Assuntos
Mediastinite , Doenças Periodontais , Abscesso Retrofaríngeo , Infecções dos Tecidos Moles , Humanos , Masculino , Antibacterianos/uso terapêutico , Mediastinite/diagnóstico por imagem , Mediastinite/etiologia , Mediastinite/patologia , Mediastinite/terapia , Necrose , Abscesso Retrofaríngeo/diagnóstico por imagem , Abscesso Retrofaríngeo/etiologia , Abscesso Retrofaríngeo/patologia , Abscesso Retrofaríngeo/terapia , Infecções dos Tecidos Moles/diagnóstico por imagem , Infecções dos Tecidos Moles/etiologia , Infecções dos Tecidos Moles/patologia , Infecções dos Tecidos Moles/terapia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Doenças Periodontais/complicações , Doenças Periodontais/diagnóstico por imagem , Doenças Periodontais/patologia , Doenças Periodontais/terapiaRESUMO
INTRODUCCIÓN: La Infección Necrotizante de tejidos blandos (INTB) tiene una elevada morbimortalidad. El objetivo de este trabajo es describir del manejo perioperatorio de menores de 15 años que cursaron con INTB durante 15 años en un Hospital pediátrico. MATERIAL Y MÉTODOS: serie de pacientes identificados INTB entre 2000 y 2015 en el Hospital Roberto del Río. Se describen variables demográficas, clínicas, vacuna, tratamiento, cirugías, complicaciones, microorganismos, seguimiento, y fallecimientos. RESULTADOS: 22 pacientes, con mediana de 2 años y 9 meses de edad. 50% estaban cursando con una varicela. Dos fallecieron. Ninguno era previamente vacunado contra el virus varicela zoster. La localización fue tronco (14), extremidades (7), cuello (1). Los pacientes conscientes presentaron hiperestesia cutánea. Se realizó aseo quirúrgico con una mediana de 6,8 horas desde el inicio de la hiperestesia y 2 horas desde la sospecha diagnóstica. Los microorganismos fueron: S. pyogenes (38%) y E. coli (31%). Los antibióticos más frecuentes fueron penicilina más clindamicina. La herida se manejó con cierre primario, injertos y/o colgajos. Cinco evolucionaron con secuelas que necesitaron tratamiento. CONCLUSIÓN: Se identificó que la INTB puede presentarse con varicela. Debe sospecharse en lesiones cutáneas e hiperestesia desproporcionada. Resección amplia y precoz son fundamentales para el tratamiento.
INTRODUCTION: Necrotizing soft tissue infection (NSTI) has a high morbidity and mortality. The objective of this study is to describe the perioperative management of children under 15 years of age who have had this condition for 15 years in a pediatric hospital. MATERIAL AND METHODS: cases series of patients identified by Pathological Anatomy with NSTI during 2000 and 2015 at the Dr. Roberto del Río Hospital. Demographic variables, treatment, antecedents of vaccination, surgeries, complications, microorganisms, follow-up, and deaths are described. RESULTS: 22 patients were identified, with a median of 2 years 9 months of age (interquartile range: 13 months to 5 years y 10 months). 50% of the cases were associated to chickenpox. Two died. No patient was previously vaccinated against varicella zoster virus. The location was trunk (14), extremities (7) and neck (1). All conscious patients presented cutaneous hyperesthesia. Surgical debridement was performed with a median of 6.8 hours from the onset of hyperesthesia and 2 hours from diagnostic suspicion. The most frequent microorganisms were: Streptococcus pyogenes (38%) and Escherichia coli (31%). The most frequent antibiotics used were penicillin plus clindamycin. The wound was handled with primary closure, grafts and / or flaps. Five patients evolved with sequelae that needed treatment. CONCLUSION: It was identified that STNI in children is associated with chickenpox. It should be suspected in cutaneous lesions and disproportionate hyperesthesia. Aggressive resection is essential for treatment
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Infecções dos Tecidos Moles/patologia , Infecções dos Tecidos Moles/terapia , Fasciite Necrosante/patologia , Fasciite Necrosante/terapia , Staphylococcus aureus/isolamento & purificação , Streptococcus pyogenes/isolamento & purificação , Infecções dos Tecidos Moles/cirurgia , Infecções dos Tecidos Moles/microbiologia , Fasciite Necrosante/cirurgia , Fasciite Necrosante/microbiologia , Assistência Perioperatória , Desbridamento , Escherichia coli/isolamento & purificação , Antibacterianos/uso terapêuticoRESUMO
