Anorectal Lymphogranuloma Venereum in Madrid: A Persistent Emerging Problem in Men Who Have Sex With Men.

Background: Since 2003, outbreaks of lymphogranuloma venereum (LGV) with anorectal syndrome have been increasingly recognized in many Western countries. All of them have been classified as LGV serovar L2b, mainly occurring in human immunodeficiency virus (HIV)-infected men who have had sex with men (MSM). We describe a series of 26 diagnosed cases of LGV proctitis in downtown Madrid, Spain, in 2014, after implementing routine diagnostic procedures for this disease in symptomatic MSM.

[Cryptococcal meningoencephalitis. Epidemiology and mortality risk factors in pre- and post-HAART era].

Introduction And Objective: Cryptococcal meningoencephalitis (CM) is an uncommon entity, but remains a major cause of morbidity and mortality in patients with AIDS.

Material And Methods: Review of CM cases in a university hospital. The diagnosis was determined by isolation of Cryptococcus neoformans in cerebrospinal fluid.

Corynebacterium striatum: an emerging nosocomial drug-resistant endocardial pathogen.

Endocarditis due to Corynebacterium striatum has been rarely reported. A 78-year-old patient developed pacemaker endocarditis caused by multidrug-resistant C. striatum, complicated by vertebral osteomyelitis and epidural abscess.

Prevalence of pharyngeal infection by Neisseria gonorrhoeae among human immunodeficiency virus-positive men who have sex with men in downtown Madrid, 2011.

The prevalence of pharyngeal gonorrhoea in human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) is not entirely known. We cultured the pharynx of 264 asymptomatic HIV-positive MSM in downtown Madrid. A questionnaire on sexual and drug use risk behaviours was also administered.

[Practices and perception of risk in human immunodeficiency virus infected males who have sex with other males].

Introduction: The incidence of human immunodeficiency virus (HIV) and other sexually transmitted diseases increases in males who have sex with males (MSM), despite the knowledge on how to prevent them. To determine the mechanisms that are driving this lack of prevention is important to reverse the trend.

Patients And Methods: An anonymous, voluntary and self-reporting questionnaire was completed by HIV+ MSM patients who were seen in a hospital clinic, with the aim of finding out the sexual risk practices and behaviour, as well as their perceptions and assessment as regards this risk.

Infective endocarditis at autopsy: a review of pathologic manifestations and clinical correlates.

The frequency of autopsies appears to be declining, and the usefulness has been challenged. We reviewed cases of autopsied active infective endocarditis (IE) during 2 periods based on the availability of high-tech 2-dimensional echocardiograms: Period 1 (P1) included 40 cases studied from 1970 to 1985, and Period 2 (P2) included 28 cases seen from 1986 to 2008--that is, before and after the introduction of echocardiograms in our institution. We conducted the study to reassess the pathology of IE and to determine how frequently diagnosis is not made during life.

Long-term survival of salvage cardiac transplantation for infective endocarditis.

Cardiac transplantation has been rarely performed in patients with infective endocarditis. A 31-year-old man developed aortic endocarditis due to Brucella melitensis. He presented with fever and developed acute myocardial infarct, severe aortic regurgitation, and heart failure.

Pulmonary infectious diseases in patients with primary immunodeficiency and those treated with biologic immunomodulating agents.

Purpose Of Review: Lung infectious disease is an important cause of morbidity and mortality in patients with primary immunodeficiencies and other conditions that alter immunologic mechanisms against microbial invasion. Lung infectious diseases occurring in patients with congenital immunodeficiency and patients on treatment with biologic anti-inflammatory compounds are discussed. Understanding of the complex relationships between the immune system and microbes is of paramount importance for timely diagnosis and successful treatment of lung infectious diseases in this group of immunocompromised hosts.

"Ophthalmia Venerea": A dreadful complication of fluoroquinolone-resistant Neisseria gonorrhoeae.

Infections caused by quinolone-resistant Neisseria gonorrhoeae are increasing worldwide. Although mostly mild and uncomplicated, serious infections causing severe morbidity are occasionally observed. We report 2 cases of sexually transmitted keratoconjunctivitis in adults resulting in severe visual disturbance.

