Rol de la cirugía en el manejo de la infección invasora por Saprochaete capitata / Role of surgery in Saprochaete capitata (S. capitata) sepsis in a patient with acute myeloid leukemia

Saprochaete capitata (S. capitata) fungal sepsis is a severe condition with a clinical presentation that is similar to other yeast originated fungal sepsis. It is observed in patients with hematological malignancies such as acute myeloid leukemia and neutropenia. We report a 23 year old male presenting with cough, fever and malaise. A bone marrow biopsy led to the diagnosis of acute myeloid leukemia. During the first cycle of chemotherapy the patient presented fever: blood cultures were positive for Klebsiella pneumoniae. Despite antimicrobial treatment, fever persisted; a computed tomography showed a focal splenic lesion; a left exudative pleural effusion appeared. A Matrix Assisted Laser Desorption Ionization-Time of Flight mass spectrometry identified the presence of S. capitata. After multiple antifungal treatments and pleural cavity cleansing by means of videothoracoscopy and laparoscopic splenectomy, the infection resolved and the patient completed his chemotherapy.

Brucella pleuritis in a 12-year old child; a case report

Brucellosis is a zoonotic disease involving several organs. Pulmonary involvement especially pleuritis is extremely rare. We report a 12-year old boy presented with a 3-week history of fever, chills, and profuse sweating, especially at night. He complained of fatigue, lack of appetite, weight loss, exertional dyspnea, nonproductive cough and mild pleuretic chest pain. Diagnosis of brucella pleuritis was verified by positive blood and pleural fluid culture and serology. Having completed a combined therapy [doxycycline/rifarnpin] for 3 months, no relapse occurred. Almost all radiological findings disappeared at the end of the therapy. Pulmonary involvement is a rare manifestation of brucellosis, however, it responds well to a combination therapy of rifampin and doxycycline

Disseminated paracoccidioidomycosis with peripleuritis in an AIDS patient

La paracoccidioidomicosis es una de las micosis sistémicas endémicas más frecuentes de Latinoamérica, causada por un hongo dimorfo. En los pacientes con SIDA se presenta como una enfermedad grave y diseminada, con un amplio espectro de manifestaciones clínicas. Los niveles de linfocitos T CD4 + son habitualmente < de 200 cél/&181;L. Presentamos un caso de paracoccidioidomicosis diseminada con peripleuritis y abscesos subcutáneos sobre la pared torácica como manifestación inicial del SIDA. En países endémicos, la paracoccidioidomicosis debe incluirse como una complicación oportunista de los pacientes con SIDA.