Staphylococcus aureus is the most prominent cause of skin and soft tissue infections (SSTI) worldwide. Mortality associated with invasive SSTI is a major threat to public health considering the incidence of antibiotic resistant isolates in particular methicillin resistant S. aureus both in the hospital (HA-MRSA) and in the community (CA-MRSA). To overcome the increasing difficulties in the clinical management of SSTI due to MRSA, new prophylactic and therapeutic approaches are urgently needed and a preventive vaccine would be welcome. The rational design of an anti-S. aureus vaccine requires a deep knowledge of the role that the different bacterial virulence factors play according to the type of infection. In the present study, using a set of isogenic deficient mutants and their complemented strains we determined that the staphylococcal surface proteins SpA and Sbi play an important role in the induction of inflammatory cytokines and chemokines in the skin during SSTI. SpA and Sbi initiate signaling cascades that lead to the early recruitment of neutrophils, modulate their lifespan in the skin milieu and contribute to proper abscess formation and bacterial eradication. Moreover, the expression of SpA and Sbi appear critical for skin repair and wound healing. Thus, these results indicate that SpA and Sbi can promote immune responses in the skin that are beneficial for the host and therefore, should not be neutralized with vaccine formulations designed to prevent SSTI.
Assuntos
Abscesso/imunologia , Antígenos de Bactérias/metabolismo , Proteínas de Bactérias/metabolismo , Proteínas de Transporte/metabolismo , Pele/imunologia , Infecções dos Tecidos Moles/metabolismo , Infecções Estafilocócicas/metabolismo , Staphylococcus aureus/metabolismo , Cicatrização/fisiologia , Abscesso/metabolismo , Abscesso/microbiologia , Animais , Quimiocinas/metabolismo , Citocinas/metabolismo , Modelos Animais de Doenças , Humanos , Queratinócitos , Staphylococcus aureus Resistente à Meticilina/metabolismo , Staphylococcus aureus Resistente à Meticilina/patogenicidade , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Pele/microbiologia , Pele/patologia , Infecções dos Tecidos Moles/imunologia , Infecções dos Tecidos Moles/microbiologia , Infecções dos Tecidos Moles/patologia , Infecções Estafilocócicas/imunologia , Staphylococcus aureus/patogenicidadeRESUMO
El éxito en el tratamiento de las infecciones necrotizantes de los tejidos blandos (INTB) depende de la precocidad diagnóstica y de la agresividad terapéutica, basada en el desbridamiento quirúrgico, la antibioticoterapia de amplio espectro y el soporte intensivo. Se presenta un caso de INTB secundaria a diverticulitis aguda perforada (Hinchey 4) con el fin de ilustrar las consideraciones particulares en el manejo de la INTB de localización en la pared abdominal, apoyadas en la evidencia disponible en la literatura científica. Se identifican como puntos clave la precocidad y la agresividad del desbridamiento quirúrgico, la antibioticoterapia dirigida por el cultivo y su suspensión guiada por la negativización microbiológica; y el empleo de técnicas combinadas de autoplastia y prótesis apoyadas en la terapia de presión negativa en la restauración de la pared abdominal, con lo que se ha obtenido un buen resultado.Successful treatment of necrotizing soft tissue infections (NSTI) depends on early diagnosis and therapeutical aggressiveness, based on surgical debridement, broad spectrum antibiotics and intensive support. A case of perforated diverticulitis (Hinchey 4)-secondary-NSTI is presented in order to illustrate the particular considerations in the management of abdominal wall located NSTI, supported on the evidence available in scientific literature. Several key points are identified, such as prompt and aggressive surgical debridement; culture-guided antibiotherapy and its suspension based on microbiological negativization; and the utilization of combined techniques of autoplastic repair and replacement, also supported on negative pressure therapy in the abdominal wall restoration, which have shown a good outcome.
