According to the results of the Spanish Network for the Research of Infection in Transplantation cohort, the incidence of some potentially severe posttransplant infections may be increased in anti-HCV-positive KT recipients.

Characteristic radiographic and computed-tomographic (CT) features of seven cases of osseous lipoma are reported: six with medullary and one with parosteal locations. Radiological diagnosis of this lesion is discussed, with emphasis on potential pitfalls in interpretation of CT scans. Although the presence of fat-equivalent density on scans is highly suggestive of osseous lipoma, comparable attenuation is documented in cases of chronic osteomyelitis and postnecrotic subchondral excavation.

A 59-year-old Caucasian male presented with progressive dyspnea, arthralgias and fever for three days. A diastolic regurgitation murmur was detected in the aortic area. A transesophageal echocardiograph showed several vegetations and severe aortic regurgitation. Blood cultures yielded Neisseria gonorrhoeae beta-lactamase negative. The patient had not noticed any urogenital discomfort or urethral discharge. The patient successfully underwent surgery for septal abscess debridement. The patient received ceftriaxone 2 g bid for eight weeks and the clinical follow-up was uneventful. The review of the literature revealed a total of the 38 additional cases reported between 1980 and the present. The majority of the patients were young, male and with native valve involvement. There has been a clear tendency for left-sided valve involvement (especially in the aortic valve). All valve cultures were reported negative despite, in most cases, the marked tissue destruction. Polymerase chain reaction was performed in two patients and positive results were shown in both. Cultures of exudates from other locations were negative in most cases. One striking fact is the high proportion of patients who underwent surgery (72 %). Information regarding antibiotic sensitivity was available in 28 cases, with penicillin resistance reported in six patients (21 %) and intermediate sensitivity in four patients (14 %). Resistance to ciprofloxacin was reported in two cases (7 %). A rapid increase and distribution of isolates resistant to third generation cephalosporins have been recently detected. The mortality is high, particularly taking into account that most were young patients who had not presented previous heart disease.

No abstract

SummaryThe parasitic tapeworm Echinococcus granulosis causes hydatid disease, which is rarely encountered in nonendemic regions. It is a progressive disease with serious morbidity risks. Rarely, these cysts are found in the spine. They are mainly found epidurally, originating from direct extension from pulmonary, abdominal or pelvic infestation. Nevertheless, the main mechanism for intradural involvement is not yet clear. Antihelminthic treatment should be administered for a long period following early decompressive surgery. We report a case of recurrent hydatid disease that presented unusual intradural dissemination. Prognosis for spinal hydatid disease remains very poor and comparable to that of a malignant neoplasm.KEY WORDS: Hydatid cysts. Intradural. Spine. Echinococcus. Hidatidosis espinal intradural extramedular: presentación de un caso ResumenEl Equinococcus granulosis es el parásito causante de la hidatidosis, que se encuentra de forma muy poco frecuente en regiones no endémicas. Es una enfermedad quística progresiva con riesgo de causar morbilidad importante, afectando principalmente al hígado y al pulmón. Muy raramente se encuentran quistes a nivel espinal. La hidatidosis espinal afecta sobre todo al espacio epidural por extensión directa de infección existente a nivel pulmonar, abdominal o pélvico. No obstante, el mecanismo para la afectación intradural todavía no está aclarado. El tratamiento antihelmíntico ha de ser administrado durante largo tiempo tras la cirugía descompresiva. Presentamos el caso de una hidatidosis espinal recurrente que presentó una diseminación intradural inusual. El pronóstico de la hidatidosis espinal continúa siendo muy pobre, comparable al de una enfermedad neoplásica maligna.