Reportamos el caso de un varón de 23 años, natural y residente de altitud, con hiperpigmentación. astenia, fatiga, náuseas, vómitos, pérdida de peso, dolor abdominal, hiporexia e hipotensión, con dosaje de cortisol disminuido y ACTH elevado. Radiografía de tórax normal, baciloscopia en esputo y en orina negativo, antígeno TB LAM negativo. En la tomografía computarizada de abdomen con contraste se visualiza incremento de dimensiones y pequeñas calcificaciones en ambas adrenales sugerentes de infiltración granulomatosa de tipo específico. En zonas endémicas de tuberculosis como en el Perú; ante la ausencia de la biopsia adrenal, se puede recurrir en forma precoz, como alternativa diagnóstica a la tomografía para descartar el compromiso adrenal. En conclusión, el presente reporte a descrito como la tomografía puede ser usado como un método diagnostico alternativo en hos...

RESUMEN: Introducción: Determinar el porcentaje de microorganismos multidrogorresistentes y describir los fármacos sensibles, muestras, sexo y edad, estancia hospitalaria y servicios de procedencia y destino de los pacientes críticos Materiales y Métodos: Estudio descriptivo donde se analizaron 119 antibiogramas y 84 pacientes, el análisis se realizó con el programa Stata versión 13 Resultados: 46.218% microorganismos MDR, Pseudomona 36.134%; secreción bronquial 39.496%; la edad 41.667% entre 50 a 70 años y el 69.048% fueron varones; estancia hospitalaria 14.800 ±8 días; procedencia: Hospitalización 35.714% Destino: Morgue 52.381%, 45 muestras sensibles a amikacina de los gram negativos 15 muestras sensibles a vancomicina de los gram positivos Conclusión: Menos de la mitad son microorganismos MDR siendo más frecuente la Pseudomona aislada en la secreción bronquial; los mic...

We report the case of a 23-year-old male, natural and resident of height, with hyperpigmentation. Asthenia, fatigue, nausea, vomiting, weight loss, abdominal pain, hiporexia and hypotension, with decreased cortisol dosage and elevated ACTH.  Normal chest X-Ray, smear in sputum and negative urine. Negative TB-LAM Antigen. In contrasted abdomen computed tomography, an increase in dimensions and small calcifications is shown in both adrenals suggestive of specific type granulomatous infiltration. In endemic areas of tuberculosis as in Peru, in the absence of the adrenal biopsy, it can be used early, as a diagnostic alternative to the tomography to rule out the adrenal commitment.  In conclusion, this report described as the tomography can be used as an alternative diagnostic method in hospitals where it is not feasible to perform the biopsy in a rapid manner.

Introduction: There is little information in Peru on the association of tuberculous orchiepididymitis in relation to immunosuppressed patients, being an endemic country of tuberculosis and there is an increase in the prevalence of chronic noncommunicable diseases such as diabetes, producing wrong diagnoses.  Clinical Case: We present the case of a 70-year-old man with a history of type 2 diabetes mellitus who was admitted to the outpatient clinic due to dysuria and frequency. On physical examination, a hard, non-painful right testicle, the ultrasound showed signs of epididymal abscess in the scrotal wall of the Right testicle, which is why an infected neoplasm is suspected, and a right orchiectomy is performed, later in the histological study, multinucleated Langhans-type giant cells with granulomatous areas suggestive of tuberculosis are shown, which is why it is proposed...

We report the case of a 23-year-old male, natural and resident of height, with hyperpigmentation. Asthenia, fatigue, nausea, vomiting, weight loss, abdominal pain, hiporexia and hypotension, with decreased cortisol dosage and elevated ACTH.  Normal chest X-Ray, smear in sputum and negative urine. Negative TB-LAM Antigen. In contrasted abdomen computed tomography, an increase in dimensions and small calcifications is shown in both adrenals suggestive of specific type granulomatous infiltration. In endemic areas of tuberculosis as in Peru, in the absence of the adrenal biopsy, it can be used early, as a diagnostic alternative to the tomography to rule out the adrenal commitment.  In conclusion, this report described as the tomography can be used as an alternative diagnostic method in hospitals where it is not feasible to perform the biopsy in a rapid manner.