Absceso parotídeo y mastitis por Staphylococcus aureus resistente a Meticillina en un neonato / Parotid abscess and mastitis by Methicillin- resistant Staphylococcus aureus in a newborn

Introducción: La parotiditis supurativa aguda se presenta con poca frecuencia en el período neonatal. Objetivo: Aportar un nuevo caso de parotiditis supurativa aguda por Staphylococcus aureus resistente a la Meticillina. Presentación del caso: El presente caso tiene la particularidad de que presentó foco de infección inicial (impétigo y conjuntamente mastitis bilateral), en el que se demostró el mismo microorganismo causal de la infección: Staphylococcus aureus resistente a la Meticillina. La mastitis bilateral evolucionó hacia la formación de absceso. En la literatura revisada solo se encontraron tres publicaciones que tratan de neonatos con un foco inicial de infección en sitios diferentes de la parotiditis. Estos aspectos fueron los que motivaron la presentación del caso. Conclusiones: Staphylococcus aureus resistente a la Meticillina ha emergido en los últimos años como agente causal de parotiditis supurativa aguda, que puede diseminarse hacia otro foco infeccioso, habitualmente se logra la curación con tratamiento antibiótico ajustado al agente causal, concretamente con Vancomicina, aunque puede requerir también tratamiento quirúrgico si ocurre abscedación(AU)

Introduction: Acute suppurative parotitis occurs infrequently in the neonatal period. Objective: To provide information of a new case of acute suppurative parotitis caused by Methicillin- resistant Staphylococcus aureus. Case presentation: The present case has the particularity that the patient presented a source of initial infection (impetigo and jointly bilateral mastitis), in which the same causal microorganism of the infection was found: Methicillin resistant Staphylococcus aureus. Bilateral mastitis evolved to the formation of abscess. In the literature reviewed, there were only 3 publications on neonates who presented an initial source of infection in sites different from parotitis. These aspects are those that motivated the presentation of this case. Conclusions: Methicillin resistant Staphylococcus aureus has emerged in the last years as a causal agent of acute suppurative parotitis that can lead to dissemination of another source of infection. Normally, the cure is achieved with antibiotic treatment adjusted to the causal microorganism, specifically with Vancomycin; although it can require surgical treatment if abscesses occurs(AU)

Tuberculosis de mama: reporte de un caso / Breast tuberculosis: a case report

RESUMEN Presentamos caso de mastitis en mujer de 45 años sin antecedentes de infección en otras regiones corporales. Presentó cuadro clínico, estudios de imágenes y baciloscopia inespecíficos, sin embargo, mediante muestras histológicas obtenidas por punción aspirativa se encontró células epiteliodes gigantes, necrosis y formaciones granulomatosas, lo cual justificó el pensamiento clínico en tuberculosis. En ausencia de evidencias confirmatorias de lesión en otros tejidos, la existencia de mastitis de evolución tórpida es un indicativo clínico para sospechar tuberculosis mamaria, pues usualmente las características del proceso suelen plantear diagnósticos erróneos con otras entidades tumorales de la mama como cáncer. La tuberculosis en mama, representa una rara enfermedad cuyo diagnóstico es difícil por las bajas evidencias clínicas, microbiológicas y la inespecificidad de los resultados imagenológicos, por lo que la sospecha de su real posibilidad diagnóstica es una condición primordial para su determinación, aun cuando no se confirme el agente causal.

ABSTRACT We present a case of mastitis in a 45-year-old woman with no history of infection in other areas of the body, with unspecific clinical picture, imaging studies, and bacilloscopy. However, histological samples obtained by aspiration showed giant epithelial cells, necrosis, and granulomatous formations, which justified a clinical inclination toward tuberculosis. In the absence of confirmatory evidence of any lesions in other tissues, the existence of mastitis of torpid evolution is a clinical indication to suspect mammary tuberculosis, since the characteristics of the process usually lead to erroneous diagnoses with other breast tumors such as cancer. Tuberculosis in the breast is a rare disease with a difficult diagnosis due to the low clinical and microbiological evidence and the lack of specificity of the imaging results, so the suspicion of its real diagnostic possibility is a fundamental condition for its determination, even when the causal agent is not confirmed.