Assuntos
Parede Abdominal/patologia , Infecções dos Tecidos Moles/patologia , Infecções dos Tecidos Moles/terapia , Idoso , Terapia Combinada , Feminino , Humanos , NecroseRESUMO
Widespread antibiotic resistance is on the rise and current therapies are becoming increasingly limited in both scope and efficacy. Methicillin-resistant Staphylococcus aureus (MRSA) represents a major contributor to this trend. Quorum sensing controlled virulence factors include secreted toxins responsible for extensive damage to host tissues and evasion of the immune system response; they are major contributors to morbidity and mortality. Investigation of botanical folk medicines for wounds and infections led us to study Schinus terebinthifolia (Brazilian Peppertree) as a potential source of virulence inhibitors. Here, we report the inhibitory activity of a flavone rich extract "430D-F5" against all S. aureus accessory gene regulator (agr) alleles in the absence of growth inhibition. Evidence for this activity is supported by its agr-quenching activity (IC50 2-32 µg mL-1) in transcriptional reporters, direct protein outputs (α-hemolysin and δ-toxin), and an in vivo skin challenge model. Importantly, 430D-F5 was well tolerated by human keratinocytes in cell culture and mouse skin in vivo; it also demonstrated significant reduction in dermonecrosis following skin challenge with a virulent strain of MRSA. This study provides an explanation for the anti-infective activity of peppertree remedies and yields insight into the potential utility of non-biocide virulence inhibitors in treating skin infections.
Assuntos
Anacardiaceae/química , Percepção de Quorum , Dermatopatias/patologia , Alelos , Animais , Antibacterianos/farmacologia , Biofilmes/efeitos dos fármacos , Modelos Animais de Doenças , Proteínas Hemolisinas/farmacologia , Humanos , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Camundongos , Testes de Sensibilidade Microbiana , Microbiota , Necrose , Extratos Vegetais/química , Extratos Vegetais/isolamento & purificação , Extratos Vegetais/toxicidade , Percepção de Quorum/efeitos dos fármacos , Pele/efeitos dos fármacos , Pele/microbiologia , Pele/patologia , Dermatopatias/microbiologia , Infecções dos Tecidos Moles/microbiologia , Infecções dos Tecidos Moles/patologia , Toxinas Biológicas/química , Toxinas Biológicas/toxicidade , Virulência/efeitos dos fármacosRESUMO
Among the opportunistic mycoses that are emerging in patients with immunosuppression or severe underlying illness, many isolates lack of characteristic sporulation and until recently could not be identified. Clinical signs are mostly nonspecific and therefore such infections have often been disregarded. In the present paper we describe a novel, nonsporulating fungal species causing subcutaneous phaeohyphomycosis in two patients of different origin. One is a 73-year-old female from Martinique who suffered from rheumatoid arthritis, while the other case concerns a 72-year-old male from Mexico who had a history of type 2 diabetes mellitus. Sequencing of the partial ribosomal operon revealed that in both cases a member of the order Pleosporales was concerned which could not be affiliated to any family within this order. Multilocus analysis revealed that the fungus was related to another, unaffiliated agent of human mycetoma, Pseudochaetosphaeronema larense, and therefore the name Pseudochaetosphaeronema martinelli was introduced.
Assuntos
Ascomicetos/classificação , Ascomicetos/isolamento & purificação , Feoifomicose/diagnóstico , Feoifomicose/patologia , Infecções dos Tecidos Moles/diagnóstico , Infecções dos Tecidos Moles/patologia , Idoso , Artrite Reumatoide/complicações , Ascomicetos/genética , Análise por Conglomerados , DNA Fúngico/química , DNA Fúngico/genética , Complicações do Diabetes , Feminino , Humanos , Masculino , Martinica , México , Microscopia , Dados de Sequência Molecular , Feoifomicose/microbiologia , Filogenia , Análise de Sequência de DNA , Infecções dos Tecidos Moles/microbiologia , Tela Subcutânea/microbiologia , Supuração/microbiologiaRESUMO
Prescription drug abuse ranks as the second most common class of illicit drug use in the United States, and one mechanism of opiate abuse involves intravenous injection of enteral narcotics such as oxycodone or hydrocodone. The authors describe a patient who sustained significant soft tissue necrosis after intravenously injecting a solution made from crushed enteral narcotics, with a focus on the operative course that resulted due to a delay in initial definitive treatment. The patient's wounds encompassed 8% total body surface area and covered 247 cm2. A 55-year-old female was admitted to the burn unit (West Penn Burn Center, Western Pennsylvania Hospital, Pittsburgh, PA) after she initially presented with infection and cellulitis to her bilateral upper extremities 3 weeks after intravenously injecting herself with crushed oxycodone/acetaminophen. She underwent numerous sequential operative repairs including initial debridement, placement of dermal replacement templates, and several split-thickness autografts and xenografts. Her total length of stay was 59 days, broken into an initial 47-day stay, and a subsequent 12-day readmission due to graft failure secondary to poor follow-up. As the number of prescription drug abusers rises, it is possible that an increase in attempts to intravenously abuse enteral narcotics may also rise. As such, burn centers should be prepared for the extent of potential limb necrosis and the operative treatment that may ensue.
