Repositório Científico da Unidade Local de Saúde de Santo António
Scientific Repository of the ULS Santo António
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Miliary tuberculosis – A challenging diagnosis
Silva, Catarina Pinto; de Sousa, Beatriz; Lima, Joana; Vasconcelos, Sofia; Rebelo, Alícia; Lobo, Ana Luísa; Fernandes, Alexandre
Tuberculosis is a challenging diagnosis with marked clinical heterogeneity that can lead to diagnostic delay and serious and potentially life-threatening problems. The most prevalent form of the disease is pulmonary tuberculosis. The present case has unique features as in that it describes a case of miliary tuberculosis in an immunocompetent adolescent vaccinated with the Bacillus Calmette-Guerin vaccine and raises awareness of the occurrence of normal radiograph and early in the course of pulmonary tuberculosis, and normal head tomography even in the presence of tuberculous meningitis, highlighting the need for a high index of suspicion. It also shows that tuberculosis should be included in the differential diagnosis of fever of unknown origin with weight loss, even when no epidemiologic link has been established
Snakebite poisoning: A neglected disease
De Matos, Bárbara Barroso; Gaspar, Nélio Santos; Ferreira, Sara
Snakebite is a rare but potentially fatal cause of poisoning in children worldwide. It is a neglected public health issue in Europe, mainly affecting farmers and children, the latter suffering more severe consequences due to their small body mass. If poisoning is suspected, hospitalization of these patients is mandatory for clinical monitoring and early initiation of therapy. Snakebite can be a medical emergency. However, unlike many other serious health conditions, there is a highly effective treatment – anti-ophidian serum. It is crucial to invest in more effective and safer serums and to make them easily accessible in the event of a snakebite. The case of an adolescent affected by viper bite, its treatment and clinical course is reported.
Pediatric hospitalizations for respiratory infections: Before and after SARS-CoV-2
Monteiro, Sara; Salazar, Luís; Oliveira, João; Souto, Mariana; Morais, Lurdes; Ramos, Ana; Ferreira-Magalhães, Manuel
Introduction: With the emergence of the COVID-19 pandemic, several non-pharmacological measures were adopted to prevent and control the transmission of SARS-CoV-2.
Objective: To compare pediatric hospitalizations for acute respiratory infections (ARIs) before and after the emergence of SARS-CoV-2.
Materials and Methods: This was a retrospective, observational study of admissions for ARIs in the pediatric ward of a tertiary hospital between April 2018 and March 2021. Inclusion criteria comprised: hospitalization of pediatric patients ([0-17[ years); length of stay >24 hours; and a respiratory infection diagnosis code from ICD-10. Data were collected using electronic clinical records. The first two years were considered ‘non-COVID-19 years’ (year[Y]1 and Y2), while the period between April 2020 and March 2021 was considered the ‘COVID-19 year’ (Y3).
Results: A total of 783 hospitalizations were included in the analysis. There was a significant decrease in ARIs admissions in Y3 compared to Y1 and 2 (-67% from Y2 to Y3; p<0.001), with a decrease in the proportion of bronchiolitis cases (-42% from Y2 to Y3; p<0.001) and an increase in pneumonia cases (+124% from Y2 to Y3; p<0.001). There was a significant decrease in the incidence of respiratory viruses from Y2 to Y3 (76.6% vs. 56.4%; p<0.001), mainly driven by a decrease in respiratory syncytial virus (RSV; 46.8% in Y2 vs. 2.0% in Y3; p<0.001). Conversely, there was a significant increase in the incidence of rhinovirus from Y2 to Y3 (15.3% vs. 22.8%; p<0.001), and SARS-CoV-2 was identified in 31.7% of cases in Y3. More chest computed tomography scans were performed (5.6% vs. 10.9%; p<0.001) and more systemic steroids were used (26.3% vs. 40.6%; p=0.023) from Y2 to Y3.
Conclusions: Population-based non-pharmacological measures implemented during the COVID-19 pandemic were associated with a reduction in pediatric hospitalizations for ARIs. The decrease in ARIs due to RSV is particularly noteworthy in this pandemic context.
The influence of socio-cultural features in the contents of delusions, football delusion – Two Clinical cases
Publication . Caseiro, João; Queirós, Otília
We describe the clinical cases of two 17 year-old patients presenting a first psychotic episode in which football was central to their delusional beliefs. These two patients were admitted with a five-month’s gap in an inpatient clinic after the intervention of the authorities who conducted them to the emergency room.Football has become the main global mass entertainment phenomenon of the contemporary European society. Therefore, it’s not surprising that in the year that Portuguese football had its most glorious moment with the Euro Cup victory, the game took part in the delusional beliefs of two young people presenting their first psychotic episode.With the description of these two clinical cases we intend to emphasise on the relation between socio-cultural features and the content of the delusional beliefs.
Acromicric dysplasia and hearing loss: A case report
Publication . Pinto, Ana Nóbrega; Coutinho, Miguel Bebiano; Soares, Teresa; Sousa, Cecília Almeida
Introduction: Acromicric dysplasia is an extremely rare autosomal dominant bone dysplasia characterized by progressive growth retardation, short hands and feet, mild facial dysmorphism and generalized joint limitation. Association with ear, nose and pharyngolaryngeal alterations has been previously reported. However, little is known about the otolaryngologic aspects that may accompany this disease. We pretend to raise awareness to the otolaryngologic aspects that may accompany acromicric dysplasia and to the possible interventions that improve these patients quality of life.Clinical Case: We present the case of a ten-year-old girl referred to the otorhinolaryngology consultation with complaints of progressive hearing loss. Hearing evaluation confirmed bilateral severe mixed hearing loss and the patient was successfully rehabilitated with bone-anchored hearing aids.Discussion/Conclusions: Evaluation by an otolaryngologist should be part of the management of children with bone dysplasias, especially if they present with associated symptoms, to allow an early diagnosis and proper intervention