Acute hematogenous osteomyelitis is an inflammatory process in the bone tissue. It's usually of bacterial etiology, caused by a contiguous infection focus. In pediatric patients, the main isolated pathogen is Staphylococcus aureus. Salmonella spp. as a causative agent of osteomyelitis is infrequent; it can be found in less than 1% of the casesand it is generally associated with risk factors. We analyze the case of a 4 years old male patient known to be healthy, who enters the emergency service with a 2 weeks of increasing fever and difficulty when walking. Upon physical examination, he presented acute pain, edema and a local increased temperature in the right ankle. He was hospitalized for suspicion of septic arthritis and he was treated empirically with clindamycin. Positive cultures were reported for Salmonella spp, isolated from blood and a tibia's secretion sample. The betalactambased approach, specifically third-generation cephalosporins, is recommended in international treatment guidelines, so the success of the use of ampicillin was expected. Thus, identifying the etiological agent of the infectious process is determinant in the success of antibiotic therapy, as well as the joint approach of the medical personnel and the laboratory service.
Malaria is one of the most important parasitic diseases in the world. It is caused by parasites of the genus Plasmodium sp., which enter humans through the bite of mosquitoes of the genus Anopheles. Automated hematology analyzers based on flow cytometry have been widely used to aid in the diagnosis of malaria, based on the existence of alterations in the scatter plots that suggest the presence of parasites of the genus Plasmodium. The case of a 55-year-old male patient is presented, worker from a Costa Rican rural zone, correlating the alterations in channel DIFF and WBC/BASO of the Sysmex XT-1800i® hematological analyzer with what was found in the thick drop. The objective of this case report is to demonstrate the utility of hematological analyzers in the detection of relapses, reinfections and follow-up in patients diagnosed with malaria.
In recent years, literature has reported a relation between Periodontal Disease and Cardiovascular Disease. Periodontal diseases can influence the onset and/ or progression of a systemic disease; therefore, to know the actors involved in it, demonstrating its presence in cardiovascular diseases, has been fundamental. This descriptive review aims to present the latest studies that evidence the importance of this epidemiological relation and how the mechanisms that act as aggravating factors in cardiovascular diseases have been enlightened. Understanding and studying this relation in the Costa Rican context could generate great benefits to the public health of the country.
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