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Revista da Sociedade Brasileira de Medicina Tropical

Print version ISSN 0037-8682

Rev. Soc. Bras. Med. Trop. vol.3 no.3 Uberaba May/June 1969

http://dx.doi.org/10.1590/S0037-86821969000300001 

Aspectos gerais das septicemias e bacteriemias estafilocócicas no adulto*

 

 

Adrelirio J. R. GonçalvesI; Francisco Duarte G. NetoII; Maria Helena Silva BrasilIII; Vitorino Modesto dos SantosIV; Sílvio HenriqueV; Leopoldo VI; Albino J. Souza FilhoIV; Lúcia Emi SuzukiVII

IDo Hospital Isolamento Francisco de Castro e Médico Assistente do Serviço de Clínica Médica do H. S. E.
IIChefe de Clínica do Serviço de Anatomia Patológica
IIIResidente Assistente do Serviço de Anatomia Patológica
IVEx-Residente do Serviço de Clínica Médica
VEx-Residente Chefe do Serviço de Clínica Médica
VIEx-Residente do Serviço de Clínica Médica. Instrutor de Ensino da Cadeira de C.M. da Faculdade da U.F.S.C
VIIResidente-Júnior do Serviço de Clínica Médica

 

 


RESUMO

São apresentados 25 casos de infecções sistêmicas por estafilococos por pacientes adultos.
Foram incluídos somente os casos em que houve concordância entre os achados bacteriológicos e clínicos. O Staphylccoceus aureus foi o mais encontrado em hemoculturas (17 casos). Dezoito casos comportaram-se verdadeiramente como septicemias caracterizadas por lesões metastáticas principalmente pulmonares, configurando os quadros clássicos de infartos pulmonares sépticos múltiplos.
As principais complicações cardiovasculares foram a miocardite, endocardite, choque e o cor pulmonale agudo.
As complicações neurológicas mais freqüentes foram meningite, coma e convulsões, tôdas seguidas de óbito.
A porta de entrada mais freqüente foi através de infecção cutânea presente em 48% dos casos, seguida do aparelho genital feminino em conseqüência do abôrto provocado (20%).
É apresentado estudo anátomo-patológico de 4 casos.
Na discussão são apresentadas características biológicas do germe no sentido de facilitar o entendimento da fisiopatologia destas infecções sistêmicas assim como de esclarecer o quadro clínico exibido pelos pacientes.
Breves considerações são realizadas no que concerne a patogenia e o quadro clínico nestas infecções e aspectos gerais de conduta terapêutica são assinalados.


SUMMARY

Systemic infections by staphylococcus in 25 adult patients is reviewed.
In all cases observed the germ identified bacteriologically as Staphylococcus aureus was isolated in blood culture in 17 cases. Clinical picture of septicemia with metastatic lesions mainly to the lungs and presenting the classical clinical findings of multiple septic pulmonary infarts was observed in 18 cases.
The most frequent cardiovascular complications were: myocarditis, endocarditis, shock and acute cor pulmonale. Meningitis, convulsions and coma were the outstandig neurological complications.
The most frequent portal of entry was through skin infection (48% of our cases). In 20% of the cases criminal abortion was responsible for inception of the systemic infection.
Pathological study in 4 cases is presented.
The biological characteristics of the germ are paramount in the understanding of physiopathology of the systemic infection and in the understanding of the clinical picture as is discussed at length.
The pathogenesis, clinical aspects and fundamentals of the therapeutic approach are briefly considered.


 

 

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*Trabalho do Serviço de Clinica Médica do Hospital dos Servidores do Estado.

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