João Maurício Scarpellini Campos

Pneumocephalus and Exophthalmos Secondary To Acute Sinusitis and Nasopharyngeal Oxygen Catheter

Pneumocephalus is a well-known complication of skull trauma, certain neurosurgical procedures, and sinus neoplasms.1,2 The association between pneumocephalus and infection is very rare, usually occurring in patients with mastoiditis, chronic otitis media, and sinusitis.1,3 In a recent report, pneumocephalus and exophthalmos developed secondary to administration of oxygen by a nasopharyngeal catheter in a patient without sinusitis.4 We describe an infant admitted for treatment of bacterial pneumonia and maxillary and ethmoid sinusitis, in whom pneumocephalus and right-sided severe exophthlalmos developed while the patient was receiving oxygen by a nasopharyngeal catheter.

Cryptococcus gattii molecular type VGII as agent of meningitis in a healthy child in Rio de Janeiro, Brazil: report of an autochthonous case

Cryptococcus gattii causes meningoencephalitis in immunocompetent hosts, occurring endemically in some tropical and subtropical regions. Recently, this fungus was involved in an outbreak in Vancouver Island and British Columbia (Canada). In this temperate region, the VGII type is predominant. The paper describes an autochthonous case of meningoencephalitis by C. gattii VGII in a previously health child in Rio de Janeiro, considered nonendemic region of Brazil. The fungus was identified by biochemical tests and the molecular type was determined by URA5-RFLP. The present report highlights the need for clinical vigilance for primary cryptococcal meningitis in nonendemic areas.

[Non-reactive tuberculosis: a clinicopathological study].

The authors report a case of non-reactive tuberculosis diagnosed at autopsy. This is a very rare type of clinical presentation of tuberculosis and is usually associated with immunosuppression and gross abnormalities of haemopoiesis.

Positive reaction for cysticercosis and multicentric anaplastic oligoastrocytoma

IntroductionAn unusual case of positive immunological testing for cysticercosis in the cystic fluid obtained from an anaplastic oligoastrocytoma is presented.Case reportA 15-year-old boy was admitted with multiple brain lesions. The biggest was a cyst with a mural node and neurocysticercosis was suspected. In order to relieve intracranial pressure, the cyst was punctured and the immunological testing for cysticercosis was positive, reinforcing the clinical suspicion and leading to a clinical trial with albendazole and steroids. As the patient deteriorated the cystic lesion was removed and the diagnosis of anaplastic oligoastrocytoma was established. A second lesion was eventually approached and the histopathological diagnosis of both specimens concurred.DiscussionAlthough some authors believe that chronic inflammatory changes following neurocysticercosis could induce the formation of brain tumors, this association may be a mere coincidence. In our case no clinical evidence of a prior infestation by Cysticercus was found. In fact, an exhaustive examination of the specimens did not reveal any areas of inflammatory reaction. We believe that the similarity of the glioma and cysticercosis antigens may be the cause of the positive reactions in the cystic fluid.