ABSTRACT
La criptococosis es una micosis sistémica oportunista con distribución universal causada por una levadura capsulada. El Cryptococcus neoformans (C. neoformans). C. neoformans infecta al hombre y a animales susceptibles por vía inhalatoria, provocando en huéspedes inmunocompetentes una primoinfección asintomática. Crece preferentemente en ambientes ricos con componentes nitrogenados, principalmente a partir de las excretas desecadas de las palomas que son ricas en nitrógeno y creatinina, con alto contenido en sales y pH alcalino, cualidades que facilitan la supervivencia del hongo. La diseminación hematógena del agente causal provoca múltiples localizaciones, las cuales se hacen clínicamente evidentes en pacientes con deterioro de la inmunidad mediada por células. A partir de la eclosión del SIDA se produjo un aumento significativo del número de casos, transformándose esta última condición en la causa predisponente más importante de esta micosis. La mayoría de los pacientes con SIDA y criptococosis del SNC presentan signos y síntomas de meningitis o meningoencefalitis subagudas como cefalea, fiebre, parálisis de nervios craneales, letargo, coma o amnesia de varias semanas de evolución. La anfotericina B es el pilar terapéutico del tratamiento. En nuestro estudio analizamos las características demográficas, epidemiológicas, clínicas, el líquido cefalorraquídeo, el diagnóstico micológico y el tratamiento empleado en los pacientes hospitalizados en Sala 11 con diagnóstico de criptococosis meníngea. En la criptococosis meníngea asociada al SIDA, el diagnóstico puede realizarse por el análisis de distintos tipos de especímenes biológicos, siendo los principales el examen microscópico directo del LCR con tinción de tinta china y el cultivo.
Cryptococcosis is a fungal opportunistic infection systemic who has universal distribution, caused by capsulated yeast, Cryptococcus neoformans. C. neoformans infects humans and susceptible animals by inhalation, causing an asymptomatic primary infection in immunocompetent hosts. It grows preterentially in rich environments with nitrogen components, mainly from dried excreta of pigeons that are rich in nitrogen and creatinine, with a high salt content and alkaline pH, qualities which facilitate the survival of the fungus. Haematogenous dissemination of the causative agent leads to multiple locations, which are clinically evident in patients with impairment of cell-mediated immunity. Since the emergence of AIDS, it was a significant in crease in the number of cases, who becomes in the most important predisposing cause of this mycosis. Most patients with AIDS and CNS cryptococcosis have signs and symptoms of subacute meningitis or meningoencephalitis as headache, fever, cranial nerve palsy, lethargy, coma or amnesia of several weeks of evolution. Amphotericin B therapy is the mainstay of treatment. We analyzed the demographic, epidemiological, clinical, cerebrospinal fluid, mycological diagnosis and treatment used for hospitalized patients in the unit 11 of the Infectious Disease Hospital Muñiz with the diagnosis of meningeal cryptococcosis. In meningeal cryptococcosis associated with AIDS, the diagnosis can be performed by the analysis of different types of biological specimens, mainly direct microscopic examination of CSF with India ink staining and culture.
