RESUMO
Group B streptococcus (Streptococcus agalactiae) is a common etiology of bacteremia among adults. Pyomyoma is a rare infectious complication of uterine leiomyomas. We report the case of a diabetic postmenopausal woman with a giant pyomyoma simulating an ovarian cancer. It was associated with S. agalactiae endocarditis and deep venous thrombosis of the right external iliac and femoral veins. Treated initially with intravenous penicillin, amikacin, and anticoagulation, the patient later had abdominal hysterectomy with an uneventful recovery. We also review the cases of pyomyoma reported since 1945. Of 14 cases described (including ours), mortality was 21%. Endocarditis was never reported in association with pyomyoma. The presence of bacteremia and a leiomyoma should raise suspicion for this disease.
Assuntos
Abscesso/diagnóstico , Endocardite Bacteriana/diagnóstico , Leiomioma/diagnóstico , Neoplasias Ovarianas/diagnóstico , Infecções Estreptocócicas/diagnóstico , Streptococcus agalactiae , Abscesso/microbiologia , Abscesso/cirurgia , Diagnóstico Diferencial , Endocardite Bacteriana/complicações , Feminino , Humanos , Leiomioma/microbiologia , Leiomioma/cirurgia , Pessoa de Meia-Idade , Fatores de Risco , Infecções Estreptocócicas/complicações , Tomografia Computadorizada por Raios XRESUMO
Primary biliary cirrhosis (PBC) is a cholestatic liver disease, which is characterized by a chronic inflammatory destruction of intrahepatic bile ducts. It is a rare disorder whose precise etiology is still to be elucidated. Even though the liver is the principal target of PBC, other organ systems also might be affected. Muscular involvement has rarely been described in this disease, and in the majority of cases, muscular weakness has been interpreted as polymyositis. We report the case of a 48-year-old woman suffering from classic PBC, in association with a myopathy whose histological features are distinct from the cases reported before. We also performed a MEDLINE research for PBC and concomitant muscular diseases.
Assuntos
Cirrose Hepática Biliar/complicações , Polimiosite/etiologia , Feminino , Humanos , Cirrose Hepática Biliar/diagnóstico , Cirrose Hepática Biliar/patologia , Pessoa de Meia-Idade , Polimiosite/patologiaRESUMO
Legionella sp has been emerging over the last decade as an important cause of pneumonia both hospital and community-acquired. Following an outbreak in a Renal-Transplant Unit stocked serum was tested for antibodies against Legionella pneumophila serogroup 1, and 5 cases of Legionnaires' Disease were reviewed. Two of the cases were nosocomial and three cases were community-acquired. Clinical and laboratorial aspects were similar to those expected for other causes of pneumonia, however jaundice was encountered in two cases. This study suggests that the real incidence of pneumonia caused by Legionella sp is being underestimated and the authors emphasize the importance of considering Legionnaires' Disease when empirically treating community-acquired pneumonia.