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- Cytomegalovirus Pulmonary Involvement in an Immunocompetent AdultPublication . Luís, Helena; Barros, Carolina; Gomes, Mariana; Andrade, José Luís; Faria, NancyCytomegalovirus (CMV) is a linear double-stranded DNA virus that may cause severe and potentially fatal infection in immunocompromised hosts. In immunocompetent individuals, the infection is typically mild or asymptomatic. However, in the last years, some cases of severe cytomegalovirus infection in immunocompetent individuals have been described. Clinical Presentation. 'e authors present a male patient aged 42 years, without specific medical history, who presented a 15-day history of fever, headache, night sweats, odynophagia, and bilateral otalgia, without improvement after four days of therapy with amoxicillin/clavulanic acid. Blood count and biochemistry were performed with liver cytolysis pattern. Chest teleradiography showed diffuse interstitial infiltrate. 'oracic CT scan revealed areas in a ground glass with a cross-linking component in the left and right upper lung lobes compatible with an inflammatory/infectious process. Blood serology was positive for CMV IgG and IgM. 'e detection on blood and bronchoalveolar lavage of CMV DNA by polymerase chain reaction (PCR) was also positive. Ganciclovir was started based on the clinical features and the result of CMV serology. After 48 hours, there was a significant clinical improvement, with remission of fever, and he was discharged on the 13th day of hospitalization with oral valganciclovir, completing a 21-day antiviral course at home. Conclusion. With this clinical case, the authors highlight the importance of considering CMV infection in evaluating patients with pneumonia, even in immunocompetent ones, particularly in those with no clinical improvement with antibiotics instituted for bacterial pneumonia, and when other causes have been ruled out
- Pneumomediastino Espontâneo: Uma Complicação de um Jogo de FutebolPublication . Barros, Carolina; Gomes, Rodolfo Viríssimo; Morna, Carolina; Gomes, Mariana; Luís, HelenaPneumomediastino espontâneo é uma entidade autolimitada cujo fator desencadeante nem sempre é passível de ser identificado. Deverá ser contemplado no diagnóstico diferencial da toracalgia súbita, especialmente em jovens do sexo masculino de morfologia longilínea. O seu diagnóstico é determinado pela suspeição clínica e é fundamento pelos exames imagiológicos. O prognóstico é maioritariamente benigno e o tratamento assenta essencialmente em medidas conservadoras.