JUSSARA BIANCHI CASTELLI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
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article 3 Citação(ões) na Scopus Fatal adenoviral necrotizing bronchiolitis case in a post-cardiac surgery intensive care unit(2011) CASTELLI, Jussara Bianchi; SICILIANO, Rinaldo F.; VIEIRA, Ricardo D.; AIELLO, Vera D.; STRABELLI, Tania M. V.We report a case of a 67 year-old-male patient admitted to the intensive care unit in the post-coronary bypass surgery period who presented cardiogenic shock, acute renal failure and three episodes of sepsis, the latter with pulmonary distress at the 30th post-operative day. The patient expired within five days in spite of treatment with vancomycin, imipenem, colistimethate and amphotericin B. At autopsy severe adenovirus pneumonia was found. Viral pulmonary infections following cardiovascular surgery are uncommon. We highlight the importance of etiological diagnosis to a correct treatment approach.article 9 Citação(ões) na Scopus Infectious endocarditis caused by Nocardia sp.: histological morphology as a guide for the specific diagnosis(2011) CASTELLI, Jussara Bianchi; SICILIANO, Rinaldo Focaccia; ABDALA, Edson; AIELLO, Vera DemarchiNocardia is a rare opportunistic agent, which may affect immunocompromised individuals causing lung infections and exceptionally infective endocarditis (IE). There are few reports of IF caused by Nocardia sp., usually involving biological prostheses but rarely in natural valves. Its accurate microbiological identification may be hampered by the similarity with Rhodococcus equi and Corynebacterium spp. Here we report a case of native mitral valve IF caused by this agent in which the clinical absence of response to vancomycin and the suggestion of Nocardia sp. by histology pointed to the misdiagnosis of Corynebacterium spp. in blood cultures. The histological morphology can advise on the need for expansion of cultivation time and use of extra microbiological procedures that lead to the differential diagnosis with Corynebacterium spp. and other agents, which is essential to establish timely specific treatment, especially in immunocompromised patients.- Case 4-A 79-Year-Old Man with Congestive Heart Failure Due to Restrictive Cardiomyopathy(2015) MUSTAFA, Sumaia; YAMADA, Alice Tatsuko; LIMA, Fabio Mitsuo; CARVALHO, Valdemir Melechco; AIELLO, Vera Demarchi; CASTELLI, Jussara Bianchi
- Human Hemorrhagic Pulmonary Leptospirosis: Pathological Findings and Pathophysiological Correlations(2013) BRITO, Thales De; AIELLO, Vera Demarchi; SILVA, Luis Fernando Ferraz da; SILVA, Ana Maria Goncalves da; SILVA, Wellington Luiz Ferreira da; CASTELLI, Jussara Bianchi; SEGURO, Antonio CarlosBackground: Leptospirosis is a re-emerging zoonosis with protean clinical manifestations. Recently, the importance of pulmonary hemorrhage as a lethal complication of this disease has been recognized. In the present study, five human necropsies of leptospirosis (Weil's syndrome) with extensive pulmonary manifestations were analysed, and the antibodies expressed in blood vessels and cells involved in ion and water transport were used, seeking to better understand the pathophysiology of the lung injury associated with this disease. Principal Findings: Prominent vascular damage was present in the lung microcirculation, with decreased CD34 and preserved aquaporin 1 expression. At the periphery and even inside the extensive areas of edema and intraalveolar hemorrhage, enlarged, apparently hypertrophic type I pneumocytes (PI) were detected and interpreted as a non-specific attempt of clearence of the intraalveolar fluid, in which ionic transport, particularly of sodium, plays a predominant role, as suggested by the apparently increased ENaC and aquaporin 5 expression. Connexin 43 was present in most pneumocytes, and in the cytoplasm of the more preserved endothelial cells. The number of type II pneumocytes (PII) was slightly decreased when compared to normal lungs and those of patients with septicemia from other causes, a fact that may contribute to the progressively low PI count, resulting in deficient restoration after damage to the alveolar epithelial integrity and, consequently, a poor outcome of the pulmonary edema and hemorrhage. Conclusions: Pathogenesis of lung injury in human leptospirosis was discussed, and the possibility of primary non-inflammatory vascular damage was considered, so far of undefinite etiopathogenesis, as the initial pathological manifestation of the disease.
- Diagnostic challenges in systemic amyloidosis: A case report with clinical and laboratorial pitfalls(2021) LINO, A. M. M.; CASTELLI, J. B.; SZOR, R. S.; FERNANDES, F.; AIELLO, V. D.Currently, there is growing evidence in the literature warning of misdiagnosis involving amyloidosis and chronic inflammatory demyelinating polyneuropathy (CIDP). Although inducing clinical manifestations outside the peripheral nervous system, light chain and transthyretin amyloidosis may initially present with peripheral neuropathy, which can be indistinguishable from CIDP, leading to a delay in the correct diagnosis. Besides, the precise identification of the amyloid subtype is often challenging. This case report exemplifies clinical and laboratory pitfalls in diagnosing amyloidosis and subtyping amyloid, exposing the patient to potentially harmful procedures. © 2021 The Author(s).