Peritoneal tuberculosis due to Mycobacterium caprae.

The incidence of tuberculosis in humans due to Mycobacterium caprae is very low and is almost confined to Europe. We report a case of a previously healthy 41-year-old Moroccan with a 6 month history of abdominal pain, weight loss, fatigue and diarrhea. A diagnosis of peritoneal tuberculosis due to M. caprae was made.

Primary cutaneous cryptococcosis in an immunocompetent host: case report and review of the literature.

We report a 46-year-old male who developed cellulitis of his third right finger after being injured with a metallic object. Cryptococcus neoformans var. neoformans was isolated from both the skin and the metallic object. Systemic cryptococcosis and immunosuppression was excluded by appropriate tests. Complete healing was achieved after 10 months of itraconazole 100 mg/12 h and surgical excision of the remaining lesion. Our literature review shows another 16 cases of primary cutaneous cryptococcosis in nonimmunocompromised hosts. The clinical, mycological and therapeutic characteristics of these patients are reviewed.

[Outbreak of Q fever and seroprevalence in a rural population from Soria Province]. / Brote de fiebre Q y seroprevalencia en una población rural de la provincia de Soria.

BACKGROUND: The aim of this study was to describe an outbreak of acute fever in a rural town from Soria (Spain) in the spring of 1998 and to know the prevalence of IgG antibodies to Coxiella burnetii in this population. METHODS: 1. Outbreak of Q fever: epidemiological, clinical and analytical data were obtained by standardised questionnaire and the clinical records from all clinical cases. These cases were confirmed by complement fixation test.2. Seroprevalence: 253 sera were chosen by not probabilistic sampling of convenience of sera samples collected between 1 September 1996 and 28 February 1999. Were regarded as positive anti-phase II C. burnetii IgG titles by indirect inmunoflourescence assay equal or higher to 1/80. RESULTS: 1. A total of 14 cases of Q fever with a mean age of 21.5 +/-3.1 years were confirmed. 64% presented pneumonia and in 36% the symptoms were nonspecific. No patient had direct contact with animals but near to the town there were 4 flocks with 2,614 sheeps overall. 2. The seroprevalence was 60% (95% confidence interval: 54-66). The seroprevalence was not increased with the outbreak (p > 0.05). CONCLUSION: The high prevalence of antibodies to C. burnetii in this population shows that this area is hyperendemic for such infection, but generally is asymptomatic or clinical signs are extremely mild because no cases of Q fever had been reported in the years before. Probably indirect exposure to flocks of sheep was the source of infection and transmission mechanism airborne.

Epidemiological characteristics of dogs with Lyme borreliosis in the province of Soria (Spain).

From the point of view of the human disease, dogs are the most important animal reservoir of Lyme borreliosis; therefore, they are used as 'sentinel animals'. In order to know the epidemiological characteristics of dogs with antibodies against Borrelia burgdorferi, 146 canine sera samples collected during 1993-94 have been studied. The antibody detection was made by an indirect immunofluorescence method and confirmed by a haemagglutination test. Seventeen dogs (11.6%) were seropositive, of which seven were hunting dogs, three were shepherd dogs, five were domestic pets, one was a watchdog and one was a stray dog. Seven dogs had longhair phenotype, 2 medium length type, 4 hard-hair and the other 4 were short-haired. Twelve seropositive dogs were males and five were females. All seropositive dogs were more than 1 year old. The dogs with greater seroprevalence were those that harboured ticks more often than the rest. Spring and summer were the seasons when more ticks were observed. The seroprevalence found in dogs was similar to that previously obtained in humans in this area. This finding gave evidence to an intimate association between human and canine seroprevalence.

[Cutaneous myiasis by Sarcophaga sp]. / Miasis cutánea por Sarcophaga sp.

