Infecção fúngica pulmonar por hialo-hifomicose associada a zigomicose e Actinomyces spp. em paciente com espondilite anquilosante Pulmonary fungal infection with hyalohyphomycosis associated with zygomycosis and Actinomyces spp. in a patient with ankylosing spondylitis
A espondilite anquilosante (EA) pode cursar com manifestações extra-articulares e, dentre elas, as pulmonares. A fibrose nos ápices pulmonares ocorre em até 30% dos casos e as formações císticas são menos frequentes e observadas em casos avançados. A colonização dessas cavidades é uma complicação ra...
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Sociedade Brasileira de Reumatologia
2009-10-01
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| Series: | Revista Brasileira de Reumatologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0482-50042009000500013 |
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| author | Valderílio Feijó Azevedo Lúcio Ricardo Hiurko Felippe Larissa Luvison Gomes da Silva Carlos Frederico Rodrigues Parchen Flávio Queiros Telles |
| author_facet | Valderílio Feijó Azevedo Lúcio Ricardo Hiurko Felippe Larissa Luvison Gomes da Silva Carlos Frederico Rodrigues Parchen Flávio Queiros Telles |
| author_sort | Valderílio Feijó Azevedo |
| collection | DOAJ |
| description | A espondilite anquilosante (EA) pode cursar com manifestações extra-articulares e, dentre elas, as pulmonares. A fibrose nos ápices pulmonares ocorre em até 30% dos casos e as formações císticas são menos frequentes e observadas em casos avançados. A colonização dessas cavidades é uma complicação rara. Um paciente com diagnóstico de EA desde 1998, com comprometimento axial, histórico de tuberculose pulmonar tratada em 2002 e 2007, evoluiu com um quadro de aspergilose bilateral em ápices pulmonares associada à zigomicose e Actinomyces spp. Havia sido internado para investigar queixa de emagrecimento, sudorese noturna, tosse produtiva e lesão nos ápices pulmonares. Foi submetido a tratamento cirúrgico de lobectomia de lobo pulmonar superior direito, após identificação de bola fúngica nos ápices pulmonares nas radiografias e tomografias, comprovados por exames de fibrobroncoscopia e biópsia com exame anatomopatológico. Evoluiu sem expansão pulmonar direita, foi submetido à nova fibrobroncoscopia que sugeriu oclusão do brônquio lobar médio. Uma nova toracotomia não confirmou o achado da fibrobroncoscopia. Permaneceu sem expansão pulmonar direita, evoluiu com choque séptico refratário ao tratamento e ao óbito.<br>Ankylosing spondylitis (AS) can be associated with extra-articular manifestations, among which we find pulmonary disorders. Fibrosis of the pulmonary apices is seen in up to 30% of the cases, and cyst formation is less common, being seen in advanced cases. Colonization of those cavities is a rare complication. A patient with a diagnosis of AS since 1998 with axial involvement and history of pulmonary tuberculosis treated in 2002 and 2007, developed bilateral aspergillosis of the pulmonary apices associated with zygomycosis and Actinomyces spp. The patient had been hospitalized to investigate complaints of weight loss, nocturnal diaphoresis, productive cough, and lesion in both lung apices. He was submitted to right upper pulmonary lobectomy after identification of a fungus ball on chest X-ray and CT scan, which was confirmed by a fibrobronchoscopy and biopsy for anatomopathological exam. The patient evolved without expansion of the right lung and underwent another fibrobronchoscopy that suggested occlusion of the middle lobar bronchus. Repeat thoracotomy did not confirm the findings of the last fibrobronchoscopy, but the right lung failed to expand. The patient developed septic shock refractory to treatment and died. |
| first_indexed | 2024-04-13T03:06:48Z |
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| institution | Directory Open Access Journal |
| issn | 0482-5004 1809-4570 |
| language | English |
| last_indexed | 2024-04-13T03:06:48Z |
| publishDate | 2009-10-01 |
| publisher | Sociedade Brasileira de Reumatologia |
| record_format | Article |
| series | Revista Brasileira de Reumatologia |
| spelling | doaj.art-b131ccdd9b43479d89403440ee093a322022-12-22T03:05:13ZengSociedade Brasileira de ReumatologiaRevista Brasileira de Reumatologia0482-50041809-45702009-10-0149563063710.1590/S0482-50042009000500013Infecção fúngica pulmonar por hialo-hifomicose associada a zigomicose e Actinomyces spp. em paciente com espondilite anquilosante Pulmonary fungal infection with hyalohyphomycosis associated with zygomycosis and Actinomyces spp. in a patient with ankylosing spondylitisValderílio Feijó AzevedoLúcio Ricardo Hiurko FelippeLarissa Luvison Gomes da SilvaCarlos Frederico Rodrigues ParchenFlávio Queiros TellesA espondilite anquilosante (EA) pode cursar com manifestações extra-articulares e, dentre elas, as pulmonares. A fibrose nos ápices pulmonares ocorre em até 30% dos casos e as formações císticas são menos frequentes e observadas em casos avançados. A