Case Report: Hemophagocytic Lymphohistiocytosis Secondary to Plasmodium ovale wallikeri Infection.

We report the first known case of hemophagocytic lymphohistiocytosis (HLH) secondary to imported Plasmodium ovale wallikeri infection in a 58-year-old white woman. A delayed diagnosis of malaria and HLH was made after protracted fever and pancytopenia failed to respond adequately to antimalarial treatment, which required intravenous methylprednisolone and gamma-globulin therapy to resolve.

Infección cutánea por Gordonia araii / Skin infection due to Gordonia araii

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Uveítis intermedia en paciente inmunocompetente / Intermediate uveitis in an immunocompetent patient

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Staphylococcus lugdunensis: características clínicas, microbiológicas y sensibilidad antibiótica de 27 casos / Staphylococcus lugdunensis: clinical features, microbiology and antimicrobial susceptibility of 27 cases

Introducción. Staphylococcus lugdunensis es un estafilococo coagulasa negativo (SCN) con características microbiológicas, clínicas, de virulencia y de sensibilidad a antimicrobianos que le hacen ser una especie claramente diferente de otras especies de estafilococos coagulasa negativos. Presentamos las características clínico microbiológicas de S.lugdunensis aislados en 27 enfermos de nuestro hospital. Material y métodos. Se estudiaron los aislamientos de Staphylococcus lugdunensis del año 2004 al 2011. La identificación y antibiograma se realizó por el sistema MicroScan (Siemens). Se revisaron las historias clínicas de los pacientes con aislamientos de S. lugdunensis. Resultados. Se obtuvieron 27 aislamientos de S. lugdunensis procedentes de: abscesos (9), heridas (9), líquido articular (3), sangre (2), líquido peritoneal (1), exudado ótico (1), exudado nasal (1), orina (1). En 20 casos el cultivo fue puro y en 7 mixto. En 8 casos (30%) las muestras procedían de Ginecología, 6 (22%) de Traumatología, 5 (19%) de Cirugía, 3 (11%) de Medicina interna, 2 (7%) de Pediatría, 3 (11%) de otros servicios. En 15 casos (55,5%) existían antecedentes de cirugía o traumatismo reciente. Fueron sensibles a la penicilina 20 (74%) y no hubo ninguna cepa resistente a oxacilina. Conclusiones. S. lugdunensis se ha aislado mayoritariamente en infecciones de piel y tejidos blandos, y en infecciones de heridas post-quirúrgicas. Se ha aislado en cultivo puro en el 74% (20/27) de los casos. Es importante la correcta identificación de S. lugdunensis para evitar que sea descartado como simple estafilococo coagulasa negativo, lo que nos permitirá tener un mejor conocimiento de las infecciones causadas por este microorganismo (AU)

Introduction. Staphylococcus lugdunensis is a coagulase-negative staphylococcus (CNS) with microbiological characteristics, clinical virulence and antimicrobial susceptibility testing, which makes it a distinctly different species from other coagulase-negative staphylococcus species. We present the microbiological and clinical characteristics of 27 S.lugdunensis isolates in patients of our hospital. Material and methods. Staphylococcus lugdunensis isolates collected in our hospital from 2004 to 2011 were studied. Identification and susceptibility testing were performed using the MicroScan (Siemens) system. The clinical records of patients with S.lugdunensis were reviewed. Results. A total of 27 isolates of S.lugdunensis were obtained from the following sources: abscesses (8), wounds (8), joint fluid (3), blood (2), peritoneal fluid (1), ear exudate (1), nasal discharge (1), and urine (1). In 22 cases the culture was pure and in 5 cases mixed. Samples came from Gynaecology in 8 cases (30%), Traumatology in 6 (22%), Surgery in 5 (19%), Internal Medicine in 3 (11%), Paediatrics in 2 (7%), and 3 (11%) from other departments. Just over half (15 cases, 55.5%) had a history of recent surgery or trauma. A total of 20 (74%) were sensitive to penicillin, and none of the isolates was resistant to oxacillin. Conclusions. S. lugdunensis has been isolated mainly in skin and soft tissue infections, as well as in surgical wounds. The microorganism was obtained in pure culture in 20 cases (74%). The proper identification of S.lugdunensis is important in order to avoid being ruled out as simple coagulase-negative staphylococci, and to give us a better understanding of infections caused by this microorganism(AU)

Influenza-like illness criteria were poorly related to laboratory-confirmed influenza in a sentinel surveillance study.

OBJECTIVE: To analyze the most related clinical data for influenza and the utility of influenza-like illness criteria as the clinical threshold for sampling in an influenza sentinel surveillance over a 3-year period. METHODS: Sentinel physicians collected throat specimens and data from outpatients with acute respiratory infection (< or = 72 hours duration). Laboratory-confirmed influenza infection was compared with independent symptoms and the influenza-like illness criteria, as defined by the Classification Committee of the World Organization of Family Doctors. RESULTS: From 1934 patients, 359 (18.56%) yielded positive results for influenza viruses. Only 199 (55.4%) of laboratory-confirmed cases fulfilled clinical criteria of influenza-like illness: positive and negative predictive value (PPV and NPV) of 0.36 and 0.88, respectively. Fever, cough, and rhinorrhea individually correlated with influenza infections (PPV: 0.30, 0.20, and 0.20, respectively; NPV: 0.92, 0.87, and 0.85, respectively). Multivariate analysis demonstrated that the correlation of influenza infection with the presence of fever and cough was similar to the correlation between influenza infection and influenza-like illness criteria (odds ratio 2.24 vs. 2.71, respectively). CONCLUSION: Influenza-like illness criteria are poorly related to laboratory-confirmed influenza. For early detection of influenza viruses in surveillance systems, a less restrictive clinical criterion (specifically, acute respiratory infection) perhaps should be followed.