Assuntos
Acetaminofen/efeitos adversos , Analgésicos não Narcóticos/efeitos adversos , Entorpecentes/efeitos adversos , Oxicodona/efeitos adversos , Uso Indevido de Medicamentos sob Prescrição/efeitos adversos , Infecções dos Tecidos Moles/induzido quimicamente , Celulite (Flegmão)/induzido quimicamente , Celulite (Flegmão)/patologia , Desbridamento/métodos , Combinação de Medicamentos , Toxidermias/etiologia , Toxidermias/patologia , Toxidermias/cirurgia , Feminino , Rejeição de Enxerto , Humanos , Pessoa de Meia-Idade , Necrose/induzido quimicamente , Necrose/patologia , Necrose/cirurgia , Transplante de Pele/métodos , Infecções dos Tecidos Moles/patologia , Infecções dos Tecidos Moles/cirurgia , Lesões dos Tecidos Moles/induzido quimicamente , Lesões dos Tecidos Moles/patologia , Lesões dos Tecidos Moles/cirurgia , Abuso de Substâncias por Via Intravenosa/complicações , Abuso de Substâncias por Via Intravenosa/patologiaRESUMO
INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) emerged at the Pediatric Hospital of Misiones Province, north Argentina, in 2003 as a cause of community-acquired (CA) infections, mostly associated with skin and soft tissue infections (SSTIs). This study aimed to assess the microbiological, epidemiological, and clinical features of CA-MRSA SSTIs treated at the hospital. METHODOLOGY: From 2003 through 2006, a longitudinal study on CA-MRSA SSTIs was conducted. Clinical, bacteriological, and molecular data were collected and analyzed by multiple correspondences and cluster analysis (MCCA). RESULTS: A total of 138 children were enrolled; 55.8% of the children required hospitalization. The main clinical presentation was abscesses (51%). Antibiotic therapy in the previous six months was registered in 41% of the patients, and 72% of the patients had relatives with similar symptoms. Resistance to non-b-lactam antibiotics was found in less than 12% of patients. All 44 isolates carried staphylococcal cassette chromosomemec (SCCmec) type IV, and 30/44 had Panton-Valentine leucocidin (PVL) coding genes. Six pulsed-field gel electrophoresis (PFGE) patterns were detected from 17 isolates. MCCA hierarchic classification resulted in four distinctive patient classes (new variable). No relationship could be observed regarding the PVL detection, as PVL (+) isolates were detected in all classes; the same lack of significance was observed concerning the distribution of resistance to non-ß-lactam antibiotics. CONCLUSIONS: This study increases the understanding and knowledge about CA-MRSA skin and soft tissue infections in pediatric patients. Continuous efforts should be made to control this significant public health problem.
Assuntos
Infecções Comunitárias Adquiridas/epidemiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções dos Tecidos Moles/epidemiologia , Infecções Cutâneas Estafilocócicas/epidemiologia , Adolescente , Antibacterianos/farmacologia , Argentina/epidemiologia , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/patologia , Eletroforese em Gel de Campo Pulsado , Feminino , Genótipo , Hospitais Pediátricos , Humanos , Lactente , Estudos Longitudinais , Masculino , Staphylococcus aureus Resistente à Meticilina/classificação , Staphylococcus aureus Resistente à Meticilina/genética , Tipagem Molecular , Infecções dos Tecidos Moles/microbiologia , Infecções dos Tecidos Moles/patologia , Infecções Cutâneas Estafilocócicas/microbiologia , Infecções Cutâneas Estafilocócicas/patologia , Fatores de Virulência/genética , beta-Lactamas/farmacologiaRESUMO
Necrotising fasciitis (NF) is a soft tissue bacterial-derived infection characterised clinically by fulminant tissue destruction of the poorly blood-supplied muscle fascia and overlying subcutaneous fat. Although these infections first appear as minor superficial manifestations, they are capricious in nature and often lead to sepsis, organ failure and high mortality. We report a case of type II necrotising fasciitis in a 39-year-old Caucasian female patient who presented to the emergency department with cellulitis of her right foot and lower leg that rapidly developed into tissue necrosis. The patient course is of unique interest due to progressive history over a 104â days time frame with complications following surgical treatments and outpatient follow-up. We highlight the importance of early detection and pertinent clinical awareness from a wide range of medical specialties that were involved in this case, and how this process is critical, in order to properly diagnose and treat NF-derived tissue infections.
