27/Jan/2022
Mysterious ureteral migration of a wooden toothpick from the digestive tract: case report and diagnostic considerations
DOI: 10.31744/einstein_journal/2022RC5743
ABSTRACT Migration of foreign bodies into the urinary tract is a rare event. In certain instances, to unravel the way that objects arrived in the urinary tract is not easy. We report the case of an accidentally swallowed wooden toothpick that migrated and was found in the left ureterovesical junction, protruding into the bladder. Even though the computed tomography scan is widely employed to evaluate the urinary tract, this resource does not have a good sensitivity for detecting foreign bodies. […]
Keywords: Foreign bodies; Toothpick; Ureter
27/Jan/2022
COVID-19 related acute genital ulcer: a case report
DOI: 10.31744/einstein_journal/2022RC6541
ABSTRACT Acute vulvar ulcer (Lipschütz’s ulcer) is a rare lesion with local hyperimmunoreactivity triggered by infection, which is characterized by acute, painful, and necrotic ulcerations. This condition is usually found in non-sexually active adolescents, and it resolves spontaneously. We report a case of a 35-year-old woman who was diagnosed with COVID-19 who did not have severe symptoms, but had high levels of D-dimer for 9 days. The COVID-19 diagnosis was followed by the appearance of an acute, necrotic, extremely painful […]
Keywords: Coronavirus infections; COVID-19; Lipschütz’s ulcer; Vulvar diseases
25/Nov/2021
Long term persistence of coronavirus SARS-CoV-2 infection
DOI: 10.31744/einstein_journal/2021RC6369
ABSTRACT During the COVID-19 pandemic, a case of a long-term persistence of SARS-CoV-2 infection (from March 26 to May 20, 2020) was identified at a private hospital in São Paulo, SP, Brazil. The long-term positivity for SARS-CoV-2 in reverse transcriptase polymerase chain reaction tests of a patient diagnosed with COVID-19 suggests, at least part of patients who recovered, may still carry and transmit the SARS-CoV-2 virus. This fact emphasizes the importance of having at least two negative reverse transcriptase polymerase […]
Keywords: COVID-19; Infecções Coronavírus
13/May/2021
Primary cutaneous histoplasmosis difficult to treat in immunocompetent patient: case report and literature review
DOI: 10.31744/einstein_journal/2021RC5488
ABSTRACT Histoplasmosis is an infection caused by the dimorphic fungus Histoplasma capsulatum. The disease is endemic in several regions of tropical and temperate climate. The fungus presents opportunistic behavior, causing widespread infection in immunocompromised patients, resulting from complication of primary pulmonary infection, due to exogenous reinfection or reactivation of a quiescent source. In immunocompetent individuals, approximately 95% of pulmonary infections are asymptomatic. However, prolonged exposure to high amount spores may lead to acute or chronic lung infection. Due to the […]
Keywords: Histoplasmosis; Immunocompetence; Itraconazole
13/May/2021
Use of wide-field optical fluorescence for visualization of oral biofilm in a patient with peri-implant mucositis: a new approach
DOI: 10.31744/einstein_journal/2021RC5638
ABSTRACT Peri-implant diseases, caused by bacteria from biofilm related to dental implants, are one of the main causes of late loss of implants. In this sense, peri-implant diseases are divided into peri-implant mucositis, when it affects only the soft tissues, and peri-implantitis, when there is a bone involvement, which can lead to the failure of dental implant therapy. Thus, biofilm removal is essential for peri-implant health, allowing long-term success in implant therapy. To improve the visualization of oral biofilm, which […]
Keywords: Biofilms; Dental implantation; Diagnosis, oral; Gram-negative anaerobic bacteria; Mucositis
28/Apr/2021
Efficacy and safety of dupilumab in two adolescents with severe atopic dermatitis
einstein (São Paulo). 28/Apr/2021;19:eRC6064.