Inhibitory effect of Persea cordata Mez. (pau-andrade) bark extracts against Clostridium perfringens causing gangrenous mastitis

Introduction: Gangrenous mastitis is a special clinical presentation of mastitis in cattle and small ruminants. The bark of the tree Persea cordata Mez. is used in Brazilian ethnoveterinary medicine to treat wounds in farm animals. Objectives: Examine in vitro antimicrobial action of apolar fractions of P. cordata bark against a wild strain of C. perfringens isolated from the udder of a cow with gangrenous mastitis, and against a reference strain. Methods: A milk sample was collected from the udder, aliquots were diluted and Gram-stained smears were performed. The aliquots were inoculated in broth and planted in blood agar, and then incubated in anaerobiosis at 37oC / 24h. Biochemical identification was based on bacterial isolation. In vitro inhibitory activity of apolar fractions of P. cordata was evaluated by agar diffusion and MIC (minimum inhibitory concentration) using the agar dilution method. Results: In both tests the plant extracts displayed significant in vitro inhibitory activity against the clinical and reference strains of C. perfringens assayed. Conclusion: The study is the first demonstration of the inhibitory effect of P. cordata on C. perfringens, due to its antimicrobial properties, which serves as evidence supporting its folk use. The extracts could be used as coadjuvants in the treatment of gangrenous mastitis(AU)

Introducción: la mastitis gangrenosa es una presentación clínica especial de mastitis en el ganado y pequeños rumiantes. Persea cordata Mez. , es un árbol conocido en la etnoveterinaria brasileña, cuya corteza se utiliza en la curación de heridas en animales de granja. Objetivos: investigar el efecto antimicrobiano in vitro de fracciones apolares de la corteza de P. cordata contra una cepa salvaje de C. perfringens, aislada de la ubre de una vaca con mastitis gangrenosa y una cepa de referencia. Métodos: Se recogió una muestra de leche de la ubre, se diluyeron alícuotas, y se realizaron frotis teñidos por Gram. Las alícuotas fueron inoculadas en caldo y sembradas en agar sangre, y posteriormente incubados en anaerobiosis a 37 oC/24h. La identificación bioquímica fue realizada a partir del aislamiento bacteriano. La actividad inhibitoria in vitro de las fracciones apolares de P. cordata fue evaluada utilizando la técnica de difusión en agar y la CMI (concentración minima inhibitoria) mediante el método de dilución en agar. Resultados: los extractos de la planta, en ambas pruebas, presentaron significativa actividad inhibitoria in vitro contra las cepas clínica y de referencia de C. perfringens ensayadas. Conclusión: se concluyó que, por primera vez, se demuestra un efecto inhibitorio de P. cordata sobre C. perfringens, reforzando el uso popular, debido a sus propiedades antimicrobianas. Los extractos podrán ser utilizados como coadyuvantes en el tratamiento de la mastitis gangrenosa(AU)

Antibiotics for mastitis in breastfeeding women

ABSTRACT: BACKGROUND: Mastitis can be caused by ineffective positioning of the baby at the breast or restricted feeding. Infective mastitis is commonly caused by Staphylococcus aureus . The prevalence of mastitis in breastfeeding women may reach 33%. Effective milk removal, pain medication and antibiotic therapy have been the mainstays of treatment. OBJECTIVES: This review aims to examine the effectiveness of antibiotic therapies in relieving symptoms for breastfeeding women with mastitis with or without laboratory investigation. METHODS: Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2012), contacted investigators and other content experts known to us for unpublished trials and scanned the reference lists of retrieved articles. Selection criteria: We selected randomised controlled trials (RCTs) and quasi-RCTs comparing the effectiveness of various types of antibiotic therapies or antibiotic therapy versus alternative therapies for the treatment of mastitis. Data collection and analysis: Two review authors independently assessed trial quality and extracted data. When in dispute, we consulted a third author. MAIN RESULTS: Two trials met the inclusion criteria. One small trial (n = 25) compared amoxicillin with cephradine and found no significant difference between the two antibiotics in terms of symptom relief and abscess formation. Another, older study compared breast emptying alone as 'supportive therapy' versus antibiotic therapy plus supportive therapy, and no therapy. The findings of the latter study suggested faster clearance of symptoms for women using antibiotics, although the study design was problematic. AUTHORS CONCLUSIONS: There is insufficient evidence to confirm or refute the effectiveness of antibiotic therapy for the treatment of lactational mastitis. There is an urgent need to conduct high-quality, double-blinded RCTs to determine whether antibiotics should be used in this common postpartum condition.

