A consensus defi nition of internal medicine and the internist L as especialidades médicas surgen basadas en diferentes criterios: sistemas, edades, género, enfermedades o tecnologías 1,2 . La Medicina Interna (MI), especialidad básica de la Medicina se refería a la disciplina que enfrentaba problemas de los órganos internos que el cirujano no podía abordar. Actualmente, cirujanos e internistas abordan patologías "externas" e "internas" y, aunque el nombre persiste, estaría obsoleto. El primer texto de medicina interna fue publicado por el médico alemán J. von Mering, en 1901 ("Lehrbuch der Inneren Medizin") 3 . Internal Medicine is a basic clinical specialty in Medicine, but due to it's vast fi eld of action it is quite diffi cult to defi ne. This consensus article analyzes different defi nitions and proposes a current defi nitionComo toda especialidad, cambia permanentemente; Sir W. Osler, uno de los padres de la medicina interna 4 , consideraba las necropsias parte de la MI. Una encuesta del American College of Physicians (ACP) a 990 internistas generales (IG) mostró que entre 1986 y 2004 disminuyó el número y variedad de procedimientos realizados por IG; procedimientos como paracentesis, tóra-cocentesis y punciones lumbares que realizaban la mayoría de los IG, el 2004 sólo las realizaban la cuarta parte de ellos 5,6 .Su amplitud también genera confusión en la sociedad.
Caso Clínicowww.sochinf.cl 363Tumor cervical por Salmonella Typhimurium como forma de presentación clínica de SIDA en un paciente con infección por VIHSebastián Paredes E., Constanza Norambuena N., Sylvia Echavarri V. y Martín Lasso B.Cervical mass caused by Salmonella Typhimurium as a clinical presentation of AIDS in a HIV-positive patientInfections due to non-typhi salmonellae (NTS) generally cause a mild and self-limited gastrointestinal disease. However, there have been reports of atypical and severe presentations in immunocompromised patients. We report the case of a male patient who consulted with a cervical mass. He was found to be HIV-positive and Salmonella Typhimurium was isolated in one blood culture and cervical mass tissue culture. We discuss the relevance of infections by NTS in immunodefi cient patients because they present with more severe illness than normal population. We emphasize the importance of NTS bacteremia as a marker of underlying immunodefi ciency. We present some localized infection sites reported in the literature and their relation with particular diseases. We discuss the future relevance that an early start of antiretroviral therapy (ART) may have in HIV patients with NTS acute bacteremia or focal infections. Because infections by NTS can be severe and highly lethal they must be considered in the differential diagnosis of causative organisms of localized infections and bacteremia in HIV patients.
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