RESUMO
Nontuberculous mycobacteria are a rare cause of disease in solid organ and hematopoietic stem cell transplant recipients. The impact of mycobacterial infections in transplant recipients necessitates prompt diagnosis and early initiation of therapy. However, diagnosis remains difficult and there is a lack of specific recommendations for the choice of anti-mycobacterial drugs, duration of therapy, and monitoring of graft function as well as immunosuppression in these patients. Issues involved in the management are illustrated by an index case of hepatic allograft infection due to Mycobacterium avium complex.
Assuntos
Antibacterianos/uso terapêutico , Transplante de Fígado/efeitos adversos , Fígado/microbiologia , Complexo Mycobacterium avium/genética , Infecção por Mycobacterium avium-intracellulare/tratamento farmacológico , Hepatite C Crônica/terapia , Hepatite C Crônica/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Complexo Mycobacterium avium/classificação , Complexo Mycobacterium avium/efeitos dos fármacos , Complexo Mycobacterium avium/isolamento & purificação , Infecção por Mycobacterium avium-intracellulare/microbiologia , Resultado do TratamentoRESUMO
The utility of the inferior oblique m. radioanatomical study by a FLASH 3D sequence in magnetic resonance imaging (MRI). Twenty eyes (ten healthy volunteers aged 21-32 years, without any history of significant ocular pathology) were explored by MRI (1 Tesla; cranial coil) and comparisons were made between spin echo (SE) T1 sequence (through the neuro-ocular and coronal planes; thickness of slices = 3 mm) and a gradient echo FLASH 3D sequence (thickness of slices = 1 mm). This enabled a mm by mm reformation of the inferior oblique m through the frontal-oblique plane, made possible by new SE T1 sequences through the same plane. Position, height, and signal of the m. were estimated. The mean frontal angle formed by the muscle and the sagittal axis measured 29 degrees for the right eye and 27 degrees for the left eye. The muscle was always identifiable in the reformation despite its thin dimensions: 1.9 mm (1.5 - 2.8) on the right and 2 mm (1.7 - 2.5) on the left, in low signal silhouetted by the high signal of orbital fat. Thus, thanks to mm by mm reconstructions using FLASH 3D sequence, a good radioanatomic study of the inferior oblique m. by MRI is possible. This could be useful particularly for the strabismus of children.
