Browsing by Author "Pedro, B"
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- Nódulo de irmã Mary-Joseph – a primazia da clínicaPublication . Pedro, B; Sousa, R; Patrícia, T; Aldomiro, FO nódulo da Irmã Mary Joseph (NIMJ) trata-se de um nódulo palpável na região peri-umbilical, com origem em tumores metastáticos avançados intra-abdominais ou intra-pélvicos. O nódulo da Irmã Mary Joseph pode ser o primeiro sinal de neoplasia e indica doença avançada, bem como, mau prognóstico. Apresentamos o caso de um homem de 61 anos de idade, com um nódulo umbilical à admissão, cujo estudo adicional revelou um tumor do pâncreas.
- Not All ENT Granulomas Are Wegener's - Keep Tuberculosis in Mind.Publication . Pedro, B; Meleiro, M; Marinho, AMycobacterium tuberculosis affects the middle ear in rare cases and is a challenging diagnosis. In this case, we present a 57-year-old patient diagnosed with anti-neutrophil cytoplasmic antibody (ANCA)-negative granulomatosis with polyangiitis (GPA) following a biopsy result of nasal granulomas, who was immediately started on immunosuppressive treatment. Years later, she developed progressive hypoacusis. Magnetic resonance imaging (MRI) revealed an extensive mass in the tympanic cavity extending to the mastoid. A biopsy of the mass was positive for Mycobacterium tuberculosis. Immunosuppressants were weaned and the patient was started on anti-tuberculous therapy with resolution of the complaints and findings. Tuberculous infections are difficult to diagnose and frequently mimic other illnesses, but in our case, we believe that an indolent tuberculous process was present from the beginning and evolved under immunosuppressive therapy. LEARNING POINTS: The differential diagnosis of rhinosinus granulomatous findings includes inflammatory and infectious diseases (for example, tuberculous infections), in addition to neoplasms, cocaine abuse and trauma.A comprehensive differential diagnosis list is essential to mitigate diagnostic errors, especially in patients where auto-immune studies are negative or there is any doubt in the diagnosis.Latent tuberculosis screening should be a concern for physicians treating patients with immunosuppressive therapy, especially in endemic countries.
- Pituitary Apoplexy May Be Mistaken for Temporal ArteritisPublication . Pedro, B; Patrícia, T; Aldomiro, FPituitary apoplexy is a rare endocrine emergency, characterized by a sudden increase in pituitary gland volume secondary to acute ischaemic infarction or haemorrhage of the pituitary gland, usually in the presence of a pituitary adenoma. We present the case of a 79-year-old man admitted for new-onset, bi-temporal and severe headache, associated with photophobia and vomiting, whose additional study revealed pituitary apoplexy. This case highlights the need for high clinical suspicion of this rare entity in order to reduce the associated mortality.
- Scrofula Caused by Multidrug-Resistant TuberculosisPublication . Pedro, B; Alves, L; Magano, R; Nunes, T; Marques, NTuberculosis (TB) is one of the top 10 causes of death worldwide. Multidrug-resistant tuberculosis (MDR-TB) occurs when at the minimum there is resistance to isoniazid and rifampin. Prevention of new infections of Mycobacterium tuberculosis and progression to TB disease is critical to reduce the burden and mortality of this disease. We present the case of a 73-year-old human immunodeficiency virus (HIV)-negative female who presented with cervical lymphadenopathy and who was diagnosed with MDR-TB. LEARNING POINTS: Tuberculosis is one of the most important causes of morbidity and mortality worldwide and approximately a quarter of the world's population is estimated to be latently infected by Mycobacterium tuberculosis.Multidrug-resistant tuberculosis lymphadenitis is a rare manifestation of the disease in Portugal.With the advent of multidrug-resistant tuberculosis, disease surveillance by the government should be intensified, with the aim of national and global TB control, focusing on prevention.