Hidroneumotórax en paciente inmunocompetente / Hydroneumothorax in an immunocompetent patient

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Factores pronósticos, mortalidad e indicaciones de vacunación en la neumonía neumocócica bacteriémica / Prognostic factors, mortality and pneumococcal vaccination recommendations in bacteriemica pneumococcal pneumonia

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[Miliary tuberculosis associated with acute respiratory distress and pancytopenia in HIV-negative patient]. / Tuberculosis miliar asociada a síndrome de distrés respiratorio agudo y pancitopenia en paciente VIH negativo.

The acute respiratory distress syndrome (ARDS) is a rare but serious complication of miliary tuberculosis with a mortality rate near 100% when associated with pancytopenia. This association has been rarely reported (eleven cases in a Medline search, 1966-1999). A case is here reported of an HIV-negative patient with miliary tuberculosis which presented as ARDS associated with pancytopenia. This case prompted us to review the literature and risk factors, diagnosis and treatment issues are discussed. In patients with predisposing factors miliary tuberculosis must be considered as a possible cause of ARDS.

Tuberculosis miliar asociada a síndrome de distrés respiratorio agudo y pancitopenia en paciente VIH negativo / Miliary tuberculosis associated with acute respiratory distress syndrome and pancytopenia in an HIV-negative patient

El síndrome de distrés respiratorio agudo (SDRA) es una complicación rara pero muy grave de la tuberculosis miliar que cuando se asocia a pancitopenia se acerca a una mortalidad del 100 por ciento. Esta asociación ha sido escasamente descrita (11 casos en revisión Medline, 1966-1999).Presentamos el caso de 1 paciente VIH negativo con una tuberculosis miliar que comienza como un SDRA, al que se asocia pancitopenia. A propósito del mismo se revisa la literatura, describiéndose los factores de riesgo, diagnóstico y tratamiento. Es fundamental considerar la tuberculosis como etiología posible en pacientes con factores de riesgo que presentan SDRA (AU)

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[Liver tuberculous abscess in patients with human immunodeficiency virus infection: report of 2 cases and review of the literature]. / Abscesos tuberculosos hepáticos en pacientes con infección por el virus de la inmunodeficiencia humana: presentación de dos casos y revisión de la literatura.

Two cases are reported of hepatic tuberculous abscesses (HTBA) in patients infected with the human immunodeficiency virus (HIV), stressing the rarity of this location. Likewise, a review is made of cases reported in the literature. Our two patients presented with a prolonged febrile condition, with constitutional symptoms and nonspecific abdominal discomfort. In one patient the hepatic location was accompanied by a pulmonar location too. The course of the patients was good and symptoms subsided with tuberculostatic therapy. To note the possibility of finding hepatic tuberculous abscesses in HIV patients with prolonged fever and nonspecific abdominal pain more frequently than considered until now.

Association of leukemia and pregnancy: clinical and obstetric aspects.

The association of leukemia and pregnancy is not common. We have analyzed the hematologic and obstetric problems occurring in 10 pregnant leukemic patients, 7 with acute leukemia and 3 with chronic myeloid leukemia. One patient died in the fifth month of pregnancy with a nonviable fetus. There was one premature twin birth with both fetuses dead. The other fetuses were viable, although there was one premature birth and three fetuses had below-normal birth weights. No bleeding complications were observed during delivery. Three patients had infections during puerperium. This article discusses the possible influences and relations between leukemia and pregnancy, based on our observations and on data in the literature.