The article describes a case of polysegmental destructive viral-bacterial pneumonia complicated with acute pulmonary abscess, pleural empyema, and pneumopleurofibrosis in a 50-year-old female patient infected with the SARS-CoV-2 virus. The first clinical, laboratory and radiological signs of purulent-necrotic inflammation appeared only 20 days after receiving a positive RT-PCR test result with a nasopharyngeal swab. A month later, an emerging abscess in the lower lobe of the right lung was diagnosed. Subsequently, it spontaneously drained into the pleural cavity.Coagulopathy with the formation of microthrombi in small pulmonary vessels is one of the causative factors of lung abscess in patients infected with the SARS-CoV-2 virus.
Представлен клинический разбор случаев COVID-19, сочетанных с острыми респираторными заболеваниями.Цель исследования -анализ клинических и лабораторных данных пациентов при сочетанной с COVID-19 инфекцией.У пациента А., инфицированного SARS-CoV-2, без рентгенологического подтверждения поражения легких выявлены острый тонзиллит, полиаденопатия, гепатоспленомегалия, умеренный лейкоцитоз, лимфомоноцитоз и присутствие реактивных лимфоцитов. С целью дифференциальной диагностики проведены серологические и молекулярно-биологические исследования. Получен положительный результат анализа на антитела IgM к вирусу Эпштейна-Барр (ВЭБ). Методом полимеразной цепной реакции (ПЦР) выявлена дезоксирибонуклеиновая кислота (ДНК) ВЭБ в плазме крови. Результат определения гетерогенных антител IgG к каспидному антигену ВЭБ -отрицательный.У пациентки М. с COVID-19 диагноз подтвержден серологическими реакциями и характерными рентгенологическими изменениями в легких. Выявлены клинические симптомы: лихорадка, боль в горле при глотании, гиперемия и гипертрофия нёбных миндалин, гепатомегалия, изменения в клеточном составе крови. Вместе с тем лимфатические узлы на шее, в грудной и брюшной полости не были увеличены, не обнаружено присутствия реактивных лимфоцитов и плазматических клеток. Не выявлены серологические маркеры ВЭБ, а ПЦР-тест на ДНК ВЭБ дал отрицательный результат.Финансирование. Исследование не имело спонсорской поддержки. Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов. Вклад авторов. Концепция и дизайн исследования, написание текста и его редактирование -Каленчиц Т.И., Кабак С.Л.; сбор материала и его обработка -Рысевец Е.В.
The myocardial bridge (MB) is a congenital anomaly, in which a segment of a coronary artery courses through the myocardium. The aim of the study was to establish the location of myocardial bridges and the severity of atherosclerotic lesions of the coronary arteries in patients with coronary heart disease symptoms and in individuals who are the potential heart donors for transplantation. The data of the multislice computed tomography coronary angiography of the patients of the Republican Scientific and Practical Centre “Cardiology” from 2016 to 2018 were included in this study. 324 hearts of the deceased donors, which had not been used for orthotopic transplantation, were studied. According to the autopsy and the CT coronary angiography, the myocardial bridges were localized mainly in the left anterior descending artery of the left coronary artery (LCA). In 7.4 % of cases, MBs were found in a distal portion of the intermediate branch of LCA, in the left postero-lateral branch, in the right coronary artery, in the first diagonal artery, as well as along the obtuse marginal artery and the left circumflex coronary artery. In 36 % of cases, the identified bridges were considered as hemodynamically significant with regard to the length of the tunneled artery segment and its depth. Microscopic examination of the tunneled fragments of the coronary arteries in 4.9 % of cases showed the initial signs of damage of the vessel wall in the form of fibromuscular dysplasia and lipidosis. According to the CT coronary angiography results, no causal relationship has been established between the presence of MBs and atherosclerosis in the subepicardial segments of the coronary arteries.
This article reports on head-and-neck computed tomography angiography imaging findings and data of ultrasound examination of the extracranial carotid and vertebral arteries of 69-year-old patient with unilateral asymptomatic complete occlusion of extracranial internal carotid artery (ICA) in combination with unusually elongated styloid processes of temporal bone. The aim of the study was to specify the collateral pathways blood supply to the brain and to assess the possible clinical significance of an abnormally elongated styloid pro cess. Adequate cerebral blood flow was provided by anastomoses between the arteries at the base of the brain. This can explain the asymptomatic unilateral complete occlusion of the extracranial ICA. Occlusion of the artery was not associated with the presence of a 5.5 cm styloid process. Computed tomography angiography is a highly informative method for visualizing the individual morphological variants to clarify their clinical significance.
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