RESUMO
El género salmonella incluye enterobacterias responsables de numerosos casos de patología infecciosa. Las complicaciones focales son poco frecuentes. Se realizó el estudio retrospectivo entre los años 1996 y 2002 de los casos diagnosticados en el Hospital Clínico de Santiago de Compostela, España. Se diagnosticaron 153 casos como infección por salmonella, de los que 13 (8,5%) presentaron complicaciones. Las edades incluidas fueron entre 17 y 80 años, con una mediana de 37 años, de los que nueve casos (69%) eran hombres y en 7 (54%) no existían factores de riesgo asociados. En 12 pacientes (93%) existía antecedente de gastroenteritis. Los diagnósticos se realizaron por coprocultivo (5 casos), en 6 pacientes (46%) por hemocultivo, en otros 3 casos ambos fueron positivos. Las complicaciones incluyeron absceso esplénico, neumonía, endocarditis, endarteritis, sepsis, hepatitis y artritis reactiva. No existió un claro predominio estacional. El antibiótico pautado fue en 8 pacientes (64%) ciprofloxacino; tres pacientes fueron intervenidos. Dos pacientes fallecieron. En esta serie de casos se concluyó que la prevalencia y morbimortalidad de complicaciones, es elevada. La presentación más habitual es sepsis (4 casos), neumonía (3 casos) y absceso esplénico (2 casos), frente a la osteomuscular o partes blandas (1 caso). Se detectó bacteriemia en un porcentaje elevado de los casos...
Genus salmonella includes enterobacteriaes responsible of a great amount of infectious diseases. Focal complications are not frecuent. We conducted a 5 retrospective study between 1996 and 2002. We included 153 cases with salmonella infection, 13 of which (8, 5%) with ages between 17 and 80 years (median 37) presented focal complications. Nine of the patients were male (69%) and in 7 cases (54%) risk factors were present, 12 (93%) presented previously gastroenteric signs. Microbiological diagnosis established through stool examination (5 cases), in 6 (46%) with blood culture, in other 3 cases, both were positive. Complications included splenic abscess, pneumonia,endocarditis, endarteritis, sepsis, hepatitis and reactive arthritis. No clear seasonal pattern was established. Eight patients (64%) received ciprofloxacin. Three patients were surgically treated. Two patients died. Conclusion: In our series prevalence and morbimortality in focal complications is high. The most common presentation was sepsis (4 cases), pneumonia (3) and splenic abscess (2). Bacteraemia was documented in a high percentage of cases. No seasonal pattern was established...
Assuntos
Salmonella , Infecções por Salmonella , Salmonella typhi , Gastroenterite , Pneumonia , SepseRESUMO
Background: Due to the increasing number of intravenous drug users, subjects with immune deficiencies or with prosthetic valves, infective endocarditis (IE) continues to be prevalent and to have a high mortality. Aim: To review all cases of infective endocarditis diagnosed in an Internal Medicine Service. Material and methods: Retrospective review of medical records of all patients with infective endocarditis, hospitalized in an Internal Medicine ward, between 1989 and 2003. Dukes criteria were used to define definitive, possible and less probable cases of IE. Results: Eighty seven patients with definite IE were identified (66 males, age range 19-84 years), with a mean incidence of 5.3 per 1000 hospitalizations. IE in intravenous drugs users was usually caused by Staphylococcus aureus and presented high risk of embolism (RR: 3,21). Subjects aged over 70 years had a relative risk of mortality of 5.5. Hospital acquired IE was associated with advanced age and IV catheters appeared as the only predisposing factor. Patients with prosthetic valves were also older, their main complication was abscess formation and their mortality was higher. Conclusions: A closer approach to differential conditions of patients, according to age, intravenous drug use or the presence of prosthetic valves, is necessary