[Rapidly progressive myonecrosis by Aeromonas veronii biotype sobria]. / Mionecrosis rápidamente progresiva por Aeromonas veronii biotipo sobria.

Myonecrosis due to Aeromonas spp is exceptional. We report the case of a diabetic patient with liver cirrhosis who developed a rapidly progressive myonecrosis by Aeromonas veronii biotype sobria. The portal of entry was an injury after falling down in an irrigation canal. The outcome was not favourable and surgical amputation of left leg was performed in spite of antibiotic treatment with cefotaxime and tobramicin. Aeromonas spp can be very aggressive and this microorganism should be considered in the differential diagnosis of skin and soft tissue infections with myonecrosis, specially after posttraumatic wound infections with a history of freshwater exposure.

[Susceptibility of Streptococcus pyogenes to macrolides and quinolones in Guadalajara, Spain]. / Sensibilidad de Streptococcus pyogenes a los macrólidos y las quinolonas en Guadalajara (España).

We carried out a retrospective study of the susceptibility of 104 Streptococcus pyogenes strains, which were isolated in 2000 and 2001 from clinical samples of different origins, to penicillin, erythromycin, clindamycin, ofloxacin and levofloxacin. The susceptibility testing was performed using the agar difusion method according to the guidelines of the NCCLS. All of the isolates showed susceptibility to penicillin and clindamycin. However, we detected 11 strains that were resistant to erythromycin (10.6%) and 4 strains resistant to ofloxacin (3.8%). We studied the resistance phenotypes of macrolides and lincosamides using erythromycin and clindamycin discs. Nine of the eleven strains that were resistant to erythromycin showed an M phenotype, while the remaining two showed inducible resistance to clindamycin, thus suggesting an MLS(B) inducible phenotype. No strains with constitutive resistance to erythromycin or clindamycin (MLS(B) constitutive phenotype) were identified. While penicillin is still uniformly active against S. pyogenes, in Guadalajara, there are 10.6% strains that are resistant to 14- and 15-atoms macrolides.

[Incidence and risk factors for hepatitis A in the province of Guadalajara (Spain)]. / Incidencia y factores de riesgo de hepatitis A en la provincia de Guadalajara.

BACKGROUND: The decrease in the prevalence of hepatitis A in Spain may modify the characteristics of this infection because of the rise in the susceptible adult population. The aim of this study was to determine the incidence of this disease, as well as the epidemiological characteristics and the complications of patients diagnosed in the province of Guadalajara between 1991 and 1999. PATIENTS AND METHODS: The inclusion criterion was the presence of specific IgM together with an increase in alanine aminotransferase concentrations and/or symptoms compatible with acute hepatitis. RESULTS: The mean incidence was 7.13 cases/105 inhabitants. Considerable differences were found between years due to the presence of an outbreak. Most cases occurred in children and young adults. The most frequent risk factor found overall was contact with an infected individual but the distribution of risk factors differed between children and adults. CONCLUSIONS: The decrease in the prevalence of hepatitis A in Spain entails an increase in the susceptible adult population. Consequently, hepatitis A may cease to be a typically pediatric disease and may become one that also affects young adults in whom it may have different characteristics. This consideration should be borne in mind when designing a vaccination strategy.

[Urinary infection caused by non typhi Salmonella]. / Infección urinaria por Salmonella no typhi.

BACKGROUND: The aim of this study was to know the frequency and the clinical characteristics of urinary infection by non typhi Salmonella in our area in Spain. PATIENTS AND METHODS: The clinical histories of patients with urinary infection by non typhi Salmonella diagnosed in the Hospital General del Guadalajara from January 1990 to July 1999 were reviewed. RESULTS: During the period studied nine patients with urinary infection by non typhi Salmonella were diagnosed, representing 0.056% of the urinary infection diagnosed in our hospital over the same period. All the patients presented underlying disease and five were undergoing immunosuppressor treatment. Four patients presented urological disease. The most frequent serogroup was Salmonella enteritidis (7 cases). All the episodes were symptomatic. The same microorganism was isolated in stools in four patients. The evolution was favorable in five of the nine cases. Recurrence was observed in two patients and secondary bacteremia in one. Six patients required antibiotic treatment over two or more weeks. The mean length of treatment was of 2.5 weeks. CONCLUSIONS: Urinary infection by non typhi Salmonella is predominantly observed in patients undergoing immunosuppression or with urological disease. Prolonged antibiotic treatment is recommended due to its bad evolution.

Human infection with Hymenolepis diminuta: case report from Spain.

We report a case of Hymenolepis diminuta infection in a human. The patient was a 5-year-old girl referred to us through the onset of a cyanotic attack. Treatment with a single dose (10 mg/kg of body weight) of praziquantel was ineffective, but the parasite was eradicated after three treatment cycles with the same drug at dosages of 25 mg/kg/day for 5 days.

Spleen abscess caused by Eikenella corrodens.

A case is reported of splenic abscess due to Eikenella corrodens, a gram-negative rod which is found as part of normal flora in human mucous surfaces. A 64-year-old man presented with fever, chills, anorexia and abdominal pain. Abdominal ultrasound examination showed a perisplenic fluid collection which was considered to be either blood or a subcapsular spleen abscess. The presence of a splenic abscess was later confirmed during surgery and a splenectomy was performed. Splenic purulent material and blood cultures yielded Eikenella corrodens. The patient received cefotaxime for 19 days and was discharged asymptomatic.

Recovery of Campylobacter from human faeces stored at 4 degrees C.

Six hundred and thirteen fresh diarrhoeal faeces were inoculated on Skirrow blood agar (SK), on Preston blood free agar (PBF), and in Campy-thioglycolate broth (CT). After 24 h of storage at 4 degrees C, specimens were again inoculated on SK and PBF, and in Campylobacter enrichment broth (CEB). CT tubes were placed overnight at 4 degrees C. Plates and CEB tubes were incubated at 43 degrees C in microaerophilic conditions. A total of 68 specimens was positive for campylobacter on direct plating. Sixty-four of them were also recovered after subculturing from CT, and only 51 from CEB. Delayed inoculation of plates after storage of samples at 4 degrees C yielded 57 isolates. The storage of faeces at 4 degrees C for 24 h significantly reduces the number of campylobacter isolates. When samples are not plated immediately we recommend inoculating a CT tube maintained at 4 degrees C overnight as a holding medium.