colonização dessas cavidades é uma complicação rara. Um paciente com diagnóstico de EA desde 1998, com comprometimento axial, histórico de tuberculose pulmonar tratada em 2002 e 2007, evoluiu com um quadro de aspergilose bilateral em ápices pulmonares associada à zigomicose e Actinomyces spp. Havia sido internado para investigar queixa de emagrecimento, sudorese noturna, tosse produtiva e lesão nos ápices pulmonares. Foi submetido a tratamento cirúrgico de lobectomia de lobo pulmonar superior direito, após identificação de bola fúngica nos ápices pulmonares nas radiografias e tomografias, comprovados por exames de fibrobroncoscopia e biópsia com exame anatomopatológico. Evoluiu sem expansão pulmonar direita, foi submetido à nova fibrobroncoscopia que sugeriu oclusão do brônquio lobar médio. Uma nova toracotomia não confirmou o achado da fibrobroncoscopia. Permaneceu sem expansão pulmonar direita, evoluiu com choque séptico refratário ao tratamento e ao óbito.<br>Ankylosing spondylitis (AS) can be associated with extra-articular manifestations, among which we find pulmonary disorders. Fibrosis of the pulmonary apices is seen in up to 30% of the cases, and cyst formation is less common, being seen in advanced cases. Colonization of those cavities is a rare complication. A patient with a diagnosis of AS since 1998 with axial involvement and history of pulmonary tuberculosis treated in 2002 and 2007, developed bilateral aspergillosis of the pulmonary apices associated with zygomycosis and Actinomyces spp. The patient had been hospitalized to investigate complaints of weight loss, nocturnal diaphoresis, productive cough, and lesion in both lung apices. He was submitted to right upper pulmonary lobectomy after identification of a fungus ball on chest X-ray and CT scan, which was confirmed by a fibrobronchoscopy and biopsy for anatomopathological exam. The patient evolved without expansion of the right lung and underwent another fibrobronchoscopy that suggested occlusion of the middle lobar bronchus. Repeat thoracotomy did not confirm the findings of the last fibrobronchoscopy, but the right lung failed to expand. The patient developed septic shock refractory to treatment and died.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0482-50042009000500013espondilite anquilosantehialo-hifomicosezigomicoseactinomicoseankylosing spondylitishyalohyphomycosiszygomycosisactinomycosis |
| spellingShingle | Valderílio Feijó Azevedo Lúcio Ricardo Hiurko Felippe Larissa Luvison Gomes da Silva Carlos Frederico Rodrigues Parchen Flávio Queiros Telles Infecção fúngica pulmonar por hialo-hifomicose associada a zigomicose e Actinomyces spp. em paciente com espondilite anquilosante Pulmonary fungal infection with hyalohyphomycosis associated with zygomycosis and Actinomyces spp. in a patient with ankylosing spondylitis Revista Brasileira de Reumatologia espondilite anquilosante hialo-hifomicose zigomicose actinomicose ankylosing spondylitis hyalohyphomycosis zygomycosis actinomycosis |
| title | Infecção fúngica pulmonar por hialo-hifomicose associada a zigomicose e Actinomyces spp. em paciente com espondilite anquilosante Pulmonary fungal infection with hyalohyphomycosis associated with zygomycosis and Actinomyces spp. in a patient with ankylosing spondylitis |
| title_full | Infecção fúngica pulmonar por hialo-hifomicose associada a zigomicose e Actinomyces spp. em paciente com espondilite anquilosante Pulmonary fungal infection with hyalohyphomycosis associated with zygomycosis and Actinomyces spp. in a patient with ankylosing spondylitis |
| title_fullStr | Infecção fúngica pulmonar por hialo-hifomicose associada a zigomicose e Actinomyces spp. em paciente com espondilite anquilosante Pulmonary fungal infection with hyalohyphomycosis associated with zygomycosis and Actinomyces spp. in a patient with ankylosing spondylitis |
| title_full_unstemmed | Infecção fúngica pulmonar por hialo-hifomicose associada a zigomicose e Actinomyces spp. em paciente com espondilite anquilosante Pulmonary fungal infection with hyalohyphomycosis associated with zygomycosis and Actinomyces spp. in a patient with ankylosing spondylitis |
| title_short | Infecção fúngica pulmonar por hialo-hifomicose associada a zigomicose e Actinomyces spp. em paciente com espondilite anquilosante Pulmonary fungal infection with hyalohyphomycosis associated with zygomycosis and Actinomyces spp. in a patient with ankylosing spondylitis |
| title_sort | infeccao fungica pulmonar por hialo hifomicose associada a zigomicose e actinomyces spp em paciente com espondilite anquilosante pulmonary fungal infection with hyalohyphomycosis associated with zygomycosis and actinomyces spp in a patient with ankylosing spondylitis |
| topic | espondilite anquilosante hialo-hifomicose zigomicose actinomicose ankylosing spondylitis hyalohyphomycosis zygomycosis actinomycosis |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0482-50042009000500013 |
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