[Tuberculosis in La Rioja from 1988 to 1993. Clinical course, localization, influence of human immunodeficiency virus infection, and sensitivity of mycobacterial tests]. / Tuberculosis en La Rioja de 1988 a 1993. Evolución, localizaciones, influencia de la infección por el virus de la inmunodeficiencia humana y sensibilidad de la baciloscopia.

BACKGROUND: The present study was performed to analyze the evolution of the incidence of tuberculosis in La Rioja (Spain) from January 1988 to March 1993. The influence of factors such as HIV infection and alcoholism was analyzed. The sensitivity of the bacilloscopy in the diagnosis was studied. METHODS: The cases were collected from the Regional Tuberculosis Program of the Public Health Department in La Rioja, with clinical histories being collected from the Internal Medicine Department of the Hospital San Millán in Logroño. Cases of tuberculosis were microbiologically confirmed by cultures of Mycobacterium tuberculosis. RESULTS: The total number of cases studied was 649 with the incidence of tuberculosis in La Rioja being 51 cases/100,000 inhabitants in 1992. The mean age of all the patients was 45 years with 80% of the tuberculosis being pulmonary and 20% extrapulmonary. Twelve percent of the patients were HIV+; 18% being extrapulmonary tuberculosis and 10.8% pulmonary tuberculosis, p < 0.02. Pleural and urogenital tuberculosis were present in fewer HIV+ patients. Bacilloscopy was negative requiring a culture for diagnosis in 28.6% of the cases with this circumstance more frequently occurring in the pleural and urogenital forms of the diseases. Treatment has evolved from the use of ethambutol in the first few years to the present use of pyrazinamide. CONCLUSIONS: No trend towards an increase in the incidence of tuberculosis in the time period studied was observed in La Rioja. Extrapulmonary tuberculosis was the type of tuberculosis most frequently found in HIV positive patients, with pleural and urogenital forms of the disease being less frequently found in these patients. In these case the bacilloscopy was also found to be negative more frequently.

[Prolonged febrile syndrome as a manifestation of Coxiella burnetii infection, presentation of infrequent clinical cases]. / Síndrome febril prolongado como manifestación de infección por Coxiella burnetii, presentando casos clínicos poco frecuentes.

We present two cases of infection by Coxiella burnetii which developed with sustained fever symptoms. During its evolution, the first case presented granulomatous hepatitis, whereas the second case presented left Cosofemoral Arthritis. We describe the clinical-evolutive characteristics of these clinical forms and within the evolution of the chronic forms of Q fever.

[Brucellosis: 50 cases. Clinico-epidemiologic study and evaluation of diagnostic methods]. / Brucelosis: 50 casos. Estudio epidemiológico-clínico y valoración de métodos diagnósticos.

Fifty cases of brucellosis attending our Service of Internal Medicine during the period 1985-1990 are restrospectively studies. The number of patients in which the potential transmission mechanism and the risk factor involved are unknown is very high, being the percentage higher among women from urban areas (50%). Thus, greater attention should be paid to transmission sources considered unfrequent and to survival of the germ in several biological environments, as well as to consumption of non-pasteurized dairy products. The evolution period of the disease until hospitalization and diagnosis is large (48.6 days), especially in its oligosymptomatic forms. The diagnostic method is based mainly in clinical observations plus agglutinations, with positive hemocultive as the diagnostic method in just 6% of the cases. Treatment with streptomycin and tetracycline is still highly effective.