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Biomedical subjects

M Montejo

Publications and source records attributed to M Montejo.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Cat-scratch disease: series of 14 cases. The diagnostic usefulness of serology].

BACKGROUND: Disease by cat scratch (CSD) is a syndrome characterized by regional adenopathies following cat scratch or bite. Despite knowing the etiologic agent of the same, there is still controversy in the diagnosis of the syndrome in daily clinical practice. MATERIALS AND METHODS: The cases of CSD diagnosed from 1990 to 1997 with positive serology for Bartonella henselae performed by indirect immunofluorescence were reviewed. RESULTS: In 13 out of the 14 patients studied direct contact with cats was reported. Lymph node involvement corresponded to the following regions: axillary (57%), inguinal (28%), epitroclear (21%), cervical (14%), and periauricular (7%). In 35% of the cases, several territories were involved. In 3 patients the adenopathies were fluctuating. Eleven anatomopathologic studies were performed with 6 diagnoses of granulomatous adenitis, 3 reactive adenitis and 2 purulent adenitis. The serology for Bartonella henselae was positive in all the patients with a range of 1/64-1/256. The evolution was favorable in all the patients. DISCUSSION: Interpretation of the results of serology should be cautions and always related to the clinical and epidemiological picture of the patient. This technique should be considered as another criteria in the diagnosis of cat scratch disease to the detriment of the cutaneous test.

Adolescent↗
PubMed1999

[Osteomyelitis of the frontal bone (Pott's puffy tumor). A report of 5 patients].

BACKGROUND: Frontal bone osteomyelitis is considered to be rare but it may develop intracranial complications such as subperiosteal abscess that appears as a painful fluctuated forehead tumor (Pott's puffy tumor). METHODS: We reviewed retrospectively the clinical history of those patients showing frontal swelling tumour in our Neurosurgery and Infectious Diseases Departments between July 1994 and December 1997 and whose definitive diagnosis was cranial osteomyelitis. RESULTS: We reported five cases of patients who had been submitted to a neurosurgical operation between 9 months and 27 years ago. The main clinical features were intermittent painful frontal swelling episodes (with or without fever). These episodes were self-limited or limited after short trend of antibiotics. Imaging techniques were necessary for the diagnosis and especially in order to exclude intracranial complications (such as epidural abscess found in two patients). The ascertain diagnosis is made by debriding, histological studies and cultures from the material. Staphylococcus aureus was isolated in three of the patients, Haemophilus influenzae in one patient and Pseudomonas aeruginosa in the other one. All patients were treated with surgery and specific antibiotic therapy during twelve weeks minimum, being definitively cured. CONCLUSIONS: It is not well know the etiopathogenic mechanism concerning this rare disease. We remark the importance of a prompt diagnosis because of the high frequency of intracranial complications as well as combined treatment: surgery and long term antibiotic therapy (not less than 8 weeks), is necessary to cure the disease.

Aged↗
PubMed1998

[Tularemia: report of 16 cases in the Castilla-Leon community].

OBJECTIVE: To report the clinico-epidemiological characteristics of 16 patients with the diagnosis of tularemia. METHOD: Retrospective review of clinical records of patients admitted to the hospital or examined at health centers in Vizcaya, with clinical course and epidemiology consistent with tularemia, from January to March 1998. CASE DEFINITION: Patient with suggestive clinical course and epidemiology (exposure to hares coming from the epizootic area) and positive serology (antibodies to Francisella tularensis > 1/160 in convalescent phase serum). RESULTS: Sixteen patients (8 males, 8 females) with a mean age of 53 years. The incubation period ranged from 1 and 8 days (mean: 5). Nine patients had the ulceroganglionar form, two the pharyngeal form, one the oculoganglionar form and one the typhoidal form. In three patients only cutaneous lesion or lesions were observed. The antibiotic treatment administered included streptomycin for five patients, tobramycin for 2 patients, and ciprofloxacin, azithromycin and amoxicillin (plus doxycycline) for other three patients. Three patients received initially antitermic drugs (with poor response) and later two of them, doxycycline. The administered antibiotic in the remaining three patients was unknown. The clinical course was satisfactory in all of them and so far no relapses have been detected. CONCLUSIONS: The ulceroglandular form, as it appears in literature, was the most common form in this series of patients with tularemia. Neither severe diseases nor complications were observed. Although streptomycin is considered the drug of choice, other antibiotics are likely equally effective, at least for the non complicated forms of the disease.

Adult↗
PubMed1997

Inborn errors of metabolism with a protein-restricted diet: effect on polyunsaturated fatty acids.

Previous studies have shown that phenylketonuric patients display a deficiency in long-chain polyunsaturated fatty acids. A study has now been performed on 13 cases (5 with methylmalonic acidaemia and 8 with urea cycle disorders) whose dietary treatment also implies a limitation in protein-rich food. Plasma and red-cell phospholipid fatty acid profiles were studied. The most relevant results were a lower percentage of docosahexaenoic acid in plasma and red-cell phospholipids (0.91% +/- 0.53% vs 2.88% +/- 1.17% and 2.07% +/- 0.92% vs 3.62% +/- 1.01% (p < 0.001)) and a lower percentage of arachidonic acid in plasma (5.22% +/- 2.02% vs 8.3% +/- 2.11% (p < 0.001)). A long-chain polyunsaturated acid deficiency has also been confirmed in this group of metabolic patients and a dietary supplement is recommended since this population is subject to a special risk factor with regard to adequate psychomotor development. By extrapolating these data to the general population, the possibility can be inferred that long-chain polyunsaturated fatty acids are semi-essential in infant nutrition far beyond the breast-feeding period.

Amino Acid Metabolism, Inborn Errors↗
PubMed1997

[Otomastoiditis caused by Aspergillus in AIDS].

BACKGROUND: Aspergillus otomastoiditis is an infrequent infection that occurs in most cases in immunocompromised hosts. Although fungal infections are common in AIDS patients, few cases of Aspergillus otomastoiditis have been reported. METHODS: Two clinical cases of AIDS patients with Aspergillus otomastoiditis are reported, and a review of the literature is performed. RESULTS: Clinical presentation in both cases was similar to those of other diseases involving middle and internal ear. Infection was linked to severe immunosuppression (C3 group). CONCLUSIONS: Aspergillus otomastoiditis is an infrequent infection in AIDS patients. Different routes by which Aspergillus obtains access to the middle ear have been proposed (tympanogenic, meningogenic, hematogenous and direct spread from paranasal sinuses or external auditory canal). Otorrhea, otalgia, hearing loss and facial nerve involvement are common findings. Bone destruction and invasion of brain or skull base may occur. CT or MRI are necessary to evaluate the extent of the disease. Etiologic diagnosis requires histopathologic confirmation on deep tissue biopsy or isolation from blood cultures or fistula exudates, because Aspergillus is a common saprophytic fungus in external auditory canal. Concurrent infections (i.e. Pseudomonas aeruginosa) frequently delay the correct diagnosis. Aggressive surgical resection and intravenous antifungal chemotherapy (amphotericin B or itraconazole) are the main therapeutic options. Outcome is poor as a consequence of severity, delay of etiologic diagnosis and difficulty of aggressive surgical approach in compromised patients. In patients with AIDS a low CD4 cell count would favour invasive Aspergillus infection, implying a worse outcome.

AIDS-Related Opportunistic Infections↗