Abscesos subcutaneos por hongos dematiaceos. presentación de dos casos

Resumen Se presentan dos casos de abscesos subcutáneos por hongos dematiáceos. Uno de cellos con localización en miembro superior derecho y cuya lesión revistió el aspecto microscópico clásico. El otro caso, en planta derecha, cuyo aspecto histopatológico fue indistinguible del que présenta el eumicetoma. En ambos casos las lesiones fueron asintomáticas y el diagnóstico clinico fue erróneo. Se discuten los aspectos de morfologia, clinica, etiopatogenia y denominación de la entidad, los cuales no son claros.Se sugiere tomar siempre muestras para cultivos (micológico y bacteriológico) a partir de lesiones que semejen la entidad clinica y además que se tenga en cuenta para el diagnóstico diferencial la posibilidad de formas incipientes del eumicetoma.

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Two cases of subcutaneous abscesses due to dematiaceous fungi are presented. The first, localized in the elbow, exhibited the characteristic microscopic picture of the disorder. The second was localized in the sole, but histologically it showed well-organized mycotic granules much like those reported for eumycetoma. Both patients were asymptomatic and the clinical diagnosis was erroneous. The morphologic, clinical and etiologic aspects are discussed in the text. These cases indicate the need to consider mycotic infections in the differential diagnosis of all lesions which clinically resemble subcutaneous abscesses, so that proper mycological studies can be done and the relationship between the process and the various etiologic agents implicated can be clarified.

     

Absceso tiroideo. Serie de casos y revisión de la literatura

Thyroid abscess is rare in children but the presence of previous thyroid disease, and congenital remanants such as a pyriform sinus fistula, are predisposing factors. The classical presentation consists of fever, cervical pain and a painful mass. The diagnosis is confirmed through clinical findings, and by diagnostic imaging (ultrasound and computerized axial tomography). A barium swallow must be performed in order to detect a fistula and to consider surgical drain. We present the cases of thyroid abscess in five patients who were admitted in four medical centers (Fundación Cardioinfantil, Hospital Universitario San Ignacio, Clínica infantil de Colsubsidio and Hospital de la Misericordia) in Bogotá, Colombia between 2000 and 2010.     

Infiltración perineural por células fúngicas. Presentación de un caso y revisión de la literatura

The perineural spread by fungal cells during the progression of the infection could be an important prognostic factor, especially in mycoses localized in the rhino-orbito-cerebral and pulmonary areas. We present a clinical case of a 73-year-old male, with diabetes and acute myelomonocytic leukaemia that began with tumefaction on the left side of his face, spreading to the sinus with invasion of the soft tissues and fistulae in the oral cavity. Clinical examination showed cerebral involvement. The histopathological sections and the histochemical techniques showed perineural involvement by fungal cells. Although the patient was diagnosed and treated in a short period of time, he died due to the infection. We would like to alert that perineural spread could be a retrograde way of mycoses dissemination, particularly in infections located in areas rich in neural cells.     

Isopódos litorales de la Costa de concepción,Chile central

Littoral isopods of the coast of Concepción, Central Chile

A collection of isopods is studied from the intertidal region of the province of Concepción (Chile), located on the South American pacifics coast between 36 and 37° S latitude.

The collection consists of 11 species, two of them new for science: Ianiropsis kussakini, described here, and Janira sp., still under study. The distribution of species is, grosso modo, restricted to the central zone or south center of Chile, which seems to corroborate the opinion of some authors who consider it as a region of biogeographic transition between the Peruvian and Magellan provinces.     

Impacto de la hospitalización en pacientes centenarios ingresados por enfermedad aguda. Descripción de una serie de 165 casos y comparación con la literatura

IntroductionThe number of centenarians is increasing with the aging of the Spanish population. This age group might present different clinical features from younger groups. This study was carried out to determine the impact hospital admission on centenarians with an acute disease.Materials and methodsA retrospective observational study was conducted that included patients ≥100 years-old admitted from 1995 to 2016 to a third level university hospital and attended by the Geriatrics department in the acute ward, the Orthogeriatric ward, and by request. An analysis was made using the clinical-administrative databases containing information about the demographics, clinical, functional and cognitive features, length of hospital length, as well as discharge destination.ResultsThe study included 165 patients with a mean age of 101.6 ± 1.7 (range 100-109) years, of whom 140 (85%) were female. The mean hospital stay was 10.3 ± 7.4 days. Respiratory infections (41%) were the most common cause of admission to the Acute Geriatric Unit (AGU). The overall in-hospital mortality was 16%, but mortality in AGU reached up to 31%. There was an increase on moderate-severe functional disability (51% to 96%), and on the inability to walk independently (52% to 99%) from baseline to admission. There was a reduction in people living in their own home from 71% prior to admission to 29% at hospital discharge.ConclusionsCentenarians who required hospital admission showed a high rate of mortality, a significant deterioration in their functional capacity, and a decrease in their chances of going back to their own home at discharge.     

Incorporación de la ecografía y la punción de tiroides a la actividad de endocrinología en una consulta de alta resolución

IntroductionFine-needle aspiration biopsy (FNAB) is considered the reference diagnostic procedure for thyroid nodules.Materials and methodsRoutine performance of thyroid ultrasound and ultrasound-guided FNAB by endocrinologists allows a more efficient approach in the setting of a high-resolution practice, thus reducing costs and the time elapsed until diagnosis.ResultsWe present our initial results of this procedure 2 years after its introduction, with a total of 286 biopsies performed. After a progressive learning curve over time and according to the endocrinologists’ previous experience, 72.72% samples were considered satisfactory for diagnosis. Greater difficulty was observed in obtaining optimal cytological specimens in smaller nodules. In conclusion, we have successfully incorporated thyroid ultrasound and ultrasound-guided FNAB into routine endocrine practice.ConclusionRoutine performance of thyroid ultrasound in endocrine practice will considerably aid the management of nodular thyroid disease.