Salmonella enteritidis: un patógeno emergente en Chile / Salmonella enteritidis: an emergent pathogen in Chile

Materials and methods: Cases of clinical infections by Salmonella enteritidis were recorder from bacteriological and demographic notifications obtained at The National Reference Laboratory for Enterobacteria. Infection rates were calculated using the total Chilean population and the population of the different Health Services along the country. Results: Until 1993, 13,57 Salmonella enteritidis strains per year were received at the Reference Laboratory. The figures increased to 478 and 432 in 1994 and 1995, respectively. National rates were 3,41 and 3.04 notifications/100.000 inhabitans in 1994 and 1995 respectively. Northern regions were the most affected and 90 percent of observed cases during 1994 came from Arica and Antofagasta. At the present time, 20 percent of cases are observed in Santiago, located in the mid-portion of the country. The outbreak has mainly affected children and young adults (yo percent of cases). Strains have been isolated from stool cultures, suggestig gastrointestinal infections as the main clinical presentation. More than 98 percent of strains are susceptible to chloramphenicol, ampicillin, tetracycline, sulfa-trimetroprim, cefotaxime or ciprofloxacin. Conclusions: The obtained data clearly indicate the existence of an epidemic outbreak of Salmonella enteritidis infections, with a geographic progression from North to South

Endocarditis de válvula aórtica nativa y absceso septal por un bacilo gram negativo: capnocytiphaga sputigena / Native aortic valve endocarditis and septal abscess by a gram negative bacilli: capnocytophaga sputigena

A male patient aged 32 developed infectious endocarditis on a congenital (and repaired) stenotic aortic valve defect. He presented with prolonged fever and wasting symptoms and also referred recurrent gingivitis. At admission, fever, systolic and diastolic aortic murmurs, and periodontitis were registered. Ultrasound imaging showed aortic vegetations reaching a maximal diameter of 49 mm and a severe aortic stenosis and insufficiency. Patient received treatment with vancomycin and gentamycin due to penicillin allergy but developed a progressive non-oliguric acute renal failure. Blood cultures revealed bacilli of uncertain gram stain that were recognized as gram negative bacilli and identified as Capnocytophaga sputigena at the National Reference Laboratory. Patient remained stable but murmurs increased and new imaging studies revealed the development of a unique septal abscess despite antibiotic therapy with intravenous ciprofloxacin. Intraoperative finding showed a perforated aortic coronary leaflet