<?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>1727-897X</journal-id>
<journal-title><![CDATA[MediSur]]></journal-title>
<abbrev-journal-title><![CDATA[Medisur]]></abbrev-journal-title>
<issn>1727-897X</issn>
<publisher>
<publisher-name><![CDATA[Universidad de Ciencias Médicas de Cienfuegos, Centro Provincial de Ciencias Médicas, Provincia de Cienfuegos.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1727-897X2022000400760</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Osteomielitis crónica como evidencia de una fuente de sepsis no controlada. Presentación de un caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Chronic osteomyelitis as evidence of a source of uncontrolled sepsis. A case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Uriarte Méndez]]></surname>
<given-names><![CDATA[Ariel E.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Capote Padrón]]></surname>
<given-names><![CDATA[Jorge L.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Requeiro Molina]]></surname>
<given-names><![CDATA[José Julio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Kauteks Pardiñas de León]]></surname>
<given-names><![CDATA[Lioby]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Pediátrico Universitario Paquito González Cueto  ]]></institution>
<addr-line><![CDATA[Cienfuegos ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2022</year>
</pub-date>
<volume>20</volume>
<numero>4</numero>
<fpage>760</fpage>
<lpage>766</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1727-897X2022000400760&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1727-897X2022000400760&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1727-897X2022000400760&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN La sepsis y el shock séptico son problemas importantes de salud, que afectan a millones de personas en todo el mundo y tienen una elevada letalidad. El control de la fuente de infección es uno de los aspectos fundamentales para lograr el éxito en el tratamiento. Una vez sospechada la sepsis como síndrome, se deben realizar todas las pruebas para identificar el sitio primario de origen y recurrir a los equipos de especialistas necesarios. El objetivo de este trabajo es transmitir las experiencias derivadas de la atención de una lactante cuyo diagnóstico de shock séptico se hizo de manera retrospectiva al descubrir osteomielitis crónica del extremo distal del fémur derecho como fuente primaria de infección no diagnosticada. La paciente se recibió en la unidad de cuidados intensivos pediátricos con disfunción de varios órganos. El diagnóstico se enfocó al principio hacia una miocarditis aguda viral, pero cuatro semanas después se diagnosticó una osteomielitis con criterios de cronicidad. El análisis retrospectivo hizo descartar el diagnóstico anterior y plantear una osteomielitis aguda como desencadenante de un shock séptico, cuadro de inicio solapado, pero que casi comprometió la vida de la paciente. En presencia de un cuadro sospechoso de sepsis se debe buscar de forma exhaustiva la presencia de una fuente de infección. Dada su frecuencia, la osteomieltis hematógena aguda debe ser tenida en cuenta.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT Sepsis and septic shock are major health problems that affect millions of people worldwide and have a high lethality. The infection source control is one of the fundamental aspects to achieve success in treatment. Once sepsis is suspected as a syndrome, all tests should be performed to identify the primary site of origin and the necessary specialist teams should be used. The objective of this work is to transmit the experiences derived from the care of an infant whose diagnosis of septic shock was made retrospectively when chronic osteomyelitis of the distal end of the right femur was discovered as a primary source of undiagnosed infection. The patient was admitted to the pediatric intensive care unit with multi-organ dysfunction. The diagnosis initially focused on acute viral myocarditis, but four weeks later osteomyelitis was diagnosed with chronicity criteria. The retrospective analysis ruled out the previous diagnosis and suggested acute osteomyelitis as the cause for septic shock, a clinical picture that began in a hidden way, but which almost compromised the patient's life. In the presence of a suspicious case of sepsis, the presence of a source of infection should be exhaustively searched. Given its frequency, acute hematogenous osteomyelitis should be taken into account.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[osteomielitis]]></kwd>
<kwd lng="es"><![CDATA[sepsis]]></kwd>
<kwd lng="es"><![CDATA[informes de casos]]></kwd>
<kwd lng="en"><![CDATA[osteomyelitis]]></kwd>
<kwd lng="en"><![CDATA[sepsis]]></kwd>
<kwd lng="en"><![CDATA[case reports]]></kwd>
</kwd-group>
</article-meta>
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