Kaposi's sarcoma is considered an acquired immunodeficiency syndrome-defining illness and is caused by human herpesvirus 8. It has been associated with patients infected with human immunodeficiency virus (HIV) who have CD4 T lymphocytes <200 cells/uL and high viral loads. We report a case of a 23-year old woman infected with HIV-1 and receiving antiretroviral treatment since diagnosis, with high CD4 cell count and low viral load that presented with disseminated Kaposi's sarcoma. Clinicians should be aware of the occurrence of Kaposi's sarcoma despite robust CD4 cell counts.
Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin's lymphoma (NHL) and it can metastasize to extranodal sites. The involvement of the adrenal glands is rare. In this report, we discuss the case of a 65-year-old man with complaints of asthenia, anorexia, hypersudoresis, and a weight loss of 10 kg in the month prior to his presentation. Suprarenal insufficiency and bilateral masses with heterogeneous contrast uptake in the adrenal glands were documented on a thoracoabdominopelvic CT. Infectious causes and functioning tumors were excluded. After an exhaustive study, DLBCL was diagnosed. Through this case report, the authors intend to sound the alert on the existence of a rare presentation of DLBCL.
Klebsiella pneumoniae is a common cause of pyogenic liver abscess in patients with diabetes mellitus, preexisting hepatobiliary disease and those from Southeast Asia 1 , where it accounts for 50% to 73% of cases 2. But, in the last decades, there has been an increasing number of reports in Western countries 3. A 61-year-old portuguese male, without significant past medical history, was admitted with right upper quadrant abdominal pain and fever. He denied any recent foreign travel. Laboratory analysis showed 6900 leucocytes, C-reactive protein 287.5 mg/L, total billirubin 1.1 mg/ dL, AST 116 UI/L, ALT 88 UI/L, alkaline phosphatase 180 UI/L. Abdominal Computed Tomography (CT) scan revealed a 3.4x3.3cm complex mass in the IV hepatic segment with multiple septations. Blood cultures grew Klebsiella pneumoniae and, according to the antibiogram, he was placed on ceftriaxone for 21 days. The abscess was drained by interventional radiology and gram stain and cultures of pus were positive for Klebsiella pneumoniae. His clinical condition improved and a follow-up CT, after antibiotic therapy, showed complete resolution of liver abscess.
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