Assuntos
Fármacos Anti-HIV , Infecções por HIV , HIV-1 , Humanos , HIV-1/genética , Infecções por HIV/tratamento farmacológico , Genótipo , Antirretrovirais/uso terapêutico , Rilpivirina/uso terapêutico , Piridonas/uso terapêutico , Mutação , Fármacos Anti-HIV/uso terapêutico , Fármacos Anti-HIV/farmacologiaRESUMO
BACKGROUND: Human immunodeficiency virus-infected patients are 100 times more likely to develop aseptic osteonecrosis compared with the general population. While 90% of cases concern the femoral head, the involvement of humeral bone remains rare. CASE PRESENTATION: We report a case of aseptic osteonecrosis of the left humeral head complicating antiretroviral therapy in a female, 46-year-old, Bissau-Guinean human immunodeficiency virus-infected patient received in a context of progressive pain in the left shoulder followed by limitation of articular movements. Standard x-ray of the shoulder allowed us to make the diagnosis by showing a typical image of osteonecrosis. The treatment was medical combined with physiotherapy. CONCLUSIONS: Aseptic osteonecrosis should be systematically looked for in human immunodeficiency virus patients on antiretroviral treatment. In addition to femoral head aseptic necrosis, the involvement of the humeral bone should also be considered.
Assuntos
Infecções por HIV , Osteonecrose , Emtricitabina , Feminino , HIV , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Humanos , Cabeça do Úmero/diagnóstico por imagem , Lopinavir , Pessoa de Meia-Idade , Osteonecrose/induzido quimicamente , Osteonecrose/diagnóstico por imagem , Ritonavir , Tenofovir/efeitos adversosRESUMO
Cysticercosis is a neglected tropical disease set as health priority by WHO. Most of the reported cases included isolated types of cysticercosis affecting the skin, the eyes or the brain . Disseminated types, however, are rare. We here report a case of disseminated cysticercosis affecting the brain, the eyes and the skin in a Senegalese female patient aged 66 years admitted with headaches and chronic seizures. Clinical examination showed cerebellar syndrome associated with generalized and painless nodular subcutaneous lesions. Diagnosis was confirmed based on histopathological examination of skin biopsy which showed cysticerci. Patient's outcome was good under albendazole therapy.
Assuntos
Encéfalo/parasitologia , Cisticercose/diagnóstico , Olho/parasitologia , Pele/parasitologia , Idoso , Albendazol/administração & dosagem , Encéfalo/patologia , Cisticercose/tratamento farmacológico , Cisticercose/patologia , Diagnóstico Diferencial , Olho/patologia , Infecções Oculares Parasitárias/diagnóstico , Infecções Oculares Parasitárias/tratamento farmacológico , Infecções Oculares Parasitárias/patologia , Feminino , Cefaleia/diagnóstico , Cefaleia/tratamento farmacológico , Cefaleia/parasitologia , Humanos , Neurocisticercose/diagnóstico , Neurocisticercose/tratamento farmacológico , Neurocisticercose/patologia , Fenobarbital/administração & dosagem , Prednisolona/administração & dosagem , Convulsões/diagnóstico , Convulsões/tratamento farmacológico , Convulsões/parasitologia , Senegal , Pele/patologia , Dermatopatias Parasitárias/diagnóstico , Dermatopatias Parasitárias/tratamento farmacológicoRESUMO
Management of chronic hepatitis B infection complicated by hepatocellular carcinoma (HCC) in pregnancy poses a treatment dilemma as the pregnancy accelerates disease progression and narrows the diagnostic tools and therapeutic choices. Studies have reported higher maternal and fetal losses. We share our experience with a 36-year-old pregnant woman who presented at 35 weeks' gestation with a large painful nodular liver and significant weight loss. She tested HBsAg-positive and had both clinical and laboratory features of severe liver decompensation. The abdominal ultrasound rightly described HCC on a cirrhotic background. The fetus was delivered by cesarean section but the mother died soon after.
