Erick Malheiro Leoncio Martins

Histoplasmose pulmonar aguda: relato de uma microepidemia

The authors report a pulmonary histoplasmosis outbreak occurring in five children after the cleaning of a deactivated coal furnace. The symptoms were high fever, dry cough, asthenia and anorexia. By the time parents seeked for medical care, only one child remained symptomatic with fever, tachypnea and hepatomegaly. All the patients had similar radiological findings. Chest films showed diffuse, bilateral, reticulonodular infiltrates and lymph node enlargement. Computed tomography showed small nodules with a random distribution and hilar and mediastinal lymph nodes. Diagnosis was confirmed by positive gel immunodiffusion for Histoplasma capsulatum. Only one patient needed to be hospitalized to receive supportive treatment. The use of antifungal agents was not necessary in any of the patients. After 50 days all patients were submitted to computed tomography studies that revealed significant remission of the lesions.

Ruptura traumática do diafragma: aspectos na tomografia computadorizada

Traumatic diaphragmatic rupture is an uncommon condition that has been diagnosed more frequently with the aid of computed tomography, particularly when using helical technique in association with multiplanar reconstructions. This technique allows adoption of an efficient and quick surgical therapeutic approach. The authors studied six patients with traumatic diaphragmatic rupture that were submitted to computed tomography. In four of the patients there was herniation of intraabdominal viscera through a site of rupture in the left diaphragm. The two other patients underwent surgery due to abdominal injuries, which revealed diaphragmatic lesions but no herniation of intraabdominal viscera.

Nocardiose pulmonar em paciente com síndrome da imunodeficiência adquirida: relato de caso

The authors describe a case of pulmonary nocardiosis in a 37-year-old man with acquired immunodeficiency syndrome in treatment with antiretroviral drugs. Clinical symptoms were productive cough, hemoptysis and progressive weight loss. A chest x-ray film showed a right upper lobe consolidation while the computed tomography demonstrated consolidation and areas of cavitation. The radiologic findings were unspecific. Consequently, a bronchoscopy with bronchoalveolar lavage was performed, revealing filamentous Gram-positive bacteria (Nocardia sp). Treatment with trimethoprim-sulfamethoxazole resulted in complete remission of the respiratory symptoms. The authors review the literature and discuss the main radiological features of this disease.

Pneumonia lipídica - aspectos na tomografia computadorizada: relato de caso

The authors report a case of lipoid pneumonia in an 80-year-old man with chronic constipation in regular use of mineral oil as a laxative. According to his family, he experienced coughing episodes when he took his medication. He also presented dyspnea at rest and diminished consciousness levels. Chest radiographs showed a consolidation area in the posterior segment of right upper lobe, which did not change on successive exams. High resolution computed tomography demonstrated low-density consolidation with negative Hounsfield units (-29 to -83 UH) and ground-glass opacities in the right upper lobe and inferior lobes. These opacities predominated in the posterior regions of the lungs. The diagnosis was confirmed by the presence of oil material on bronchoalveolar washing. The patient was advised to discontinue the ingestion of mineral oil and did not return for follow-up.