RESUMO
Tricuspid valve endocarditis (TVE) is rarely considered in the differential diagnosis of a febrile patient who does not use intravenous drugs.We describe the case of a 62-year-old male patient with a 3-month history of remittent fever and 13% weight loss. The patient denied intravenous drugs use or recent invasive procedures. His medical history included type 2 diabetes, alcohol abuse and smoking. Clinical evaluation revealed systemic inflammatory syndrome with unremarkable physical examination. Ancillary tests showed leucocytosis, thrombocytopenia and elevated C reactive protein. Empiric intravenous ceftriaxone was started, but after an initial improvement, fever relapsed 2 days after stopping antibiotherapy. A CT scan showed multiple disseminated lesions, suggesting lung metastatic tumour. Further studies excluded malignancy and revealed TVE caused by Streptococcus bovis with pulmonary embolism. The aim of our study is to stress the importance of evoking TVE in the differential diagnosis of fever with lung manifestations, and to highlight the possible association between S bovis, colorectal cancer and liver disease.
Assuntos
Endocardite Bacteriana/diagnóstico , Embolia Pulmonar/diagnóstico , Infecções Estreptocócicas/diagnóstico , Streptococcus bovis , Alcoolismo/complicações , Ecocardiografia , Endocardite Bacteriana/complicações , Endocardite Bacteriana/diagnóstico por imagem , Varizes Esofágicas e Gástricas/complicações , Humanos , Hepatopatias Alcoólicas/complicações , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/complicações , Embolia Pulmonar/diagnóstico por imagem , Infecções Estreptocócicas/complicações , Trombocitopenia/complicações , Tomografia Computadorizada por Raios X , Valva TricúspideRESUMO
Glioblastoma (GBM) is the most aggressive and malignant brain tumor. Recent studies indicated that glioma samples are characterized by increased expression of CXCR4, the CXCL12/SDF-1 chemokine receptor. To better understand the role of CXCR4 in GBM biology we performed an integrated study where we simultaneously evaluate the contribution of the CXCR4/CXCL12 signaling pathway to the proliferation, survival and motility of a human GBM cell line. Our results indicated that CXCR4/CXCL12 axis induced an increase in cell proliferation and in cell motility. The blockage of CXCR4 induced a significant increase of apoptosis. Together, our results indicated that CXCR4/CXCL12 signalling pathway may contribute to GBM development and emphasize the therapeutic potential of this pathway in patients with GBM.
