Miastenia gravis asociada a la infección por SARS-CoV-2: una conjunción de factores / Myasthenia gravis associated with SARS-CoV-2 infection: a conjunction of several factors

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[Genitourinary mycobacteriosis: retrospective study of 45 cases in a general hospital]. / Micobacteriosis genitourinaria: estudio retrospectivo de 45 casos en un hospital general.

INTRODUCTION: Genitourinary tuberculosis (GUT) is the third most frequent extrapulmonary tuberculous infection, following pleural and nodal involvement. Associated clinical symptoms are mild, and the diagnosis and treatment of this condition are often delayed. METHODS: This study determines the clinical and epidemiological characteristics, and outcome of patients diagnosed with GUT in our center over the last 10 years. Patients with positive Löwenstein-Jensen urine or biopsy culture, or pathologic study suggestive of tuberculosis were included. Cases of multifocal tuberculosis and positive Löwenstein-Jensen, but with no urinary symptoms or radiological alterations, were considered to have mycobacteriuria. RESULTS: Forty-five patients were analyzed (62% men; mean age, 49.4 years). Among the total, 33% had a coexisting disease (14 were infected by human immunodeficiency virus). Twenty-six patients (57%) had renal tuberculosis, 5 (11%) orchiepididymitis, and 14 (31%) were classified as having mycobacteriuria. The most frequent clinical manifestations were urination syndrome (61%), low back pain (44%), and macroscopic hematuria (12%). Ziehl stain was positive in 38% cases. Urine culture was positive for other microorganisms in 9 patients (20%). Intravenous urography oriented the diagnosis in 87.5% of cases. The average interval between onset of symptoms and diagnosis was 15 months. Cure without sequelae was obtained in 60%. Surgery was indicated in 10 patients. CONCLUSIONS: The index of suspicion for GUT should be high when patients present with repeated urinary syndromes. The current use of imaging studies other than urography and the finding of other microorganisms in urine culture can delay the diagnosis.

Micobacteriosis genitourinaria: estudio retrospectivo de 45 casos en un hospital general / Genitourinary mycobacteriosis: retrospective study of 45 cases in a general hospital

INTRODUCCIÓN. La tuberculosis genitourinaria (TGU) es la afección extrapulmonar más frecuente tras la pleural y ganglionar. Dada su escasa sintomatología clínica su diagnóstico y tratamiento son, a menudo, tardíos. MÉTODOS. Estudio de las características clínicas, epidemiológicas y evolutivas de los pacientes diagnosticados de TGU en nuestro centro los últimos10 años. Se han incluido los pacientes con cultivo de Löwenstein positivo, en orina o en muestras de biopsiaso con estudio anatomopatológico compatible con tuberculosis. Los casos de tuberculosis multifocal, Löwenstein positivo sin clínica urinaria ni alteraciones radiológicas se consideraron micobacteriuria. RESULTADOS. Se han analizado 45 pacientes (el 62%hombres con una edad media de 49,4 años). En el 33%coexistía enfermedad de base (14 infectados por el virus de la inmuno deficencia humana). Se diagnosticaron de tuberculosis renal 26 pacientes (57%), 5 (11%) de orquiepididimitis y 14 (31%) se catalogaron como micobacteriuria. La sintomatología más frecuente fue síndrome miccional (60%), dolor lumbar (44%) y hematuriama croscópica (12%). La tinción de Ziehl fue positiva en el38% de los casos. El urocultivo fue positivo para otros gérmenes en 9 pacientes (20%). La urografía intravenosa orientó el diagnóstico en 28/32 casos (87,5%). El intervalo medio de síntomas previos al diagnóstico fue de 15 meses. La curación sin secuelas se logró en el 60%. Se indicó cirugía en 10 casos. CONCLUSIONES. Se debe incrementar el grado de sospechade TGU ante síndromes urinarios de repetición. La menor utilización actual de la urografía frente a otras pruebas de imagen y el hallazgo de otros gérmenes en el urocultivo pueden retrasar el diagnóstico (AU)

INTRODUCTION. Genitourinary tuberculosis (GUT) is the third most frequent extrapulmonary tuberculous infection, following pleural and nodal involvement. Associated clinical symptoms are mild, and the diagnosis and treatment of this condition are often delayed. METHODS. This study determines the clinical and epidemiological characteristics, and outcome of patients diagnosed with GUT in our center over the last 10 years. Patients with positive Löwenstein-Jensen urine or biopsyculture, or pathologic study suggestive of tuberculosis were included. Cases of multifocal tuberculosis and positive Löwenstein-Jensen, but with no urinary symptoms or radiological alterations, were considered to have mycobacteriuria. RESULTS. Forty-five patients were analyzed (62% men; mean age, 49.4 years). Among the total, 33% had acoexisting disease (14 were infected by human immunodeficiency virus). Twenty-six patients (57%) had renal tuberculosis, 5 (11%) orchiepididymitis, and 14 (31%)were classified as having mycobacteriuria. The most frequent clinical manifestations were urination syndrome(61%), low back pain (44%), and macroscopic hematuria(12%). Ziehl stain was positive in 38% cases. Urine culture was positive for other microorganisms in 9 patients (20%).Intravenous urography oriented the diagnosis in 87.5% of cases. The average interval between onset of symptoms and diagnosis was 15 months. Cure without sequelae was obtained in 60%. Surgery was indicated in 10 patients. CONCLUSIONS. The index of suspicion for GUT should be high when patients present with repeated urinary syndromes. The current use of imaging studies other than urography and the finding of other microorganisms inurine culture can delay the diagnosis (AU)