Infection by Strongyloides stercoralis is a highly prevalent helminthiasis, which is mostly distributed in the tropical and subtropical regions of the world. Although a substantial number of cases are asymptomatic or paucisymtomatic, severe and life-threatening forms of this infection still occur and not infrequently is lately diagnosed. Gram-negative bacteria septicemia, which frequently accompanies the severe helminthiasis, contributes to the high mortality rate. Severe infection is invariably triggered by any imbalance in the host's immunity, favoring the auto-infective cycle, which increases the intraluminal parasite burden enormously. Clinical presentation of severe cases is varied, and diagnosis requires a high suspicion index. Acute abdomen has been reported in association with S. stercoralis infection, but intestinal necrosis is rarely found during the surgical approach.The authors report the case of a man who sought the emergency unit with recent onset abdominal pain. Clinical and imaging features were consistent with obstructive acute abdomen. Scattered adhesions and a necrotic ileal segment with a tiny perforation represented the surgical findings. The patient outcome was unfavorable and respiratory distress required an open lung biopsy. Both surgical specimens showed S. stercoralis infection. Unfortunately the patient underwent multiple organ failure and septicemia, and subsequently died.The authors call attention to the finding of intestinal necrosis and impaired intestinal motility disorder as possibilities for the diagnosis and risk factor, respectively, for a severe infection of S. stercoralis.
Madelung disease or multiple symmetric lipomatosis (MSL) is a rare entity among the overgrowth syndromes. It is characterized by painless non-encapsulated and symmetric fatty deposits in the neck, torso, mammary, and abdominal areas, and in the upper and lower limbs. The etiology of the disease is still unknown. Chronic alcohol consumption may play a role in adipocyte hyperplasia in genetically susceptible individuals. Besides the overgrowth of adipose tissue, patients with MSL present features of metabolic syndrome. Patients seek medical attention usually for esthetic reasons. We present the case of a middle-aged man who sought the outpatient clinic complaining of bulging masses in the posterior upper part of the thorax, the occipital area, and the neck. The masses grew over a period of 2 years. The physical examination and imaging study revealed the presence of symmetric lipomatosis. A two-step surgical treatment was undertaken for the excision of the lipomatous tissue. The postoperative outcome was uneventful with satisfactory esthetic results.
Endotracheal intubation injuries are rare, but may be devastating—mostly among the pediatric patients or when these occur in the distal trachea. Such complications typify a therapeutic challenge, which, besides requiring intellectual and technical resources, takes a long time to reach a resolution. The authors present the case of a 15-year-old girl admitted with an abnormal state of consciousness due to diabetic ketoacidosis. She was submitted to endotracheal intubation with hyperinflation of the tube cuff, which rendered tracheal necrosis and detachment of the tracheal mucosa, and consequent obstruction. Later, she developed scarring retraction and stenosis. The patient was successfully treated with an endotracheal prosthesis insertion. The aim of this report is to illustrate a preventable complication.
The authors report the case of a 66-year-old male patient diagnosed with a pseudoaneurysm of the distal aorto-aortic anastomosis treated with the inner tubing technique. The patient had been operated on 1 year before when he had an aortic prosthesis implanted as treatment for a ruptured abdominal aortic aneurysm. The inner tubing technique was developed to facilitate the treatment in bifurcated vascular lesions, where endovascular conventional prosthesis is not available.
ResumoIntroduction: Pulmonary tuberculosis is a zoonotic disease caused by the Mycobacterium tuberculosis family of bacteria in dogs, and Mycobaterium bovis in cattle or cats . Animals can be infected by inhaling the infectious agent, often causing respiratory problems, or by bites causing skin granulomas . The disease affects the lungs causing damage and lesions on these organs . Variable clinical signs are observed, such as diarrhea or fever . Thus, it is important to perform diagnostics to confirm that the animal has pulmonary tuberculosis . Objectives: The purpose of this work is to correlate the anatomical features of the lungs with pulmonary tuberculosis in animals. Methods: literature revision. Results: The diagnoses can be antemortem or postmortem . Scientists are still looking for a treatment for pulmonary tuberculosis in animals to avoid euthanasia as much as possible. They are also studying in the search for new, more effective vaccines that can significantly reduce the disease . Being a zoonotic disease, it is important to control and regulate this disease in the world by different epidemiological means, which can be sanitary or medical . Conclusions: It is fundamental for researchers to know the pulmonary anatomy and the different specific variations in animals to succeed in finding potential treatments. Pulmonary tuberculosis is a disease with a high severity rate, especially in animals. Whether for the animal or human population, the awareness of the owners to vaccinate their animals and following the different diagnostic techniques to prevent the disease has a great influence on the control of the disease. Introduction:The peritoneal cavity is the seat of primary or secondary infectious and inflammatory processes. The omentum plays a crucial role in controlling these processes through specific cellular and molecular mechanisms. Objectives: To carry out a bibliographic review of the literature to determine the state of the art on the inflammatory processes that occur in the omentum that lead to the formation of peritoneal blocks. Material and Methods: A bibliographic search was carried out on PubMed with the descriptors omental inflammation in peritoneum. Original
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