| Journal: | RB. Radiologia brasileira |
| Database: | PERIÓDICA |
| System number: | 000302481 |
| ISSN: | 0100-3984 |
| Authors: | Faucz, Rafael Artigas1 Quadros, Marianne Siquara de Andrade, Celso Alessandro Troncoso, Flavio Trentin Ribeiro-Filho, Nelson Furtado, Juvencio Duailibe Souza, Ricardo Pires de |
| Institutions: | 1Hospital Heliopolis, Servico de Radiologia e Diagnostico por Imagem, Sao Paulo. Brasil |
| Year: | 2006 |
| Season: | Ene-Feb |
| Volumen: | 39 |
| Number: | 1 |
| Pages: | 79-82 |
| Country: | Brasil |
| Language: | Portugués |
| Document type: | Artículo |
| Approach: | Caso clínico, analítico |
| English abstract | The authors report a case of a 38-year-old male patient who works as a driver, HIV positive for eight years and with no follow up since diagnosis presenting with productive cough with grayish secretion and intermittent attacks of dyspnea two weeks before hospital admission. He also reported two previous episodes of treated pulmonary tuberculosis (in 1983 and 2001). Chest X-ray showed nodular hypolucent areas and air bronchograms bilaterally. Computed tomography of the chest revealed many unspecific findings, including scattered areas of consolidation, cavitations, bronchial dilatation, ground glass opacities, interstitial thickening and air bronchograms. The bronchoalveolar lavage showed a number of hyphaes with rare bifurcated septa suggestive of Aspergillus sp. Cultures of Nocardia sp. and Mycobacterium tuberculosis were positive. Therefore, treatment with amphotericin B, trimethoprim-sulfamethoxazole and antiretroviral was started. The patient was discharged twenty days later without pulmonary symptoms. Fifteen days later, the patient returned to the hospital with diarrhea, fever, dysphagia and significant weight loss. The patient died five days later due to staphylococci sepsis |
| Portuguese abstract | Os autores relatam um caso de paciente do sexo masculino, 38 anos de idade, motorista, soropositivo para HIV há oito anos, sem acompanhamento, com quadro de tosse produtiva com secreção acinzentada e episódios intermitentes de dispnéia há 15 dias. Informava dois episódios pregressos de tuberculose pulmonar (1983 e 2001) tratados. A radiografia de tórax evidenciou áreas de hipotransparência nodular e broncogramas aéreos bilateralmente. A tomografia computadorizada de tórax evidenciou vários achados inespecíficos, dentre eles áreas esparsas de consolidação, cavitação, bronquiectasia, opacidade em vidro fosco, espessamento intersticial e broncogramas aéreos. A lavagem broncoalveolar evidenciou numerosas hifas com raros septos bifurcados sugestivos de Aspergillus sp. e a cultura foi positiva para Nocardia sp. e Mycobacterium tuberculosis. Foi instituída terapia com anfotericina B, sulfametoxazol-trimetoprim e anti-retrovirais. Após 20 dias, recebeu alta sem queixas pulmonares. Decorridos 15 dias, retornou com diarréia, febre, disfagia e emagrecimento importante. Foi a óbito após cinco dias, por sepse estafilocócica |
| Disciplines: | Medicina |
| Keyword: | Neumología, Terapéutica y rehabilitación, Inmunología, Radiología, SIDA, Tuberculosis, Aspergilosis, Nocardiosis, Infecciones, Pulmones, TAC |
| Keyword: | Medicine, Pneumology, Therapeutics and rehabilitation, Radiology, AIDS, Tuberculosis, Aspergillosis, Nocardiosis, Infections, Lungs, CAT, Immunology |
| Full text: | Texto completo (Ver HTML) |
