Miasis cutánea en mal perforante plantar de la lepra. A propósito de un caso / No disponible

La miasis cutanea es una zoonosis producida por la infestacion o invasion de tejidos vivos por larvas de diptera. Las miasis son mas frecuentes en paises tropicales, y subtropicales, especialmente si la actividad humana se desarrolla en ambientes con escasa higiene, pocos casos han sido reportados en Cuba. Se trata de una paciente blanca, femenina de 70 anos de edad con antecedentes de haber tenido lepra lepromatosa 20 anos atras por lo cual fue tratada con multidrogo- terapia y dada de alta. La paciente refiere que producto de la enfermedad le quedaron deformidades en nariz, en dedos de manos y pies y una ulcera en planta de pie derecho, desde hace aproximadamente una semana le aparecieron unos gusanos por lo cual fue remitida por su medico de familia a nuestro hospital para mejor tratamiento. Al examen dermatologico se observa cuadro cutaneo diseminado constituido por lesiones en placas exulceradas que tienden a reunirse y ocupar gran extension que abarca tercio inferior de ambas piernas, asi como lesiones cicatrizales y escamo - costrosas en la periferia de las placas, se constata ademas ulcera plantar derecha en el antepie donde se observan numerosos gusanos. Se realizo extraccion de las larvas con pinza y curacion de la ulcera. Se realiza la presentacion de un caso de una paciente femenina que presento lepra lepromatosa 20 anos atras con secuelas dadas fundamentalmente por mal perforante plantar donde asento la miasis cutánea

Cutaneous myiasis is a zoonosis caused by infestation or invasion of living tissues by diptera larvae. Myiasis are more frequent in tropical and subtropical countries, especially if human activity takes place in environments with poor hygiene. Only few cases are reported in Cuba. This is a white, female patient of 70 years of age with a history of having had lepromatous leprosy 20 years ago, for which she was treated with multidrug therapy and discharged. The patient reports that the disease caused deformities in the nose, fingers and toes, and an ulcer on her right foot. About a week ago, worms appeared and her family doctor referred her to our hospital for better treatment. Dermatological examination revealed disseminated cutaneous plaque consisting of lesions in ulcerated plaques that tend to meet and occupy a large area that covers the lower third of both legs as well as scarring and scaly lesions in the periphery of the plaques. In addition, there is a right plantar ulcer. in the forefoot where numerous worms were observed. The larvae were extracted with a clamp and the ulcer was cured. We present this case of a female patient treated for lepromatous leprosy 20 years ago with a remaining perforating plantar ulcer on her right foot where cutaneous myiasis was detected

[Tuberculous abscess of the thoracic wall secondary to nodular tuberculosis: Atypical presentation in an older adult]. / Absceso tuberculoso de pared torácica secundario a tuberculosis ganglionar; presentación atípica.

Tuberculosis (tb) of the chest wall is uncommon and it represents less than 5% of all cases of musculoskeletal tb and only 1-2% of tb. We present the case of an elderly woman with tb of the chest wall secondary to a nodal tb with an unusual presentation. The diagnosis of this entity is difficult because the disease often mimics other diseases such as pyogenic abscess, chest wall.

[Jaundice secondary to bile duct obstruction by polycystic liver disease]. / Ictericia secundaria a obstrucción de vía biliar por enfermedad hepática poliquística: reporte de un caso.

Polycystic liver disease is an autosomal dominant disorder commonly associated with autosomal dominant polycystic kidney disease. It is a rare disease that usually occurs asymptomatically in 85% of cases and diagnosis is incidentally. We present the case of 57 years old woman with progressive pruritus and jaundice secondary to stenosis of the common hepatic duct and common bile by liver cyst, rare presentation which only has been documented in case reports: Deepak, et al., Wittig, et al. and Howard, et al.1-3.