[Occipital intermittent rhythmic delta activity as the interictal pattern in an adult with focal epilepsy]. / Actividad delta ritmica intermitente occipital como patron intercritico en un adulto con epilepsia focal.

TITLE: Actividad delta ritmica intermitente occipital como patron intercritico en un adulto con epilepsia focal.

Paciente con fiebre y exantema / Patient with fever and rash

Presentamos el caso de una paciente de 23 años de edad,con fiebre, cefalea, inyección conjuntival bilateral, hepatomegaliadolorosa y exantema macular generalizado con elevaciónde enzimas hepáticas. Se realizó un estudio serológicoque confirmó la sospecha diagnóstica de infección agudapor el virus del sarampión (AU)

We report the case of a 23-year old woman with fever, headache,bilateral conjunctival injection, painful hepatomegalyand generalized macular rash with elevated liver enzymes.Acute measles infection was suspected based on the clinicalfindings and was serologically confirmed (AU)

Pancreatitis autoinmune. A propósito de un caso / Autoimmune pancreatitis. Related to a case

La pancreatitis autoinmune es una reciente entidad a tener en cuenta en el diagnóstico diferencial de pancreatits crónica-masa pancreática. La presencia de estenosis difusa e irregular del Wirsung, junto con niveles elevados de IgG4, presencia de determinados autoanticuerpos e infiltración linfoplasmocitaria de páncreas son la clave del diagnóstico. La sospecha diagnóstica precoz y la colaboración multidisciplinar es vital en estos casos, ya que puede evitar cirugía innecesaria, puesto que el diagnóstico diferencial se establece con entidades entre las que se encuentra cáncer de páncreas, pancreatitis crónica, cirrosis biliar primaria o colangitis esclerosante primaria. Además, la pancreatitis autoinmune tiene excelente respuesta a tratamiento esteroideo, con resolución completa de parámetros clínicos, analíticos y radiológicos, como ocurría en nuestro paciente. Debido al escaso número de casos descritos en la Literatura, sería necesario la elaboración de estudios con seguimiento largo plazo para conocer pronóstico y frecuencia de asociación a otras patologías

Autoimmune pancreatitis is an entity that has recently been included in the differential diagnosis of chronic pancreatitis-pancreatic mass. The presence of diffuse, irregular Wirsung’s duct stenosis, together with high levels of IgG4, the existence of certain autoantibodies and lymphoplasmacytic infiltration of the pancreas are key factors in the diagnosis. An early diagnostic suspicion and multidisciplinary collaboration are vital in these cases to avoid unnecessary surgery as the differential diagnosis is established with such entities as pancreas cancer, chronic pancreatitis, primary biliary cirrhosis or primary sclerosing cholangitis. Autoimmune pancreatitis has an excellent response to steroid therapy, with complete resolution of clinical, analytical and radiological parameters, as occurred in our patient. The very few cases reported sofar suggest the need for the elaboration of long-term follow-up studies to determine the prognosis and frequency of its association with other diseases

Parálisis del nervio recurrente y derrame pleural por cabergolina / Paralysis recurrent nerve and pleural effusion due to cabergoline

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Paciente con fenómeno de Raynaud, derrame pleuropericárdico e infartos digitales / Patient with Raynaud’s phenomenon, pleuropericardial efussion and digital infarctions

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[Autoimmune pancreatitis. Related to a case]. / Pancreatitis autoinmune. A propósito de un caso.

Autoimmune pancreatitis is an entity that has recently been included in the differential diagnosis of chronic pancreatitis-pancreatic mass. The presence of diffuse, irregular Wirsung's duct stenosis, together with high levels of IgG4, the existence of certain autoantibodies and lymphoplasmacytic infiltration of the pancreas are key factors in the diagnosis. An early diagnostic suspicion and multidisciplinary collaboration are vital in these cases to avoid unnecessary surgery as the differential diagnosis is established with such entities as pancreas cancer, chronic pancreatitis, primary biliary cirrhosis or primary sclerosing cholangitis. Autoimmune pancreatitis has an excellent response to steroid therapy, with complete resolution of clinical, analytical and radiological parameters, as occurred in our patient. The very few cases reported so far suggest the need for the elaboration of long-term follow-up studies to determine the prognosis and frequency of its association with other diseases.

