Acute hepatitis secondary to febuxostat.

Febuxostat is a drug from the group of xanthine dehydrogenase inhibitors and is used in the treatment of hyperuricemia and gouty arthritis. However, it is not free of adverse effects, including alteration of liver profile tests. This is why we must pay attention to this type of adverse events in case it is necessary to suspend treatment. We present a clinical case of acute hepatitis secondary to Febuxostat.

DRESS syndrome secondary to carbamazepine.

DRESS syndrome is a multisystem disorder that appears in the context of an adverse drug reaction, characterized by fever, rash and peripheral eosinophilia with involvement of other organs such as the liver. The typical liver involvement is acute toxic hepatitis (DILI), showing improvement and a tendency to resolution when corticotherapy is started. We must not forget this manifestation in the clinical context of a DRESS syndrome.

Adrenal insufficiency and hepatic cirrhosis: a relationship to discover.

Liver cirrhosis is an entity that predisposes to adrenal insufficiency. Adequate screening for this condition in patients with liver cirrhosis, since several studies have shown increased survival with the use of corticosteroids in cirrhotic patients with septic shock, it seems reasonable to identify patients with adrenal insufficiency in the context of liver cirrhosis and individualize your treatment.

Cefditoren-induced hepatitis.

There are many daily antibiotic prescriptions, especially beta-lactams in trivial infections such as cystitis in young women. Many of these drugs carry an implicit probability of producing hepatotoxicity, manifested by a nonspecific general picture and elevated analytical transaminases. We must take it into account when making the differential diagnosis in the hepatotoxicity study and suspend it as soon as we recognize it.

Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism.

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.

Papel del Staphylococcus caprae en la infección nosocomial / Role of Staphylococcus caprae in nosocomial infection

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Endocarditis infecciosa por Aerococcus urinae / Aerococcus urinae infective endocarditis

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Bacteriemia por Nocardia farcinica / Bacteremia by Nocardia farcinica

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Vasculitis leucocitoclástica inducida por cotrimoxazol / Cotrimoxazole-induced leukocytoclastic vasculitis

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