Assuntos
Celulite (Flegmão)/diagnóstico , Fasciite Necrosante/diagnóstico , Extremidade Inferior/lesões , Infecções dos Tecidos Moles/diagnóstico , Lesões dos Tecidos Moles/complicações , Adulto , Celulite (Flegmão)/etiologia , Celulite (Flegmão)/patologia , Fasciite Necrosante/complicações , Fasciite Necrosante/patologia , Fasciite Necrosante/cirurgia , Feminino , Humanos , Extremidade Inferior/patologia , Necrose/diagnóstico , Necrose/etiologia , Infecções dos Tecidos Moles/complicações , Infecções dos Tecidos Moles/patologia , Infecções dos Tecidos Moles/cirurgiaRESUMO
Actinomyces europaeus was first described in 1997 as a new species causing predominantly skin and soft-tissue infections. Mastitis due to A. europaeus is an unusual condition. This article reports a case of primary breast abscess caused by A. europaeus in a postmenopausal woman.
Assuntos
Abscesso/microbiologia , Actinomyces/isolamento & purificação , Actinomyces/patogenicidade , Doenças Mamárias/microbiologia , Abscesso/tratamento farmacológico , Abscesso/patologia , Actinomyces/genética , Idoso , Doenças Mamárias/tratamento farmacológico , Doenças Mamárias/patologia , Feminino , Humanos , RNA Ribossômico 16S/genética , Infecções dos Tecidos Moles/tratamento farmacológico , Infecções dos Tecidos Moles/microbiologia , Infecções dos Tecidos Moles/patologia , Resistência beta-LactâmicaRESUMO
La infección por Streptococcus dysgalactiae subsp equisimilis es causa frecuente de faringitis, artritis e infecciones de piel y tejidos blandos; excepcionalmente se ha descrito como causa de endocarditis infecciosa. Se presenta el caso de un paciente masculino de 42 años quien ingresa al Hospital Vargas de Caracas con fiebre, astenia, dolor en hombro derecho con limitación funcional y dolor en hipocondrio derecho; a las 48 horas se evidencia soplo mesosistólico en foco mitral, hemorragias en astillas y lesiones de Janeway, por lo que se plantea Endocarditis Infecciosa, y se inicia tratamiento con Vancomicina + Gentamicina. Los hemocultivos muestran crecimiento de Streptococcus equisimilis en ambos frascos; el ecocardiograma transtorácico evidencia una vegetación en valva posterior de válvula mitral. Luego de 48 horas de inicio de tratamiento remite la fiebre. El ecocardiograma control a los 14 días mostró la desaparición de la vegetación en la válvula mitral. El paciente recibió tratamiento por 6 semanas
Streptococcus dysgalactiae subsp equisimilis is frequent in patients with pharyngitis, arthritis and skin infections; it rarely causes infective endocarditis. We describe a 42 year-old male patient complaining of fever, malaise, right shoulder pain and right upper quadrant pain who was admitted to the Hospital Vargas, Caracas, Venezuela. After 48 hours his physical examination revealed mesosystolic murmur at the apex, splinter hemorrhages and Janeway lesions, suggestive of Infective Endocarditis Blood cultures identified Streptococcus equisimilis; transthoracic echocardiogram revealed a vegetation over the posterior leaflet of mitral valve; the patient was treated with Vancomycin + Gentamycin. After 48 hours of treatment the fever subsided. A transthoracic echocardiogram after 14 days showed no vegetations. The patient was treated during 6 weeks
Assuntos
Humanos , Masculino , Adulto , Artrite/patologia , Ecocardiografia/métodos , Endocardite/diagnóstico , Faringite/patologia , Gentamicinas , Infecções Cutâneas Estafilocócicas/patologia , Infecções dos Tecidos Moles/patologia , Streptococcus/patogenicidade , VancomicinaRESUMO
Desde las últimas décadas se observa un incrmento cada vez mayor de resistencia microbiana a los quimioterápicos ocasionada por malas prescripciones, falta de adherencia al tratamiento, automedicación, entre otros. El cefadroxilo, comparte las cualidades de la cefalexina, pero además las concentraciones séricas y urinarias mas sostenidas permiten el tratamiento de infecciones con una a dos dosis diarias. Dicha particularidad farmacocinética otorga un beneficio para el paciente que permite asegurar la adherencia al tratamiento.
