Reação Dimorfa com comprometimento ósseo nas extremidades superiores, em paciente com endocardite-bacteriana

Abstract

A patient, 54 year old, with a diagnosis of dimorphous Hanseniasis, interned in the hospital for physical therapy, presents a systemic infectious involvement of sub-acute evolution associated with acute inflamatory manifestations in the upper limbs, with bone involvement. This involvement is characterized by periostitic lesions of the phalanges and metacarpus and by areas suggesting bone erosions. He died of toxic-infectious shock and congestive heart failure. The autopsy indicated bacterial endocarditis with thrombotic ulcerations and the involvement of skin, peripheral nerves, and bone tissue by tuberculoid granulomas with a positive (+) B.I. Cicatricial fibrosis, disorganization, and bone neoformations are also noted in the bone tissue, principally in sub-periosteal locations. The relationship between bacterial
endocarditis and dimorphous hanseniasis reactivations are discussed.