RESUMEN
INTRODUCTION: Sphingomonas paucimobilis bacteraemia is a rare infection typically related to nosocomial outbreaks. MATERIAL: A 33-year-old immunocompetent man requested evaluation in the Internal Medicine Department for fever without source. His physical examination was normal. Laboratory analysis showed mild hypertransaminasemia. In both blood culture sets grew Gram-negative bacilli, being identified as S. paucimobilis. The patient was treated with oral levofloxacin with full recovery. CONCLUSION: S. paucimobilis infections can occur in the community setting in a relatively non-immunocompromised patient. In a patient with bacteraemia, microbiological studies are crucial to ensure a successful outcome.
Asunto(s)
Bacteriemia/microbiología , Fiebre de Origen Desconocido/microbiología , Infecciones por Bacterias Gramnegativas/diagnóstico , Sphingomonas , Adulto , Antibacterianos/uso terapéutico , Infecciones Comunitarias Adquiridas , Fiebre , Infecciones por Bacterias Gramnegativas/complicaciones , Infecciones por Bacterias Gramnegativas/tratamiento farmacológico , Humanos , Huésped Inmunocomprometido , Levofloxacino/uso terapéutico , MasculinoRESUMEN
Dissection of internal carotid artery is an unusual cause of stroke. It generally affects the extracranial portion of the vessel, rarely the intra-cranial portion and exceptionally both sections simultaneously. We present two cases of spontaneous dissection with extra and intra-cranial involvement. Two females, 46 and 36 years old, presented as stroke of the right internal carotid (ICA) associated with headaches and ipsilateral Horner's syndrome. An echo-Doppler was done on the first patient, which turned to be normal, and carotid angiography was done to both patients. The first patient showed a filiform stenosis of the right ICA that ran from the origin to the carotid siphon. The second patient showed a longitudinal stenosis of the right ICA 2 cm from the origin, which ended in an obstruction of the terminal branches. The control angiographs at five and six months respectively, showed partial re-channelling or complete re-channelling. The first case was treated with anti-aggregants and the second with anticoagulants. There were no new episodes in either cases. Dissection of the ICA usually only affects the extracranial portion of the artery, stopping in the petrous portion. We do not know why dissection also affected the intra-cranial section of the artery in these two cases.