Factors determining serologic response to treatment in patients with syphilis.

Background: The goal of this study was to describe the clinical and epidemiologic manifestations of a syphilis outbreak in downtown Madrid, Spain. Because human immunodeficiency virus (HIV)-positive patients may be at increased risk of serologic failure during syphilis treatment, analysis of factors determining the response to treatment was performed in a cohort of HIV-positive and HIV-negative patients with syphilis.

Methods: We performed a longitudinal, retrospective study of patients with syphilis who received the diagnosis at a university-affiliated hospital in Madrid from 2003 through 2007.

Spontaneous epidural abscess: analysis of 15 cases with emphasis on diagnostic and prognostic factors.

Purpose: To describe the incidence and characterize the clinical manifestations, diagnosis and outcome of spontaneous epidural abscess (SEA) not associated with neurosurgical procedures or instrumentation of the spine.

Methods: Review of cases of SEA over 10 years. Diagnosis was made by imaging-techniques and surgical examination.

Nodular lung schistosomiais lesions after chemotherapy for dysgerminoma.

We report an unusual case of pulmonary schistosomiasis in a traveler to Mali that was diagnosed 16 months after primary infection, one month after she finished chemotherapy for a malignant tumor. Serologic analysis showed marked eosinophilia. Our case emphasizes the need to detect parasitic infections in cancer patients with unexplained eosinophilia, particularly in immigrants and travelers to tropical countries.

Surgical treatment of prosthetic valve endocarditis in patients with double prostheses: is single-valve replacement safe?

Objective: Bias against operating on patients with prosthetic valve endocarditis (PVE) who have multiple prostheses may preclude the use of life-saving valve replacement. We investigated the accuracy of the preoperative diagnosis of PVE in patients with both mitral and aortic prosthesis and the safety of single-valve replacement when only one valve seemed infected.

Methods: Patients with a diagnosis of active PVE who had mitral and aortic prosthesis in place were assessed.

Endocarditis caused by Staphylococcus aureus: A reappraisal of the epidemiologic, clinical, and pathologic manifestations with analysis of factors determining outcome.

Staphylococcus aureus is the leading cause of infectious endocarditis and its mortality has remained high despite better diagnostic and therapeutic procedures over time. We conducted a retrospective review of 133 cases of definite S. aureus endocarditis seen at a single tertiary care hospital over 22 years to assess changes in the epidemiology and incidence of the infection, manifestations, outcome, risk factors for mortality, and impact of cardiac surgery on prognosis.

Enterococcal endocarditis on native and prosthetic valves: a review of clinical and prognostic factors with emphasis on hospital-acquired infections as a major determinant of outcome.

Enterococci are the third leading cause of infectious endocarditis, and despite advances in diagnosis and treatment, the mortality of enterococcal endocarditis has not changed in recent decades. Although variables such as advanced age, cardiac failure, and brain emboli have been recognized as risk factors for mortality, cooperative multi-institutional studies have not assessed the role of other variables, such as nosocomial acquisition of infection, the presence of comorbidities, or the changing antimicrobial susceptibility of enterococci, as factors determining prognosis.We conducted the current study to determine the risk factors for mortality in patients with enterococcal endocarditis in a single institution.

Long term failure of miltefosine in the treatment of refractory visceral leishmaniasis in AIDS patients.

We carried out a retrospective and descriptive study of 4 HIV infected patients with relapsing visceral leishmaniasis (VL) seen at 2 tertiary-care hospitals in Spain during the last 6 y, in whom miltefosine was used as a compassionate use treatment at a dosage of 50 mg b.i.d.

Endovascular repair of mycotic aneurysms of the aorta: an alternative to conventional bypass surgery in patients with acute sepsis.

Treatment of mycotic aneurysms of the aorta includes excision of infected tissue followed by anatomic or extra-anatomic bypass. However, operative mortality remains high particularly in elderly patients with comorbidities. We describe here 2 patients with mycotic aneurysms of the descending aorta in whom endovascular repair was successfully performed.