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Biomedical subjects

C Pigrau

Publications and source records attributed to C Pigrau.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Neurologic complications of infective endocarditis].

BACKGROUND: Neurologic involvement is a frequent cause of morbidity and mortality in patients with endocarditis. The aim of this study was to evaluate the most relevant clinical, epidemiologic and evolutive characteristics of patients presenting neurologic complications during the evolution of endocarditis. METHODS: Fifty adult non intravenous drug addict patients who had neurologic complications during endocarditis were prospectively evaluated. The presence of cerebral ischemia, hemorrhage, or infectious complications were studied by established criteria. RESULTS: Neurologic complications were detected in 50 of the 282 patients (18%) with endocarditis diagnosed over 17 years in one institution. The most common complications were seen in patients with mitral endocarditis of either native valves (28%) or prosthetic valves (30%). The prevalence was identical in the endocarditis of either type of valve (18%). The most frequent complication was cerebral ischemia (29 episodes) and central nervous system infection (8 episodes). Fifty-nine percent of the complications presented prior to the diagnosis of endocarditis with half of the remaining 41% occurring during the first 2 weeks of antibiotic treatment. Endocarditis by Staphylococcus aureus was associated with neurologic complications in 40% of the cases. Global mortality was 48%, being related with prosthetic endocarditis, the existence of cerebral hemorrhage or central nervous system infection, etiology by S. aureus and the presence of anticoagulant treatment. CONCLUSIONS: Neurologic complications are frequent during the evolution of infectious endocarditis, both or an initial feature and during its evolution. The presence of complications considerably impairs the prognosis of this disease.

Adolescent↗
PubMed1992

[Psoas abscess: diagnostic and therapeutic usefulness of echography and computerized tomography].

BACKGROUND: Psoas abscess (PA) is a clinically infrequent entity. The abscess may form spontaneously (primary PA) or as a complication of contiguous infection (secondary PA). The use of ultrasonography (US) and computerized tomography (CT) facilitates diagnosis and treatment of a disorder which previously required surgery. METHODS: Nineteen cases of PA diagnosed over the last 7 years were retrospectively studied. Confirmation of diagnosis was established by exteriorization of pus with US, CT or during surgery. RESULTS: Three primary PA (16%) and 16 secondary PA (84%) were diagnosed. The foci of origin of the secondary PA were: urologic (50%), rachydeal (25%), gastrointestinal (12.5%) and iatrogenic lumbar infection (12.5%). The most frequent germs in the primary PA were: Staphylococcus aureus (67%) and in the secondary PA, enterobacteriae (50%). The diagnostic profitability of US was 41% (7/17) and for CT was 100% (15/15). Percutaneous drainage was performed in 9 patients which failed in 2 cases due to compactness of pus (22%) and in another 2 because of undiagnosed osteomyelitis (22%). Two patients (10%) with underlying disease died despite adequate medical-surgical treatment. CONCLUSIONS: Psoas abscess were secondary in 84% of the patients studied with most being due to enterobacteriae. The diagnostic profitability of computerized tomography was greater than that of ultrasonography (100% vs 41%). Percutaneous drainage is a valid therapeutic alternative. Relapse observed in this study was due to previously undiagnosed osteomyelitis.

Adolescent↗
PubMed1990

[Infections in 96 cases of systemic lupus erythematosus].

The incidence, localization, etiology and predisposing factors of infections were evaluated in 96 cases of systemic lupus erythematosus (SLE) (15 males and 81 females) with a mean age of 40 years. Fifty-three patients (55%) had overall 102 infections (incidence 0.17 per year). 31% had urinary tract infections. In these, Escherichia coli was the most common causative organism (56%). 25% had respiratory infections (pneumonia in 14, pulmonary tuberculosis in 8, infections by opportunistic organisms in 4). 17% had skin infections, of which one half were due to Staphylococcus aureus. 16% had bacteremia, due to Staphylococcus spp in 5, to Salmonella spp in 4, and to Pseudomonas aeruginosa in 3. There was a higher incidence of infections in patients with active SLE, in those with nephropathy, and in those with previous immunosuppressant and/or corticosteroid therapy, Leukopenia was not associated to a higher number of infections. In 6 of the 12 patients who died, death was directly related with the infection; in one half of them, infections were due to an opportunistic organism (cytomegalovirus in 2 cases, disseminated candidiasis in one) and were not identified until necropsy. The need to rule out an opportunistic infection in any patient with SLE and fever is emphasized, particularly when there is pulmonary involvement and the patients have undergone aggressive diagnostic and/therapeutic interventions (immunosuppressants, plasmapheresis, renal dialysis).

Adolescent↗