RESUMEN
Monkeypox is the latest reemerging zoonosis worldwide. Anyone is susceptible to contracting this infection; however, the clinical presentation may be atypical in a particularly vulnerable group that identifies as men who have sex with men. Herein, we present two cases of patients diagnosed with monkeypox infection, both of whom were also co-infected with human immunodeficiency virus (HIV) and exhibited different degrees of immunosuppression. Notably, the clinical presentations differed significantly. Patients co-infected with HIV are prone to develop clinical features ranging from barely visible lesions to severe or even fatal disease.
RESUMEN
Emphysematous pyelonephritis (EPN) is a severe disease of the renal system in which gas formed by facultative anaerobe microorganisms accumulates, being Escherichia coli the most representative causative agent. A series of conditions foster its development including uncontrolled diabetes mellitus, diabetic nephropathy and obstructive uropathy. Abdominal CT scan continues to be the gold standard for diagnosis. Currently, nephrectomy is avoided as much as possible, and more conservative treatments are given. Mortality is still as high as 21 % despite new therapeutic options, all of which are mostly surgical. The rarest cases are those classified as grade IV, which affect both kidneys; these are considered the most lethal of the clinical presentations and they are also of particular interest, since a multidisciplinary team must be in charge of treatment. Herein, we present the case of an elderly woman with chronic diseases and a presentation of massive emphysematous pyelonephritis concurrent with emphysematous cystitis and pneumoperitoneum, who required bilateral radical nephrectomy despite efforts of preserving at least one of the kidneys.
