Terapia fotodinámica con azul de metileno en úlceras cutáneas infectadas con Pseudomonas aeruginosa y Fusarium spp / Photodynamic Therapy With Methylene Blue for Skin Ulcers Infected With Pseudomonas aeruginosa and Fusarium spp

La terapia fotodinámica tiene una importante acción antimicrobiana. Se presentan 2 casos clínicos de úlceras crónicas en las extremidades inferiores sobreinfectadas por hongos y bacterias de difícil manejo, en los que el tratamiento fotodinámico con azul de metileno como fotosensibilizante resultó en la curación clínica y microbiológica. No se presentaron efectos adversos reseñables. La posibilidad de utilizar la terapia fotodinámica con azul de metileno en el manejo de las úlceras crónicas sobreinfectadas constituye una interesante alternativa para reducir el uso de antibióticos y disminuir la aparición de resistencias (AU)

Photodynamic therapy (PDT) is a therapeutic modality with significant antimicrobial activity. We present 2 cases of chronic lower limb ulcers in which fungal and bacterial superinfection complicated management. PDT with methylene blue as the photosensitizer led to clinical and microbiological cure with no significant adverse effects. PDT with methylene blue is a valid option for the management of superinfected chronic ulcers, reducing the use of antibiotics and the induction of resistance (AU)

Photodynamic Therapy With Methylene Blue for Skin Ulcers Infected With Pseudomonas aeruginosa and Fusarium spp. / Terapia fotodinámica con azul de metileno en úlceras cutáneas infectadas con Pseudomonas aeruginosa y Fusarium spp.

Photodynamic therapy (PDT) is a therapeutic modality with significant antimicrobial activity. We present 2 cases of chronic lower limb ulcers in which fungal and bacterial superinfection complicated management. PDT with methylene blue as the photosensitizer led to clinical and microbiological cure with no significant adverse effects. PDT with methylene blue is a valid option for the management of superinfected chronic ulcers, reducing the use of antibiotics and the induction of resistance.

Características diferenciales en las bacteriemias según la edad en un hospital comunitario / Differential characteristics of bacteraemias according to age in a community hospital

Objetivo. Describir las características de las bacteriemias, según la edad, en un hospital comunitario. Material y método. Estudio prospectivo de las bacteriemias en el año 2011. Los pacientes se clasificaron en 3 grupos de edad: menos de 65, de 65 a 79 y 80 o más años. Se recogieron variables de los pacientes y de los episodios. Resultados. Se analizaron 233 bacteriemias en 227 pacientes (23,8% en<65; 38,3% entre 65 y 79; y 37,9% en≥80 años). La enfermedad de base más frecuente en todos los grupos fue la diabetes mellitus. En los pacientes muy ancianos el índice de Charlson fue mayor, hubo una menor proporción de factores exógenos y casi un 25% eran dependientes graves (índice de Barthel<20). Escherichia coli fue el germen más frecuente y el foco principal fue el urológico. En los pacientes≥80 años predominó el origen de la infección asociado a cuidados sanitarios, la expresividad clínica menos grave (sepsis) (66,3%) y la mortalidad más elevada (29,1%), respecto a los de menor edad. Conclusiones. Los pacientes muy ancianos con bacteriemia presentaron menos factores exógenos, más comorbilidad y una situación funcional peor; el foco más frecuente fue el urológico y el origen el asociado a cuidados sanitarios. A pesar de que su presentación clínica fue menos grave, su mortalidad fue superior, siendo el grado de dependencia una variable de riesgo independiente muy relevante (AU)

Objective. To describe the characteristics of bacteraemias, according to age, in a community hospital. Material and method. A prospective study of bacteraemias was conducted in 2011. The patients were classified into 3 age groups: younger than 65 years, 65 to 79, and 80 or older. The study collected variables on the patients and episodes. Results. The study analysed 233 bacteraemias in 227 patients (23.8% in those younger than 65 years; 38.3% in the 65 to 79 age group; and 37.9% in the 80 years or older group). The most common underlying disease in all the groups was diabetes mellitus. In the most elderly patients, the Charlson index was highest, there was a lower proportion of exogenous factors, and almost 25% were severely dependent (Barthel index<20). Escherichia coli was the most common germ, and the main focus was urological. The patients aged 80 years or older had predominantly healthcare-associated infections, less severe symptoms (sepsis) (66.3%) and higher mortality (29.1%) compared with the younger patients. Conclusions. The very elderly patients with bacteraemia presented fewer exogenous factors, greater comorbidity and a poorer functional situation. The most common focus was urological and the origin was healthcare related. Despite their less severe clinical presentation, these patients’ mortality was greater, and their degree of dependence was a highly relevant independent risk factor (AU)

Differential characteristics of bacteraemias according to age in a community hospital. / Características diferenciales en las bacteriemias según la edad en un hospital comunitario.

OBJECTIVE: To describe the characteristics of bacteraemias, according to age, in a community hospital. MATERIAL AND METHOD: A prospective study of bacteraemias was conducted in 2011. The patients were classified into 3 age groups: younger than 65 years, 65 to 79, and 80 or older. The study collected variables on the patients and episodes. RESULTS: The study analysed 233 bacteraemias in 227 patients (23.8% in those younger than 65 years; 38.3% in the 65 to 79 age group; and 37.9% in the 80 years or older group). The most common underlying disease in all the groups was diabetes mellitus. In the most elderly patients, the Charlson index was highest, there was a lower proportion of exogenous factors, and almost 25% were severely dependent (Barthel index<20). Escherichia coli was the most common germ, and the main focus was urological. The patients aged 80 years or older had predominantly healthcare-associated infections, less severe symptoms (sepsis) (66.3%) and higher mortality (29.1%) compared with the younger patients. CONCLUSIONS: The very elderly patients with bacteraemia presented fewer exogenous factors, greater comorbidity and a poorer functional situation. The most common focus was urological and the origin was healthcare related. Despite their less severe clinical presentation, these patients' mortality was greater, and their degree of dependence was a highly relevant independent risk factor.

Interacción de Pseudomonas aeruginosa y hongos dermatofitos: repercusión en el curso clínico y en el diagnóstico microbiológico de la tinea pedis / Interaction between Pseudomonas aeruginosa and dermatophyte fungi: Repercussions on the clinical course and microbiological diagnosis of tinea pedis

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[Megacalyces or Puigvert's disease. Apropos of 2 cases]. / Mégacalicose ou maladie de Puigvert. A propos de deux cas.

Megacalyces is an uncommon congenital urinary anomaly consisting of oversized calyces and a renal pelvis of normal caliber. The under development of the pyramids with lack of projection of the papillae into the calyces probably produces the dilatation of the calyces. The diagnostic criteria are the characteristic appearance of the calyces, the normal caliber of the pelvis and ureter, and the absence of vesico-ureteral reflux. Two cases of congenital megacalyces are presented.

[Malignant fibrous histiocytoma of soft tissue. Apropos of 2 cases]. / Histiocytome fibreux malin des parties molles. A propos de deux cas.

Two cases of Malignant Fibrous Histiocytoma of soft tissue are presented. The value and limitations of computerized tomography, ultrasonography findings and percutaneous aspiration biopsy in these cases are discussed.