Infecciones parameníngeas: reporte de dos casos asociados con sinusitis

El absceso cerebral y el empiema subdural son infecciones parameníngeas graves y poco frecuentes en la actualidad. Se presentan un caso de absceso cerebral y uno de empiema subdural asociados con sinusitis; ambos fueron tratados con ceftriaxona, vancomicina y metronidazol (uno de ellos además con drenaje quirúrgico) y presentaron evolución clínica satisfactoria. Es importante la sospecha diagnóstica temprana para dar un tratamiento oportuno y mejorar el pronóstico en estos pacientes

Bacteremia caused by B. cepacia. A sign of alarm for an outbreak?

We present the case of two children with cancer in the final stage of life, we describe the treatment given in this phase based on palliative sedation and analgesia to provide comfort to the patients and to offer calm to their relatives. We reviewed the literature information on support of sedation and analgesia at this stage of life, and the use of drugs such as midazolam and morphine. With the information provided in this article we expect physicians to convince themselves that opportune sedation and analgesia are useful and beneficial at the terminal stage of life

BCG: a vaccine with multiple faces

BCG has been recommended because of its efficacy against disseminated and meningeal tuberculosis. The BCG vaccine has other mechanisms of action besides tuberculosis protection, with immunomodulatory properties that are now being discovered. Reports have shown a significant protective effect against leprosy. Randomized controlled trials suggest that BCG vaccine has beneficial heterologous (nonspecific) effects on mortality in some developing countries. BCG immunotherapy is considered the gold standard adjuvant treatment for non-muscle-invasive bladder cancer. BCG vaccine has also been tested as treatment for diabetes and multiple sclerosis. Erythema of the BCG site is recognized as a clinical clue in Kawasaki disease. BCG administration in the immunodeficient patient is associated with local BCG disease (BCGitis) or disseminated BCG disease (BCGosis) with fatal consequences. BCG administration has been associated with the development of autoimmunity. We present a brief review of the diverse facets of the vaccine, with the discovery of its new modes of action providing new perspectives on this old, multifaceted and controversial vaccine