Objective: This study aimed to report the case of a female patient with chronic myeloid leukemia affected by cryptococcal meningitis. Case report: ML, white, 48 years old, female sex, previously diagnosed with chronic...Objective: This study aimed to report the case of a female patient with chronic myeloid leukemia affected by cryptococcal meningitis. Case report: ML, white, 48 years old, female sex, previously diagnosed with chronic myeloid leukemia that has been refractive to the use of imatinib and who has recently begun using nilotinib, was admitted complaining of sudden and disabling migraine in the last 1 month associated with asthenia, adinamia, anorexia, disinterest for daily activities, dizziness, nausea, and vomiting. She evolved with ataxia, and started to stroll with help and showed decrease of muscular strength in her upper limbs. She also presented episodes of decrease of consciousness, with look fixation, no respond to sound stimulation, and short-term hearing loss. The cerebrospinal fluid showed presence of Cryptococcus sp. and, therefore, we began treatment with intravenous liposomal amphotericin B in the dose of 3 mg/kg/day, for 6 weeks. A new cerebrospinal fluid analysis, at the end of treatment, also showed rare structures that are compatible with Cryptococcus sp. As sequelae, she continued with hearing loss in her right ear and enhancement in her right auditory canal, seen in the magnetic resonance imaging. After stabilization and clinical improvement, she was discharged. After 3 weeks, she was hospitalized again with degeneration of the condition, and died due to intracranial hypertension secondary to cryptococcal infection. Final Considerations: This report reinforces the need of reflecting on fungi pathologies, especially in immunosuppressant patients, as well as the importance of early diagnosing and making a fast intervention, with the aims of providing quality of life and comfort to the patient and of minimizing neurological sequelae to the patient.展开更多
Background: Among hemoglobinopathies, the most prevalent in our population are hemoglobins S and C, which are capable of producing disease when homozygous. In cases of double heterozygotes with sickle hemoglobin C (SC...Background: Among hemoglobinopathies, the most prevalent in our population are hemoglobins S and C, which are capable of producing disease when homozygous. In cases of double heterozygotes with sickle hemoglobin C (SC), the disease is less expressive in its clinical condition and rarer. Case report: Patient has a previous hospitalization with pain in the joints in knee and hip and several febrile peaks. Upon physical examination, the patient had difficulty in walking, without edema, pedal and tibial posterior pulses present, with no signs of compartment syndrome. Complementary exams revealed anemia, leukocytosis and lymphopenia. The hemoglobin electrophoresis showed the SC Hemoglobinopathy. The treatment with antibiotic therapy according to the protocol (Oxacillin and Ceftriaxone) was restarted and submitted to joint drainage in affected limb. Conclusion: Osteomyelitis and septic arthritis in patients in the pediatric age group should be considered as serious infections that deserve hospitalization and more expressive treatment.展开更多
文摘Objective: This study aimed to report the case of a female patient with chronic myeloid leukemia affected by cryptococcal meningitis. Case report: ML, white, 48 years old, female sex, previously diagnosed with chronic myeloid leukemia that has been refractive to the use of imatinib and who has recently begun using nilotinib, was admitted complaining of sudden and disabling migraine in the last 1 month associated with asthenia, adinamia, anorexia, disinterest for daily activities, dizziness, nausea, and vomiting. She evolved with ataxia, and started to stroll with help and showed decrease of muscular strength in her upper limbs. She also presented episodes of decrease of consciousness, with look fixation, no respond to sound stimulation, and short-term hearing loss. The cerebrospinal fluid showed presence of Cryptococcus sp. and, therefore, we began treatment with intravenous liposomal amphotericin B in the dose of 3 mg/kg/day, for 6 weeks. A new cerebrospinal fluid analysis, at the end of treatment, also showed rare structures that are compatible with Cryptococcus sp. As sequelae, she continued with hearing loss in her right ear and enhancement in her right auditory canal, seen in the magnetic resonance imaging. After stabilization and clinical improvement, she was discharged. After 3 weeks, she was hospitalized again with degeneration of the condition, and died due to intracranial hypertension secondary to cryptococcal infection. Final Considerations: This report reinforces the need of reflecting on fungi pathologies, especially in immunosuppressant patients, as well as the importance of early diagnosing and making a fast intervention, with the aims of providing quality of life and comfort to the patient and of minimizing neurological sequelae to the patient.
文摘Background: Among hemoglobinopathies, the most prevalent in our population are hemoglobins S and C, which are capable of producing disease when homozygous. In cases of double heterozygotes with sickle hemoglobin C (SC), the disease is less expressive in its clinical condition and rarer. Case report: Patient has a previous hospitalization with pain in the joints in knee and hip and several febrile peaks. Upon physical examination, the patient had difficulty in walking, without edema, pedal and tibial posterior pulses present, with no signs of compartment syndrome. Complementary exams revealed anemia, leukocytosis and lymphopenia. The hemoglobin electrophoresis showed the SC Hemoglobinopathy. The treatment with antibiotic therapy according to the protocol (Oxacillin and Ceftriaxone) was restarted and submitted to joint drainage in affected limb. Conclusion: Osteomyelitis and septic arthritis in patients in the pediatric age group should be considered as serious infections that deserve hospitalization and more expressive treatment.
