[Coxiella burnetii endocarditis. A report of the first case diagnosed in Mexico]. / Endocarditis por Coxiella burnetii. Informe del primer caso diagnosticado en México.

The first case of Q fever endocarditis that has been diagnosed in Mexico is presented. A 10-year-old girl with discrete subaortic stenosis (SAS) and patent ductus arteriosus (PDA) was seen in December of 1996 with fever, hepatomegaly and splenomegaly. She presented also anemia, leukopenia, hypergammaglobulinemia, positive rheumatoid factor, cryoglobulinemia, antinuclear and anticytoplasmic antibodies (anti-RNA-proteins and anti-DNA). An aortic valve vegetation was seen by echocardiogram. Blood-cultures were negative. Antibody test for Coxiella burnetii was positive. Treatment with doxicyclin was initiated as soon the diagnosis was done. PDA was closed, SAS was liberated and two aortic vegetations were resected. Endocarditis in Q fever occurs when there is predisposing heart disease and/or immunodeficiency. Effective therapy has not yet been established. The diagnosis of Q fever endocarditis is difficult; it should be considered, in case of clinical suspicion of endocarditis with negative blood-cultures.

Metastasis de melanoma en cadera. Reporte de un caso. / Melanoma metastasis in hip. Report of a case

El melanoma maligno es uno de los tumores con peor pronostico, por ser de gran malignidad y capacidad de metastasis. Tiene una incidencia de 1.1% de todos los carcinoma y en la revision hecha por Stewart de 1.677 pacientes con melanoma solo 6.9% presentaron metastasis oseas. Estas metastasis cursan clinicamente como fracturas patologicas. Presentamos el primer caso de metastasis osea por melanoma hallado en el Hospital Mexico bien documentado clinica, radiologica e histopatologicamente. Ademas con tratamiento quirurgico, usando osteosintesis con pin-placa cementado (methilmetacrylate), siendo una tecnica salvadora en este caso

[Double outlet of the right ventricle with anterior aorta to the left of the pulmonary artery in situs solitus]. / Doble cámara de salida de ventrículo derecho con aorta anterior e izquierda en situs solitus.

Two cases of double outlet of the right ventricle with an anterior aorta to the left of the pulmonary artery are described. Both in situs solitus. One had an anterior interventricular communication, and other had a middle posterior communication. The importance of the aortic component of the second sound is analyzed with regard to its localization and intensity. An analysis is also made of the morphology of the cardiac silhouette and the peculiarities of the electrocardiogram as diagnostic aides in the malformation. Considerations are made of the distinct theories which explain the malformation. It is clearly shown that a correct diagnosis is necessary since this cardiopathy may be treated surgically.