[1st isolation of vancomycin-resistant Enterococcus faecium with the vanB genotype in Argentina: presentation of 2 cases]. / Primer aislamiento de Enterococcus faecium vancomicina-resistente con genotipo vanB en la Argentina: presentación de dos casos.

We describe the first isolate of van B vancomycin-resistant Enterococcus faecium in Argentina. The strains were recovered from ambulatory patients admitted to a hospital of Buenos Aires city in July 2000. They were not high-risk patients, they had not received previous antibiotic therapy, and they were assisted in different services. MICs for vancomycin were 32 micrograms/ml for both strains, whereas MICs for teicoplanin were 0.12 microgram/ml in case 1 and 0.25 microgram/ml in case 2. PCR was performed to confirm the vanB genotype. The molecular fingerprints of the isolations by PFGE revealed that they were identical. No further VanB strains were isolated in the hospital.

Breast infection. Mammographic and sonographic findings with clinical correlation.

RATIONALE AND OBJECTIVES: To characterize the mammographic, sonographic, and clinical findings of breast infection and to determine characteristics that could help differentiate it from inflammatory breast carcinoma. METHODS: The mammograms, sonograms, and clinical records of 21 consecutive patients who had mammography or sonography within 48 hours of presenting with breast infection were retrospectively reviewed. To exclude other causes of breast inflammation, patients were required to have histologic or aspiration results specific for infection. RESULTS: Twelve of 19 (63%) mammograms were abnormal. Mammographic abnormalities included an irregular mass (6; 32%), focal asymmetric density (2; 11%), diffuse asymmetric density (2; 11%), circumscribed mass (1; 5%), and architectural distortion (1; 5%). Mammographic skin thickening, present in four (21%) patients, was focal in three and diffuse in one patient with primary breast Mycobacterium tuberculosis infection. No abnormally dense lymph nodes were demonstrated. There was no abnormal soft tissue gas. All 11 (100%) sonograms showed heterogeneous masses that contained internal echoes, 5 of these in patients who had normal mammograms. All 21 patients presented with clinical abnormalities, including palpable mass (20; 95%), pain (11; 52%), erythema (11; 52%), warmth (7; 33%), skin thickening or fixation (4; 19%), and breast swelling (3; 14%). One patient was lactating. CONCLUSIONS: Mammographic, sonographic, and clinical abnormalities were usually present with breast infection that could mimic inflammatory carcinoma. However, diffuse mammographic skin thickening, edema, and dense lymph nodes were rare, and when present may prospectively suggest carcinoma or an unusual infection. Early surgical consultation is advised.