[Rhabdomyolysis and lumbosacral plexopathy in intravenous drug addict: report of a case]. / Rabdomiolisis y plexopatía lumbosacra en paciente adicto a drogas por vía parenteral: a propósito de un caso.

There are several neuromuscular complications in the intravenous heroin addict (IHA). Someone may be due to direct toxic effect of the substance, but other ones may be associated to abuser's typical diseases (i.e. HIV infection). We present a 27 year-old IHA patient, HIV positive, that develop acute rhabdomyolisis with severe neuromuscular involvement, and consistent clinical and electrodiagnostic features of lumbosacral plexus neuropathy, forteen hours after an heroin inyection. Thirty months later, the patient is severely disabled, but her initial painfull and paretic picture have improved. The association of rhabdomyolisis-lumbosacral plexopathy (RLPS) is ocasionally reported. It has been proposed that RLSP is etiologically related to mecanic, toxic and immunologic factors.

Conventional viral cultures and shell vial assay for diagnosis of apparently culture-negative Coxiella burnetii endocarditis.

A patient with culture-negative endocarditis was diagnosed with Q fever endocarditis based on the results of serological tests and positive leukocyte cultures obtained using conventional viral cultures and the shell vial technique. This case report suggests that isolation of Coxiella burnetii from blood may allow better diagnostic and therapeutical evaluation of patients with Q fever endocarditis. The use of both conventional and shell vial viral cultures is recommended for the isolation of Coxiella burnetii from the blood of patients with apparently culture-negative endocarditis.

[Hereditary hemorrhagic telangiectasia as a cause of iron-deficiency anemia]. / Telangiectasia hemorrágica hereditaria como causa de anemia ferropénica.

We reviewed cases with Rendu-Osler disease or hereditary hemorrhagic telangiectasia (HHT) between 1976 and 1989 in our area of internal medicine. Of the ten reported cases, six presented severe iron deficiency anemia-three as a result of repeated and intense epistaxis and the rest as a result of digestive losses. The most frequent clinical manifestations were: epistaxis (80%) and the presence of characteristic mucocutaneous lesions easily explored by sight (80%). We emphasize the role of this disease as a cause of iron deficiency anemia and the importance of clinical exploration.