Investor Presentaiton
IJMS
INTERNATIONAL JOURNAL of
MEDICAL STUDENTS
XXVI CECIM
S14
Abstracts
Abstracts
caused actually by G. sanguinis due to the lack of identification of
the latter and the great similarity in morphology and biochemical
test results. The available literature is scarce G. sanguinis. There
has been a case of meningitis associated with G. Sanguinis after
a surgical procedure on a patient 1 year old at the Central Military
Hospital. Case report: Female patient, 1 year old, who came HOMIC
with emesis, irritability, fever, altered state of consciousness and
bulging anterior fontanelle. She have an antecedent of surgical pro-
cedure (endoscopic ventriculostomy), with discharge six days ago
due an adequate evolution. The paraclinics showed a G. sanguinis
(tipification in LCR with StrepⓇ kit). Vancomicin and cefepime is ad-
ministrated to the patient with satisfactory evolution, and discharge.
Conclusion: The meningitis caused by unusual microorganism have a
low frequency, clinicians should be vigilant about that germs, rapid
diagnosis and treatment ensures proper patient recovery and less
serious sequelae.
Keywords: Gram positive cocci, Meningitis, Gram Positive Bacterial
Infections.
04
Sarcoidosis: A Diagnostic Challenge.
Jorge De Jesús Gómez Villa, Belis Teresa González Cogollo,
Danith Judith Estrada Osorio, Omar Enrique Cárdenas Luque,
César Redondo, Karina Ruíz Cáez, Liney Mendoza Suárez.
Scientific Society: Asociación Científica Acta médica de Carta-
gena, ACAMC.
Introduction: Sarcoidosis is a chronic granulomatous disease of unk-
nown cause, histologically characterized by the presence of nonca-
seating granulomas. The course of the disease is variable, presenting
possible remission periods during its evolution. The lungs are the
sites more frequently implied and the most common reason of mor-
bidity and mortality. Its highest incidence rates are in the northern
European countries (5 to 40 cases per 100.000 inhabitants). Case re-
port: 50-year-old feminine patient, to whom an incidental finding of
hepatic nodules is made during cholecystectomy, which are biopsied
with a histopathology result of chronic granulomatous inflammation.
In subsequent consultations, patient reports clinical picture of diffi-
culty breathing, cough and diffuse abdominal pain. A thoracoabdo-
minal CT is ordered, with a final report that demonstrates multiple
nodules with predominance of the right lung. Clinical impressions
are made of malignant neoplasia of lung, pulmonary tuberculosis
and fewer probable sarcoidosis. A new biopsy of the nodules is per-
formed and it shows noncaseating chronic inflammation, consistent
with infectious process. It was considered appropriate to start anti-
tuberculosis antibiotic treatment with the standard scheme. After 6
months of treatment, the clinical picture persists, and new hysto-
pathologic, histochemical and PCR exams are ordered, concluding
the diagnosis of sarcoidosis. Conclusion: Sarcoidosis is a systemic
disease, a challenge of diagnosis due to its variable morbidity, low
incidence and geographical distribution. Other more frequent patho-
logies, like infections or malignancies, must be ruled out and specific
studies should be done to reach the diagnosis of this illness.
Keywords: Diagnosis, granuloma, inflammation, multiple lung nodu-
les.
05
Cerebrovascular Events In Young Patients: Coexisting With
Acquired Thrombophilia.
Santiago Loaiza Betancurt, Lisceth Paola Quintero González,
Aída María Gonzáles Correa.
Scientific Society: Asociación Científica de Estudiantes de
Medicina de Universidad de Caldas, ACEMCAL.
