[Neurosyphilis: forms of presentation and clinical management]. / Neurosífilis: formas de presentación y manejo clínico.

INTRODUCTION AND AIMS: Neurosyphilis results from the infection of the central nervous system by Treponema pallidum. It causes diverse clinical pictures which are occasionally similar to other, better known neurological diseases. In this paper our aim is to offer a global clinical vision of this entity by reviewing the different forms it can take and its diagnostic and therapeutic management. DEVELOPMENT: The forms of presentation of neurosyphilis can be grouped in two categories: early (asymptomatic, meningeal and meningovascular neurosyphilis) and late (progressive general paralysis and tabes dorsalis). Other less important forms, such as gummas, ocular forms, syphilitic amyotrophy or hypoacusis, have also been described. Diagnosis is complex and is based on the study of the cerebrospinal fluid. Given the difficulty involved in performing an accurate diagnosis, different criteria have been developed in which T. pallidum serology plays a key role. The most effective treatment is penicillin, although on occasions it may have no effect and we therefore recommend clinical and fluid analysis follow ups. Lastly, we describe the changes in incidence and clinical presentation, and the complications that may arise in diagnosis when HIV carrying patients also suffer from this disease. CONCLUSIONS: Neurosyphilis is a disease that still occurs nowadays and, due to its clinical polymorphism, must be borne in mind as a differential diagnosis in a number of neurological and psychiatric illnesses. This, together with the fact the serological tests are difficult to interpret and its irregular response to the usual treatment, makes it difficult to manage and means that the neurologist must have a thorough knowledge of the disorder.

Bloqueo cardíaco completo inducido por metoclopramida intravenosa / Total hearth block after intravenous metoclopramide

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[Epidemic outbreak of scabies related to a patient with human immunodeficiency virus infection and Norwegian scabies]. / Brote epidémico de escabiosis en relación con un paciente con infección por el virus de la inmunodeficiencia humana y sarna noruega.

A patient with AIDS was admitted to our hospital because of pruritic and disabling erythroderma, it was treated with Lindane without improvement. Skin biopsy of a crusty lesion showed Sarcoptes scabiei hominis, and the diagnosis of Norwegian scabies was made. After a long and intensive treatment with several drugs, cure was achieved. In the following three months we detected 42 people with scabies, all in some relation with the index case. This feature of high contagiousness of Norwegian scabies in a constant, through the scanty literature we have found; and it is due to its diagnostic and therapeutic problems.

[Vasculitis caused by hypersensitivity: an analysis of 60 patients]. / Vasculitis por hipersensibilidad: análisis de 60 pacientes.

Sixty cases of hypersensitivity vasculitis are revised analyzing their possible etiology, clinical course, analytical and histological alterations, evolution, and treatment. Thirty of these cases corresponded to Schönlein Henoch purpura (SH). The results of this subgroup (SH) are compared to other hypersensitivity vasculitis (HV).