RESUMO
Non-tuberculous mycobacterias (NTM) are important pathogens responsible for a broad spectrum of diseases in humans. Although exposure is widespread since they are distributed in the environment, the development of the disease is rare. It will depend on the specific species, their virulence (only 50 have been found to cause disease), and the host's immune response. M Mycobacterium Malmoense is a NTM first reported in 1977 at Malmö, Sweden, based on four cases of lung infections. After these, other infections have been reported mainly involving the respiratory tract. Extrapulmonary infections are limited to cervical adenitis, and rarely to tenosynovitis and disseminated disease. We are hence reporting, to our knowledge, the first case of M. malmoense as the cause of bacterial endocarditis in the world.
RESUMO
Chikungunya virus is a recent emerging arbovirus in Latin America, and the clinical manifestations can vary from fever and rash to severe chronic inflammatory arthritis. Few reports have been published regarding this infection in immunocompromised patients, including solid organ transplant recipients. We report a case series of solid organ transplant recipients with confirmed Chikungunya infection by positive reverse transcription polymerase chain reaction (RT-PCR), identified between January 2014 and December 2016. In addition, we conducted a literature review searching PubMed, EMBASE, and LILACS databases on Chikungunya infection in solid organ transplant recipients. Ten solid organ transplant recipients were included, consisting of 5 kidney, 4 liver, and 1 liver/kidney transplant recipient. Mean age of the transplant recipients was 47 years, and the most frequent symptoms of Chikungunya infection were arthralgia and fever. None of the patients required treatment in the intensive care unit, no deaths or graft rejection occurred. None of our patients had recurrent arthritis during 3-month follow-up period after the infection. Twenty-one cases of Chikungunya virus were identified in the literature review. Most cases had a benign clinical course with no severe complications, death, or chronic inflammatory arthritis. In conclusion, Chikungunya infection in solid organ transplant recipients has a benign course and has no chronic recurrent arthritis. It is possible that the immunosuppression regimen could decrease the risk of severe or chronic inflammatory manifestations in solid organ transplant recipients infected with Chikungunya.
Assuntos
Artralgia/epidemiologia , Febre de Chikungunya/epidemiologia , Vírus Chikungunya/isolamento & purificação , Transplante de Rim/efeitos adversos , Transplante de Fígado/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artralgia/diagnóstico , Artralgia/virologia , Febre de Chikungunya/diagnóstico , Febre de Chikungunya/virologia , Vírus Chikungunya/genética , Criança , Colômbia/epidemiologia , Feminino , Humanos , Transplante de Rim/métodos , Transplante de Fígado/métodos , Masculino , Pessoa de Meia-Idade , RNA Viral/isolamento & purificação , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Adulto JovemRESUMO
There are four medical conditions characterized by high levels of ferritin, the macrophage activation syndrome (MAS), adult onset Still' s disease (AOSD), catastrophic antiphospholipid syndrome (CAPS), and septic shock, that share similar clinical and laboratory features, suggesting a common pathogenic mechanism. This common syndrome entity is termed "the hyperferritinemic syndrome." Here, we describe two different cases of hyperferritinemic syndrome triggered by Chikungunya fever virus infection: a 21-year-old female with SLE and a 32-year-old male patient who developed AOSD after the coinfection of dengue and Chikungunya viruses.