Introduction: The strokes acquire a major epidemiologic importance
in patients over 65 years old and associated to heart and metabolic
diseases. Nevertheless, this type of events in patients under 30 years
old, is usually associated to other etiologies, like acquired prothrom-
botic disorders such as Antiphospholipid Syndrome. Case report: In
this particular case, the patient is a young woman with 18 years
old, and she has experienced two clinical episodes compatible with
a stroke, the first of them involved headache and right paresis; the
second event occurred two months later, consisting of palpitations
and right paresis as well. At her physical examination, the malar rash
or "butterfly rash" is notable, referred as constant since two years
ago by the patient. After the first described event, several studies
were performed in order to establish its etiology, like a Holter that
showed alterations compatible with Variable Atrial Fibrillation, which
encourages the start of anticoagulation with Rivaroxaban, besides
Amiodarone. Likewise, in order to find an underlying autoimmune
disorder, different specific blood antibodies are measured, finding
high titers of lupus anticoagulant and IgG anti-ẞ2-glycoprotein, and
a more extended partial thromboplastine time. Conclusion: This par-
ticular case becomes interesting given the pharmacological control
of the cardiac arrhythmia when the second stroke occurred, making
more likely the coexistence of a prothrombotic disorder that had
triggered the event; likewise one of the main goals is establishing an
anticoagulation scheme that shall be effective for both pathologies.
Keywords: Anticoagulation, antiphospholipid syndrome, atrial fibri-
llation.
06
Umbilical Myiasis In A Neonate From Colombia, Case Report
Juan David Ruiz Zapata, Luis Mauricio Figueroa Gutiérrez,
Jaime Alberto Mesa Franco.
Scientific Society: Asociación Científica de Estudiantes de
Medicina de Risaralda, ACEMRIS.
Introduction: Myiasis is the infestation in live vertebrate animals,
including humans, with dipterous larvae. It is distributed around
the world in tropical areas with low socio-economic levels and pre-
sence of cattle. Neonatal umbilical myiasis is an important cause of
death in bovines and produces major economic losses in livestock.
However, its presentation in humans is rare, with 9 cases reported
worldwide. Case report: A 7 days old newborn was taken to the
hospital because she had sero-hematic discharge, foul smelling and
visualization of larvae in the umbilical stump. On admission, a blood
test showed leukocytosis, and two blood cultures at admission and
48 hours later were negative. The umbilical stump was covered with
gauze soaked in ivermectin and nitrofurazone. Due to the risk of
late onset sepsis, intravenous oxacillin and gentamicin were admi-
nistered. In total, 55 larvae were removed from the wound and the
patient recovered without complications. The causative agent was
identified as Cochliomyia hominivorax. Conclusion: Cochliomyia ho-
minivorax is an obligated parasite in its larval state, which invades
open wounds and can penetrate deeply, causing tissue destruction
and peri-lesional inflammation that facilitates bacterial superinfec-
tion. Umbilical myasis is especially dangerous because of the risk of
migration to deeper tissues, omphalitis and sepsis. The management
of this disease includes the administration of antiparasitics, applying
toxic substances to facilitate the larvae extraction and antibiotic
treatment for the prevention of secondary infections.
Keywords: Cochliomyia, neonate, umbilicus.
07
Flu-Like Syndrome In A Patient With Antitubercular Therapy
Andrés Gaviria Mendoza, Nini Johana Erazo Bravo, Andrés
Gaviria Mendoza, Jorge Enrique Machado Alba.
Scientific Society: Asociación Científica de Estudiantes de
Medicina de Risaralda, ACEMRIS.
Introduction: The flu-like syndrome is a clinical state characterized
by fever, malaise, headache, myalgia and vomiting that can be ge-
nerated by different infectious agents or drugs, including interfe-
ron, bisphosphonates and levamisole. A case of flu-like syndrome
induced by antitubercular therapy in a first level hospital (Pereira,
Colombia) is presented. Case report: A 69 years-old man, living in
crowded conditions in urban area of Pereira. He had presented cough
with purulent sputum, fatigue and night sweats for 4 months. Se-
rial sputum smear was reported as positive. Treatment began with
Rifampicin + Isoniazid + pyrazinamide + ethambutol, three tablets
daily. Three hours after consumption of antitubercular treatment the
patient presents with malaise, chills, vomiting and fever. The next
day he reported improvement of his condition, but upon taking the
second therapy dose, the referred symptoms recurred. Considering
that the flu-like syndrome has been described as an adverse reac-
tion to antitubercular therapy (especially rifampin), the chronologi-
cal relationship of symptoms with intake/re-administration of drugs
and improvement of the case when consumption was avoided, the
diagnosis of flu-like syndrome was done. Conclusion: The flu-like
syndrome is a rare entity that must be promptly identified to seek al-
ternative therapies and avoid hindering the diagnosis, management
and the patient adherence to pharmacotherapy.
