Dermatitis perianal estreptocócica / Perianal streptococcal dermatitis

La dermatitis perianal estreptocócica es una infección cutánea superficial del área perianal, descrita casi exclusivamente en niños, causada por el estreptococo betahemolítico del grupo A. Los síntomas incluyen prurito anal y dolor rectal, estreñimiento secundario y deposiciones con hebras de sangre. Existe a menudo una erupción perianal bien delimitada y brillante. La enfermedad resulta con frecuencia infradiagnosticada, y en ocasiones se trata inadecuadamente. Se exponen los casos de 2 niños, de 2 y 4 años, con la forma típica de presentación de la enfermedad

Perianal streptococcal dermatitis is a superficial skin infection of the perianal region, almost exclusively reported in children, that is caused by group A beta-hemolytic streptococci. Symptoms include perianal itching and rectal pain, secondary constipation and blood-streaked stools. There is usually a well demarcated, bright red perianal rash. The disease is often misdiagnosed and is sometimes treated inappropriately. We report the cases of a 4-year-old and a 2-year-old patient who presented the typical manifestations of the disease

Emergence of ciprofloxacin resistance in Escherichia coli isolates after widespread use of fluoroquinolones.

The evolution (from 1990 to 1996) of fluoroquinolone consumption and resistance and the current patterns of fluoroquinolone usage were examined in a 250-bed community hospital in Spain. Fluoroquinolone consumption increased from 1392 g in 1990 to 3203 g in 1996 (p < 0.05). A significant increase in ciprofloxacin resistance was observed in Escherichia coli isolated from urine samples (from 3 to 20%, p < 0.00001), but not in those E. coli isolated from blood or other sample cultures. In 69 randomly selected clinical charts, fluoroquinolone was used as prophylaxis, empirical therapy, and specific directed therapy in 20%, 65%, and 15%, respectively. Evaluation of quinolone indication was: first choice agents (29%), alternative agents (49%), experimental agents (4.3%) and, agents with no role (1.4%). Our study shows that the increase in the use of fluoroquinolones is associated with the emergence of ciprofloxacin-resistant E. coli from urinary tract sources. Based on their indications, current quinolone usage can be greatly reduced.

[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.