Caso Clínico/Case Report
Abcessos cerebrais múltiplos – Uma complicação rara de bronquiectasias
Multiple brain abscesses – A rare complication of bronchiectasis
Natália Melo1,
, Vicens Diaz-Brito2, Clara Chamadoira3, Isabel Gomes4, Adelina Amorim5
Corresponding author
nataliafmelo@hotmail.com
Natália Melo, Serviço de Pneumologia, Hospital de S. João, Alameda Professor Hernâni Monteiro, 4202-451 Porto, Telefone: 919371855.
Natália Melo, Serviço de Pneumologia, Hospital de S. João, Alameda Professor Hernâni Monteiro, 4202-451 Porto, Telefone: 919371855.
1 Interna Complementar de Pneumologia – Serviço de Pneumologia – Director de Serviço: Prof. Dr. Venceslau Hespanhol
2 Assistente Hospitalar de Doenças Infecciosas – Serviço de Doenças Infecciosas – Director de Serviço: Prof. Dr. António Sarmento
3 Interna Complementar de Neurocirurgia – Serviço de Neurocirurgia – Director de Serviço: Prof. Dr. Rui Vaz
4 Assistente Hospitalar Graduada de Pneumologia – Serviço de Pneumologia
5 Assistente Hospitalar de Pneumologia – Serviço de Pneumologia Hospital de S. João, Porto
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João, Porto" "etiqueta" => "5" "identificador" => "af0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cr0005" "etiqueta" => "*" "correspondencia" => "Natália Melo, Serviço de Pneumologia, Hospital de S. João, Alameda Professor Hernâni Monteiro, 4202-451 Porto, Telefone: 919371855." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Multiple brain abscesses – A rare complication of bronchiectasis" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2008-08-26" "fechaAceptado" => "2008-12-15" "PalabrasClave" => array:2 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec570461" "palabras" => array:2 [ 0 => "Bronquiectasias" 1 => "abcesso cerebral" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key-words" "identificador" => "xpalclavsec570462" "palabras" => array:2 [ 0 => "Bronchiectasis" 1 => "brain abscess" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Introdução:</span> O abcesso cerebral (AC) pode surgir como complicação de uma grande variedade de infec-ções, traumatismos ou cirurgias. Os microrganismos podem atingir o cérebro por contiguidade ou por dis-seminação hematogénea. Os AC estão descritos como uma complicação rara de bronquiectasias (BQ).</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Caso clínico:</span> Mulher de 44 anos com história de tuberculose pulmonar na infância e com diagnóstico de BQ bilaterais extensas que apresentou alterações do comportamento e posteriormente paresia do 6.º ner-vo craniano esquerdo, tendo sido diagnosticados AC múltiplos. O estudo microbiológico exaustivo foi negativo. A pesquisa de focos de infecção primária revelou apenas a presença de BQ infectadas. Efectuou tratamento antibiótico empírico e antiedematoso, com melhoria clínica progressiva. Contudo, por persistência das lesões cerebrais, foi submetida a excisão cirúrgica dos AC. Teve alta com diplopia, sem outras alterações neurológicas.</p><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclusão:</span> No presente caso clínico, as BQ foram o único foco de infecção detectado, motivo pelo qual, nos doentes com esta patologia e com alterações neurológicas <span class="elsevierStyleItalic">de novo</span>, deverá ser pesquisada a existência de lesões infecciosas do sistema nervoso central.</p><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009; XV (2): 319-324</span></p></span>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Background:</span> Brain abscess can arise as a complication of a variety of infections, trauma or surgery. Bac-teria can invade the brain by direct spread or through haematogenous seeding. Brain abscesses are described as a rare complication of bronchiectasis.</p><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Case description:</span> A 44-year-old woman with pul-monary tuberculosis in childhood and with the diagnosis of bilateral extensive bronchiectasis who presented behaviour alterations and later, paresis of the sixth cranial nerve, was diagnosed multiple brain abscesses. The microbiological exams were negative. The study of the primary focus of infection could only identify infected bronchiectasis. Empiric antibiotics and anti-oedematous treatment were prescribed with progressive clinical improvement. Because of inadequate response she was submitted to surgery. She was discharged with diplopia, without any other neurological alterations.</p><p id="sp0035" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclusion:</span> In the present clinical case, the infected bronchiectasis were the only focal infection detected, so in patients with this disease and with new neurological manifestations, infected lesions in the central nervous system should be excluded.</p><p id="sp0040" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009; XV (2): 319-324</span></p></span>" ] ] "lecturaRecomendada" => array:1 [ 0 => array:3 [ "vista" => "all" "titulo" => "<span class="elsevierStyleSectionTitle" id="st0025">Bibliografia</span>" "seccion" => array:1 [ 0 => array:2 [ "vista" => "all" "bibliografiaReferencia" => array:27 [ 0 => array:3 [ "identificador" => "bb0005" "etiqueta" => "1." 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Article information
ISSN: 08732159Original language: Portuguese
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