In vitro and in vivo study of the antibacterial effects of Nigella sativa methanol extract in dairy cow mastitis

Nigella Sativa [N. Sativa] seeds were used in traditional medicine for the treatment of a variety of diseases. The seed extracts and oil of this plant have shown various pharmacological properties including antimicrobial actions. In this study, the in vitro and in vivo antibacterial effects of methanol extract of the seeds against pathogenic bacteria causing mastitis in cows have been investigated. In in vivo experiments, 10 cows with mastitis were treated by local injection of different concentrations of methanol extract of the seeds into the infected breasts. In in vitro experiments, the microorganisms were collected from the same infected breasts and used for the assessment of the antimicrobial effects of the extract by means of agar dilution and disk diffusion methods. The extract showed significant in vitro and in vivo inhibitory effects on causative organisms compared to standard drugs and also induced healing of the disease. This is the first veterinary experiment, to our knowledge, that investigated the antibacterial effects of Nigella sativa

Perfil eletroforético e concentração de imunoglobulinas G (IgG) do soro sanguíneo de cabras Saanen com mastite experimental induzida por Staphylococcus aureus suplementadas com vitamina E / Electrophoretic profile and concentration of immunoglobulins G (IgG) in blood serum of Saanen goats with experimental mastitis induced by Staphylococcus aureus suplemented with vitamin E

O objetivo do trabalho foi avaliar o perfil eletroforético das proteínas e a concentração sérica de imunoglobulina G (IgG) em cabras da raça Saanen com mastite induzida experimentalmente por Staphylococcus aureus e suplementadas com vitamina E (acetato de dl-α-tocoferol). Utilizaram-se 14 cabras adultas, gestantes, primíparas, com sorologia negativa para Artrite Encefalite Caprina (CAEV), clinicamente sadias, divididas em dois grupos experimentais de sete animais. Grupo não suplementado (G1) e grupo suplementado com 2.000 U.I. de acetato de dl-α-tocoferol (G2 Vit E) via intramuscular no dia do parto e sete dias após o parto. Ao nono dia do pós-parto foram inoculados 300 UFCs da cepa de S. aureus ATCC 225923, na metade esquerda da glândula mamária de cada animal. A mastite foi determinada pela colheita das amostras de leite para a comprovação da infecção, por meio de exames bacteriológicos, contagem de células somáticas (CCS) e California Mastitis Test (CMT), a partir deste momento foram efetuadas colheitas às 12, 24, 48 e 72 horas, sendo posteriormente instituído o tratamento intramamário com antimicrobiano e nova avaliação 48 horas após o tratamento. O perfil eletroforético em gel de agarose das proteínas séricas das cabras, apresentaram cinco frações, sendo: albumina e globulinas (α, β1, β2 e γ). Houve aumento na produção de γ-globulina e menor produção da fração β2-globulina 12 horas após a infecção, com os valores reduzindo mais rapidamente no grupo suplementado, evidenciando a influência da vitamina E na diminuição da produção das proteínas de fase aguda. Não houve influência da vitamina E na concentração sérica de imunoglobulina G (IgG) nos animais suplementados. A suplementação com vitamina E aumentou a concentração de imunoglobulinas e diminuiu a produção de proteínas de fase aguda, provavelmente pelo efeito antioxidante minimizando a lesão tecidual durante o processo inflamatório localizado ...

The objective was to evaluate the electrophoretic profile of proteins and serum concentration of immunoglobulin G (IgG) in Saanen goats with mastitis experimentally induced by Staphylococcus aureus (dl-α-tocopherol acetated). 14 adult goats, (supplemented with vitamin E DL-α-tocopherol) primiparous pregnant, seronegative for caprine arthritis encephalitis (CAEV), clinically healthy, were divided into two groups of seven animals: Not supplemented group (G1) and group supplemented with 2.000 UI of DL-α-tocopherol (G2 Vit E), by intramuscular injection on the day of the parturition and seven days later. At the 9th day after delivery 300 UFCs of the S. aureus ATCC 225923 strain were inoculated into the left half of the mammary gland of each animal. The mastitis was determined through collection of milk samples for evidence of infection by means of bacteriological examination, somatic cell count (SCC) and California Mastitis Test (CMT). Then samples were collected after 12, 24, 48 and 72 hours, antimicrobial intra-mammary gland treatment was initiated, with new evaluation 48 hours after treatment. The electrophoretic profile of serum protein of the goats, showed five fractions, as follows: albumin and globulin (α, β1, β2 e γ-globulin). There was an increase in the production of γ-globulin and lower production of β2-globulin fraction 12 hours after infection, and faster decrease in the supplemented group, showing the influence of vitamin E in the production of acute phase proteins. There was no influence of vitamin E in the serum concentration of immunoglobulin G (IgG) in supplemented animals. The supplementation with vitamin E increased the concentration of immunoglobulin and decreased the production of acute phase proteins, probably the antioxidant effect minimizing the tissue injury during the inflammatory process in the mammary gland.

