Objectives (1) To describe the incidence, clinical characteristics, treatment and outcome of Aspergillus Endocarditis (AE) in a nationwide multicentric cohort (GAMES). (2) To compare the AE cases of the GAMES cohort, with the AE cases reported in the literature since 2010. (3) To identify variables related to mortality. Methods We recruited 10 AE cases included in the GAMES cohort (January 2008‐December 2018) and 51 cases from the literature published from January 2010 to July 2019. Results 4528 patients with infectious endocarditis (IE) were included in the GAMES cohort, of them 10 (0.2%) were AE. After comparing our 10 cases with the 51 of the literature, no differences were found. Analysing the 61 AE cases together, 55.7% were male, median age 45 years. Their main underlying conditions were as follows: prosthetic valve surgery (34.4%) and solid organ transplant (SOT) (19.7%). Mainly affecting mitral (36.1%) and aortic valve (29.5%). Main isolated species were as follows: Aspergillus fumigatus (47.5%) and Aspergillus flavus (24.6%). Embolisms occurred in 54%. Patients were treated with antifungals (90.2%), heart surgery (85.2%) or both (78.7%). Overall, 52.5% died. A greater mortality was observed in immunosuppressed patients (59.4% vs. 24.1%, OR = 4.09, 95%CI = 1.26–13.19, p = .02), and lower mortality was associated with undergoing cardiac surgery plus azole therapy (28.1% vs. 65.5%, OR = 0.22, 95%CI = 0.07–0.72, p = .01). Conclusions AE accounts for 0.2% of all IE episodes of a national multicentric cohort, mainly affecting patients with previous valvular surgery or SOT recipients. Mortality remains high especially in immunosuppressed hosts and azole‐based treatment combined with surgical resection are related to a better outcome.

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Introducción: las heparinas son esenciales para el manejo de muchos pacientes en los servicios de hospitalización. Objetivo: determinar los patrones de prescripción de heparinas en distintos ambientes hospitalarios en Colombia. Metodología: estudio observacional con prescripciones de pacientes tratados con heparinas en 14 clínicas de 12 ciudades colombianas durante octubre de 2015. Se evaluaron variables sociodemográficas, farmacológicas, comedicaciones; se realizaron análisis descriptivos y multivariados. Resultados: se encontraron 3 776 pacientes tratados con heparinas, con edad promedio: 60,1 ± 20,1 años, 56,9 % fueron mujeres; con una prevalencia de uso de 9,1 %, se emplearon en promedio 6,3 dosis por sujeto, siendo enoxaparina (74,8 %), y dalteparina (24,9 %) los más utilizados. Se prescribió terapia combinada con dos antiagregantes en 34,1 % de casos y las comedicaciones más frecuentes fueron antiinflamatorios no esteroideos (28,9 %) y benzodiazepinas (14,6 %). El uso de dalteparina, haber sido atendido en Cartagena, Barranquilla y ser adulto joven se asociaron con menor probabilidad de recibir alguna comedicación. Conclusión: predomina el uso de heparinas de bajo peso molecular sin utilización de la heparina convencional en las clínicas evaluadas, lo que puede estar asociado con su fácil manejo, menores efectos secundarios y mayor costo-efectividad haciéndolas más convenientes para el uso intrahospitalario.

Prostate cancer is a disease that appears with a very high frequency. However, the presence of metastasis to the penis is rare. Only 98 cases reported in the literature up to 2003. We present one case of a patient with painless metastatic nodules on the penis secondary to a prostate cancer.