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Biomedical subjects

M Miguélez

Publications and source records attributed to M Miguélez.

17 recordsLinked to original sources
PubMed1999

[Lumbosacral polyradiculomyelitis caused by herpes simplex virus (HSV) in a patient with AIDS].

To our knowledge this is the first description of lumbosacral polyradiculopathy produced by herpes simplex virus (HSV) without coinfection by cytomegalovirus (CMV) in a patient with HIV infection. The acute lumbosacral polyradiculomyelitis (ALP) in patients with AIDS is a well defined nosologic entity and classically associated to CMV infection. However, this pathology can be due to others etiologies as toxoplasmosis, syphilis, lymphoma, tuberculosis, cryptococcus, varicella-zoster virus fVZV), Epstein-Barr virus (EBT) and HSV associated CMV. The case report was documented with findings in cerebrospinal fluid, magnetic resonance imaging and was confirmed by detection of HSV DNA by polymerase chain reaction. CMV DNA was not detected and no clinical features of CMV disease was seen. Therapy with foscarnet was successful. This drug without gancyclovir associated has rarely been employed in the treatment of ALP. We believe that foscarnet may be a valuable alternative therapy for cases of ALP of suspected acyclovir-resistant herpes virus infection.

AIDS-Related Opportunistic Infections↗
PubMed1998

[Invasive fungal infections in liver transplant recipients: analysis of 21 cases].

BACKGROUND: Invasive fungal infections (IFI) are one of the most important causes of mortality in liver transplant (LT) recipients. The aim of this study was to describe the characteristics of IFI in the LT program of our institution with an special emphasis in the differences between Candida infections (CI) and that caused by other fungi (NCI). PATIENTS AND METHODS: Retrospective analysis of the hospital charts of 21 patients who underwent a LT from February 1987 to December 1995. The diagnosis of IFI required the histological evidence of tissue invasion or a positive culture in a tissue sample or in an usually sterile fluid. Esophageal candidiasis was not considered as IFI. Antifungal prophylaxis was performed either with nystatin or fluconazole. RESULTS: Twenty-one of 356 patients (6%) developed a total of 23 episodes of IFI. Pathogens were Candida spp. (n = 10), Aspergillus (n = 8), Zygomicetes (n = 4) and Cryptococcus (n = 1). Fifty-seven percent of the episodes of IFI (80% of those caused by Candida and 38% of those produced by other fungi; p < 0.05) developed in the first 3 months after transplantation and only 5 episodes appeared after the sixth month. The diagnosis of IFI was done at autopsy in 6 patients (29%). Overall, NCI (13 episodes) predominated over CI (10 episodes), being the later the cause of the 54% of the episodes in the first 178 recipients but only the 30% in the last 178 patients (p = 0.09). No differences were found in the distribution of the risk factors amongst those patients with CI or NCI. Seventeen of the 21 patients (71%) died and 15 of these deaths (72%) were attributable to fungi; 15 patients who died either did not receive amphotericin (n = 6) or received a cumulative dose lower than 500 mg. Six patients received a cumulative dose of more than 1.5 g (mean, 3.2 g) and four of them were cured. Mortality in the nonfungal infection group was 26% (p < 0.001). CONCLUSIONS: IFI was a rare but severe complication in our LT recipients. The relative frequency of CI was progressively decreasing during the study period, being NCI the predominant infections. Amphotericin therapy was effective only when a high cumulative dose could be administered.

Adult↗
PubMed1996

[Human babesiosis in a patient after splenectomy].

A case of human babesiosis in a 34-year-old male patient with previous splenectomy is reported. This is the first description of babesiosis in a splenectomized patient in Spain. The clinical picture was mainly characterized by the presence of fever and hemolysis. The findings of a reactive hemophagocytic syndrome and lymph node enlargement, the description of which is exception in this entity are of note. The therapeutic aspects are reported emphasizing the good response to treatment with clindamycin and quinine sulphate which is unusual in the splenectomized cases reported in Europe. The diagnostic tods as well as the epidemiologic implications of the description of this zoonosis in Spain are discussed.

Adult↗