RESUMO
Human infections caused by a hantavirus were reported in different regions of the State of São Paulo (SP), Brazil during the first six months of 1998. Two cases of fatal pulmonary syndrome occurred in May of 1998 in the City of Guariba, located in the Northeastern Region of SP. Both patients worked in a corn storage barn infested by rodents. These patients, after 2 or 3 days of non-specific febrile illness, developed a severe interstitial pneumonia spreading widely in both lungs, causing respiratory failure and death. At autopsy both patients showed lung interstitial edema with immunoblast-like mononuclear cell infiltrates, consistent with a viral etiology. Hantavirus infection was diagnosed by ELISA in both cases and by RT-PCR in one of the patients. Aspects of the clinical presentation, physiopathology and differential diagnosis of Hantavirus Pulmonary Syndrome are discussed.
Assuntos
Síndrome Pulmonar por Hantavirus/diagnóstico , Adulto , Brasil , Diagnóstico Diferencial , Evolução Fatal , Síndrome Pulmonar por Hantavirus/fisiopatologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-IdadeRESUMO
The case of a six-day-old neonate admitted in an emergency situation because of dyspnea and increasing cyanosis is reported. Despite abnormal opacification on the chest X-ray and left ventricular overload on the electrocardiogram and echocardiogram, features compatible with the disease, the diagnosis of massive pulmonary arteriovenous fistula affecting the whole left superior lobe, was made possible only after necroscopic examination.
Assuntos
Fístula Arteriovenosa/congênito , Artéria Pulmonar/anormalidades , Veias Pulmonares/anormalidades , Fístula Arteriovenosa/patologia , Humanos , Recém-Nascido , MasculinoRESUMO
An acute myocardial infarction occurred in a 6-year-old child with dilated cardiomyopathy. This caused severe hemodynamic deterioration that led to a fatal outcome. Autopsy revealed diffuse myocardial atrophy without cell infiltrate, normal epicardial coronary arteries, and a massive healed anteroapical infarction. Coronary embolism or spasm could not be ruled out as the cause of the infarction.
