Individualized management of bacteraemia in patients with a permanent endocardial pacemaker.

Fifty-five episodes of bacteraemia arising in patients with a permanent endocardial pacemaker (PEP), from May 1987 to March 2006, were reviewed to determine whether clinical and microbiological data might assist in individual clinical management. Episodes of PEP-related bacteraemia were divided into early-onset bacteraemia, occurring within 6 months after device implantation or manipulation, and late-onset bacteraemia, occurring thereafter. Episodes with a source different from the PEP were classified as out-of-system bacteraemia.

An unusual cause of pulmonary hypertension and refractory edema.

Refractory edema is defined as peripheral edema that does not respond to dietary sodium restriction and combined diuretic treatment including a loop diuretic, often caused by an evident underlying cardiac or pulmonary condition. We present a case of refractory edema, which remained unexplained until a hidden intrarenal arteriovenous malformation was discovered.

[Complications related with cocaine abuse that required hospital admission].

Introduction: Although cocaine abuse is an increasingly important medical problem, many manifestations of its toxicity are not well understood. The aim of this study is to review the most serious clinical manifestations related to cocaine abuse.

Patients And Method: We reviewed the medical records of all patients over 16 years of age admitted to the hospital from January 1994 to December 2005 where cocaine abuse was recorded in their clinical history.

Sternal tuberculosis after open heart surgery.

We present a 68-y-old female who had undergone aortocoronary bypass and developed Staphylococcus aureus sternal osteomyelitis. Despite prolonged therapy with different antibiotics and several local debridements and drainage, the wound remained open and suppurative. Only after sternectomy and wide excision of infected costal cartilage was the diagnosis of sternal tuberculosis made, 24 months later.

[Strongyloides stercoralis in the south of Galicia].

Strongyloides stercoralis is the only parasite which can produce a chronic illness in humans, being through autoinfection. This nematode can also provoke death when patient's immunologic state deteriorates producing a massive hyper infection. The first patient with strongyloidiasis who has always lived in the Galician South area is described.