[Pancreatic pseudocyst infection caused by Haemophilus parainfluenzae. Report of one case]. / Infección de pseudoquiste pancreático por Haemophilus parainfluenzae. Caso clínico.

We report a 48-year-old male admitted to hospital due to a severe alcoholic pancreatitis. At four weeks of evolution of the acute episode, an abdominal CAT scan showed a fluid collection of 20 cm diameter located in the pancreatic tail and 2 small collections in the head. The patient received several antimicrobials and during the seventh week of evolution, while receiving vancomycin, presented fever. A fine needle aspiration of the cyst revealed the presence of Haemophilus parainfluenzae biotype VIII. The patient was treated with amoxicillin-clavulanic acid and a laparoscopic cysto-gastrostomy, with a good clinical response.

Infección de pseudoquiste pancreático por Haemophilus parainfluenzae: Caso clínico / Pancreatic pseudocyst infection caused by Haemophilus parainfluenzae: Report of one case

We report a 48-year-old male admitted to hospital due to a severe alcoholic pancreatitis. At four weeks of evolution of the acute episode, an abdominal CAT scan showed a fluid collection of 20 cm diameter located in the pancreatic tail and 2 small collections in the head. The patient received several antimicrobials and during the seventh week of evolution, while receiving vancomycin, presented fever. A fine needle aspiration of the cyst revealed the presence of Haemophilus parainfluenzae biotype VIII. The patient was treated with amoxicillin-clavulanic acid and a laparoscopic cysto-gastrostomy, with a good clinical response.

[Pancreatic pseudocyst, Torulopsis glabrata primary infection. Report of a case]. / Pseudoquiste de páncreas, infección primaria por Torulopsis glabrata. Reporte de un caso.

BACKGROUND: T. glabrata is a saprophyte fungus that has been considered in the past years to be a pathologic agent in the pancreatic pseudocyst. Only three cases have been reported in the world literature. OBJECTIVE: To present a new case of a patient with pancreatic pseudocyst whose primary cause of infection and sepsis was Torulopsis glabrata and to analyze the possible factors that produced the infection. In the same manner, a review of the cases on literature to date was conducted. CASE REPORT: We present the clinical evolution of a post surgical patient with conventional cholecystectomy with biliary duct exploration and biliary duct derivation secondary to choledocholithiasis. This patient developed acute pancreatitis days after an endoscopic retrograde cholangiopancreatography was carried out. The patient received wide-range antibiotics and total parenteral nutrition (TPN). Later, the patient's case was complicated with pancreatic pseudocyst that was act diagnosed and managed initially with antifungus therapy due to an asymptomatic stage and a late report for T. glabrata. CONCLUSIONS: Pancreatobiliary duct instrumentation, in the same manner, prolonged therapy with wide-spectrum antibiotics and with TPN an with the means that had associated as risk factors for T. glabrata infection. Therefore, this fungus could have changed its biologic behavior from commensal to pathogenic. A potentially pathogenic agent in patients receiving this type of therapy and who have pancreatic pseudocyst must be considered to recognize these in the initial stages and begin therapy.