Colitis ulcerosa: a propósito de un caso

La colitis ulcerosa (CU) es una enfermedad inflamatoria crónica de curso variable que afecta a la mucosa del colon provocando úlceras; de causa desconocida y sin cura definitiva.  Esta afección se presenta principalmente entre los 20 y 40 años. En el Perú la incidencia de CU es muy baja y el tiempo de espera para el diagnóstico amplio pudiendo generarse complicaciones.  Se reporta el caso de una paciente de 20 años, con historia de diarreas, hematoquecia y examen físico no concluyente, cuyo abordaje inicial fue de una infección de tracto gastrointestinal. Luego de realizar los exámenes correctos, se llegó al diagnóstico de colitis ulcerosa, con evolución favorable gracias al tratamiento

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective