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Hereditary haemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, is a rare autosomal dominant vascular disorder. Patients with HHT may present with a wide spectrum of clinical manifestations, some considered to be life-threatening. We present the case of a 53-year-old male who presented with massive haemoptysis. Chest computed tomography scan was remarkable for a large anterior, left lower lobe arteriovenous malformation. The patient underwent a pulmonary angiogram with embolization of a large left lung arteriovenous malformation, which proved to be successful in controlling the bleeding.
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We describe a rare case of anterior paramediastnial abscess due to Nocardia cyriacigeorgica in an immunocompetent patient without pre-existing lung disease. High suspicious should be taken in those patients that failed to improve after first course of antibiotic therapy. Similarly, when suspected, isolation is crucial because of the variation in antibiotic susceptibilities among Nocardia spp. in order to provide adequate therapy to reduce associated comorbidities and mortality rate.
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Multidrug resistant tuberculosis (MDR-TB) is defined as a Mycobacterium tuberculosis strain resistant to two or more first-line anti-tuberculous drugs. Tuberculosis (TB) is a global threat to society despite improvement in therapy as it continues to be an economic burden especially in underdeveloped countries. The downfall of global economics and growing travel destinations in developing countries has escalade the exposure of organism not previously encountered in industrialized nations. Most cases of MDR-TB are reported on immunosuppressed patients with risk factors and from endemic areas. Nevertheless new strains with higher transmission degree are emerging as a threat in patients who have low risk factors for the development of MDR-TB.
RESUMO
INTRODUCTION: Deep venous thrombosis (DVT) is a manifestation of venous thromboembolism (VTE). It has been estimated that there are 900,000 cases of pulmonary emboli (PE) and DVT per year resulting in 60,000 to 300,000 deaths. About two-thirds of VTE cases are associated with prolonged hospitalizations, emphasizing the importance of major surgery or immobilization as risk factors. METHODS: Retrospective study conducted in a Metropolitan Hospital. A total of 46 records were obtained from the hospital database following the established inclusion and exclusion criteria. For the control group a total of 42 records were selected. Patients included in this study were admitted with the diagnosis of deep venous thrombosis identified either by lower leg Doppler. RESULTS: Monocytosis with DVT, p-value was <0.001, with an Odd Ratio (OR) 9.35 and Interval Confidence (IC) 95% (3.2-27.3). The p-value for eosinophilia with DVT was 0.092, for males with DVT the p-value was 0.35 and age related groups with DVT value was 0.720. Sensitivity of monocytosis was 67.3%, specificity 80%, positive predictive value (PPV) 79.49% and negative predictive value (NPV) 63.9%. CONCLUSION: This study revealed the association between monocytosis and DVT, thus patients with monocytosis are more likely to develop DVT. This evidence is consistent with previous studies establishing that monocytes could have an important role with the coagulation cascade activation and the formation of DVT. The association of monocyte count and DVT can be used in the future as a significant tool in those patients with suspected DVT to increase diagnostic yield.