BACKGROUND: Myasis are due to the invasion of tissue or cavities of animal organism by dipterous larvae. PATIENTS AND METHODS: Two cases of semi-specific myasis caused by Sarcophaga larvae are described. RESULTS: Case 1: A 77-year-old woman with Kaposi sarcoma in the left leg developed cutaneous radionecrosis secondary to radiotherapy. In June, 1998 five fly larvae were observed moving freeing within the wound. These were removed with forceps and local dressing of the wound was performed with povidone-iodine. Case 2: A 87-year-old man with moderate dementia, progressive immobilization syndrome prostasic neoplasm and gastric ulcer reported. In the posterior part of the right outer ear the presence of three fly larvae were observed with some dermic orifices made. The larvae were removed with forceps and local dressing was carried out with povidone-iodine. In the laboratory an adult form was obtained from one of the larva. CONCLUSIONS: Myasis in infrequent in Spain and appears particularly in people with some predisposing factor. Treatment consists in the elimination of the larvae in the infected tissue and disinfection of the wound.

[Variation of the incidence and antibiotic sensitivity of Neisseria gonorrhoeae in a 7-year period]. / Variación de la incidencia y sensibilidad antibiótica de Neisseria gonorrhoeae en un período de 7 años.

BACKGROUND: The aim of this study was to determine the incidence and antibiotic sensitivity of Neisseria gonorrhoeae versus penicillin, tetracycline, cefoxitin, ceftriaxone and spectinomycin from 1988 to 1994 in the province of Soria (Spain). METHODS: From January 1988 to December 1994, clinical samples of 57 strains of N. gonorrhoeae were isolated. Auxotype, serotype, and minimum inhibitory concentration (MIC) studies were performed versus 5 antimicrobials and analysis of plasmids in the penicillinase producer strains (PPNG), was carried out in the Bacteriology Department of the Instituto Carlos III in Madrid (Spain). RESULTS: The rate of incidence of the isolation of N. gonorrhoeae was similar from 1988 to 1990 (11.7 to 19.1 cases per 100,000 inhabitants) and decreased from 1991 to 1994 (6.4 to 0 cases per 100,000 inhabitants). The strains belonged to 30 different auxotypes/serotypes indicating a great heterogeneity among them. The proportion of penicillinase producing N. gonorrhoeae (PPNG) increased over the study period. The first strains with high resistance to tetracycline (TRNG) were first isolated in the authors' area in 1991 and the proportion increased up to the end of the study. All the strains were sensitive to ceftriaxone, cefoxitin and spectinomycin. CONCLUSIONS: A decrease was observed in the rate of incidence of N. gonorrhoeae since 1991 with an increase in the proportion of NGPP and TRNG strains. Ceftriaxone and spectinomycin present good activity versus all the strains studied with their empiric use as treatment being possible in the province of Soria (Spain).

[Development of a selective differential medium for the isolation of Corynebacterium urealyticum (group D-2)]. / Desarrollo de un medio selectivo diferencial para el aislamiento de Corynebacterium urealyticum (grupo D-2).

BACKGROUND: We have developed a new selective culture medium for the isolation of C. urealyticum, with the aim of improving and making easier the isolation and identification of this microorganism. MATERIAL AND METHODS: The medium is based on components similar to other media, usually used for diagnosis of urinary tract infections, also containing glucose, urea, phenol red, polysorbate 80 (Tween 80), polymixin B, amphotericin B, nalidixic acid and lyncomycin. The medium was tested in 65 clinical isolates and three type strains, and in 533 clinical samples of urine. RESULTS: All 65 clinical strains and 3 reference strains of C. urealyticum tested grew faster on this medium than on blood agar. E. coli, Klebsiella spp., Enterobacter spp., Citrobacter spp., M. morganii, Proteus spp., S. aureus, Enterococcus spp. and Corynebacterium spp. did not grow in the selective agar. S. epidermidis and Streptococcus spp. grew in less than 10% of cases, P. aeruginosa in 29.2% and Serratia spp. in 41.7%. The colonies were always easily differentiated from C. urealyticum. In the studies performed on 553 clinical samples from patients with urinary tract infections, six infections by C. urealyticum were detected. The growth of all strains being faster on this medium than on blood-agar. CONCLUSIONS: This new selective medium may be a valuable tool for diagnosis of UTIs caused by C. urealyticum in patients with retard risk factors.