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Cat-Scratch Disease (CSD) is a benign, self-limited illness that occurs after scratch or bite of a cat carrier of Bartonella henselae. It presents as lymphadenopathy near to the inoculation site, and affects in 80% of cases individual younger that 21 years old. Fewer than 25% of patients will have the atypical form of the disease, with involvement of organs as liver, spleen, central nervous system and retina. Osteomyelitis has been claimed in old series as rare, although more recent publications suggest a higher incidence. Axial skeleton is the most frequently involved, especially pelvis and dorsal and lumbar spine. Skeletal lesions can be only one or multiple. Lesions not always cause pain and they can appear weeks or months after the beginning of symptoms. We describe two girls with skeletal involvement, positive serology for B. henselae and complete recovery. One of them (12 yr) had fever and abdominal pain, with a hypodense lesion in liver and multifocal osteomyelitis in spine and pelvis. The other one (10 yr) had sub-maxillary adenopathy and one painless lesion in iliac crest, which was evident in bone scan (BS), without fever or worsening of general condition. We recommend the regular use of BS in patients with CSD due to poor sensitivity of radiography in detection of bone envolvement and because these lesions can be multifocal and painless in some cases.Key words: Cat-Scratch Disease; Bartonella henselae; Osseous involvement; Osteomyelitis; Bone scan. IntroducciónEl compromiso del aparato locomotor siempre significa un reto para el médico. Sus causas son diversas: desde traumáticas, infecciosas e inflamatorias, a tumorales. Sus manifestaciones clí-nicas son variables, dependiendo de la edad del paciente y su etiología. Con este espectro tan diverso, frente a un niño con síntomas y signos músculo-esqueléticos, nuestro objetivo será siempre descartar un proceso infeccioso o tumoral. Así la patología del aparato locomotor de un recién nacido o un lactante, obligará a descartar como primera posibilidad una osteo-artritis sépti-ca, la cual habitualmente se desarrollará en el contexto de un cuadro infeccioso sistémico 1 . Es diferente en el pre-escolar y escolar, donde surge una gran gama de patologías; los cuadros infecciosos en este grupo etario ya no ocupan el primer lugar y las manifestaciones pueden estar dadas tanto por focalización del microorganismo en el esqueleto, así como ser una respuesta reactiva a la presencia del mismo en el organismo. En ellos, el cuadro clínico puede expresarse como un síndrome febril, con o sin síntomas dolorosos del aparato locomotor. Actualmente, a

Five cases of probably intrauterine herpesvirus infection are discussed. Four of them had clinical evidence of neonatal herpes, which was diseminated in two patients, localized to skin in one case and w ; th SNC compromised in other. Natal or post natal infections we^e not considered to be possible in these infants due to the presence of symptoms in the first 24 hours of life, which made ascending transcervicat or transplacental the most probable route for viral transmission. All cases were treatec with a ten days course of intravenous acyclovir during 10 days. There of them had satisfactory evolution and the other two died at 9 days and at 2 months of life. (Keywords: herpes simplex, infection, prenatal.) El herpes neonatal es una enfermedad graveLa transmision natal es la forma mas frecucnte cuya principal fuente de infeccion es la transmi-y ocurre en el paso por el canal genital materno sion de la madre al hijo, que puede producirse infectado 3 . La transmision prenatal es menos en el perfodo prenatal, natal o postnatal 1 ' 2 , frecuente, pero puede causar aborto, malformaclones, parto premature e infeccion congenita.

The identification of various risk factors of vertical human immunodeficiency virus (HIV) transmission resulted in the development of strategies whose aim was to decrease the mother's viral load, to reduce her child's exposure to it during delivery, and to avoid the subsequent viral exposure due to breastfeeding. The administration of antiretroviral treatment during pregnancy, delivery and to the neonate (PACTG 076) proved to be useful. At a first stage, zidovudine was used. A triple combination therapy was then administered. Initially, the viral transmission in mothers who were enrolled in protocols for vertically transmitted HIV prophylaxis was reduced to 9.5%, whereas the last measurement carried out between 1998 and 2005, the initial figure was brought down to 2%. Nevertheless, the delivery of infected children whose mother's HIV status was unknown is still considered likely to happen. The main step to be taken to reduce HIV infection among children is to perform universal HIV tests during pregnancy, so that HIV positive pregnant patients conveniently receive proper prophylaxis. We look forward to achieving this by following the new prevention guidelines of vertically-transmitted HIV infection, developed by the Comisión Nacional del SIDA of the Chilean Health Ministry.

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