RESUMO
Limited information is available concerning the coexistence of COVID-19 and opportunistic infections in people living with HIV. The possible association of COVID-19 with AIDS-related respiratory diseases should be considered, particularly in patients with advance immunosuppression. We report the case of a male patient with AIDS-related disseminated histoplasmosis associated with COVID-19.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/complicações , Infecções por HIV/complicações , Histoplasma/isolamento & purificação , Histoplasmose/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Adulto , Contagem de Linfócito CD4 , Infecções por HIV/tratamento farmacológico , Histoplasmose/complicações , Histoplasmose/virologia , Humanos , Terapia de Imunossupressão , MasculinoRESUMO
El absceso de músculo psoas iliaco se considera una rare-za. Su detección ha mejorado con la utilización de imágenes como la tomografía computada o la resonancia magnética. Presentamos una revisión de casos de absceso de psoas-iliaco internados entre julio de 2015 y febrero de 2018 en un hospital de CABA, Argentina.En este periodo se diagnosticaron un paciente conside-rado de origen primario y ocho de origen secundario. Se observó predominio de colecciones asociadas a es-pondilodiscitis. El síntoma más frecuente fue la fiebre. Staphylococcus aureus fue el germen más rescatado en muestras microbiológicas. Se debe tener alto índice de sospecha de esta patología ante la presencia de fiebre, dolor lumbar y en ocasiones alteración de la marcha. El empleo de antibióticos de amplio espectro sumado a la evacuación de colecciones constituyen la estrategia más efectiva
Psoas-iliac muscle abscess is considered a rarity, the use of images such as computed tomography or magnetic reso-nance imaging has improved its detection.This study reviews cases of psoas-iliac abscess in hospi-talized patients between July 2015 and February 2018 in a hospital in CABA, Argentina.In one of the patients the origin was considered primary ,while in the other eight it was secondary. There was a pre-dominance of collections associated with spondylodiscitis. The most frequent symptom was fever. Staphylococcus au-reus was the most frequent organism obtained in microbio-logical samples. A high level of suspicion must be held in the presence of fever, lumbar pain and sometimes alteration of the gait. The use of broad spectrum antibiotics in addition to evacuation of collections is the most effective strategy.
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Infecções Estafilocócicas/terapia , Músculos Psoas/patologia , Abscesso do Psoas/diagnóstico , Abscesso do Psoas/etiologia , Abscesso do Psoas/terapia , Staphylococcus aureus Resistente à Meticilina , Antibacterianos/uso terapêuticoRESUMO
Acute HIV infection presenting as severe opportunistic disease is a very uncommon event associated with more rapid HIV progression and higher mortality. We describe the case of a patient with cryptococcal meningitis in the setting of primary HIV infection.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Encéfalo/diagnóstico por imagem , Infecções por HIV/diagnóstico , Meningite Criptocócica/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Adulto , Evolução Fatal , Feminino , Infecções por HIV/complicações , Humanos , Imageamento por Ressonância Magnética , Meningite Criptocócica/complicaçõesRESUMO
La infección por VIH incrementa la posibilidad de contraer tuberculosis; el riesgo resulta mayor para las formas extrapulmonares y dentro de estas, la meníngea. La infección por VIH no modifica las manifestaciones neurológi-cas pero disminuye significativamente la supervivencia. El método molecu-lar GeneXpert MTB/RIF (CEPHEID, USA), implementado en 2010, es un mé-todo de amplificación del ácido nucleico para Mycobacterium tuberculosis, en tiempo real, con la determinación adicional de la resistencia a rifampicina.Caso clínico: paciente con VIH de diagnóstico reciente que manifes-tó enfermedad consuntiva. El cuadro inicial fue de compromiso pulmo-nar y luego meníngeo; en ambos casos el método GeneXpert MTB/RIF detectó Mycobacterium tuberculosis resistente a rifampicina. Se utili-zaron drogas de segunda línea, por la presunción de estar frente a una tuberculosis multiresistente, por definición resistente al menos a iso-niacida y rifampicina. Desarrolló hidrocefalia y profundas secuelas.Conclusiones: este método molecular permitió la detección rápida de la tuberculosis, la implementación de medidas de aislamiento así como con-trol de la infección y el inicio temprano de una terapéutica más eficaz, tan-to en la forma pulmonar como meníngea
HIV infection increases the risk of developing any form of tuberculosis, but the risk is greater for meningitis and the extrapulmonary form. HIV infection does not alter the neurological manifestations, but significantly decreases survival. The GeneXpert MTB / RIF (CEPHEID, USA), implemented in 2010, is a real time PCR for Mycobacterium tuberculosis, with rifampicin sensitivity.Case report: patient with recent diagnosed HIV, stating wasting disease. The original picture involved lung and then meningeal compromise: In both cases the Xpert MTB / RIF detected the presence of Mycobacterium tuberculosis rimfapicin resistant. Second-line drugs were used by the presumption of being faced with multidrug-resistant tuberculosis that, by definition, is resistant to at least isoniazid and rifampin. Patient developed hydrocephalus and was severe aftermath.Conclusions: This molecular method allowed the rapid detection of tuberculosis, implementation of isolation measures as infection control and the early onset of a more effective therapy, both in the pulmonary form and the meningeal