Osteomielitis por providencia rettgeri / Osteomyelitis providencia rettge

Se presenta el caso de un paciente con osteomielitis por Providencia rettgeri. Recibía warfarina, por trombosis venosa profunda de miembro inferior izq.; durante su evolución antes de ingresar al Hospital General del Oeste, Caracas, Venezuela, presentó una infección secundaria a la avulsión de la uña, con varias hospitalizaciones en otros centros de salud. Hubo un antecedente no comprobado de diabetes mellitus. Se analiza el caso y se revisa la literatura en la que no se encontró descripción con compromiso de partes blandas en la literatura nacional o latinoamericana.

A case of osteomyelitis due to Providence rettgeris presented by in a patient who was receiving warfarin for a deep vein thrombosis of the left lower limb. He also presented asoft tissue infection secondary to nail avulsion and was hospitalized several times berfore being admitted to the Hospital General del Oeste, Caracas, Venezuela. There was a history of possible diabetes mellitus which was not proven. We reviewed the nationaland Latin American literature analyzed, but description of P. rettgeri was found with soft tissue involvement in reviewed literature.

Farmacovigilancia y medicina interna / Pharmacovigilance and internal medicine

En Medicina Interna es indispensable conocer y reportar las Reacciones Adversas a los Medicamentos (RAM). Se presentan cuatro (4) situaciones de este tipo, provenientes del Servicio de Medicina Interna del Hospital General del Oeste, Caracas, Venezuela. Caso 1: paciente con SIDA y toxoplasmosis cerebral, en tratamiento con antiretrovirales, trimetoprim-sulfa y pirimetamina. Consulta a la emergencia por presentar lesiones cutáneas. Caso 2: paciente de 24 años, síndrome de Down, con comunicación interventricular corregida, hipotiroidismo controlado y Hepatitis C en tratamientocon ribavirina – tegainterferon, con abscesoinguinal. Se encuentra pancitopenia severa y progresiva. Caso 3: Mujer de 70 años en preoperatori de facotomía en quien se diagnóstica trombosis venosa profunda poplítea izquierda. Se prescribe enoxaparina – warfarina y se aprecia un hematoma del recto anterior del abdomen. Se identifica el uso previo y simultáneo de productos herbarios. Caso 4: paciente que ingiere un producto sin registro sanitario y prohibido por las autoridades regulatorias del país; contiene compuestos no declarados: diclofenac sódico y esteroides. La farmacovigilancia es indispensable en un servicio de medicina interna.

Pharmacovigilanceis essential in the practice of Internal Medicine. Four situations from an Internal Medicine Department of the Hospital General del Oeste, Caracas, Venezuela, are analyzed. Case 1: patient with AIDS and cerebral toxoplasmosis, trated with antiretroviral drugs, trimetoprim-sulfimetoxasol and pyrimethamine. This patient consultedbecause of with cutaneous. Case 2: 24 year-old patient with Down syndrome, corrected congenital cardiac disease, treated hypothyroidism and hepatitis C treated with ribavirin - tegainterferon had an inguinal abscess. A severe and progressive pancytopenia is found and It analyzed the high suspicion causality of RAM. Case 3: A 70 year-old woman, was examined for a preoperative evaluation and a left popliteal deep vein thrombosis is found. Enoxaparin - warfarin were prescribed and in the next 24 hours a hematoma of abdominal rectus was found. The oriented anamnesis identifies the use of herbal products. Drug interaction is discussed. Case 4: regulatory authorities prohibit an unregistered health product that has not reported compounds: diclofenac and steroids. Pharmacovigilance is essential in a department of internal medicine.