Mycobacterium abscessus is a rapidly growing mycobacterium that has been affecting people undergoing invasive procedures, such as videosurgery and mesotherapy. This bacterium has global distribution, being found in numerous niches. The frequency of published reports of infection by rapidly growing mycobacteria associated with tattooing procedures has increased in recent years. However, in Brazil there were no case reports of M. abscessus after tattooing in the literature until now. In this paper, we describe the case of a patient with a nine-month history of lesion on a tattoo site. The diagnosis of infection with Mycobacterium abscessus was established by correlation between dermatological and histopathological aspects, culture and molecular biology techniques. The patient had significant improvement of symptoms with the use of clarithromycin monotherapy.
Methods Methods Methods Methods: We performed a retrospective study through analyzed records in the two main reference hospitals for trauma adults in this city during a period of 5 years. We considered for this study the epidemiological data, causal agent, type of incision, anatomical classification score of trauma, prognostic factors and mortality. Results Results ResultsResults Results: We analyzed 124 patients who underwent thoracotomy with a mean age of 28 years. Stab wounds were the most common casual agent (68%). The main indication for thoracotomy was massive hemothorax with 50.7% of cases, followed by cardiogenic or hypovolemic shock with 48.4%. There were 28 deaths (20.6%). Patients with vena cava injuries (5 patients) and aorta lesions (2 patients) had 100% mortality rate. There was a higher mortality in patients with major index of trauma (p = 0004), and largest quantity of blood transfused (p = 0090). Conclusion Conclusion Conclusion Conclusion Conclusion: Thoracic trauma patients submitted to exploratory thoracotomy were young, males and victims of stab wound trauma. The most contributing death factors were the lethal anatomical score, more than 15 points, and the association with major vascular lesions, as the aorta and vena cava.
Pulmonary sequestration is defined as a mass of lung tissue separated from the tracheobronchial tree and irrigated by an anomalous systemic artery. It is rarely seen in conjunction with lung neoplasms. We report the case of a 39-year-old female patient diagnosed with a carcinoid tumor, located in the intermediate bronchus and accompanied by bronchiectasis in the right lower lobe. The patient underwent thoracotomy for the resection of the affected area. During surgery, she presented with significant hemorrhage resulting from the transection of the anomalous artery that irrigated an intralobar pulmonary sequestration, which was located in right lower lobe and had not been identified in pre-operative examinations.Keywords: Bronchopulmonary sequestration; Hemorrhage; Carcinoid tumor. ResumoO sequestro pulmonar é definido como uma massa de tecido pulmonar separada da árvore traqueobrônquica e irrigada por uma artéria sistêmica anômala. Sua associação com neoplasias pulmonares é rara. Relatamos o caso de uma paciente de 39 anos com o diagnóstico de tumor carcinoide localizado no brônquio intermediário, associado a alterações caracterizadas como bronquiectasias em lobo inferior direito. A paciente foi submetida à toracotomia para ressecção da área acometida e, durante a cirurgia, apresentou hemorragia importante decorrente da transecção da artéria anômala que nutria o sequestro pulmonar intralobar localizado em lobo inferior direito, não identificado nos exames pré-operatórios. Depending on its pleural covering, PS is classically divided into intralobar and extralobar. An intralobar PS (ILPS) share the pleural covering with the rest of the lung, whereas an extralobar PS (ELPS) is completely covered by its own visceral pleura. Descritores(5) Although the extralobar form is well defined as a congenital abnormality, the intralobar form has a controversial pathogenesis, with some evidence indicating that, in many cases, it is an acquired disease. (6,7) Accounting for approximately 75% of all cases of PS, ILPS is more common in the lower lobes and on the left, involving the posterior basal segment. (5,8) Its arterial supply is nearly always derived from the aorta or from one of its branches, typically one of a large diameter. Venous drainage is via the pulmonary veins into the left atrium, creating a left-to-left shunt. In a minority of cases, drainage is via the inferior vena cava or via the azygos system. (9) In the case presented here, the PS was located in the right lower lobe and the blood supply came from an anomalous branch derived from the thoracic aorta.Cases of ILPS typically occur in adolescents and young adults with a history of recurrent infections of the respiratory tract, hemoptysis, and dyspnea. Some ILPS patients develop cardiac symptoms, which are a consequence of the lefthemoptysis. In the preoperative investigation, a CT scan of the chest revealed a lesion in the intermediate bronchus (Figure 1), as well as cystic bronchiectasis in the right lower lobe (Figure 2). Fiberoptic bronchoscopy confirme...
Lacaziosis or Jorge Lobo's disease is a fungal, granulomatous, chronic infectious disease caused by Lacazia loboi, which usually affects the skin and subcutaneous tissue. It is characterized by slow evolution and a variety of cutaneous manifestations with the most common clinical expression being nodular keloid lesions that predominate in exposed areas. We report the case of a patient who had an unusual clinical presentation, with a single-plated lesion on the back. Histopathological examination confirmed the diagnosis of Lacaziosis.
Primary follicular mucinosis is a rare dermatosis characterized by the accumulation of mucin in the follicular epithelium and sebaceous glands. Clinically, it is characterized by the presence of papules or well-circumscribed and infiltrated plaques. In this paper, we report the case of a female patient, seven years old, evolving for three months with an asymptomatic, erythematous and infiltrated plaque located in the chin region. The research of thermal, pain and tactile sensitivity was inconclusive. Histological findings confirmed the diagnosis of follicular mucinosis. There was regression of the lesion with the use of medium potency topical corticosteroids for 20 days. The pathogenesis of follicular mucinosis remains unknown, being in some cases associated with lymphoproliferative disorders. In endemic areas of leprosy, isolated and infiltrated follicular mucinosis lesions should be further differentiated from leprosy.
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