[Brain lesions in patient diagnosed of meningitis]. / Lesiones cerebrales en paciente con meningitis.

INTRODUCTION: Streptococcus pneumoniae is responsible for most community acquired bacterial meningitis in adults. During the course of meningitis, the development of a new neurological focality can be a sign of an associated complication such as cerebritis. CLINICAL CASE: We report a case of pneumococcal meningitis in a 40 year old woman who reported blurred vision one week after hospital admission. Ophthalmologic exploration was normal. Brain MR images showed areas of cerebritis. CONCLUSION: Cerebritis is a rare complication of pneumococcal meningitis. We discuss the differential diagnosis and the utility of the different imaging techniques.

Lesiones cerebrales en paciente con meningitis / Brain lesions in patient diagnosed of meningitis

Introducción. Streptococcus pneumoniae es responsable de la mayoría de las meningitis adquiridas en la comunidad en los adultos. Durante el curso de una meningitis el desarrollo de una nueva focalidad neurológica puede ser el signo de una complicación asociada como la cerebritis. Caso clínico. Presentamos el caso de una meningitis neumocócica en una mujer de 40 años que refiró visión borrosa a la semana del ingreso hospitalario. La exploración oftalmológica fue normal. Las imágenes de la resonancia magnética cerebral mostraron áreas de cerebritis. Conclusión. La cerebritis es una rara complicación de la meningitis neumocócica. Se plantea el diagnóstico diferencial y la utilidad que proporcionan las diferentes técnicas de imagen

Introduction. Streptococcus pneumoniae is responsible for most community acquired bacterial meningitis in adults. During the course of meningitis, the development of a new neurological focality can be a sign of an associated complication such as cerebritis. Clinical case. We report a case of pneumococcal meningitis in a 40 year old woman who reported blurred vision one week after hospital admission. Ophthalmologic exploration was normal. Brain MR images showed areas of cerebritis. Conclusion. Cerebritis is a rare complication of penumococcal meningitis. We discuss the differential diagnosis and the utility of the different imaging techniques

Otitis media y bacteriemia / Otitis media and bacteremia

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[Polyarteritis nodosa as a cause of sensory motor polyneuropathy.Apropos of a case]. / Poliarteritis nodosa como causa de polineuropatía sensitivomotora. A propósito de un caso.

We present a case of nodose polyarteritis (NPA) in a 65-years-old man with clinical manifestations at the level of the peripherical nervous system (PNS) as a subacute sensorimotor polyneuropathy. We believe that this is an interesting case due to the outlined symptomatology and the first clinical signs, not as common as the multiple mononeuropathy. The diagnosis was established through biopsy of muscle-nerve, without observing aneurysms at the Divas and with negative results for the Hepatitis B markers. Response to corticoid and immunosuppressive therapy was positive.

[Immunosuppressor treatment in temporal arteritis of long-term evolution]. / Tratamiento con inmunosupresores en arteritis de la temporal de larga evolución.

We report a case of rheumatic polymyalgia associated with temporal arteritis, in which clinical-biological symptoms and evolution with steroid or immunosuppressive therapy were analyzed. We confirm the lack of effectiveness of the treatment with AINES, the low response to steroids and the high response to immunosuppressive therapy.

[Dyspnea as the first clinical manifestation of amyloidosis]. / Disnea como primera manifestación clínica de amiloidosis.

We present a case of a 65-year-old woman, in whom diagnosis of primary systemic amyloidosis was established, being dyspnea the main cause of consultation. In addition, we emphasize the importance of the adequate valorization of such symptom in a patient with no precedents of cardiorespiratory pathology.