BackgroundBrucellosis is one of the most widespread zoonoses worldwide. It can affect any organ system, particularly the gastrointestinal system, but there is no report of acute liver failure as a brucellosis complication.Case presentationWe present a case of acute liver failure secondary to brucellosis infection. A 75-year-old Hispanic man presented to a University Hospital in Chía, Colombia, with a complaint of 15 days of fatigue, weakness, decreased appetite, epigastric abdominal pain, jaundice, and 10 kg weight loss. On examination in an emergency room, abdomen palpation was normal with hepatosplenomegaly and the results of a liver function test were elevated. The diagnosis of brucellosis was confirmed by epidemiological contact and positive Rose Bengal agglutination with negative enzyme-linked immunosorbent assay immunoglobulin M for Brucella. He was then treated with doxycycline plus trimethoprim/sulfamethoxazole, with a favorable clinical outcome.ConclusionsThe clinical presentation of brucellosis can be very imprecise because it can affect any organ system; however, there is no report of acute liver failure as a brucellosis complication. This is the first reported case in the Colombian literature of acute liver failure due to brucellosis. We found this case to be of interest because it could be taken into account for diagnosis in future appearances and we described adequate treatment and actions to be taken at presentation.
Currently, the only option for treating brucellosis is antibiotics especially to prevent complications. In this chapter, we want to talk about the drug therapy in brucellosis and the update of these therapies in the last years. Also, we will expose the principal antibiotics in brucellosis such as doxycycline, rifampin, streptomycin, cotrimoxazole (TMP/SMX), and gentamicin by talking about each one of their mechanism of action, pharmacokinetics, administration, risk assessment, adverse effects, and principal drug interactions. Furthermore, we will add the evidence of efficacy therapy in monotherapy or combinate therapy based on the evidence.
INTRODUCCIÓN:La aparición del SARS-CoV-2 planteó un reto a nivel educativo ya que las asignaturas de educación médica migraron completa e inesperadamente a la virtualidad. Al retornar a la presencialidad se cuestionó la calidad de las actividades virtuales realizadas, dando importancia a los entornos virtuales de aprendizaje de alta calidad de las asignaturas presenciales como complemento de la enseñanza en Medicina. Ahora, dichos entornos requieren tener diseños robustos que garanticen su calidad como complemento de las asignaturas presenciales en Medicina. MÉTODOS:Se realizó un estudio cuantitativo de caso descriptivo con el objetivo de construir un instrumento para evaluar la calidad del diseño de los entornos virtuales de aprendizaje de las asignaturas presenciales en Medicina. Se realizaron las siguientes fases: revisión de literatura, síntesis de la revisión de la literatura y desarrollo de los ítems. RESULTADOS:Se construyó el instrumento donde se definieron 7 categorías clave con su respectiva definición: funcionamiento global del curso, gestión de recursos, diseño de materiales y didáctica, metodología, espacio virtual de aprendizaje del curso, sistema de evaluación y retroalimentación. Con un total de 37 ítems a evaluar y cada ítem con una escala de respuesta tipo Likert, los cuales pueden ser contestados desde la perspectiva del creador del entorno, docente y estudiante. CONCLUSIONES:Los entornos virtuales de aprendizaje en las asignaturas presenciales de medicina deben contar con diseños de calidad. Este instrumento plantea criterios que permiten evaluar la calidad del diseño de los entornos virtuales de aprendizaje desde la perspectiva del creador, docente y estudiante.PALABRAS CLAVES: educación médica, aprendizaje, entorno virtual de aprendizaje, tecnología de la información.
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