Infecciones por amebas de vida libre. Comentarios históricos, taxonomía y nomenclatura, protozoología y cuadros anátomo-clínicosInfections caused by free-living amebas. Historical commentaries, taxonomy and nomenclature, protozoology and clinicopathologic featuresInfections caused by free-living amebae constitute one of emergent opportunistic infections with greatest medical interest. Although infrequently, they have been described in almost all world, its diagnosis depends on a high index of suspicion, especially in morpho-pathologic and laboratory studies. Exciting historical features of infections due to free-living amebae, its taxonomy and the present nomenclature are briefly reviewed. An analysis of the protozoology of the most frequent agents is done and, based on the author's own experience and the published one, already established anatomo-clinical entities are described: the primary amebic meningoencephalitis, granulomatous amebic encephalitis, Acanthamoeba keratitis, cutaneous acanthamoebiasis, disseminated infection and other rare isolated locations.

Rev Chil Infect 2005; 22 (2): 155-160 CASO CLÍNICONeumonía cavitada por Rhodococcus equi en paciente inmunocomprometido no infectado por virus de inmunodeficiencia humana. Caso clínico y revisión RICARDO RABAGLIATI B., ARTURO MORALES S., RENÉ BAUDRAND B., JORGE JORQUERA A., DAVID ODDÓ B., PATRICIA GARCÍA C., M. CECILIA CARMONA P., MARCELA CISTERNAS M. y ÁLVARO HUETE G. Necrotizing pneumonia due to Rhodococcus equi in non HIV immunocompromised host. Case report and reviewRhodococcus equi, is a grampositive intracellular bacillus, that causes infection mainly in immunocompromised hosts. We report the case of a 52 years old woman, with a systemic lupus erythematosus and a progressive 10 months evolution with cough, dyspnea, mucous-purulent sputum, occasionally hemoptysis, intermittent fever, and weight loss of 10%. With partial response to antibiotic treatment, radiological evolution of thoracic scanners evidenced the development of multiple bilateral areas of consolidation, some of them nodular. Percutaneous thoracic biopsy showed characteristic histology and microbiological analysis yielded the identification of Rhodococcus equi in both bronchoalveolar lavage and pulmonary biopsy. She received prolonged bi-associated antibiotic treatment with good clinical and radiological response. This agent must be considered in the study of immunocompromised patients that present with a prolonged evolution of pneumonia.

Survival of patients with metastatic breast cancer according to pathological types of tumors (56.4 and 11.4 months, respectively, p = 0.04). Conclusions: Patients with metastatic BC at diagnosis often had HER2 positive tumors and high HG. As in other studies, ER positive tumors had a better survival. (Rev Med Chile 2014; 142: 428-435)

Introducciónl hombre es infectado, con alta frecuencia, por amebas desnudas de vida estrictamente parasitaria, pertenecientes a la familia Endamoebidae, en especial en países en vías de desarrollo como el nuestro 1 .En 1965 se publicaron los primeros casos de infección humana por una ameba de vida libre 2 , aunque estudios retrospectivos han encontrado casos desde 1909 3 . Las primeras amebas de vida libre descritas pertenecen a la familia Vahlkampfiidae y género Naegleria 3 . A partir de 1977, se precisó que otras amebas de vida libre, de las familias Hartmannellidae y Acanthamoebidae, producen también infección humana 3 . Más recientemente, se ha agregado una nueva especia, Balamuthia mandrillaris, una ameba de la familia Leptomyxidae que afecta al ser humano 4,5 .Actualmente, se han sistematizado muy bien los principales cuadros anátomo-clínicos producidos por amebas de vida libre, a saber: encefalitis amebiana granulomatosa, meningoencefalitis amebiana primaria, y la queratitis acantoamebiana 3,6-8 .En Chile, se han aislado del medio ambiente varias especies de amebas de vida libre 9,10 y se ha publicado, según nuestra información, sólo un caso de queratitis Encefalitis amebiana granulomatosa por Balamuthia mandrillaris. Primer caso diagnosticado en Chile Granulomatous amebic encephalitis caused by Balamuthia mandrillaris. First case diagnosed in ChileThe case of a 7 month-old baby boy is presented, with a history of several weeks of evolution of personality changes, convulsions and fever. While he was hospitalized, the brain image study showed multifocal cavity lesions, which varied from millimeters to 4 cm of diameter, not producing mass effect. Their biopsy revealed necrotizing encephalitis. In spite of treatment, the lesions progressed and the boy died. The autopsy demonstrated an extensive necrotizing encephalitis with fibrinoid necrotic arteritis, signs of organization, and the presence of parasitic elements with characteristics of trophozoites and cysts of free -living amoebas belonging to the genus Acanthamoeba or Balamuthia. In addition, hypoplasia-dysplasia of the thymus and signs of shock were found. The morphologic elements correspond to the disease described as granulomatous amebic encephalitis and the agent found was identified as Balamuthia mandrillaris (Centers for Diseases Control and Prevention, Atlanta, USA ).

No abstract