Absceso tubo-ovárico por Steptococcus agalactiae en una mujer no gestante / Tubo-ovarian absceso due to Steptococcus agalactiae in a nonpregnant woman

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Endoftalmitis bacteriana endógena: a propósito de un caso y breve revisión / Endogenous bacterial endophthalmitis: a case report and brief review

La endoftalmitis bacteriana endógena es una patología poco frecuente con un pobre pronóstico visual, que requiere un diagnóstico y tratamiento precoz. Presentamos el caso de una paciente diabética que presentó una bacteriemia por Escherichia coli de origen urinario, con endoftalmitis endógena, meningitis y espondilitis secundaria. Fue tratada con antibioterapia intravenosa y tópica, consiguiendo un cese en la progresión y conservando la capacidad para percepción luminosa en el ojo afecto (AU)

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The bacterial endogenous endophthalmitis is a slightly frequent pathology with a poor visual prognosis that needs a precocious diagnosis and treatment. We present the case of a diabetic patient who presented a Escherichia colibacteremia of urinary origin, with endogenous endophthalmitis, meningitis and spondylitis. She was treated with intravenous and topic antibiotics, obtaining a cessation in the progression of the disease and preserving the capacity for luminous perception in the eye (AU)

[Anticoagulation with bemiparina after intracerebral hemorrhage as complication of bacterial endocarditis on metallic prosthetic valve]. / Anticoagulación con bemiparina tras hemorragia intracerebral como complicación de endocarditis bacteriana sobre válvula protésica metálica.

We present the case of a patient with an intracerebral hemorrhage as complication of an infectious endocarditis (EI) produced by Neisseria sicca on a prosthetic mitral valve. The patient was anticoagulated previously with Acenocumarol as prophylaxis of thrombosis of the prosthetic valve. He was diagnosed as having IE and later he presented neurological symptoms as consequence of several intracerebral hemorrhagic foci. We decided to continue the anticoagulation with sodium heparin followed of Bemiparina and no new hemorrhagic complications nor thrombosis of the valve were observed after three months of the event. We have not found in the literature any case where low molecular weight heparin has been used as method of anticoagulation in these cases beyond two weeks.

Anticoagulación con bemiparina tras hemorragia intracerebral como complicación de endocarditis bacteriana sobre válvula protésica metálica / Anticoagulation with bemiparina after intracerebral hemorrhage as complication of bacterial endocarditis on metallic prosthetic valve

Presentamos el caso de un paciente con una hemorragia intracerebral como complicación de una endocarditis infecciosa (EI) producida por Neisseria sicca sobre una válvula mitral metálica. El paciente estaba previamente anticoagulado con Acenocumarol como profilaxis de trombosis de la válvula protésica. Fue diagnosticado de EI y posteriormente presentó síntomas neurológicos como consecuencia de varios focos hemorrágicos intracerebrales. Se decidió continuar la anticoagulación con heparina sódica inicialmente y posteriormente con Bemiparina, no observándose nuevas complicaciones hemorrágicas ni trombosis de la válvula a los tres meses del evento. No hemos encontrado en la literatura ningún caso donde la heparina de bajo peso molecular (HBPM) haya sido utilizada como método de anticoagulación en estos casos más allá de dos semanas (AU)

[Endogenous bacterial endophthalmitis: a case report and brief review]. / Endoftalmitis bacteriana endógena: a propósito de un caso y breve revisión.

The bacterial endogenous endophthalmitis is a slightly frequent pathology with a poor visual prognosis that needs a precocious diagnosis and treatment. We present the case of a diabetic patient who presented a Escherichia coli bacteremia of urinary origin, with endogenous endophthalmitis, meningitis and spondylitis. She was treated with intravenous and topic antibiotics, obtaining a cessation in the progression of the disease and preserving the capacity for luminous perception in the eye.