Las infecciones por Staphylococcus aureus meticilino-resistente adquiridas en la comunidad son cada vez más frecuentes y se deben sospechar en casos de piodermitis u otras infecciones necrotizantes, tanto en niños como en adultos sin factores de riesgo clásicos. Se presenta un brote familiar de piodermitis por Staphylococcus aureus meticilino-resistente adquirido en la comunidad, ocurrido en la ciudad de Valparaíso-Chile, que afectó a una madre de veintiséis años y a su hijo de diez quienes debieron ser tratados con aseo quirúrgico y cotrimoxazol forte, con buena respuesta clínica.

El absceso hepático tiene una baja incidencia, pero alta mortalidad y su diagnóstico suele ser tardío dada la variabilidad de presentaciones clínicas. Presentamos tres casos, todos correspondientes a mujeres, dos de edad avanzada y una adulta joven con insulinoresistencia. Dos se manifestaron con síndrome febril con microbiología no precisada, mientras que el tercero con shock séptico secundario a colangitis, aislándose Escherichia Coli. Todos fueron manejados con antibioticoterapia y drenaje, uno vía laparoscópica y dos percutáneos, uno de estos asociado a CPRE. Se contrastan los datos con la bibliografía disponible, destacando la necesidad de investigaciones actualizadas en Chile.

Introduction: Renal artery embolization (RAE) is a percutaneous procedure that occludes the renal ar-tery, with consequent ischemia of the vascular territory. The most common indications include hematuria and palliation for metastatic renal cancer. Despite technical development and progressive experience, studies include a small number of patients and few cases have been published in our country. Aim: To share our experience at Valparaíso-San Antonio Health Service and to review the existing literature. Materials and Method: We performed a retrospective descriptive review of medical records of patients with severe anemia due to hematuria managed with RAE, between 2012 and 2020. Subsequently, we conducted a literature search in PubMed, from inception until April 2020. Results: We included 9 pa-tients. There were 6 (66.7%) males and 3 (33.3%) females with a median age of 69 years (IQR = 18). Main cause of hematuria was advanced kidney cancer (7 patients). There were no complications and clinical success was achieved in all patients. Our literature search yielded 571 references, 24 met our eligibility criteria. The age of patients and the underlying causes of hematuria were varied. The lowest clinical success rate was 65%, however, 15 studies (62.5%) reported a success equal to or greater than 90%. Six studies reported more than 10% of patients with complications. Conclusion: Our results and the studies reviewed show that RAE appears to be safe and effective in the management of patients with severe anemia due to hematuria.

Reports of Lactococcus garvieae infections in humans are scarce, and only one of them in a patient under-going hemodialysis. We report the first case of Lactococcus garvieae infection in Chile, presenting as an infective endocarditis, ultimately fatal, in a patient with uncomplicated colonic diverticulosis and end stage renal failure undergoing chronic hemodialysis. We review the published cases and discuss the diagnostic and therapeutic challenges associated with this new, increasingly diagnosed pathogen, capable of producing serious infections in susceptible patients.

ABSTRACT No reports about treatments applied by orofacial motricity experts, in craniofacial trauma, were found in the specialized literature. However, their knowledge, added to that of the aesthetic area, would be useful in the rehabilitation of scars. The aim of this work is to describe the mixed use of orofacial motor skills, muscle balance massage and scar management in a patient with soft tissues facial trauma. During the initial evaluation, a decrease in the vertical and horizontal oral opening and in the mimic movements, facial asymmetry and marked scars that affected the oral phase of swallowing, chewing (bolus formation), lip mobility, compromising speech intelligibility and, significantly, aesthetics, were observed. Myofunctional therapy lasted 12 months, during which the patient underwent three surgeries. The process was divided into an intensive phase (six months, two weekly sessions) and a follow-up phase (six months, one weekly session), which ended when the indicators evaluated at the beginning were stable, showing improvements in scars condition and appearance, as well as in orofacial functions, including pre-post therapy self-perception and greater muscular mobility, reflecting a management with an integrative approach.

Takotsubo syndrome is an acute heart disease usually triggered by significant emotional or physical stress, very occasionally described in association with natural disasters such as earthquakes. Clinically, it simulates an acute myocardial infarction with similar symptoms, laboratory tests, and electrocardiographic changes. Coronary angiography shows the absence of significant coronary disease. We report two women, aged 71 and 80 years, and who developed a Takotsubo syndrome after an earthquake. In both, the syndrome was diagnosed with cardiac magnetic resonance imaging.

La tuberculosis es una infección que afecta a millones de personas en el mundo cada año, provocando una alta carga de morbimortalidad. La localización pulmonar corresponde a más del 80 % de los casos. Su diagnóstico y tratamiento aún representa un desafío para los clínicos, especialmente en sus localizaciones extrapulmonares. Presentamos un caso de tuberculosis de muñeca izquierda, la cual fue diagnosticada con biopsia de hueso y tratada de forma exitosa con cuatro drogas por seis meses.

El carcinoma adenoide quístico (CAQ) es una neoplasia maligna de glándula salival, de evolución lenta pero de agresivo comportamiento, que se presenta frecuentemente en el paladar; sin embargo, en el labio superior, donde suelen encontrarse más neoplasias benignas, su presencia es escasamente relatada. Se expone un relato de una mujer de 63 años, derivada por presentar un nódulo en el labio superior derecho, de aspecto benigno, consistencia firme, circunscrito, móvil, doloroso a la palpación, sin tiempo de evolución determinado y cuyo estudio histopatológico exhibió una proliferación de células anguladas e hipercromáticas de escaso citoplasma, organizadas en patrón cribiforme y predominantemente tubular. Se realiza un estudio inmunohistoquímico, el cual mostró positividad para SMA, p63 y CD117 con un Ki-67 del 10 % aproximadamente. Estos resultados confirman diagnóstico de CAQ con patrón tubular, destacando el rol del CD117 para el diagnóstico diferencial con adenocarcinoma polimorfo. Se deriva a la paciente para tratamiento quirúrgico y radioterapia, y luego de un año de seguimiento mantiene un buen comportamiento clínico.