Browsing by Author "Sanclemente Cardoza, Valeria"
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Item Massive rectorrhage due to pulmonary and intestinal tuberculosis: A case report(Elsevier Ltd, 2024) Estela Zape, Jose Luis; Patiño, Leonardo Arzayus; Sanclemente Cardoza, ValeriaTuberculosis is a bacterial infection that predominantly affects the lungs, although it can also affect other organs, including the intestine. Massive rectal bleeding, characterized by severe rectal bleeding, is a rare but serious complication of intestinal tuberculosis, with an estimated incidence of 5 % of tuberculosis patients. This report describes the case of a 21-year-old woman with active tuberculosis and comorbidities such as asthma and a history of psychoactive substance use, who developed massive rectal bleeding and significant clinical deterioration, manifested by excessive bleeding and septic shock, which resulted in fatal outcome.Item Rhabdomyosarcoma in adults with severe thrombocytopenia: Challenges in clinical management and therapeutic complications(W.B. Saunders Ltd, 2025-01) Estela Zape, Jose Luis; Sanclemente Cardoza, Valeria; Arzayus Patiño, Leonardo; Noreña Buitrón, Lizeth Dayana; Espinosa, María AlejandraAlveolar rhabdomyosarcoma (ARMS) in adults is a rare condition with a poor prognosis compared to other subtypes. The management of this pathology is complex due to the lack of standardized guidelines and the limited response to multimodal treatments, including chemotherapy, radiotherapy, and surgery. We report the case of a 40-year-old male with stage IV ARMS and pulmonary metastasis, who underwent resection of right supraclavicular sarcoma and cervical lymph node dissection. He was later referred for palliative chemotherapy following an acute clinical presentation lasting two days, characterized by right facial edema, inflammation, ulceration, and severe pain. Initial treatment included ampicillin/sulbactam, trimethoprim/sulfamethoxazole, and dexamethasone. Chemotherapy with doxorubicin and ifosfamide was delayed due to thrombocytopenia, elevated D-dimer and fibrinogen levels, and an echocardiographic finding that required differentiation between thrombus and metastatic lesion. Anticoagulation with fondaparinux and transfusions were initiated, and the patient received 10 sessions of radiotherapy. During hospitalization, the patient developed orthopnea, pleural effusion, superior vena cava syndrome, and hemodynamic deterioration, necessitating vasopressor support and mechanical ventilation. Despite these interventions, the patient progressed to refractory shock, severe hypoxemia, and died from cardiac arrest. This case highlights the challenges in managing ARMS in adults with severe thrombocytopenia.