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"documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2021;157:407" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen médica</span>" "titulo" => "Letálides" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "407" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Skin metastases" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 367 "Ancho" => 950 "Tamanyo" => 59434 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Antonio Torres-Gómez, José Ramón Vizán-Caravaca, Sara López-García" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Antonio" "apellidos" => "Torres-Gómez" ] 1 => array:2 [ "nombre" => "José Ramón" "apellidos" => "Vizán-Caravaca" ] 2 => array:2 [ "nombre" => "Sara" "apellidos" => "López-García" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S238702062100512X" "doi" => "10.1016/j.medcle.2020.11.022" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S238702062100512X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775320308435?idApp=UINPBA00004N" "url" => "/00257753/0000015700000008/v1_202110170505/S0025775320308435/v1_202110170505/es/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>" "titulo" => "Disseminated <span class="elsevierStyleItalic">Mycobacterium avium-intracellulare</span> infection in an HIV-infected patient" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "408" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Martina Comes Escoda, Alba Mesa Tudel, Jose Tomas Navarro Ferrando, Jose Maria Ribera Santasusana" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Martina" "apellidos" => "Comes Escoda" "email" => array:1 [ 0 => "martina_comes@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Alba" "apellidos" => "Mesa Tudel" ] 2 => array:2 [ "nombre" => "Jose Tomas" "apellidos" => "Navarro Ferrando" ] 3 => array:2 [ "nombre" => "Jose Maria" "apellidos" => "Ribera Santasusana" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Hematología Clínica. Institut Català d’Oncologia – Hospital Germans Trias i Pujol, Badalona (Barcelona), Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Infección diseminada por Mycobacterium avium-intracellulare en un paciente infectado por el VIH" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1258 "Ancho" => 1675 "Tamanyo" => 457612 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 23-year-old man with history of vertical transmission of human immunodeficiency virus (HIV) infection and low adherence to antiretroviral treatment, complained with weight loss, nocturnal fever and diarrhea. On physical examination he had an enlarged spleen and multiple lymphadenopathies. Laboratory tests showed white-cell count of 1.6<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">9</span>/L, hemoglobin concentration of 7.2<span class="elsevierStyleHsp" style=""></span>g/dL and platelet count of 108<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">9</span>/L, β2-microglobulin was 4.1<span class="elsevierStyleHsp" style=""></span>mg/dL and the CD4+ T-cell count was 0.002<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">9</span>/L. An enlargement of mediastinum was shown on the chest radiography and computed tomography confirmed multiple supra and infradiaphragmatic lymphadenopathies. May–Grünwald–Giemsa stain of a biopsied lymphadenopathy revealed a massive occupation of activated macrophages with numerous rod-shaped structures in the cytoplasm and areas of necrosis. Mycobacterial cultures of the adenopathy and stools tested positive for <span class="elsevierStyleItalic">Mycobacterium avium</span> and, therefore, a diagnosis of disseminated <span class="elsevierStyleItalic">Mycobacterium avium-intracellulare</span> (MAI) infection was made. Among people infected with HIV, MAI was one of the most common opportunistic pathogens in the pre-combined antiretroviral (cART) era. The severity of the disease is closely related with low CD4+ T-cell count. However, with the widespread use of cART it has become a rare entity. Nevertheless, it is still important to rule out this opportunistic infection in deeply immunosuppressed HIV-infected patients who present with fever, multiple adenopathies and cytopenias (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1258 "Ancho" => 1675 "Tamanyo" => 457612 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00257753/0000015700000008/v1_202110170505/S0025775321000774/v1_202110170505/en/main.assets" "Apartado" => array:4 [ "identificador" => "64289" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imágenes médicas" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00257753/0000015700000008/v1_202110170505/S0025775321000774/v1_202110170505/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775321000774?idApp=UINPBA00004N" ]
