Aumento de la incidencia de neumonía de posible origen bacteriano en el último trienio / Increased frequency of pneumonia of possible bacterial etiology during the last three years

Objetivo: Estudiar a los pacientes ingresados por neumonía en el último trienio, considerando sólo la neumonía definida previamente como típica o bacteriana. Métodos: Se estudiaron retrospectivamente todas las neumonías típicas adquiridas en la comunidad ingresadas durante los años 1998, 1999 y 2000. Se consideró como neumonía típica o de origen bacteriano aquella que cumplía 3 de 5 criterios: Fiebre >39 °C y de presentación brusca, dolor de costado o equivalentes (dolor abdominal o meningismo); auscultación de condensación, radiología de consolidación; leucocitosis >-12.000 mm3 con neutrofilia >-6.000 mm. Resultados: Se diagnosticaron un total de 271 neumonías, 75 en 1998, 85 en 1999 y 111 en 2000. La incidencia por 100.000 niños al año <5 años de nuestra Area Sanitaria era de 87,9, 98,6 y 126,3, respectivamente, y el porcentaje de ingresos por neumonía típica en relación con el número total de ingresos al año en la Unidad era de 5,8, 6,8 y 8 por ciento, respectivamente. Se realizó hemocultivo en 155 pacientes, que era positivo en 8 casos (5 por ciento): Streptococcus pneumoniae (n= 6), Haemophilus in fluenzae (n= 1) y Streptococcus pyogenes (n= 1): En la radiología, el 93,4 por ciento de los pacientes tenía una consolidación y el 6,6 por ciento presentaba un infiltrado. Se diagnóstico un derrame pleural en el 10 por ciento de los casos. Conclusiones: Existe un aumento de la frecuencia de niños ingresados en nuestro hospital por neumonía de características bacterianas en el último trienio. Consideramos que este aumento es debido, fundamentalmente, a neumonías causadas por neumococo (AU)

Trombosis del seno lateral y la vena yugular interna como complicación de la otitis media aguda / Lateral sinus and internal jugular vein thrombosis as a complication of acute otitis media

Las complicaciones de la otitis media aguda (OMA) son poco frecuentes actualmente. Presentamos un caso de mastoiditis aguda con trombosis de los senos venosos sigmoide y lateral y de la vena yugular interna como complicaciones de una OMA (AU)

Complications of acute otitis media are not common nowadays. We present a case of acute mastoiditis with thrombosis of the sigmoid and lateral sinuses and internal jugular vein as a complication of acute otitis media (AU)

[Incidence and clinical characteristics of Kawasaki's disease]. / Incidencia y características clínicas de la enfermedad de Kawasaki.

OBJECTIVE: The aim of this study was to analyze the incidence and clinical spectrum of Kawasaki's disease in children attended in our hospital. PATIENTS AND METHODS: Retrospective review of all children with Kawasaki's disease evaluated in the Department of Infectious Diseases of Hospital La Paz (Madrid, Spain) from January 1999 to June 2002. Information included clinical manifestations, age, sex, seasonal occurrence, treatment, development of cardiovascular abnormalities, and incidence rate. RESULTS: Forty-five patients with Kawasaki's disease were analyzed during the study period. Age ranged between 4 months and 13 years. Thirty-seven children were aged 5 years old or less and 15 children were younger than 2 years. The most common symptom was fever in 98 % of the patients. Five patients developed coronary aneurysms. Of these, four were aged less than 2 years and three were treated after the first week of onset of fever. The annual incidence rate in our health area was estimated at 15.1 cases per 100,000 children aged 5 years or less. CONCLUSIONS: The annual incidence rate for Kawasaki's disease in our area was similar to that in Europe and the United States. Coronary aneurysms were more common in children aged less than 2 years and in patients who received treatment after 1 week of the onset of fever.

Infección pulmonar por "Mycobacterium" en huésped inmunocompetente / Pulmonary infection due to "Mycobacterium scrofulaceum" in an immunocompetent host

La existencia de micobacterias distintas a M. tuberculosis y M. leprae es conocida desde hace un centenar de años. Estudiadas más ampliamente desde los años cincuenta, su papel patógeno fue reconocido a partir de los años setenta. Entre las micobacterias atípicas se encuentra Mycobacterium scrofulaceum, que es el microorganismo causante de linfadenitis en niños, así como de infecciones en otras localizaciones en individuos inmunodeprimidos o con enfermedad pulmonar subyacente. Existen, no obstante, raros casos descritos en la bibliografía de afectación diferente a la ganglionar en individuos inmunocompetentes. Presentamos el caso de una niña de 11 años previamente sana, sin afectación del sistema inmune, con clínica pulmonar, prueba de la tuberculina positiva, afectación radiológica y aislamiento de Mycobacterium scrofulaceum. La resolución del cuadro clínico y radiológico se produjo con antituberculosos habituales, a pesar de que, in vitro, el microorganismo era resistente a todos ellos (AU)

[Anthropometric data on newborn infants: comparative study of two ethnic groups]. / Valores antropométricos en el recién nacido: estudio comparativo en dos grupos étnicos.

We have studied the birth weights, obstetrics data and anthropometrical data from 1.157 full-term newborns who were delivered in the Hospital del Insalud-Cruz Roja in Ceuta (Spain). Of these newborns, 489 were of arabic origin and 668 of hispanic origin. Arabic newborns were heavier (3.248 +/- 473 g versus 3.280 +/- 431 g, p < 0.001) and longer (50.2 +/- 1.8 cm versus 49.6 +/- 1.8 cm, p < 0.001) than their hispanic counterparts. These differences were not due to a disproportion in sex or gestational age between the groups. Furthermore, the differences were still present after adjustments were made for maternal age, parity and the mother's smoking habit. Thus, this difference in size at birth between arabic and hispanic newborns could be, at least in part, ethnically related.

[Kala-azar in childhood. 20 year review]. / Kala-azar en la infancia. Revisión de veinte años.

Authors have reviewed 43 patients with Kala-azar admitted to hospital from 1960 to 1980. Thirty two patients came from Madrid province and rest from surroundings. There was a male predominance. Disease was more common between children under two years old. Bone marrow examination was positive for parasites in 60% of patients and in the others diagnosis was established because an appropriate response to Antimonials. All patients were treated with N-metil-Glucamined and in two patients Neo-Stibosan was added later. Clinical response to treatment was to complete remission in all patients.

[Boutonneuse Mediterranean fever (author's transl)]. / Fiebre exantemática del Mediterráneo.

Authors report six cases of boutonneuse Mediterranean fever seen in the last two years. All of them presented fever, malaise, generalised maculopapulous rash and a typical black spot or inoculation canker. Diagnosis was done by a positive Weil-Félix test. The treatment used was tetracycline with good results. Incidence of this disease is increasing in our country.