RESUMEN
A case of cutaneous and nail infection due to Hendersonula toruloidea (HT), in a Senegalese woman who had been living in France for 7 years is reported. This patient presented with keratotic lesions of the palms and distal and lateral onycholysis. Culture of clinical specimens on Sabouraud's medium without cycloheximide resulted in the isolation of HT. This rare fungal infection is often misdiagnosed.
Asunto(s)
Dermatomicosis/etiología , Dermatosis de la Mano/etiología , Onicomicosis/etiología , Trichophyton , Adulto , Antifúngicos/uso terapéutico , Ciclopirox , Dermatomicosis/tratamiento farmacológico , Diagnóstico Diferencial , Femenino , Dermatosis de la Mano/tratamiento farmacológico , Humanos , Onicomicosis/tratamiento farmacológico , Piridonas/uso terapéuticoRESUMEN
Modifications of inter-alpha-trypsin inhibitor (ITI) in inflammatory syndromes were determined by studying its serum components: ITI 80 (the native form) and serum derivatives (SD), as well as urinary ITI derivatives (UID) excretion in 31 controls and 128 patients with inflammatory of various origins. The patients were divided into 4 groups: Group I bacterial infections (n = 29); Group II cancers (n = 50); Group III inflammatory diseases (n = 14); Group IV inflammatory syndromes due to other causes (n = 35). Other markers of inflammation were also studied. In bacterial infections and cancers ITI 80 concentrations were significantly decreased, with values of 0.55 +/- 0.15 g/l and 0.54 +/- 0.15 g/l respectively vs 0.65 +/- 0.11 g/l in controls. SD concentrations were significantly increased in all 4 groups: Gr I: 0.31 +/- 0.12 g/l; Gr II: 0.30 +/- 0.11 g/l; Gr III: 0.25 +/- 0.08 g/l; Gr IV: 0.24 +/- 0.10 g/l, as compared with 0.16 +/- 0.09 in controls. UID excretion was increased in all cases, particularly in bacterial infections and cancers (10.8 +/- 13.4 and 6.0 +/- 8.8 mg/mmol of creatinine vs 1.5 +/- 1.7 g/mmol). A significant correlation was observed between CRP levels and SD levels. In bacterial infections and cancers, a fall in ITI associated with a rise in SD and an increase in UID excretion is suggestive of degradation of the native form. In inflammatory diseases and inflammatory syndromes of other causes, the rise in SD without significant variations in ITI 80 suggests and increase in SD synthesis. The correlation between CRP and SD seems to indicate that SD are produced in the early stage of inflammatory syndromes.
Asunto(s)
alfa-Globulinas/análisis , Infecciones Bacterianas/sangre , Enfermedades del Tejido Conjuntivo/sangre , Glicoproteínas/análisis , Neoplasias/sangre , Adulto , Anciano , Anciano de 80 o más Años , Infecciones Bacterianas/orina , Enfermedades del Tejido Conjuntivo/orina , Humanos , Persona de Mediana Edad , Neoplasias/orina , Estudios Prospectivos , Valores de Referencia , Síndrome , Inhibidores de Tripsina/análisisRESUMEN
The authors report a case of primary osteosarcoma of the liver in a 75 year-old man with post hepatitic B cirrhosis. The hepatic tumor was discovered on ultrasound and computed tomography. Angiography showed a hypervascularized tumor. The patient died rapidly. Diagnosis of primary osteosarcoma of the liver was established through histopathological examination of post mortem specimens and was confirmed by immunohistochemical study. From this and two other previously reported cases the authors describe the different primary hepatic tumors mimicking osteosarcoma.