Endocarditis infecciosa con compromiso bivalvular por Erysipelothrix rhusiopathiae / Infective endocarditis with bivalvular involvement due to Erysipelothrix rhusiopathiae. Report of one case

The microbiology of infective endocarditis (IE) varies in different populations and depends on public health conditions and socioeconomic status. In low-income countries, oral Streptococci affect hearts with rheumatic valve disease in patients with poor dentition. In high-income countries, Staphylococci are the most common cause, affecting elderly and immunocompromised patients, or those with invasive devices. Gram - positive bacili as IE pathogens are unusual. Erysipelothrix rhusiopathiae is a Gram positive bacili. It causes skin diseases in domestic and farm animals, but in humans, is a very unusual pathogen. This infection is considered a zoonosis, since most cases are linked to direct contact with vector animals. We report a 62 year-old male patient with a history of exposure to animals, who developed an infective endocarditis with severe bivalve regurgitation and septic shock, requiring antimicrobials and surgical resolution. Erysipelothrix rhusiopathiae was isolated from blood and valve vegetation cultures. The patient had a successful evolution and was discharged from the hospital.

Consultas en urgencia en Hospital de Hualañé antes y después delterremoto de febrero de 2010 en Chile / Emergency attentions on Hospital de Hualañé before and after february 2010 earthquake in Chile

INTRODUCCIÓN: Se ha descrito que posterior a una situación de catástrofe, los motivos de consulta en las urgencias cambian, aumentando el número de consultas traumatológicas y patologías cardiovasculares. Existen pocos registros de este tema. El objetivo fue describir las consultas de la urgencia del Hospital de Hualañé, séptima región de Chile una semana antes, 48 horas inmediatas y una semana después del terremoto del 27 de febrero de 2010 en Chile. MATERIAL Y MÉTODO: Se utilizó el registro del servicio de urgencias del Hospital de Hualañé. Se establecieron categorías según motivo de consulta, sexo y edad. Se abarcó la totalidad de consultantes entre el 20 de febrero y el 6 de marzo de 2010. RESULTADOS: La muestra final fue de 614 pacientes. En las primeras 48 horas posterremoto notamos un incremento en las consultas traumatológicas (38 por ciento), de las consultas quirúrgicas (700 por ciento) y de los casos de trastornos de pánico (18 por ciento). Durante la semana siguiente la distribución tendió a normalizarse, pero las consultas por trastornos de pánico se mantuvieron altas (17 por ciento). La edad y el sexo mantuvieron su proporción en todo el tiempo del estudio. DISCUSIÓN: Nuestro estudio contribuye con una pequeña muestra del desastre ocurrido en Chile el 2010. Los resultados son concordantes en cuanto al aumento de las consultas traumatológicas y trastornos angustiosos. Limitaciones: poco tiempo de recolección de datos, clasificaciones categoriales. Queda por estudiar si el patrón se repite en los lugares que sufrieron el tsunami.

INTRODUCTION: It has been reported that following a catastrophic event, the reasons for consultation in the emergency department change, increasing the number of attentions for trauma and cardiovascular diseases. There are few records of this issue. The objective was to describe the urgency attentions at Hospital de Hualañé, 7th region (Maule) of Chile one week before, 48 hours and one week immediately after the earthquake of February 27th, 2010. MATERIAL AND METHOD: We use the registry book of Hospital de Hualañé emergency department. Established categories according to complaint, sex and age. We covered all of consultants between February 20th and March 6th, 2010. RESULTS: The final sample of 614 patients. In the first 48 hours after the earthquake it noticed an increase in trauma consultations (38 percent), surgical consultations (700 percent and cases of panic attack (1 percent to 18 percent before). During the following week, the distribution tended to normalize, but queries for panic disorder remained high (17 percent). The age and sex ratio remained throughout the study period. DISCUSSION: Our study adds a small sample of the disaster in Chile in 2010. The results are consistent with previous studies in terms of increased trauma and consultation distressing. Limitations: no time to collect data, categorical ratings. It remains to examine whether the pattern repeats itself in places that suffered the tsunami.