Browsing by Author "Cardoso, O"
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- Bacillary Angiomatosis by Bartonella Quintana in an HIV-Infected PatientPublication . Santos, R; Cardoso, O; Rodrigues, P; Cardoso, J; Machado, J; Afonso, A; Bacellar, F; Marston, E; Proença, RBacillary angiomatosis and bacillary peliosis are opportunistic infections caused by Bartonella henselae and Bartonella quintana, which occur in patients with late-stage infection. We report a case of bacillary angiomatosis in an HIV-infected patient with skin, bone, and probably liver involvement, The identification of the agent (B quintana ) was done by polymerase chain reaction in the skin specimen. The patient had complete regression of all lesions after a 6-month regimen of oral erythromycin.
- Clinical and Epidemiological Features of Hospitalized and Ambulatory Patients with Human Monkeypox Infection: A Retrospective Observational Study in PortugalPublication . Caria, J; Pinto, R; Leal, E; Almeida, V; Cristóvão, G; Gonçalves, AC; Torres, M; Santos, MB; Pinheiro, H; Póvoas, D; Seixas, D; Lino, S; Cardoso, O; Manata, MJ; Virgolino, A; Maltez, FMonkeypox, a neglected and re-emergent zoonotic disease caused by monkeypox virus (MPXV) infection, has been endemic in Central and Western Africa for decades. More recently, an outbreak has spread to a global level, occurring in sites with no previous reported cases and being clustered among men who have sex with men, suggesting new modes of transmission. There is an urgent need for research for a better understanding of the genomic evolution and changing epidemiology of the Orthopoxvirus group. Our work aimed to characterize the clinical and epidemiological features of a cohort of patients with MPXV infection in a Portuguese hospital, admitted between 5 May and 26 July 2022. In this retrospective observational study, aggregate data of a case series on the presentation, clinical course, and outcomes of confirmed MPXV infections are reported. The study included 40 men and 1 woman, with a mean age of 37.2 years old; 92.7% identified as men who have sex with men, 90.2% had unprotected sex or sex with multiple or anonymous partners in the previous month, and 39.0% reported to have had sex with an MPXV-confirmed case; 59.5% had previously known human immunodeficiency virus (HIV) infection, all of whom were under antiretroviral therapy, and no patients had acquired immunodeficiency syndrome (AIDS) criteria. About a quarter of patients were observed only a week after symptom onset. All patients had skin or mucosal lesions and the anogenital region was the most frequent lesion site. There were no statistically significant clinical differences between HIV-positive and negative individuals. Four patients were admitted to the inpatient clinic, two of whom had proctitis with difficult-to-manage anal pain. There were no reported deaths. Our findings suggest the sexual route as a relevant mode of transmission of MPXV and confirm the mostly benign presentation of this disease.
- Immunodeficiency and Autoimmunity Coming Together: a Nearly Missed DiagnosisPublication . Carreiro, F; Betkova, S; Sepúlveda, C; Manata, MJ; Cardoso, O; Maltez, F; Moraes-Fontes, MFThe coexistence of human immunodeficiency virus (HIV) and systemic lupus erythematosus (SLE) appears to be unusual and the prevalence of patients who carry the dual diagnosis is currently unknown. We hereby present a case of a C4 deficient HIV-1 positive Caucasian female under highly active antiretroviral therapy for the past eight years, admitted to hospital with an aggressive and potentially fatal clinical presentation of SLE. There was a favorable outcome despite a significant diagnostic delay. Despite its rarity, the case highlights that this association is remarkable and may be overlooked by clinicians familiar with either condition.
- Síndrome de Hipersensibilidade ao Alopurinol Simulando Linfoma CutâneoPublication . Rodrigues, P; Fernandes, C; Machado, J; Cardoso, O; Pereira, F; Botelho, A; Afonso, A; Proença, RAs reacções cutâneas secundárias às drogas são frequentes (em 2 a 3% dos doentes hospitalizados); embora na maioria sem gravidade, num pequeno número de casos podem atingir elevada morbilidade e mortalidade. É por isso essencial o rápido reconhecimento das reacções mais graves, como por exemplo síndrome de Stevens-Johnson, necrólise epidérmica tóxica ou síndrome de hipersensibilidade. Neste último as drogas mais frequentemente responsáveis são os antiepilépticos, sulfonamidas e alopurinol. Os síndromes de hipersensibilidade a fármacos assumem raramente características clínicas e sobretudo histológicas quase indistinguíveis dos verdadeiros linfomas cutâneos. Nestes casos a diferenciação entre estas duas entidades, embora difícil, é muito importante pelas naturais implicações terapêuticas. A este propósito os autores descrevem o caso clínico de um doente de 51 anos, com febre elevada de início abrupto e eritrodermia, em que o exame histológico das biópsias cutânea e ganglionar foi de linfoma cutâneo de células T com envolvimento ganglionar específico. Veio no entanto a apurar-se que o doente tinha sido medicado com alopurinol duas semanas antes do início da febre. As características clínico-laboratoriais e a evolução vieram a comprovar o diagnóstico de síndrome de hipersensibilidade ao alopurinol.
- Síndrome Hemolítico-UrémicoPublication . Rodrigues, P; Machado, J; Cardoso, O; Cruz, J; Carvalho, F; Marques da Costa; Proença, ROs síndromes de mieroangiopatia trombótica - Púrpura Trombótica Trombocitopénica (PTT) e Síndrome Hemolftico Urémico (SHU) - são caracterizados por anemia hemolftica microan giopática, trombocitopénia, alterações da função renal, febre e anomalias do sistema nervoso central. Actualmente são considerados como dois extremos de um espectro contínuo designado PTT- SHU. São doenças raras com uma taxa de mortalidade elevada, apesar dos avanços na terapêutica. Os autores descrevem um caso de síndrome hemolítico urémico num adulto jovem em que o curso inicial e a primeira biópsia sugeriam bom prognóstico. Contudo a recaída precoce e o aparecimento de hipertensão arterial grave implicaram um desfecho fatal em 6 meses. A este propósito os autores fazem uma revisão de alguns dos aspectos mais recentes da patogénese e tratamento deste síndrome.