View Article28/Apr/2021
Efficacy and safety of dupilumab in two adolescents with severe atopic dermatitis
DOI: 10.31744/einstein_journal/2021RC6064
ABSTRACT We report the cases of two adolescent siblings with severe atopic dermatitis, who, despite weighing approximately 40kg, presented a good response to dupilumab with the off-label dose for individuals aged 12 years and weighing 60kg. Both had already used cyclosporine, azathioprine, methotrexate and oral corticosteroids for long periods, plus topical treatments with no adequate disease control. Skin lesions were constant and widespread, with frequent skin infections and very poor quality of life, with numerous physical and psychosocial consequences, such […]
Keywords: Adolescent; Azathioprine; Conjunctivitis, allergic; Dermatitis, atopic/drug therapy; Dermatologic agents; Dupilumab; Efficacy; Immunosuppressive agents; Safety; Severity of illness index
19/Feb/2021
Paracentral acute middle maculopathy in patient with atherosclerosis and angioplasty with stents in the coronary artery
DOI: 10.31744/einstein_journal/2021RC5521
ABSTRACT Sophisticated imaging systems have helped to redefine the clinical presentation of acute macular neuroretinopathy and have markedly enhanced diagnostic sensitivity. The proposed mechanism of paracentral acute middle maculopathy is related to ischemia at the level of the superficial and deep retinal capillary plexi. This is a case report of a patient who developed an acute macular neuroretinopathy after an uneventful angioplasty with stents in the coronary artery.
Keywords: Angioplasty; Constriction, pathologic; Macula lutea; Macular degeneration; Retinal vessels; Stents; Tomography, optical coherence
26/Nov/2020
Caecal appendix lipomatosis in a pregnant patient mimicking acute appendicitis
DOI: 10.31744/einstein_journal/2020RC5415
ABSTRACT A 34-years-old pregnant woman admitted in the emergency unit complaining about worsening right iliac fossa pain for 2 days. Acute appendicitis was the suspected diagnosis. Laboratory exams were ordered and results were within normal limits for infectious and inflammatory aspects. Ultrasound scan revealed a pregnancy in course without alterations and a thickness of the appendix wall without inflammatory signs in the surrounding tissue. Because the suspicion of acute appendicitis remained, a magnetic resonance was done and confirmed the diagnosis […]
Keywords: Appendicitis; Diagnosis, differential; Lipomatosis; Magnetic resonance imaging; Pregnant Women; Ultrasonography
26/Nov/2020
Radiation-induced angiosarcoma: case report
DOI: 10.31744/einstein_journal/2020RC5439
ABSTRACT Angiosarcoma of the breast accounts for less than 1% of breast tumors. This tumor may be primary or secondary to previous radiation therapy and it is also named “radiogenic angiosarcoma of the breast”, which is still a rare entity with a poor prognosis. So far, there are only 307 cases reported about these tumors in the literature. We present a case of a 73-year-old woman with a prior history of breast-conserving treatment of right breast cancer, exhibiting mild pinkish […]
Keywords: Breast neoplasms/radiotherapy; Hemangiosarcoma; Mastectomy
26/Nov/2020
Transfusion-related acute lung injury associated to intravenous immunoglobulin infusion in a pediatric patient
DOI: 10.31744/einstein_journal/2020RC5606
ABSTRACT Case report of a patient with an immunodeficiency who demands regular replacement of intravenous immunoglobulin. She presented an episode of transfusion-related acute lung injury shortly after using an immunoglobulin product different than the one she usually received. The patient evolved with respiratory changes (hypoxia, dyspnea, change in pulmonary auscultation) minutes after the end of the infusion, and received non-invasive respiratory support. She was discharged after 36 hours with good outcome. The patient achieved full recovery, showing no further reactions […]
Keywords: Child; Drug-related side effects and adverse reactions; Immunoglobulins; Immunoglobulins, intravenous; Immunologic deficiency syndromes; Transfusion-related acute lung injury