A cultura homeopática de paz na saúde / The homeopathic culture of peace in health

A Medicina Homeopática (MH) considera que há uma LEI que ordena o TODO do mundo a partir de uma díade que lhe é comum: o Princípio de Semelhança. Para a Homeopatia, o TODO é um discurso vivo e dialético compreendido como uma experiência hermenêutica de semelhança. Essa conversa emanativa é a saúde que representa a LEI se atualizando no organismo de todas as coisas. Já a doença corresponde ao impedimento desse livre discurso ou vida. Assim, a obstaculização da saúde equivale a uma violência simbólica e genérica capaz de se atualizar em violências circunstanciais e específicas. Objetiva-se demonstrar como a MH contribui para a resolução dessas violências estudando-se um caso clínico de ferida simbólica e dialética do pesar atualizada em abscessos recorrentes de mama, tratado com Sarsaparilla. A partir de seu método de assimilação das atualizações de saúde a MH trata representações de doença e promove a saúde pela comunhão ou consenso da díade médico-paciente baseado em memória sintética experimental. A demonstração do consenso homeopático permite concluir que a MH pode contribuir para a construção da cultura de paz na saúde, auxiliando as pessoas na resolução de seus conflitos íntimos.

The Homeopathic Medicine (HM) considers that there is a LAW that organizes the WHOLE in the world through a dyad that is common to it: the Principle of Similitude. For Homeopathy the WHOLE is a living and dialectic discourse understood as a hermeneutic experience of similitude. This emanative conversation is the health that represents the LAW being updated in the organisms of all things. However, the disease corresponds to an impediment of this free discourse or life. Then, the impediment of health equates to a symbolic and generic violence capable of renewing itself in specific and circumstantial moments of violence. The goal of this essay is to demonstrate how HM contributes to the resolution of these moments of violence through the study of a clinical case of a symbolic and dialetic wound of grief updated by recurring breast abscesses, which was treated with Sarsaparilla. Through its method of assimilation of the health renewals HM treats the representations of the sickness and promotes health through the communion or the consensus of the physician-patient dyad based on the synthetic experimental memory. The demonstration of the homeopathic consensus allows us to conclude that the HM can contribute to the construction of a peace culture in health, helping people to solve their inner conflicts.

Mastitis granulomatosa idiopática: diagnóstico y tratamiento en 14 casos / Idiopathic granulomatous mastitis: report of 14 cases

Introducción: La mastitis granulomatosa idiopática es una enfermedad inflamatoria benigna, infrecuente, de etiología desconocida. Puede simular carcinoma mamario, por lo cual su diagnóstico definitivo es histopatológico. No existe consenso respecto a su tratamiento. Realizamos una caracterización clínica de esta patología considerando su forma de presentación, métodos diagnósticos y tratamiento con especial énfasis en la efectividad de la corticoterapia. Material y método: Estudio retrospectivo realizado mediante protocolo tipo. Se revisaron los registros y fichas clínicas de los pacientes manejados con diagnóstico de mastitis granulomatosa idiopática en el Hospital Regional Valdivia entre los años 1995-2006. Resultados: La serie corresponde a 14 pacientes de sexo femenino. El promedio de edad fue de 31,6 años. La presentación clínica más frecuente fue absceso mamario en 9/14. Se realizó estudio imagenológico en 11/ 14 casos mediante mamografía en 7/14 y ecotomografía en 10/14. Las muestras para estudio histopatológico fueron obtenidas por biopsia percutánea en 8/14 y quirúrgica en 6/14. Se realizó tratamiento corticoidal con prednisona en 12/14 pacientes logrando buena respuesta en todos los casos. Se presentaron 2 recidivas durante el seguimiento que comprende un promedio de 28 meses. Conclusiones: La presentación clínica de las mastitis fue similar a la reportada en la literatura. La respuesta al tratamiento corticoesteroidal logró el control de la enfermedad en todos los casos. Las reacciones adversas al tratamiento fueron menores y las 2 recidivas fueron de menor magnitud y duración respecto al cuadro inicial.