Subject(s)
Humans , Male , Meningitis, Cryptococcal/epidemiology , Meningitis, Cryptococcal/etiology , Meningitis, Cryptococcal/cerebrospinal fluid , Meningitis, Cryptococcal/pathology , Meningitis, Cryptococcal/therapy , Acquired Immunodeficiency Syndrome/complications , Amphotericin B/administration & dosage , Amphotericin B/therapeutic use , Azoles/therapeutic use , Cryptococcus neoformans/pathogenicity , Central Nervous System Diseases , Hospitals, Municipal , AIDS-Related Opportunistic InfectionsABSTRACT
El objetivo de este trabajo es evaluar la seroprevalencia del Chagas y de la Toxoplasmosis en mujeres embarazadas. Se estudiaron 290 mujeres en un período de 3 meses que fueron controladas durante su embarazo en la Maternidad del Hospital Ramos Mejia de la ciudad de Buenos Aires. La detección de toxoplasmosis y de Chagas fue realizado midiendo en todas las pacientes inmunoglobulina G y M, por métodos de inmunofluorescencia y hemoaglutinación indirecta. La seroprevalencia de toxoplasmosis fue de 39.31 por ciento de las cuales 2.63 por ciento presentaron infección aguda y fueron tratadas durante el embarazo. La seroprevalencia de Chagas fue de 9.66 por ciento. Concluimos que este estudio nos muestra la importancia de estas enfermedades en la población embarazada y el control que hay que tener sobre ellas
Subject(s)
Adolescent , Adult , Humans , Female , Pregnancy , Chagas Disease/epidemiology , Chagas Disease/etiology , Pregnancy Complications, Infectious , Pregnancy Trimester, First , Serologic Tests , Toxoplasmosis , ArgentinaABSTRACT
Several diseases have been associated with hepatitis C virus infections, including rheumatologic, hematologic and neoplastic disorders. We report two women, aged 57 and 39 years old whom the initial presentation of hepatitis C virus infection was an arthritis resembling rheumatoid arthritis. Laboratory work up revealed abnormal liver function tests, stimulating the search for hepatitis C virus infection, having both patients positive ELISA tests. Detection of this agent is extremely important when selecting a therapy for the articular disease, since several drugs used in the treatment of rheumatic disorders are potentially hepatotoxic and immunosuppression is risky in the setting of a viral hepatitis
Subject(s)
Humans , Female , Adult , Middle Aged , Arthritis/etiology , Hepacivirus/pathogenicity , Hepatitis C, Chronic/complications , Ribavirin/therapeutic use , Thymosin/therapeutic use , Enzyme-Linked Immunosorbent Assay , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Interferon-alpha/therapeutic use , Ursodeoxycholic Acid/therapeutic use , Liver Cirrhosis/prevention & control , Hepatitis C, Chronic/diagnosisABSTRACT
The aim of this study was to evaluate the prevalence of antibodies to hepatitis C virus (anti-HCV) in health-care workers (HCW). Sera from 439 unselected HCW were assessed for anti-HCV by 2nd generation enzyme-linked immunoassay (ELISA) and anti-HBc by ELISA. Anti-HCV (+) sera were evaluated by line immunoassay (LIA) (LiaTeK, Organon). Anti-HCV proved positive by ELISA in 12 (2.73
) subjects, 6 of whom were reactive by LIA, one was indeterminate and 5 non reactive. The prevalence of anti-HCV confirmed by LIA was 1.59
(7 subjects). Positive anti-HCV results with an ELISA ratio greater than 3 were LIA reactive in 6/6 as compared with 5 LIA non reactive with an ELISA ratio less than 2, while in the indeterminate serum the ratio was 2.5. No differences in age, profession, seniority, history of hepatitis or transfusions were found between anti-HCV (+) and (-) subjects, but females predominate significantly. The areas of higher risk were hemodialysis, obstetrics, surgery and intensive care. Anti-HBc was (+) in 85.7
(6/7) of the anti-HCV (+) subjects. Follow-up of anti-HCV (+) subjects showed raised alaninoaminotransferase levels in 4 cases, while liver biopsies in 3 disclosed cirrhosis, chronic active hepatitis and chronic persistent hepatitis. The anti-HCV prevalence in HCW is low compared with other risk groups perhaps due to the peculiar epidemiological features of HCV. In low risk groups for HCV infection a positive ELISA result with a ratio lower than 3 should be confirmed by more specific tests.
Subject(s)
Aged , Humans , Male , Prolactin , Testosterone , Climacteric , Luteinizing Hormone , Follicle Stimulating HormoneABSTRACT
Se analizan dos pacientes con microadenoma hipofisario operadas por via transesfenoidal.Se comenta su evolucion posterior y las alternativas de tratamiento medico o quirurgico de esta patologia