[Kidney failure as a complication of the treatment of pulmonary paracoccidioidomycosis]. / Insuficiência renal como complicação do tratamento da paracoccidioidomicose pulmonar.

Sulfadiazine is one of the drugs of choice in the treatment of paracoccidioidomycosis. Side effects are uncommon. Cutaneous and gastrointestinal reactions and rarely leucopenia and jaundice may occur. A patient on sulfadiazine 6 g daily exhibiting a good response is reported. On the 12th day, he presented an intense abdominal pain and reduced urinary output. An ultrasonography revealed diffuse calculosis in urinary tract. Peritoneal dialysis, urinary alkalinization and rehydration were instituted with complete restoration of renal function. This case illustrates the importance of an adequate hydratation of patients receiving sulfadiazine, a simple measure in the prevention of this uncommon complication which carries a high morbidity.

A resposta do fluxo aereo a administracao de broncodilatadores em pacientes portadores de doenca pulmonar obstrutiva cronica ou asma / Response of airflow to administration of bronchodilator agents in patients with chronic obstructive lung disease or asthma

Analisamos as espirometrias de 30 pacientes portadores de DPOC ou asma antes e apos a administracao de 200 mcg de salbutamol, via inalatoria. Todos os pacientes apresentaram resposta significante quanto ao fluxo. Quinze pacientes responderam com aumento do "VEF IND. 1" maior que 13 por cento (grupo I) e quinze com aumento exclusivo do"FEF IND. 25-75 por cento" (porcentagem do predito) iniciais, cujos valores foram significantemente menores (p < 0.01) no grupo I. Nao houve diferenca significante quanto a idade, sexo e CVF (porcentagem do predito) iniciais.

Tuberculose ganglionar em adultos / Lymph node tuberculosis in adults

A linfadenite e uma importante forma de acometimento tuberculoso extra-pulmonar que contribui com 8,4 por cento do total de casos de tuberculose nos adultos tratados em nosso Servico. A exerese ganglionar com exame histologico do fragmento, propiciou o diagnostico em 77,8 por cento dos casos. A boa evolucao clinica e a alta porcentagem de reatores ao PPD (84,2 por cento) faz-nos supor a predominancia de M. tuberculosis como o agente etiologico da linfadenite na nossa serie. Houve boa resposta em 75 por cento dos pacientes submetidos ao esquema quimioterapico com seis meses de duracao.

Embolia septica pulmonar com foco primario em ouvido medio / Septic pulmonary embolism with primary focus in middle ear

Apresentamos o caso de um paciente com embolia septica de pulmao cujo foco primario era em ouvido medio. As bacterias implicadas foram aerobios Gram positivos, Gram negativos e anaerobios, sendo isolados oito diferentes agentes etiologicos em hemoculturas. As culturas de urina e escarro tambem se mostraram positivas. O tratamento consistiu em antibioticoterapia de amplo espectro e na exploracao cirurgica do foco inicial. A resposta foi favoravel apos 40 dias de antibioticoterapia.

[Response of airflow to the administration of bronchodilator agents in patients with chronic obstructive lung disease or asthma]. / A resposta do fluxo aéreo à administração de broncodilatadores em pacientes portadores de doença pulmonar obstrutiva crônica ou asma.

Spirometric tests of 30 patients with chronic obstructive pulmonary disease (COPD) or asthma were evaluated just before and 15 minutes after the administration of 200 mg of salbutamol by inhalation. All patients had a significant increase os their airflow after the bronchodilator administration. In 15 patients the increase of FEV1 was greater than 13% (Group I) and in other 15 patients the increase of FEF25-75% was greater than 23% (Group II). The two groups showed differences with respect to the initial FEV1, and FEF25-75% (% of predicted), with values significantly lower (p 0.01) in Group I. There was no significant difference between the two Groups concerning the age, sex and the initial FVC (% for predicted).

[Lymph node tuberculosis in adults]. / Tuberculose ganglionar em adultos.

Tuberculous lymphadenitis is a form of extrapulmonary tuberculosis that was observed in 8.4% of all cases with tuberculosis in our series. In all instances the organism isolated was M. tuberculosis. There was a high rate of PPD positiveness. The chemotherapy yielded good results. The evolution was satisfactory in 75% of the patients treated for six months.

[Septic pulmonary embolism with primary focus in the middle ear]. / Embolia séptica pulmonar com foco primário em ouvido médio.

A case of septic pulmonary embolism is presented in which the primary site of infection was the middle ear. The implicated bacteria were aerobics both Gram positive and Gram negative and anaerobics. There were 8 different agents isolated from blood cultures. The cultures of urine and sputum were also positive. The patient received a broad spectrum antibiotic therapy and a surgical exploration of the initial site of infection was performed. A favorable response was observed after 40 days of treatment with antibiotics.