Mastitis por Mycobacterium fortuitum en una paciente HIV negativa / Mastitis due to Mycobacterium fortuitum in an HIV negative patient

A case of a 39 year old HIV negative female patient with a Mycobacterium fortuitum mastitis without previous pathogenic history is reported. She was treated on the bases of drug-susceptibility testing and bibliographic empirical evidence with kanamycin, doxicicline, ciprofloxacin and trimetoprim-sulfametoxazol. A complete remission of her lesions was obtained after 15 months of treatment. Lesions due to this rapidly growing mycobacterium, diagnosis and treatment are commented.

Se presenta el caso de una paciente HIV negativa de 39 años con una mastitis por Mycobacterium fortuitum, sin antecedentes patogénicos previos. Fue tratada en base a las pruebas de susceptibilidad a antibióticos y quimioterápicos y a la evidencia empírica citada por la bibliografía, con kanamicina, doxiciclina, ciprofloxacina y trimetoprima-sulfametoxazol. Se obtuvo la remisión completa de sus lesiones luego de 15 meses de tratamiento. Se comenta la capacidad de producir lesiones de esta micobacteria de crecimiento rápido, su diagnóstico y tratamiento

Tuberculose mamária / Tuberculosis disease of the breast

Os autores relatam dois casos de tuberculose mamária e discutem a mastite tuberculosa, patologia relativamente incomum, sob aspectos etiopatogênicos, diagnósticos e terapêuticos.

Tuberculose mamária: relato de caso / Tuberculous mastitis: a case report

É relatado um caso de mastite tuberculosa em uma paciente de 72 anos. O quadro clínico constituiu-se de um nódulo de 6 x 6 cm, sem sinais flogísticos. Com suspeita clínica de carcinoma, a paciente foi submetida à tumorectomia. O exame anátomopatológico revelou processo granulomatoso crônico, tendo sido demonstrada a presença do bacilo álcool-ácido-resistente. A mastite tuberculosa é abordada sob os pontos de vista etiopatogênico, taxinômico, clínico e terapêutico.

Abscesso de mama: importância do antibiograma / Breast abscess: the importance of the antibiogram

O abscesso da mama foi avaliado em 32 pacientes que procuraram o Serviço de Ginecolofia e Obstetrícia em 1990 e 1991. A idade média das pacientes era de 27 anos e 78 por cento delas eram puérperas. O Staphylococcus aureus foi o agente etiológico mais encontrado (90,64 por cento). A penicilina (89,6 por cento) e a ampicilina (75,8 por cento) apresentaram alta resistência. A eritromicina (89,6 por cento), a oxacilina (96,5 por cento), a cefalotina (96,5 por cento), a lincomicina (76,5 por cento), a vancomicina (100 por cento) e o sulfametoxazol-trimetoprim (89,6 por cento) apresentaram alta sensibilidade.

Sensibilidade "in vitro" dos Staphylococcus aureus e Staphylococcus coagulase negativos, isolados em casos de mastite caprina, à açäo de antibióticos e quimioterápicos / \"In vitro\" sensitivity of Staphylococcus aureus and coagulase-negative Staphylococcus, isolated from caprine mastitis cases, to antibiotics and chemotherapics

Foram submetidas aos testes de sensibilidade "in vitro" frente a 11 antibióticos e quimioterápicos, 12 amostras de Staphylococcus aureus e 68 de Staphylococcus coagulase negativos, isoladas a partir de 198 amostras de leite, procedentes de 99 cabras, reagentes aos "California Mastitis Test", em 10 criatórios localizados no Estado do Rio de Janeiro. As amostras de estafilococos testadas apresentaram 100 por cento de sensibilidade apenas a dois antibióticos, gentamicina e cefalotina

Mastitis: contraindicación de lactancia? / Mastitis: lactation contraindication?

La mastitis es, como su nombre lo indica, la inflamación de la mama o mamas producida generalmente por Staphylococcus aureus, así como por otros microrganismos presentes en la flora normal de la piel. Este padecimiento se manifiesta entre el 5 a 10% de mujeres en periodo de lactancia. Dentro del Instituto Nacional de Perinatología uno de los objetivos primordiales es el de fomentar la lactancia al seno materno. Considerando que entre las causas que con relativa frecuencia inducen a la madre a suspender la lactación, la mastitis ocupa un lugar importante, en este trabajo se analizan los aspectos más significativos de esta patología. Para ejemplificar algunas características clínicas y el tratamiento que se sugiere en estas pacientes, se presenta uno de los casos tratados en el Instituto