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Medicina (B.Aires) ; 83(5): 836-840, dic. 2023. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1534894


Resumen Se presentan los casos de dos pacientes con tu berculosis (TB) mamaria, una de ellas también con compromiso pleural y ganglionar. Ambas HIV nega tivas, sin antecedentes de TB previa, con lesiones mamarias de largo tiempo de evolución. Las dos pre sentaron buena evolución con tratamiento antifímico. La TB mamaria es una afección muy poco frecuente de difícil diagnóstico. Se presentan los casos con el fin de plantear su diagnóstico diferencial en pa cientes con mastitis crónicas y/o lesiones nodulares o ulceradas de la mama. Se recomienda el manejo multidisciplinario.

Abstract Two cases of mammary tuberculosis (TB) are present ed, one of them with additional pleural and lymph node involvement. Both were HIV-negative, with no history of previous TB, with long-standing breast lesions. Both presented a successful outcome with antituberculosis treatment. Breast TB is a very rare pathology that is dif ficult to diagnose. The cases are presented to consider their differential diagnosis in patients with chronic mas titis and/or nodular or ulcerated lesions of the breast. Multidisciplinary management is recommended.

Medicina (B.Aires) ; 62(1): 19-13, 2002. tab
Article in Spanish | LILACS | ID: lil-314491


A cohort evaluation of the microbiology, epidemiology and outcome of adult patients with positive blood cultures was performed on 336 patients, from July 1997 to March 2000. Data for mortality were obtained from 328 of these patients. The six most common pathogens were Staphylococcus aureus: 81 (23.5 percent), coagulase negative staphylococci: 50 (14.5 percent), Escherichia coli: 48 (14.0 percent), Streptococcus pneumoniae: 30 (8.7 percent), enterococci: 19 (5.5 percent) and Pseudomonas aeruginosa: 19 (5.5 percent). In 169 episodes infections were hospital-acquired and community-acquired in the remaining 159. Main infection foci included the respiratory and urinary tracts. Infection associated mortality was 33.2 percent; 29.6 percent of patients received inappropriate empiric antibiotic treatment. Univariate analysis showed that an age of 70 or more years, a systemic inflammatory response syndrome (SIRS) score higher than 2, a polimicrobial episode, certain foci (abdominal, respiratory or unknown), and an inappropriate empiric antibiotic treatment influenced outcome. By multivariate analysis the variables that influenced death by infectious cause were age of 70 or more years, a SIRS score higher than 2, certain foci (abdominal, respiratory or unknown), and an inappropriate empiric antibiotic treatment. SIRS score was useful to predict the positivity of the blood culture. No relation between outcome and presence of underlying disease, isolation of Gram negative microorganism and nosocomial vs. community acquired episode was observed (univariate analysis). In order to improve outcome in bacteremic patients, after performing cultures of blood and other relevant clinical foci, prompt and appropriate antibiotic treatment remains critical. Microbiologic, clinical and epidemiological information results crucial for the management of this critically ill population. AD - Hospital Municipal de San Isidro, Provincia de Buenos Aires, Capitan Juan de San Martin 1531, 1609 Boulogne, Pcia. Buenos Aires.

Humans , Male , Female , Adult , Middle Aged , Gram-Negative Bacterial Infections , Gram-Positive Bacterial Infections , Argentina , Cohort Studies , Confidence Intervals , Multivariate Analysis