Keywords: Adverse Drug Reaction, Flu-like syndrome, Pulmonary tu-
berculosis, Rifampin, Therapeutics.
08 Massive Empyema By Streptococcus Constellatus, Case Re-
port
Felipe Vera Polanía, Julián Andrés Hoyos Pulgarín, Alexander
Alzate.
Scientific Society: Asociación Científica de Estudiantes de
Medicina de Risaralda, ACEMRIS.
Introduction: Streptococcus constellatus is a member of the group
now called Streptococcus anginosus, which includes 3 species. These
microorganisms are considered normal flora of the mouth, throat,
gastrointestinal and genitourinary tracts, but can cause opportunistic
infections such as pharyngitis, bacteremia and have been associated
with serious purulent infections. In this paper the case of a patient
with an unusual presentation of infection by S. constellatus with
multiorgan involvement is described. Case report: Presents the case
of an adult male patient with no relevant medical history who pre-
sented to emergency department with nonspecific abdominal pain,
whose laboratory test results show an important systemic inflamma-
tory response and in whom is achieved to establish Streptococcus
constellatus spp constellatus, with radiographical evidence of mul-
tiorgan abdominal engagement, with poor response to medical and
surgical management. Conclusion: As this is the first case report of
infection by S. constellatus found in the national literature is deci-
ded describe for the unusual presentation of massive empyema and
severe septic shock, so that future studies be undertaken to enable
facilitate early recognition of this disease, assess risk factors and
prognostic factors.
Keywords: Streptococcus constellatus, Gram-Positive Bacterial Infec-
tions, Gram-Positive Bacteria, Empyema, Septic Shock.
09
Urofacial Ochoa's Syndrome (UFOS): A Case Report Of 16
Years of Clinical Evaluation In Medellín, Colombia.
Pérez Velásquez Camilo Andrés, Osorio Rico Sebastián, Quin-
tero Vanegas Santiago, Cristian David Ramírez Lujan, Laura
Elisa Villegas Sierra, Paul Bryan Vélez Taborda.
Scientific Society: Asociación de Estudiantes de Medicina de
la Universidad de Antioquia, ASCEM-UDEA.
Introduction: The Urofacial Ochoa's Syndrome (UFOS) is characteri-
zed by inversion of facial expression and bladder dysfunction, spe-
cifically non neurogenic neurogenic bladder without any obstructive
abnormality. There have been reported about 100 cases of this syn-
drome and according to researches the mutation of the gene that
is associated with the symptoms has been mapped to chromosome
10923-924. This syndrome is recessively inherited. Case report: A
case of an 18-year old young man with urofacial syndrome is repor-
ted. He was diagnosticated at 2 years of age because of absence of
bladder and bowel control, frequent urinary infections and inversion
of his facial mimic. There was not any familiar antecedent
the syn-
drome present. Based on that, many clinical examinations and diag-
nosis as well as chirurgical procedures have been done. They include
a vesicostomy at age 4, where thick bladder walls were observed, a
barium enema because of the constant constipation, where an alte-
red function of the colon was diagnosticated. A Mitrofanoff procedu-
re was done at age seven as well as a clam ileocistoplasty. At age
10, a renal echography showed mild bilateral hydroureteronephrosis,
which was more severe in the left kidney. Since age 13, the patient
has been stable and presents oliguria, but his paraclinical studies
are within normal limits. Conclusion: His signs and symptoms are
very similar to those observed in the description of the UFOS. He was
clinically diagnosed, so it is important to do genetical and neurop-
sychological studies to him and his family to confirm the diagnosis.
Keywords: Urofacial Ochoa's Syndrome, neurogenic bladder, Elimina-
tion dysfunction.
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2015 Vol 3 Suppl 1
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2015 Vol 3 Suppl 1
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