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Percorrer por autor "Germano, Nuno"

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  • Acute kidney injury associated with COVID-19 infection : a case report
    Publication . Duarte, Tiago; Caeiro, Fernando; Góis, Mário; Matos, António; Viana, Lena; Vieira, César; Paulos, Jorge; Paixão, Paulo; Matos, Bruno; Germano, Nuno; Nolasco, Fernando
    SARS-Cov2 infection is a highly transmissible disease associated with serious pulmonary disease. Renal involvement is frequent and associated with poor prognosis; however, mechanisms of kidney injury are not well established. We present a SARS-Cov2 patient with severe acute kidney injury. Kidney biopsy findings revealed a pattern of acute tubular necrosis with isometric vacuolization of the proximal tubule. The interstitium and glomeruli were normal. Electronic microscopy showed multiple viral-like particles in both the glomeruli and proximal tubule. This case study shows how SARS-Cov 2 infection can result in different kinds of kidney lesion.
    2021Contributo em revista Acesso aberto Ver mais
  • Fatal case of progressive Mpox in a patient with AIDS : viral enteropathy and malabsorption demanding the use of full parenteral ARV and endovenous cidofovir
    Publication . Caria, João; Vara-Luiz, Francisco; Maia, Inês; Joosten, Anneke; Val-Flores, Luís; Pinheiro, Hélder; Póvoas, Diana; Germano, Nuno; Maltez, Fernando
    We report a fatal case of disseminated mpox infection that progressed over more than three months in an HIV-infected patient with acquired immunodeficiency syndrome (AIDS). Mucocutaneous, pleuropulmonary, central nervous system, and gastrointestinal involvement was documented. This course of disease resembles progressive vaccinia, a formerly reported disease caused by uncontrolled replication of smallpox vaccination orthopoxviruses in immunosuppressed patients. Severe small bowel involvement jeopardized normal oral tecovirimat and antiretroviral therapy absorption. This problem prompted the use of full parenteral antiretrovirals and endovenous cidofovir. Although a remarkable decrease in HIV viral load occurred in six days, mpox infection continued to progress, and the patient died of septic shock. This case offers new clinical insights on the presentation of severe disease in AIDS patients. Moreover, this case alerts for the need for prompt therapy initiation in patients at risk of ominous clinical progression.
    2023-02Contributo em revista Acesso aberto Ver mais