[Invasive infection by Aspergillus terreus treated successfully with liposomal amphotericin B]. / Infección invasiva por Aspergillus terreus tratada con éxito con anfotericina B liposomal.

A woman of 75 years old was admitted at our hospital for evaluation of worsening and weakness in inferior limbs. Several vertebral fractures by crushing, one doubtful discitis, an infiltrate with cavitation in the right superior lobe and one infiltrate in the left superior lobe were detected. In the biopsy of the consolidation a filamentous fungus was watched and in the bronchial washing specimen culture grew Aspergillus terreus. The infiltrates disappeared with liposomal Amphotericin B remaining with oral Itraconazol during three months more. The clinical and analytical data demonstrate the existence of a Overlap syndrome associate to antiphospholipid-antibody syndrome. We comment the peculiarity of the infection by Aspergillus terreus in patients who have not been in critical care and the good response at treatment with liposomal Amphotericin B. It contrasts with the high mortality referred in a recent review. Other aspects to comment are the coexistence with a collagen vascular and an antiphospholipid-antibody syndrome with the higher titles of IgM ACA that we have found in literature.

[Tuberculosis en pediatric patients in the island of Gran Canaria]. / Tuberculosis en pacientes pediátricos en la isla de Gran Canaria.

OBJECTIVE: Tuberculosis is still an important sanitary problem in our country, which has a high rate of endemia. The pediatric population is highly susceptible to being exposed and has a high risk of developing the disease, as well as of suffering serious forms of it. The aim of this study was to analyze the clinical aspects and characteristics of pediatric patients who were diagnosed with tuberculosis in Gran Canaria during a nine years period. PATIENTS AND METHODS: The clinical charts of 49 children between 0 and 14 years of age who were diagnosed of having tuberculosis between 1986 and 1994 were revised. Tuberculosis was diagnosed when M. tuberculosis was isolated from at least one clinical sample. RESULTS: Of the children diagnosed, 69.4% were less than 5 years of age. Only one child had antibodies against HIV. Clinical forms were; pulmonary (33 cases), disseminated (13 cases), genitourinary (1 case), osteoarticular (1 case), and lymphatic (1 case). No association was found between any clinical form and any age group. The disseminated form presented more frequently with a negative Mantoux test (p < 0.01). In all cases lung disease was present and three patients also suffered meningitis. In most of the cases (77.8%), it was necessary to wait for the result of the culture to reach the diagnosis. Two children (4.1%) died and six (12.2%) had sequeale. CONCLUSIONS: Disseminated tuberculosis is relatively frequent (26.5%) in this population and is usually associated with a negative Mantoux test. Therefore, it appears that in this serious form of the disease, a high degree of clinical suspicion is needed and mycobacteria cultures must be done in clinical samples of different origins.