Síndrome de Austrian: reporte de caso / Austrian syndrome: report of one case

Austrian syndrome is a triad characterized by pneumonia, meningitis and endocarditis, as a result of a Streptococcus pneumoniae bacteremia. We report a previously healthy 49 year-old male, who consulted at the emergency care unit with a history of one week of pleuritic pain, fever leading to an altered level of consciousness and seizures. A diagnosis of community-acquired pneumonia and meningitis was reached, isolating Streptococcus pneumoniae in the cerebrospinal fluid and blood cultures. Antibiotic treatment was started but the patient had an unsatisfactory response. During hospitalization a new heart murmur was found in the physical examination. An echocardiography was performed and a massive aortic valve insufficiency was found along with vegetations and a perforation of the same valve. The valve was replaced by a prosthetic one and the patient responded satisfactorily to the surgical and antibiotic treatment, without complications.

Logro de metas de prevención secundaria, prescripción farmacológica y eventos cardiovasculares mayores en pacientes con enfermedad coronaria / Achievement of cardiovascular prevention goals, pharmacologic prescription and major cardiovascular events among patients with coronary disease

Background: Implementation of health programs to reduce cardiovascular risk, are needed for secondary prevention of cardiovascular diseases. Aim: To evalúate achievements of secondary prevention goals, pharmacologic prescription and major cardiovascular events in patients with coronary artery disease. Material and Methods: Patients who had a first event of acute coronary syndrome, angioplasty or revascularization surgery, between January 2008 and June 2010, were contacted for a clinical and laboratory evaluation between June and October 2011. Results: Seven hundred and two medical records were reviewed and 245 eligible patients were identified. Ofthese, we assessed 202 patients aged 64 ± 10 years (70% males). Sixty seven percent had two ormore cardiovascular riskfactors. A goal ofHDL cholesterol level over 40 mg/dL was achieved in 91 % of patients, smoking cessation in 84% and a total cholesterol < 200 mg/dL in 66%. A blood pressure below 130/85 mm Hgwas achieved in 30% of patients, a normal BMI in 19% and LDL cholesterol levels below 70 mg/dL in 18%. At the moment of assessment, 87%> were using aspirin, 78%> statins, 74% angiotensin converting enzyme inhibitors or angiotensin II receptor antagonists and 66%o were using β - blockers. Twenty two percent of patients had a major cardiovascular event during the follow up, which lasted 28 ± 8 months. Conclusions: A low percentage of cardiovascular goals achievement was observed in this sample of patients, with a high prevalence of overweight and obesity. A high percentage quit smoking after their first cardiovascular event. Despite the high percentage of drug prescription, hypertension and dyslipidemia were not fully controlled.