Fulminant streptococcal toxic shock syndrome.

We present a case of a previously healthy 37-year-old male who developed fever, nausea, vomiting, diarrhoea, and hypovolaemia. Within 5.5 h he presented with tachycardia, tachypnoea, became hypotensive and displayed a diffuse erythematous rash. In the following hours he developed persistent hypotension, acute respiratory distress syndrome, liver failure, kidney failure and disseminated intravascular coagulation. A diagnosis of toxic shock syndrome was made, but despite antibiotic therapy, immunoglobulin administration, and supportive measures, the patient died 50 h after presentation. Streptococcus pyogenes was isolated from blood cultures.

Potential of Spanish sour-sweet pomegranates (cultivar C25) for the juice industry.

Commercial juices of sweet pomegranates and fresh juices of sour-sweet pomegranates were analysed for organic acids, sugars, antioxidant activity, volatile composition, sensory profile and consumer liking. Organic acids and sugars were analysed by high-performance liquid chromatography, while volatiles were extracted using hydrodistillation and analysed by gas chromatography-mass spectrometry and gas chromatography-flame ionisation detector. Malic acid was predominant in sweet juices while citric acid in sour-sweet samples. Fructose and glucose were found as the predominant sugars in all juices. A total of 18 compounds were found in pomegranate aroma profile, including monoterpenes, aldehydes, alcohols, monoterpenoids and linear hydrocarbons; the most abundant compounds were 3-carene, α-terpinene and α-terpineol. The total concentration of volatiles ranged from 2.0 up to 5.1 mg/L, with commercial samples presenting higher total concentrations due to the presence of peel volatiles. The high potential of sour-sweet pomegranate fruits for the juice industry was supported by (a) the high values of positive attributes, such as colour and fresh pomegranate flavour and (b) the high overall liking of consumers.

[PARASITARY INFECTIONS OF THE LIVER] / Infecciones Parasitarias del Hígado.

In Perú three are the parasites which affect frequently the liver: Entamoeba histolytica, Echinococcus granulosus and hepatic Fasciola.Amebic liver abscess can start acutely or insidiously with fever and right upper quadrant abdominal pain, with or without liver or intercostal tenderness. The main complications are thoracic, peritoneal or pericardial extension (left lobe abscess). Diagnosis by images study and serology techniques are effective. Currently, Metronidazole is the treatment of choice.Hydatid liver cyst is usually asymptornatic until it produces a mass effect, allergic reactions or a cyst infection occurs as a result of rupture of the cyst to the billary ducts. Rupture to the peritoneum produces secondary seeding with protoscolices which develop into multiple intraabdominal cysts. Study techniques by images and serology methods are also very helpful for diagnosis. Surgery is the most successful treatment but there is also the possibility of medical treatment with Albendazole or a combination of both.Hepatic fascioliasis can be asymptornatic or produce fever, right upper quadrant abdominal pain and hypereosinophilia during the invasive phase, or billary tract obstruction during the chronic phase, which sometimes is only diagnosed during surgical operation. Hemobilia and biliary cirrhosis have been described as complications. During the invasive phase it is based y serological methods, and during the chronic phase diagnosis is made by detection of parasite's eggs in stools. Presently, the treatment of choice is with Triclabendazole.