[Cutaneous infections by Mycobacterium marinum. Description of 3 cases and review of the literature]. / Infecciones cutáneas por Mycobacterium marinum. Descripción de 3 casos y revisión de la bibliografía.

BACKGROUND: Human infection by Mycobacterium marinum is infrequent and is currently reported in association with the management of aquariums. The epidemiologic, clinical and microbiologic characteristics of three cases in our hospital are herein reported. METHODS: Three cases of cutaneous infection by M. marinum attended in our hospital from February 1993 to October 1994 are described. RESULTS: The three patients were related with the management of aquariums. In two cases the clinical presentation was of sporotricoid cutaneous dissemination, while the third patient presented a localized cutaneous form. The lesions were localized in the upper right extremity in the three cases. The delay in diagnosis was important in two of the cases. Cure, or improvement, were achieved in three cases with' treatment; one with cotrimoxazol, another with first line tuberculostatic drugs and another did not receive treatment. CONCLUSIONS: Human infection by M. marinum is currently described is association with the management of aquariums. The infection is usually cutaneous, alone or well disseminated, with invasion of deep tissue occasionally observed. The lesions are generally found on the upper extremities. Diagnostic delay is frequent. The most adequate treatment appears to be the combination of rifampicin plus etambutol or cotrimoxazol alone, with cases of spontaneous remission also being observed.

[Epidemiology of gastroenteritis by Salmonella (1983-1994)]. / Epidemiología de las gastroenteritis por Salmonella (1983-1994).

BACKGROUND: The incidence of Salmonella enteritidis infection has been study in order to determine their epidemic spread from 1983 to 1994, and the impact of the measures introduced to attempt its control. METHOD: Review of the stool cultures positives for enteric pathogens obtained in the Hospital de Navarra from 1983-1994. RESULTS: Looking at the isolation rates of the different enteric pathogens from 1983 to 1994, a sharp increase of S. enteritidis was recorded on 1985 as a consequence of several outbreaks associated with the consumption of mayonnaise elaborated with row eggs. From 409 strains of Salmonella isolated that year, 302 were serotype enteritidis, this means a 7.5 fold rise since the preceding year in which the prevailing serotype was S typhimurium. From 1985 through 1991 the incidence of S. enteritidis stand high, and pick again on 1990. Since then, a decline has been observed, and in 1994 the number of Salmonella cases recorded were about those on 1984, however, S. enteritidis is now the prevailing serotype. CONCLUSIONS: The egg-borne S. enteritidis epidemic emerged as a major public health problem in Navarra in 1995, associated to the consumption of home made mayonnaise. The measures introduced by local Public Health authorities to attempt control of non pasteurized mayonnaise were insufficient. Evidence from other places links human infections to vertical transmission from breeding flocks to layers. And makes of S. enteritidis infection an international challenge. The severity of the lived experience demands a time-temperature control of eggs in the interval from purchaser to consumer and a more generalized use of pasteurized egg products, no only in the industry but also in the household.