<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1996-3696</journal-id>
<journal-title><![CDATA[Revista del Instituto de Medicina Tropical]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Inst. Med. Trop.]]></abbrev-journal-title>
<issn>1996-3696</issn>
<publisher>
<publisher-name><![CDATA[Instituto de Medicina Tropical]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1996-36962017000100027</article-id>
<article-id pub-id-type="doi">10.18004/imt/201712127-31</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Caso Clínico de Osteomielitis por Mycobacterium abscessus]]></article-title>
<article-title xml:lang="en"><![CDATA[Clinical Case of Mycobacterium abscessus Osteomyelitis]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Araya]]></surname>
<given-names><![CDATA[Soraya]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Acuña]]></surname>
<given-names><![CDATA[José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Troche]]></surname>
<given-names><![CDATA[Avelina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sanabria]]></surname>
<given-names><![CDATA[Gabriela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arbo]]></surname>
<given-names><![CDATA[Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Católica Nuestra Señora de la Asunción  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto de Medicina Tropical Servicio de Pediatría ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto de Medicina Tropical Dirección de Investigación y Docencia ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>07</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>07</month>
<year>2017</year>
</pub-date>
<volume>12</volume>
<numero>1</numero>
<fpage>27</fpage>
<lpage>31</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S1996-36962017000100027&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S1996-36962017000100027&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S1996-36962017000100027&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[ Caso Clínico: El 14 de setiembre del año 2016, fue remitido al departamento de Urgencias del Instituto de Medicina tropical, un escolar de sexo masculino de 6 años de edad, procedente de Eusebio Ayala, cuyos antecedentes fueron relatados por la madre y se detallan a continuación. Lesión en planta del pie derecho, por objeto punzo cortante, de 42 días de evolución acompañado de tumefacción e impotencia funcional que impide la deambulación, desde el inicio del cuadro. Temperatura de 38 ºC 30 días antes de su ingreso, la cual persistió hasta la fecha, medicado con paracetamol e ibuprofeno por tiempo prolongado (1 mes) con los que cedía parcialmente. Al inicio del cuadro la madre acudió al hospital de Caacupé donde indicaron al niño Ibuprofeno, no cediendo el cuadro, posteriormente acudió a un centro médico privado donde le prescribieron cefalexina (500 mg) 5 cc vía oral cada 6 hs por 7 días, ante la falta de mejoría acudió nuevamente a otro centro privado donde le indicaron tratamiento con Amoxicilina- Sulbactam vía oral y TMP - SMX vía oral por 14 días. El traumatólogo del servicio ante la sospecha de Osteomielitis en pie derecho le realizo un toilette quirúrgico, en cuyo acto quirúrgico se tomó muestra de material purulento para cultivo cuyo resultado estaba pendiente). Se solicitó interconsulta a un infectólogo quien indico tratamiento parenteral con ciprofloxacina, clindamicina, amikacina y claritromicina por vía oral, hasta retorno del informe final del cultivo. Ante persistencia del cuadro y falta de medios económicos, el paciente fue remitido a nuestro servicio para manejo y seguimiento.  Antecedentes patológicos personales: Niega cuadro similar anterior, niega internaciones previas, sin patologías de base]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Clinical Case: On September 14, 2016, a 6-year-old male student from Eusebio Ayala was referred to the emergency department of the Tropical Medicine Institute, whose records were reported by the mother and detailed continuation. Injury in the right sole of the foot, due to sharp cutting, of 42 days of evolution accompanied by swelling and functional impotence that prevents ambulation, from the beginning of the picture. Temperature of 38 ºC 30 days before admission, which persisted to date, medicated with acetaminophen and ibuprofen for a prolonged time (1 month) with which it partially ceded. At the beginning of the study, the mother went to the Caacupé hospital where the child was given ibuprofen, not giving up the picture, then went to a private medical center where they prescribed cefalexine (500 mg) 5 cc orally every 6 hours for 7 days, before Lack of improvement returned to another private center where they were treated with Amoxicillin-Sulbactam oral and TMP-SMX oral for 14 days. The traumatologist of the service before the suspicion of Osteomyelitis in the right foot made a surgical toilette, in which surgical act was sample of purulent material for crop whose result was pending). Interconsultation was requested from an infectologist who indicated parenteral treatment with ciprofloxacin, clindamycin, amikacin and clarithromycin orally until the final culture report was returned. With persistence of the picture and lack of financial means, the patient was referred to our service for management and follow-up.  Personal pathological history: Deny previous similar picture, deny previous hospitalizations, no basic pathologies]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[pediatría]]></kwd>
<kwd lng="es"><![CDATA[infección]]></kwd>
<kwd lng="es"><![CDATA[osteomielitis]]></kwd>
<kwd lng="en"><![CDATA[pediatrics]]></kwd>
<kwd lng="en"><![CDATA[infection]]></kwd>
<kwd lng="en"><![CDATA[osteomyelitis]]></kwd>
</kwd-group>
</article-meta>
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