Extirpación de adenoma paratiroideo mediastínico mediante videotoracoscopia radioguiada por sonda gamma. Presentación de un caso

We present a case of primary hyperparathyroidism in a 47 year old woman. The pre-operative 99mTc-sestaMIBI scan detected a single parathyroid adenoma located in the anterior or medium mediastinum. Surgery was carried out following 99mTc-sestaMIBI administration and using gamma probe radio-guided video-assisted thoracoscopy. The aim of this case report is to present this technique that allows adenoma resection with minimally invasive surgery. A reduction of surgical complications and an increase in the probability of surgical success could be obtained.

[Soft tissue infections with S. Lugdunensis. Presentation of 2 cases and general review]

Staphylococcus lugdunensis was first described in 1988 by Freney et al. Since that moment, it has been recognised as an important cause of endocarditis that is able to involve native valves and follow an aggressive, often fatal course. By now, we know only few potential virulence factors, but its ability to produce a wide range of human infections, varying from life threatening (such us endocarditis) to more benign ones, is unquestionable. Unlike other coagulase negative Staphylococci, S. lugdunensis is frequently implicated in soft tissue infections and affects commonly persons with clinical antecedents of neoplastic diseases. We report two new cases of deep tissue abscesses in patients that had history of uterine tumours. In both occasions we isolated coagulase negative Staphylococci that were markedly susceptible to all the antimicrobial agents tested. It is relevant to perform a detailed microbiological study in order to avoid misidentification of this species, since it differs significantly from other coagulase negative ones and may lead to important morbidity--and even mortality--. There are great differences in the rates of resistant strains between countries and, up-to-date, the lack of antibiotics susceptibility seems not to be a serious problem in Europe if we compare with the 30% american strains that are resistant via production of beta-lactamase.