Assuntos
Humanos , Cefadroxila/uso terapêutico , Resistência Microbiana a Medicamentos/imunologia , Declaração de Helsinki , Infecções dos Tecidos Moles/microbiologia , Infecções dos Tecidos Moles/patologia , ArgentinaRESUMO
Jorge Lobo's and chromoblastomycosis are chronic deep mycosis that clinically manifests as keloid and verrucous polymorphic lesions of solid consistency and variable size that contain small scales and crusts. Few studies are available in the literature characterizing the in situ cellular and humoral immune response, especially the involvement of cytokines which immunosuppressive and fibrogenic effects as the TGF-beta. The hypothesis of the present paper is explaining the possible mechanism of this cytokine in cutaneous lesions pathology in chromoblastomycosis and lacaziosis (Jorge Lobo's disease). The results of this investigation are a new hypothesis for ethiopatogenesis of these diseases: TGF-beta is a double effect that follows fibrosis and immunosuppression in local skin.
Assuntos
Dermatomicoses/etiologia , Dermatomicoses/microbiologia , Modelos Imunológicos , Infecções dos Tecidos Moles/etiologia , Infecções dos Tecidos Moles/microbiologia , Fator de Crescimento Transformador beta/imunologia , Doença Crônica , Dermatomicoses/patologia , Humanos , Pele/microbiologia , Pele/patologia , Infecções dos Tecidos Moles/patologia , Tela Subcutânea/microbiologiaRESUMO
In this study we determined whether exposing mice to hyperbaric oxygen (HBO) would alter various disease parameters of a susceptible mouse strain infected with Leishmania amazonensis. BALB/c mice exposed to HBO (100% O2 at a pressure of 2.5 ATA, 1h before parasite inoculation and subsequently for 20 days) showed significant delay in lesion development and reduction in lesion parasite burdens compared with HBO-unexposed mice. Circulating levels of interferon gamma (IFN-gamma) and tumor necrosis factor (TNF-alpha) were significantly elevated in HBO-exposed as compared to HBO-unexposed mice. Concanavalin A-stimulated lymph nodes cultures from HBO-exposed mice released significantly more IFN-gamma and less interleukin 10 (IL-10) than cultures from HBO-unexposed mice, consistent with a skewed Th1 response. These results demonstrate, for the first time, that HBO can play a pathogen control role during leishmaniasis. Further studies are needed to elucidate whether hyperoxia alone or increased atmospheric pressure alone can exert a similar effect.
Assuntos
Oxigenoterapia Hiperbárica/métodos , Leishmania/crescimento & desenvolvimento , Leishmaniose/terapia , Infecções dos Tecidos Moles/terapia , Animais , Feminino , Histocitoquímica , Interferon gama/sangue , Interleucina-10/imunologia , Leishmaniose/imunologia , Leishmaniose/parasitologia , Leishmaniose/patologia , Linfonodos/imunologia , Linfonodos/parasitologia , Camundongos , Camundongos Endogâmicos BALB C , Infecções dos Tecidos Moles/imunologia , Infecções dos Tecidos Moles/parasitologia , Infecções dos Tecidos Moles/patologia , Fator de Necrose Tumoral alfa/imunologiaRESUMO
La sinovitis simétrica seronegativa remitente con edema blando (Síndorme R S3 P E por las iniciales en ingles) constituye una forma diferente de artritis que se observa en personas de edad, generalmente mayores de 60 años y se caracteriza por tener pronóstico excelente a pesar de iniciarse en forma aguda e incapacitante en la mayoría de los casos. Se presenta el resumen de dos historias que reunen los criterios clínicos establecidos para esta entidad.