACT
During the SARS-CoV-2 pandemic, various rashes associated with COVID-19 infection have been reported, including urticaria. Urticaria is a limited and usually benign condition, presenting as pruritic wheals, with or without edema. A 39-year-old woman presented with a pruritic rash on her arms spreading to her trunk and face over two days, followed by headache, nausea, vomiting, abdominal discomfort, diarrhea, myalgia, arthralgia, anosmia, and dyspepsia for three days. Fever, dry cough, and odynophagia started on the day of the consult. The patient had a history of hypertension but denied a history of atopic conditions, similar previous presentations, or recent ingestion of new medications. SARS-CoV-2 COVID-19 PCR testing was positive. She was prescribed oral antihistamine for the itching and was discharged. During a follow-up after two weeks, the patient was asymptomatic with complete resolution of the rash on day 7 of symptoms. Knowing the cutaneous manifestations of COVID-19 can aid in the early identification of this disease and prevent misdiagnosis. The presence of cutaneous manifestations in COVID-19 is suggested to be related to disease severity, but data are needed to study any prognostic value of dermatologic manifestations in COVID-19.
ABSTRACT
ABSTRACT Aggressive angiomyxoma (AAM) is a rare infiltrative tumor of mesenchymal origin that has high rates of local recurrence. We present the case of a 42-year-old patient with a lump in the vaginal canal, treated with excisional biopsy. Histopathologic evaluation revealed myxoid spindle-cell proliferation in the subepithelial region, and immunohistochemical analysis was positive for CDK4, CD34, desmin, estrogen and progesterone receptors. The markers S100 and smooth muscle actin were negative, what corroborated the diagnosis of AAM. Because of its high recurrence rates, we opted for outpatient follow-up during the two subsequent years.
RESUMO O angiomixoma agressivo (AA) é uma neoplasia rara de origem mesenquimal, caráter infiltrativo e altas taxas de recidiva local. Apresentamos o caso de uma paciente de 42 anos com nódulo no canal vaginal, submetida à biópsia excisional. A avaliação histopatológica demonstrou proliferação fusocelular mixoide na região subepitelial, e a análise imuno-histoquímica revelou positividade para CDK4, CD34, desmina e receptores de estrogênio e progesterona. Os marcadores S100 e actina de músculo liso foram negativos, o que corroborou o diagnóstico de AA. Devido às altas taxas de recidiva, optou-se por acompanhamento ambulatorial pelos dois anos subsequentes.
ABSTRACT
Acinetobacter are among the most common bacteria isolated in hospital infections, especially in developing countries. Multi-drug, extended-drug or pan-drug resistance makes treatment a real medical challenge. In the present review, the authors describe clinical and experimental data in order to present different current and potential future strategies to treat infections caused by multi-drug-resistant Acinetobacter. The therapeutic options for carbapenem-resistant Acinetobacter are scarce, and the current options have poor pharmacokinetic aspects and several side effects. Combined therapy has been an alternative for multi-drug-resistant Acinetobacter. However, this issue is always controversial. In some studies combined therapy has shown superiority for some strains of Acinetobacter in animal models and in vitro studies. However, studies with humans are scarce and too poor quality to suggest the best approach for the treatment of infections caused by multi-drug-resistant Acinetobacter baumannii.
Subject(s)
Acinetobacter Infections/drug therapy , Acinetobacter Infections/microbiology , Acinetobacter baumannii/drug effects , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/pharmacology , Drug Resistance, Multiple, Bacterial , HumansABSTRACT
The aim of this study is to determinate the prevalence of oropharyngeal colonization by group A beta-hemolytic Streptococcus (GABHS) in pediatric population of Ponta Grossa, a midsize city of southern Brazil; estimate the effectiveness of antistreptolysin-O (ASO), compared to culture, in presence of infection; and design an unpublished investigative algorithm of rheumatic fever's suspicion, based on needs identified in worldwide consensus. It is an epidemiologic, observational and transversal study, involving 180 children younger than 12 years. Secretion of posterior oropharynx was collected for culture; and peripheral blood for determination of ASO. Student-t and chi-square tests, with Yates correction, were performed for statistical analysis. The ASO cutoff was determined by Receiver Operating Characteristic (ROC) curve. The prevalence encountered was 3.9%, and 25.5% of the children showed reagent ASO. This serological test demonstrated quantitatively and qualitatively significant associations to the GABHS presence (p=0.0001 for both associations) throughout the ROC curve, 200 U Todd was the value that resulted in the best accuracy, demonstrating 100% of sensibility and 80% of specificity in the GAS infection documentation. Also, it was found that the value of 1.200 U represents a specificity of 100%. The results emphasize the need for similar studies in other populations, to provide better targeting of the diagnosis and treatment of oropharyngitis by GABHS, which in turn can prevent up to 80% the cases of rheumatic fever, and consequently, the chronic rheumatic heart disease.
