RESUMO
Antecedentes: La enfermedad de Kawasaki (EK) es una vasculitis aguda y autolimitada frecuente en menores de cinco años; sin embargo, su diagnóstico es un reto en menores de seis meses. Reporte de caso: Reportamos un lactante de tres meses con fiebre y tumoración cervical dolorosa de tres días de enfermedad. Fue diagnosticado como tumoración cervical abscedada y recibió tratamiento con antibióticos por 10 días. En hospitalización presentó lesiones eritematosas maculares en todo el cuerpo, persistencia de fiebre y elevación de marcadores inflamatorios. Se realizó una ecocardiografía encontrándose dilatación de las arterias coronarias siendo diagnosticado de EK incompleto. Recibió inmunoglobulina humana endovenosa y ácido acetil salicílico. Actualmente está en controles por cardiología con ácido acetil salicílico por persistencia de dilatación de las arterias coronarias. Conclusiones: La adenitis cervical puede imitar a otras infecciones cutáneas como el absceso cervical ocasionado retraso en el diagnóstico de EK produciendo complicaciones como el aneurisma coronario.
Background: Kawasaki disease (KD) is an acute and self-limited vasculitis common in children under five years. The diagnosis is a challenge in children under six months of age. Report case: We report a three-month-old infant with fever and a painful neck tumor of three days of disease. He was diagnosed with an abscessed cervical mass and received antibiotic treatment for ten days. During hospitalization, macular erythematous lesions developed throughout the body, persistence of fever, and elevated inflammatory markers. Echocardiography was performed, finding dilatation of the coronary arteries, being diagnosed with incomplete KD. He received intravenous human immunoglobulin and acetylsalicylic acid. He is currently undergoing cardiology controls with acetylsalicylic acid due to persistent dilatation of the coronary arteries. Conclusions: Cervical adenitis can mimic other skin infections such as cervical abscesses. It can cause a delay in the diagnosis of KD, producing complications such as a coronary aneurysm.
RESUMO
La sarcoidosis es una enfermedad granulomatosa no caseificante, multisistémica, de causa desconocida, que compromete el pulmón y los ganglios linfáticos mediastinales entre el 90-95 por ciento de los casos. También puede afectar otros órganos como las glándulas salivales, piel, ojos, hígado, bazo, corazón, huesos y sistema nervioso central. El compromiso torácico representa la principal causa de morbilidad con unas 10/100 000 personas al año y mortalidad. Nuestro estudio tuvo como objetivo presentar a un paciente de 45 años de edad atendido por tener manifestaciones clínicas, paraclínicas y radiográficas que permitieron establecer, sin confirmar mediante estudio histológico, el diagnóstico de una forma aguda de sarcoidosis. Su forma clínica de expresión coincidió con el síndrome de Löfgren con ensanchamiento mediastinal bilateral por linfoadenopatía hiliar, síndrome febril, eritema nudoso y artritis aguda en miembros inferiores, que desarrollan entre un 20-30 por ciento de los pacientes con sarcoidosis. Se le realizó una tomografía por emisión de positrones, cuyos resultados ofrecieron elementos diagnósticos propios de un proceso inflamatorio pulmonar alejado de las características propias de una neoplasia maligna. Después de una profunda evaluación del riesgo-beneficio, se impuso tratamiento inmunosupresor con esteroides a dosis elevadas y seguimiento estrecho. Observamos una evolución muy positiva e inmediata desde el punto de vista clínico y radiográfico. Luego de varias semanas de tratamiento se apreciaron los cambios con marcada mejoría hasta pasados 3 meses que constatamos prácticamente una casi desaparición de las imágenes radiográficas(AU)
Sarcoidosis is a multisystemic, non-caseating granulomatous disease of unknown cause that involves the lung and the mediastinal lymph nodes in between 90 percent and 95 percent of cases. It can also affect other organs, such as the salivary glands, skin, eyes, liver, spleen, heart, bones, and central nervous system. Thoracic involvement represents the main cause of morbidity and mortality in patients with this entity, which occurs in about 10 / 100,000 people a year. Our study aimed to present a 45-year-old patient treated for presenting clinical, paraclinical and radiological manifestations that allow the diagnosis of an acute form of sarcoidosis to be established without confirming by histological study. Its clinical form of expression showed the presence of Löfgren's syndrome with bilateral mediastinal widening due to hilar lymphadenopathy, febrile syndrome, erythema nodosum, and acute arthritis in the lower limbs, which 20-30 percent of patients with sarcoidosis develop. A positron emission tomography scan was performed and its results offered us diagnostic elements typical of a pulmonary inflammatory process far from the characteristics of a malignant neoplastic process(AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Sarcoidose/diagnóstico , Terapia de Substituição Renal/métodos , Tomografia por Emissão de Pósitrons/métodos , Linfadenopatia , Imunossupressores/uso terapêuticoRESUMO
