Impacto de la tuberculosis en Madrid: análisis de parámetros clínicos y epidemiológicos en un Hospital General durante 2002 / Impact of tuberculosis in Madrid: analysis of clinical and epidemiological parameters in a General Hospital during 2002

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[Bacteremic infection due to Nocardia otitidiscaviarum: case report and review]. / Infección bacteriémica por Nocardia otitidiscaviarum: revisión a propósito de un caso.

We present a case of bacteremic pneumonia caused by Nocardia otitidiscaviarum in a corticodependent COPD. Blood and sputum cultures on Mycobacterial media were positives and identification was done using 16S rDNA sequencing. In this article we review the most relevant communications about Nocardia spp infection and study the strain susceptibility using E-test.

Infección bacteriémica por Nocardia otitidiscaviarum: revisión a propósito de un caso / Bacteremic infection due to Nocardia otitidiscaviarum: case report and review

Presentamos un caso de neumonía bacteremica causada por Nocardiaotitidis caviarum en un paciente con bronconeumopatia crónica obstructiva corticodependiente. Los cultivos de sangre y esputo en medios para micobacterias resultaron positivos y la identificación se realizó mediante la secuenciación de 16S rDNA. En el presente artículo se realiza una revisión de conjunto sobre el agente etiológico y se practica el estudio de susceptibilidad de la cepa mediante la técnica de E-Test

We present a case of bacteremic pneumonia caused by Nocardia otitidiscaviarum in a corticodependent COPD. Blood and sputum cultures on Mycobacterial media were positives and identification was done using 16S rDNA sequencing. In this article we review the most relevant comunications about Nocardia spp infection and study the strain susceptibility using E-test

Malaria, una enfermedad en auge. Análisis del quinquenio 1997-2001 en un hospital de Madrid / Malaria, an emergent infectious disease. Analysis of the period 1997-2001 in a hospital of Madrid

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Endocarditis por Stenotrophomonas maltophilia / Endocarditis due to Stenotrophomonas maltophilia

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[Vesicourethral dysfunction in the acquired immunodeficiency syndrome (AIDS)]. / Disfunción vesicouretral en el síndrome de inmunodeficiencia adquirida (SIDA).

OBJECTIVES: Ten patients with AIDS and voiding disorders were assessed to determine the most common type of lower urinary tract dysfunction and its possible usefulness in detecting neurological disease. METHODS: A complete urodynamic evaluation was performed. RESULTS: The most common symptom was urge incontinence and the most common urodynamic finding was detrusor-external sphincter dyssynergia. Of the 5 patients found to have a neurological disorder, only 3 had demonstrable functional disorder of the lower urinary tract (2 patients had detrusor hyperreflexia: one of them had a history of encephalopathy from HIV and the other patient had polyneuritis; the third patient had myelitis and a urodynamically diagnosed sympathetic decentration. CONCLUSIONS: Knowing the functional disorders of patients with AIDS can avoid complications and improve patient quality of life. Furthermore, it can be useful in detecting an existing neurological lesion or one that may develop in the future.

[Alpha tumor necrosis factor in central nervous system disease associated with HIV infection]. / El factor de necrosis tumoral alfa en la afectación del sistema nervioso central asociada a la infección por el VIH.

The aim of the present study is to evaluate the relationship between the alpha tumor necrosis factor (TNF-alpha), interleukin 1 beta (IL-1 beta) and the neurological disease associated to the HIV-1 infection and different neurological manifestations (15 infections of the CNS and 11 AIDS-dementia complexes) and 14 from a control group. The mean value of TNF-alpha in CSF of patients with HIV-1 infection and AIDS-dementia complex was 19.8 +/- 30.6 pg/ml, superior to that of the control group (p < 0.05). The group of patients with HIV-1 and opportunistic CNS infection has a TNF-alpha value of 28.5 +/- 37.8 pg/ml, that is superior to that of the patients with the AIDS-dementia complex (TNF-alpha = 7.9 +/- 9.4 pg ml; p < 0.05). Within the group of patients with a CNS infection, the value of TNF-alpha was greater in those in the acute phase (44.2 +/- 42.4 pg/ml) than in those in the chronic phase (6.8 +/- 7.6 pg/ml; p < 0.05). The TNF-alpha in the CSF is a good marker of infection of the CNS in the HIV-1 infection.

[The spectrum of liver disease in infection by the human immunodeficiency virus: a study of 50 liver biopsies]. / El espectro de la hepatopatía en la infección por el virus de la inmunodeficiencia humana: estudio de 50 biopsias hepáticas.

BACKGROUND: The patients with human immunodeficiency virus (HIV) infection have hepatic abnormalities due to infective, neoplastic and toxic disorders. The aim of the present study was to describe the spectrum of liver disease in the HIV infection and to establish the usefulness and indications of hepatic biopsy. METHODS: The hepatic biopsies prospectively carried out in 50 patients infected by HIV with abnormal hepatic biochemical parameters, fever of unknown origin or space occupying lesions were evaluated. RESULTS: Hepatic granulomatosis was found in 37 patients (74%). In 15 (30%) the culture in Löwenstein medium was positive. The strains were typified as Mycobacterium tuberculosis in 14. This finding took place in 8 out of 18 biopsies carried out because of fever of unknown origin (FUO) (44%). The rate of granulomatosis due to mycobacteria was 40%. Other diagnoses were steatosis in 22 patients, chronic active hepatitis in 10, chronic lobular hepatitis in 3, infiltration by Hodgkin's lymphoma in one and metastatic invasion by non-differentiated carcinoma in one. Hepatic biopsy was diagnostic in 8 out of 18 carried out for FUO (44%) and in 24 out of 30 carried out for abnormal hepatic biochemical parameters (80%). CONCLUSIONS: In the evaluated patients with HIV infection, hepatic granulomatosis was the most common finding and was due to mycobacteria in 40%. Hepatic steatosis and chronic active and lobular hepatitis were the most common causes of abnormal hepatic biochemical parameters. Considering the high yield of hepatic biopsy, the authors think that it should be carried out in patients with HIV infection and FUO or unexplained abnormal hepatic biochemical parameters.

[Herpes simplex infections in patients with AIDS]. / Infección por herpes simple en pacientes con SIDA.

Herpes type infections in AIDS patients tend to be more severe, generalized and have a torpid evolution. We present here two cases of intravenous drug addicts with a clinical picture of ulcerative lesions with a scar in the perioral and ungual regions with an evolution of several months an which were diagnosed of Herpes Simplex by a histopathological study. They were treated with intravenous Acyclovir achieving a complete remission; one patient developed a pneumocystis carinii pneumonia a month later. We want to highlight the importance of this case as a clinical sign of profound cellular immunity depression as well as the risk of developing more severe conditions.