RESUMO
Prosthetic joint infection with Mycobacterium tuberculosis usually involves the hips or knees and can result from either local reactivation, or less often from hematogenous spread. Predisposing conditions include rheumatoid arthritis, chronic steroid use and pulmonary diseases. The most common symptom at presentation is pain, and the most common physical finding is joint swelling and/or a draining sinus tract. The sedimentation rate is helpful when elevated but is nonspecific, and initial skin testing is only helpful when positive. The diagnosis depends on culture and histologic examination of tissue. Removal of the joint combined with oral antituberculous treatment is necessary when the infection is discovered greater than six weeks post joint replacement. Early diagnosis leads to decreased morbidity. Tuberculous infection of prosthetic joints is a rare disease and its diagnosis depends on a high degree of clinical suspicion.
Assuntos
Articulação do Joelho , Prótese do Joelho/efeitos adversos , Mycobacterium tuberculosis/isolamento & purificação , Infecções Relacionadas à Prótese/microbiologia , Tuberculose Osteoarticular/microbiologia , Idoso , Antituberculosos/uso terapêutico , Remoção de Dispositivo , Feminino , Humanos , Prótese do Joelho/microbiologia , Infecções Relacionadas à Prótese/tratamento farmacológico , Infecções Relacionadas à Prótese/cirurgia , Tuberculose Osteoarticular/tratamento farmacológico , Tuberculose Osteoarticular/cirurgiaRESUMO
Bronchiolitis obliterans organizing pneumonia (BOOP) is a disease of the small airways characterized by intraluminal polyps of myxoid connective tissue. Although various infectious and non-infectious agents have been implicated as possible precipitants of BOOP, the concomitant occurrence of BOOP with human immunodeficiency virus (HIV) infection has rarely been described. We describe a unique case in which BOOP was a presenting feature in a patient with newly diagnosed AIDS, and we review the literature of BOOP occurring in the setting of HIV infection.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Pneumonia em Organização Criptogênica/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Pneumonia em Organização Criptogênica/tratamento farmacológico , Diagnóstico Diferencial , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Infecções por Citomegalovirus/diagnóstico , Ganciclovir/análogos & derivados , Infarto do Baço/diagnóstico , Antivirais/uso terapêutico , Infecções por Citomegalovirus/tratamento farmacológico , Feminino , Febre/etiologia , Ganciclovir/uso terapêutico , Humanos , Imunocompetência , Pessoa de Meia-Idade , Infarto do Baço/tratamento farmacológico , Infarto do Baço/virologia , ValganciclovirRESUMO
Severe acute respiratory syndrome (SARS) is a severe pulmonary infection that has been identified in multiple outbreaks around the world after emerging from mainland China in early 2003. The syndrome is caused by SARS-associated coronavirus, a novel human infection. SARS-associated coronavirus is spread by multiple mechanisms, including direct contact and large-droplet aerosolization, and may be spread by droplet nuclei as well. Clinical disease is characterized by fever, dry cough, interstitial infiltrates, and variable progression to respiratory failure. No treatment has clearly been shown to be effective. Aggressive infection control measures to prevent viral spread are key to outbreak management.