Background: Lymphoma, although rare, is the most common hematopoietic neoplasia in horses. The overall incidence of lymphoma is between 1.3-2.8% of all equine neoplasia and it has a prevalence of 0.002-0.5% in the equine population. Lymphoma can be classified as multicentric, alimentary, mediastinal, cutaneous and solitary. The cutaneous is the rarest form and it usually presents with multifocal skin lesions, with no other clinical signs. The diagnoses is accomplished by histopathological examination of a biopsy or cytological examination of a fine needle aspirate. The aim of the current study is to report a case of the rarest form of equine lymphoma, the cutaneous. Case: An 8-year-old equine female, Quarter Mile, was evaluated due to volumes increase and subcutaneous nodules disseminated along the body. These lesions developed gradually during 2 years. The mare was used for ridding, it was kept in the field with 10 other equines and was the only one affected. The mare was vaccinated for influenza and was negative for glanders and equine infectious anemia. During clinical exam, all vital parameters were within limits and body condition score was classified as 6 (Henneke Chart). It was observed bilateral nasal secretion and depigmentation in ocular and vulvar mucous. It was observed multiple delimited areas with size ranging from few cm up to 7 cm, hard, mobile, painless, located in the subcutaneous and disseminated in the body (including head, neck, thorax, limbs and perineum). Red blood cell, leucocytes, fibrinogen, total plasmatic protein were within normal limits. Due to clinical signs and the potential risk of a zoonosis, the glanders test was repeated (complement fixation test) and the result was negative. Differential diagnoses also included insect hypersensitive, which was discarded since the female did not presented pruritus nor alopecia, lesions gradually increased in size and no [ ](AU)
Assuntos
Animais , Linfoma/veterinária , Neoplasias Cutâneas/veterinária , Cavalos , Linfadenopatia/veterinária , Linfonodos/patologiaRESUMO
Background: Lymphoma, although rare, is the most common hematopoietic neoplasia in horses. The overall incidence of lymphoma is between 1.3-2.8% of all equine neoplasia and it has a prevalence of 0.002-0.5% in the equine population. Lymphoma can be classified as multicentric, alimentary, mediastinal, cutaneous and solitary. The cutaneous is the rarest form and it usually presents with multifocal skin lesions, with no other clinical signs. The diagnoses is accomplished by histopathological examination of a biopsy or cytological examination of a fine needle aspirate. The aim of the current study is to report a case of the rarest form of equine lymphoma, the cutaneous. Case: An 8-year-old equine female, Quarter Mile, was evaluated due to volumes increase and subcutaneous nodules disseminated along the body. These lesions developed gradually during 2 years. The mare was used for ridding, it was kept in the field with 10 other equines and was the only one affected. The mare was vaccinated for influenza and was negative for glanders and equine infectious anemia. During clinical exam, all vital parameters were within limits and body condition score was classified as 6 (Henneke Chart). It was observed bilateral nasal secretion and depigmentation in ocular and vulvar mucous. It was observed multiple delimited areas with size ranging from few cm up to 7 cm, hard, mobile, painless, located in the subcutaneous and disseminated in the body (including head, neck, thorax, limbs and perineum). Red blood cell, leucocytes, fibrinogen, total plasmatic protein were within normal limits. Due to clinical signs and the potential risk of a zoonosis, the glanders test was repeated (complement fixation test) and the result was negative. Differential diagnoses also included insect hypersensitive, which was discarded since the female did not presented pruritus nor alopecia, lesions gradually increased in size and no [ ]