The cat scratch disease is a relatively rare disease caused by Bartonella henselae. Only a small proportion of the cases that described extranodal involvement occurs. We report a 11 year old male patient with persistent fever, liver and osteoarticular involvement with a predominance of dorsolumbar spine. Evolution was satisfactory with complete clinical and imaging evidenced recovery in several months of monitoring. Case was analyzed considering EAG published literature, emphasizing the need to include this condition in the differential diagnoses in patients with bone involvement suggestive of systemic disease.
Background: Bacterial meningitis and encephalitis are lifethreatening infections, a delay in its treatment is associated with high mortality. In 2015, FDA approved the Multiplex PCR FilmArray™ meningitis/encephalitis syndromic panel (FA-MEP), and it is available in our hospital since 2019. Aim: To estimate the number of positive FA-MEP, to evaluate the correlation to conventional culture (CC) results and to describe if the FA-MEP technology allowed changes in the treatment. Methods: Retrospective analysis of children with meningitis, encephalitis and meningoencephalitis and pathological cerebrospinal fluid analysis between 2019-2021, who were subject to FA-MEP testing at the Pedro Elizalde Children´s Hospital. Results: 32 children, mean age: 48 months. 11 patients had positive FA-ME tests: 7 bacterial, 6 viral. 2 patients correlated with CC. Based on the FA-MEP results, treatment was adjusted in 2 bacterial meningitis and the duration of intravenous treatment was shortened. Discussion: Our study allowed to establish the etiology of 5 culture negative bacterial meningitis, (2 had prior antibiotics), administer chemoprophylaxis to close contacts, and to administer fewer doses of acyclovir. Conclusions: The FA-MEP allowed us to identify 5 bacterial meningitis that tested negative by CC and early adjustment of inappropriate empirical antibiotics and to shorten the duration of parenteral treatments.
Presentación de casos clínicos RESUMENSe analiza el caso de un niño con sinusitis frontal, con una forma de presentación poco habitual que, además, padecía una complicación intracraneal grave. Las complicaciones intracraneales de las sinusitis son raras en la actualidad, pero comprenden un amplio rango de entidades graves, como meningitis, abscesos cerebrales y trombosis del seno cavernoso. Se hace hincapié en la importancia del diagnóstico precoz y de un tratamiento empírico inicial adecuado para evitar las posibles complicaciones. Asimismo, cabe enfatizar que una vez producidas estas, requieren un tratamiento médico-quirúrgico intensivo para su resolución. Palabras clave: tumoración de Pott, sinusitis frontal, complicaciones intracraneales. SUMMARYWe present the case of a child with frontal sinusitis, who also suffers from a severe intracranial disease. Although sinusitis intracranial issues are rare nowadays, they include a wide range of serious entities such as meningitis, brain abscesses and thrombosis of the cavernous sinus. We emphasize the importance of early diagnosis and an adequate initial empirical treatment to prevent possible complications. Once they are presented, an aggressive surgical medical treatment is required for its resolution.
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