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Resumen ANTECEDENTES: El micetoma es una infección causada por hongos y actinomicetos aeróbicos. Es un padecimiento frecuente en México, con mayor afectación en hombres que en mujeres (3:1). Se caracteriza por aumento de volumen, deformidad del sistio de lesión y formación de fístulas. OBJETIVO: Reportar un caso de actinomicetoma durante el embarazo y analizar el protocolo de tratamiento. CASO CLINICO: Paciente de 29 años de edad, en su cuarto embarazo, con 29 semanas de gestación. El padecimiento se inició 13 años atrás, con dermatosis localizada en la extremidad inferior izquierda, constituida por un nódulo indoloro, que permaneció sin cambios hasta el inicio de la gestación actual, cuando le aparecieron múltiples lesiones nodulares y fístulas. En el examen directo de la secreción se observaron granos y en el cultivo se identificó Nocardia brasiliensis. Después del embarazo a término y con recién nacido sano, si indicó lactancia durante 4 meses y se interrumpió para prescribir bromocriptina. La dermatosis se extendió al doble, sin afectación ósea; se indicó tratamiento con sulfametoxazol-trimetoprima y dapsona. El tiempo total de tratamiento fue de 15 meses y seguimiento sin medicación durante un año. Se obtuvo curación clínica y microbiológica. CONCLUSIONES: El micetoma en mujeres embarazadas es excepcional. La mayor parte de los portocolos de tratamiento deben contraindicarse durante el embarazo. Cuando el micetoma se localiza en una zona que no afecta otros órganos ni se extiende, se sugiere continuar el embarazo y la lactancia sin prescripción de medicamentos pero iniciarla posterior al nacimiento.

Abstract BACKGROUND: Mycetoma is an infection caused by fungi and aerobic actinomycetes. It is a frequent condition in Mexico; it presents less in women than men (1:3). It is characterized by increased volume deformity of the region and sinuses. OBJECTIVE: We present a case of actinomycetoma in a pregnant patient and to analyze the behavior in its therapeutic management CLINICAL CASE: We present female, 29 years old, attending her fourth pregnancy at 29 weeks of gestation. It began 13 years ago with a localized dermatosis of the lower left limb, constituted by a painless nodule, remained unchanged until the beginning of the current gestation, developed multiple nodules and sinuses. A direct examination of the secretion was performed, observing grains, Nocardia brasiliensis was identified. After product birth, lactation was allowed for 4 months and discontinued with bromocriptine. The dermatosis extended to double without bone affection, treatment with sulfamethoxazole/trimethoprim + dapsone was given. Total time was 15 months and follow-up without medication for one year. Clinical and microbiological cure was achieved. CONCLUSIONS: The development of mycetoma in pregnant women is rare, it is important to know the etiology, in eumycetoma all the antimycotics are teratogenic and in actinomycetoma most antibiotics cannot be used in pregnancy with some exceptions. If mycetoma is located in an area that does not compromise other organs or does not spread it is best to leave the course of pregnancy and lactation and then start treatment.

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It's a report of a case of abdominal pregnancy of 36.3 weeks, at Hospital General de México and obtained a male newborn child, weight 1.920 grammes, Apgar 2/5/7 and Capurro of 36.3 weeks. Statistics, clinical manifestations and management are described.

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To know the situation of the toxoplasmosis in Comitán Chiapas, we made a serological indirect inmunofluorecent antibody test (IFA) to the population of this city and to fifty women with abortion in evolution. The results show us that around five percent of the population in general have positive title of antitoxoplasma gondii antibiodies, and 18% in the women with abortion evolution case. The statistics concluded that seropositive for this parasitic disease is real higher between cases of abortion than population in general (P < 0.006), as well as it is significantly higher in abortion cases than women of the general population of Comitán Chiapas (P < 0.01).

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Since 70 years ago, the possibility that the etiology of Gravidic Toxemia is inmunologic has been studied. Several researchers agree in the disminution of the levels of IgG with no modifications on the levels of complement fractions. The determination of IgA, IgM, IgC, C3 and C4 was made on fifteen pacients with gravidic toxemia and fifteen pacients that presented no complicated pregnancy. The results are the same as the reported facts like disminution of IgG, it was observed also, a disminution on the complement fractions C3 and C4. The research let us stabblish the posibility of a sikness caused by immune complexs having as an antigenic stimulations the trofoblast.

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Benign tumors of smooth muscle are relatively common in the genitourinary and gastrointestinal tracts. Retroperitoneal leiomyoma is a rare. A case of a 37 year old woman with diagnostic of leiomyoma of the uterus with the finding of retroperitoneal leiomyoma is presented.

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La toxemia gravidica ocurre como complicacion del embarazo, se inicia en la 26 semana de gestacion, se caracteriza por edema, hipertension arterial y proteinuria, la causa se desconoce, desde hace 70 anos se sospecha que sea inmunologica. Los cambios inmunologicos que se han encontrado son los siguientes: disminucion de IgG, disminucion de celulas T, presencia de complejos inmunes IgG, IgM y complemento en el glomerulo y anticuerpos trofoblasticos en suero. En el presente trabajo se estudiaron 30 pacientes: 15 con toxemia gravidica y 15 con embarazo normal, en estas no se encontro variacion de la IgG, IgA, IgM y la fraccion C3 del complemento la C4 se encontro baja en el 57%. En las pacientes con toxemia gravidica no se encontro variacion de IgM e IgA, en cambio se encontro una baja de IgG en el 70% y C3 y C4 se encontro disminuida en un 70%

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