[Creutzfeldt-Jakob disease: two new cases in Talavera de la Reina]. / Enfermedad de Creutzfeldt-Jakob: dos nuevos casos en Talavera de la Reina.

Creutzfeldt-Jakob disease is a prion spongiform encephalopathy that causes a rapidly progressive dementia whose neuropathological features are neuronal loss, proliferation of glial cells, and the presence of small vacuoles, which produces a spongiform appearance. Two cases detected in the year 2005 in the <> Hospital are presented. The first one is the case of a man who presented with intense malaise and weight loss, developing dementia in 4 months. The second one was a woman who presented with diplopia, headache and gait disturbances who developed severe neurological impairment with dementia in three months. In both cases the 14.3.3 protein in the cerebrospinal fluid was positive and the EEG showed a characteristic pattern. The genetic studies were negative and both were homozygous for methionine at codon 129. Given that the incidence of this disease in Castilla la Mancha is 0.6 cases/100000 inhabitants/year, the detection of 2 cases in less than a year in Talavera de la Reina (whose population is 150,000) surprised us, leading us to intensify surveillance.

Enfermedad de Creutzfeldt-Jakob: dos nuevos casos en Talavera de la Reina / Creutzfeldt-Jakob disease: two new cases in Talavera de la Reina

La enfermedad de Creutzfeldt-Jakob (ECJ) es una encefalopatía espongiforme producida por priones que provoca una demencia progresiva cuyas características neuropatológicas son la pérdida neuronal, la proliferación de células gliales y las vacuolas, lo que origina el aspecto de esponja. Se presentan dos casos detectados en el año 2005 en el Hospital Nuestra Señora del Prado. El primero es el de un hombre que comenzó con intensa astenia y cuadro constitucional, desarrollando una demencia en 4 meses; y el segundo caso es el de una mujer que comenzó con diplopía, cefalea y alteraciones de la marcha, desarrollando un deterioro neurológico con demencia en tres meses. En ambos casos la proteína 14.3.3 del líquido cefalorraquídeo fue positiva y el electroencefalograma mostró un patrón característico. Los estudios genéticos fueron negativos, y ambos presentaban polimorfismo del codón 129, siendo homocigotos para la metionina. Nos ha sorprendido la aparición de dos casos en menos de un año en Talavera de la Reina y nos ha hecho aumentar la vigilancia

Creutzfeldt-Jakob disease is a prion spongiform encephalopathy that causes a rapidly progressive dementia whose neuropathological features are neuronal loss, proliferation of glial cells, and the presence of small vacuoles, which produces a spongiform appearance. Two cases detected in the year 2005 in the «Nuestra Señora del Prado» Hospital are presented. The first one is the case of a man who presented with intense malaise and weight loss, developing dementia in 4 months. The second one was a woman who presented with diplopia, headache and gait disturbances who developed severe neurological impairment with dementia in three months. In both cases the 14.3.3 protein in the cerebrospinal fluid was positive and the EEG showed a characteristic pattern. The genetic studies were negative and both were homozygous for methionine at codon 129. Given that the incidence of this disease in Castilla la Mancha is 0.6 cases/100000 inhabitants/year, the detection of 2 cases in less than a year in Talavera de la Reina (whose population is 150,000) surprised us, leading us to intensify surveillance

[Colon lymphoma as a cause of fever of unknown origin]. / Linfoma de colon como causa de fiebre de origen desconocido.

We present a case of a 49 year old man who presented with a 2 month history of fever, nausea vomiting and weight loss (10 kg). He was admitted to the Hospital with the diagnosis of fever of unknown origin. A CT scan showed a wide thickening of the colonic wall (transverse colon and hepatic flexure) suggesting a colon tumor, and a solid mass in the left liver lobe. A colonoscopy was performed showing a circumferential neoplasm and biopsies were taken. The histopathology was informed as a diffuse large B cell lymphoma. Primary colon lymphoma is a rare gastrointestinal tumor that represents less than 1% of the gastrointestinal lymphomas. Based on this case, we reviewed the most recent articles about gastrointestinal lymphomas.

Linfoma de colon como causa de fiebre de origen desconocido / Colon lymphoma as a cause of fever of unknown origin

Presentamos el caso de un varón de 49 años que presentó un cuadro de fiebre de dos meses de evolución, acompañado de nauseas, vómitos y perdida de 10 kilogramos de peso. Con el diagnostico de fiebre de origen desconocido ingresó. En la TAC abdominal se objetivó un extenso engrosamiento de la pared de colon transverso y ángulo hepático, sugestivo de neoplasia de colon y una gran lesión sólida en lóbulo hepático izquierdo. Se realizó una colonoscopia observándose una neoplasia circunferencial, tomándose biopsias. La anatomía patológica fue informada de linfoma de células grandes difuso tipo B. El linfoma primario de colon es un tumor muy poco frecuente del tracto gastrointestinal, no superando el 1% en las series consultadas. Basándonos en este caso se hizo una revisión de los artículos más recientes sobre linfoma gastrointestinal

We present a case of a 49 year old man who presented with a 2 month history of fever, nausea vomiting and weight loss (10 kg). He was admitted to the Hospital with the diagnosis of fever of unknown origin. A CT scan showed a wide thickening of the colonic wall (transverse colon and hepatic flexure) suggesting a colon tumor, and a solid mass in the left liver lobe. A colonoscopy was performed showing a circumferential neoplasm and biopsies were taken. The histopathology was informed as a diffuse large B cell lymphoma. Primary colon lymphoma is a rare gastrointestinal tumor that represents less than 1% of the gastrointestinal lymphomas. Based on this case, we reviewed the most recent articles about gastrointestinal lymphomas

Bacteriemia por Pantoea agglomerans / Bacteremia caused by Pantoea agglomerans

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Dificultades en la selección de pacientes coinfectados por el VIH para recibir tratamiento contra el virus de la hepatitis C / Difficulties of selecting patients to receive treatment against hepatitis C virus in patients with HIV coinfection

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