RESUMO
Brain MRI was performed in an immunocompromized febrile and lethargic patient, revealing an asymmetric bilateral temporal lobe involvement, strongly suggestive of herpetic encephalitis. Nevertheless, PCR in CSF for Listeria monocytogens was positive. This case implies that Listeria might be considered in patients with clinical and imaging suspicion of herpetic encephalitis.
Assuntos
Encefalite por Herpes Simples/diagnóstico , Meningite por Listeria/diagnóstico , Idoso , Encéfalo/diagnóstico por imagem , Líquido Cefalorraquidiano/microbiologia , DNA Bacteriano/análise , DNA Bacteriano/genética , Diagnóstico Diferencial , Feminino , Humanos , Hospedeiro Imunocomprometido , Listeria monocytogenes/genética , Imageamento por Ressonância Magnética , Reação em Cadeia da Polimerase , RadiografiaRESUMO
Clinically apparent pulmonary embolism is a rare complication of permanent transvenous pacing catheters. Here we report an unusual case of a 71-year-old man who developed massive pulmonary embolism 12 hours after a permanent transvenous pacemaker implantation in the absence of any patient-related predisposing factor. Transesophageal echocardiography showed a large thrombus within the right atrium closely attached to the pacemaker lead. Anticoagulation with heparin, followed by warfarin therapy, led to a complete resolution of the thrombus.
