RESUMO
OBJECTIVES: Describe a series of atypical presentations of pandemic influenza A (H1N1) 2009. METHODS: Description of case series using hospital records. RESULTS: Six patients aged 1 to 65 years with confirmed pandemic influenza A (H1N1) 2009 infection presented with neurological complications within 2 to 5 days after the first signs of influenza-like illness. All six were admitted with seizures or altered mental status. No abnormalities were found in brain scans or cerebral spinal fluid studies of any of the six. All were discharged without sequelae within days of admission. CONCLUSIONS: This is only the second report of pandemic influenza presenting with neurological manifestations. Clinicians caring for patients when pandemic influenza is prevalent in their communities should maintain a high level of awareness of the potential atypical presentations with which this disease can appear.
Assuntos
Transtornos Cognitivos/etiologia , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Influenza Humana/complicações , Convulsões/etiologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-IdadeRESUMO
Community acquired infections with methicillin resistant strains of Staphylococcus aureus (MRSA) infections have a more aggressive clinical course and involve mostly skin and lungs. These infections appear as outbreaks among prisoners, sportsmen, men having sex with men and military personnel. The higher aggressiveness of these strains is due to the production of several toxins, mainly Panton- Valentine leukocidine. The detection of the gene that codes for this toxin is a distinctive feature of these strains. We report five patients with community acquired MRSA infections. The clinical presentation was a skin infection in all. One patient had a pleuropneumonia in addition. Apart for resistance to beta-lactam antimicrobials, the strains were resistant to erythromycin and ciprofloxacin. Patients were treated with vancomycin, clotrimoxazole or intravenous clindamycin with a good evolution. An epidemiological surveillance for community acquired MRSA strain infections should be started and measures to adequately treat infected patients and avoid dissemination should be implemented.
Assuntos
Resistência a Meticilina , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Cutâneas Estafilocócicas/microbiologia , Adolescente , Adulto , Antibacterianos/uso terapêutico , Chile , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/microbiologia , Feminino , Humanos , Masculino , Resistência a Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/genética , Reação em Cadeia da Polimerase , Infecções Cutâneas Estafilocócicas/tratamento farmacológico , Viagem , Adulto JovemRESUMO
Community acquired infections with methicillin resistant strains of Staphylococcus aureus (MRSA) infections have a more aggresive clinical course and involve mostly skin and lungs. These infections appear as outbreaks among prisoners, sportsmen, men having sex with men and military personnel. The higher aggressiveness of these strains is due to the production of several toxins, mainly Panton- Valentine leukocidine. The detection of the gene that codes for this toxin is a distinctive feature of these strains. We report five patients with community acquired MRSA infections. The clinical presentation was a skin infection in all. One patient had a pleuropneumonia in addition. Apart for resistance to beta-lactam antimicrobials, the strains were resistant to erythromycin and ciprofloxacin. Patients were treated with vancomycin, clotrimoxazole or intravenous clindamycin with a good evolution. An epidemiológical surveillance for community acquired MRSA strain infections should be started and measures to adequately treat infected patients and avoid dissemination should be implemented.
