RESUMEN
Four cases of people living with HIV/AIDS (PLWHA) with calcified cerebral toxoplasmosis associated with perilesional edema causing a single episode of neurological manifestations have recently been reported. Here, we describe the first detailed description of perilesional edema associated with calcified cerebral toxoplasmosis causing three episodes of neurological manifestations in a PLWHA, including seizures in two of them. These recurrences occurred over approximately a decade. Throughout this period, the patient showed immunological and virological control of the HIV infection, while using antiretroviral therapy regularly. This case broadens the spectrum of an emerging presentation of calcified cerebral toxoplasmosis, mimicking a well-described finding of neurocysticercosis in immunocompetent hosts.
Asunto(s)
Humanos , Calcinosis/complicaciones , Infecciones por VIH/complicaciones , Toxoplasmosis Cerebral/complicacionesRESUMEN
ABSTRACT Four cases of people living with HIV/AIDS (PLWHA) with calcified cerebral toxoplasmosis associated with perilesional edema causing a single episode of neurological manifestations have recently been reported. Here, we describe the first detailed description of perilesional edema associated with calcified cerebral toxoplasmosis causing three episodes of neurological manifestations in a PLWHA, including seizures in two of them. These recurrences occurred over approximately a decade. Throughout this period, the patient showed immunological and virological control of the HIV infection, while using antiretroviral therapy regularly. This case broadens the spectrum of an emerging presentation of calcified cerebral toxoplasmosis, mimicking a well-described finding of neurocysticercosis in immunocompetent hosts.
RESUMEN
Calcified chronic subdural hematomas (CCSDHs) are rare entities, whose yearly incidence ranges from 1.72 to 20.6 per every 100 thousand persons. Several different approaches to their management are reported in the literature, ranging from conservative treatment to craniotomy with full removal of the neomembranes. Currently, there are no guidelines or consensus that establish the best technique. We herein report a case of symptomatic CCSDH initially drained through a burr-hole craniotomy, with no resolution of the symptoms. Later, our patient underwent a craniotomy and partial membranectomy, which resulted in full symptomatic recovery.
Hematomas subdurais crônicos calcificados (HSDCCs) são entidades raras, cuja incidência anual varia de 1,72 a 20,6 casos a cada 100 mil pessoas. Várias abordagens diferentes para seu manejo são relatadas na literatura, desde o tratamento conservador até a craniotomia com remoção total das neomembranas. Atualmente não há diretrizes ou consensos que estabeleçam a melhor técnica. Nós relatamos um caso de HSDCC inicialmente drenado por meio de uma craniotomia por trepanação, sem resolução dos sintomas. Posteriormente, nosso paciente foi submetido a uma craniotomia e membranectomia parcial, que resultou em plena recuperação dos sintomas.
RESUMEN
OBJECTIVE: To assess the influence of subjective enhancement of brightness and contrast of digital panoramic radiographs on the detection of soft tissue calcifications. MATERIALS AND METHODS: In this observational study, 500 digital panoramic radiographs were evaluated by two examiners in consensus, who scored the images for the presence of calcifications for each right and left side of the image. After 30 days, all images were revaluated under subjective manipulation of digital brightness and contrast. Calcifications were classified based on the diagnostic hypothesis: sialolith, tonsillolith, calcified atheroma, phlebolith, rhinolith, maxillary sinus antrolith, synovial chondromatosis, lymph node calcification, stylohyoid ligament, triticeous cartilage, or/and upper horn of thyroid cartilage calcification. For intra-examiner agreement, 20% of the sample was reevaluated. The Kappa test and McNemar test were used (α = 0.05). RESULTS: In original images, calcifications were observed in 44.2% of the patients, and in enhanced images, this number was 70.8%. Many calcifications were detected only in enhanced images, mainly in the diagnostic hypotheses of calcified atheroma and stylohyoid ligament. Intra-examiner agreement was excellent for the detection of soft tissue calcifications (0.82) and for the classification (0.81). CONCLUSION: Subjective enhancement of brightness and contrast alters the detection of soft tissue calcifications in digital panoramic radiograph.
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Calcinosis/diagnóstico por imagen , Radiografía Dental Digital , Radiografía Panorámica/métodos , Adulto , Anciano , Cartílago , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuello , Enfermedades Faríngeas , Radiografía Panorámica/normasRESUMEN
La calcinosis cutis es un trastorno raro causado por el depósito anormal de sales de calcio en la piel y tejido subcutáneo. Clínicamente se caracteriza por pápulas, placas o nódulos calcificados. Según su etiopatogenia se distinguen cinco tipos clínicos: distrófica, metastásica, iatrogénica, idiopática y calcifilaxis.Comunicamos el caso clínico de un paciente en edad pediátrica con una calcinosis cutis idiopática universal, sin afectación extra-cutánea. Esta publicación reviste importancia debido a lo infrecuente de esta enfermedad y a que su diagnóstico nos permite detectar padecimientos asociados, que son determinantes para el pronóstico y tratamiento.
Cutaneous calcinosis is a rare disorder caused by the deposit of abnormal calcium salts in the skin and subcutaneous tissue. Itpresents with calcified papules, plaques or nodules. Five clinical types are distinguished: dystrophic, metastatic, iatrogenic, idiopathic and calcifilaxis. This paper reports a pediatric patient with aidiopathic calcinosis cutisuniversalis, without extracutaneous manifestations. This publication is important because of the rarity of this disease. The diagnosis allows us to investigate the possible associated diseases that determine patient prognosis and treatment.