ABSTRACT
Ante la emergencia del virus del Zika y sus complicaciones, entre ellas el Síndrome de Guillain-Barré (SGB), la Organización Mundial de la Salud declaró la emergencia de salud pública de importancia internacional, en la que insta a los Estados Miembros a fortalecer la vigilancia y desarrollar investigaciones. Esto constituye una oportunidad para construir una línea de base del SGB, caracterizarlo y diseñar una estrategia de vigilancia.
Subject(s)
Humans , Guillain-Barre Syndrome , Public Health SurveillanceABSTRACT
Se presenta el primer caso humano de peniciliosis por Penicillium marneffei observado en la República Argentina. El paciente era un joven de 16 años, HIV-positivo, procedente de un área rural del sur de China. El paciente fue internado en el Hospital "F. J. Muñiz" por padecer una neumonía grave con insufciencia respiratoria aguda. El agente causal fue aislado de un lavado broncoalveolar y se lo observó en un citodiagnóstico de piel. La identifcación de P. marneffei fue confrmada por las características fenotípicas del aislamiento y la amplifcación del ADNr. El enfermo padecía una infección muy avanzada por HIV que condujo a la aparición simultánea de infecciones por citomegalovirus, Pneumocystis jirovecii y procesos bacterianos nosocomiales. Este complejo cuadro derivó en una evolución fatal.
The frst case observed in Argentina of AIDS-related human penicillosis is herein presented. The patient was a six- teen year-old young man coming from a rural area of southern China. He was admitted at the F. J. Muñiz Hospital of Buenos Aires city with severe pneumonia and adult respiratory distress. Penicillium marneffei was isolated from bronchoalveolar lavage fuid and was microscopically observed in a skin cytodiagnosis. P. marneffei identifcation was confrmed by rRNA amplifcation and its phenotypic characteristics. The patient suffered an advanced HIV infection and also presented several AIDS-related diseases due to CMV, nosocomial bacterial infections and Pneumocystis jirovecii which led to a fatal outcome.
Subject(s)
Adolescent , Humans , Male , AIDS-Related Opportunistic Infections/microbiology , Dermatomycoses/microbiology , HIV-1 , HIV-2 , Lung Diseases, Fungal/microbiology , Penicillium/isolation & purification , AIDS-Related Opportunistic Infections/epidemiology , Argentina/epidemiology , Bronchoalveolar Lavage Fluid/microbiology , China/ethnology , Cytomegalovirus Infections/complications , Diagnosis, Differential , DNA, Fungal/analysis , Dermatomycoses/epidemiology , Fatal Outcome , Histoplasmosis/diagnosis , Lung Diseases, Fungal/diagnosis , Lung Diseases, Fungal/epidemiology , Pneumocystis carinii , Polymerase Chain Reaction , Penicillium/classification , Pneumonia, Pneumocystis/complications , RibotypingABSTRACT
El objetivo del trabajo es comunicar los hallazgos epidemiológicos, clínicos y de diagnóstico de la neumonía y hemorragia pulmonar por leptospirosis, en el período enero 2007 a octubre 2009. Un 64% (20/31) de pacientes con diagnóstico de leptospirosis tuvieron neumonía. Quince de ellos (75%) presentaron neumonía grave, de los cuales siete (35%) desarrollaron hemorragia pulmonar. En diez enfermos (32%) el motivo de consulta e inicio del cuadro clínico fue una gastroenteritis secretoria con fiebre y dolor abdominal. La ictericia sólo se manifestó en once pacientes (35%). La técnica de reacción en cadena de la polimerasa (PCR) fue útil para el diagnóstico en muestra obtenida post mortem. De un hemocultivo se aisló una cepa clasificada dentro del serogrupo canicola. Se clasificaron las neumonías en tres tipos: neumonías de curso no grave con escasa repercusión general; neumonías graves asociadas a formas clínicas sistémicas con ictericia, insuficiencia renal, trombocitopenia y hemorragia pulmonar; también de curso grave, no asociada a ictericia, insuficiencia renal o trombocitopenia grave. El tratamiento antibiótico iniciado en los primeros días de enfermedad (promedio 3.2 días) no tuvo influencia en la evolución de las neumonías graves. Se plantea además considerar tres formas clínicas de leptospirosis: anictérica, ictérica (con sus variantes evolutivas) y hemorragia pulmonar.
The aim of this paper is to report the epidemiological, clinical and diagnosis findings of pneumonia and pulmonary hemorrhage observed in patients with leptospirosis in the period January 2007 to October 2009. A 64% (20/31) of patients diagnosed with leptospirosis presented pneumonia. Fifteen of them (75%) had severe pneumonia, of which seven (35%) were pulmonary hemorrhage. In ten patients (32%) reason for consultation and clinical early stage was a secretory gastroenteritis with fever and abdominal pain. Jaundice was only expressed in eleven patients (35%). The technique of chain reaction (PCR) was useful for diagnosis in samples obtained post mortem. A strain classified in serogroup canicola was isolated from blood culture. Pneumonia was classified into three types: non-severe pneumonia course with little overall impact; severe pneumonia associated with systemic clinical forms with jaundice, renal failure, thrombocytopenia, and pulmonary hemorrhage, and of serious course, not associated with jaundice, kidney failure or thrombocytopenia. Antibiotic treatment started in the early stages of disease (average 3.2 days) had no influence on the development of severe pneumonia. It is puggested to consider three clinical forms of leptospirosis: anicteric, icteric (with its evolutionary variants) and pulmonary hemorrhage.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Young Adult , Hemorrhage/etiology , Leptospirosis/complications , Lung Diseases/etiology , Pneumonia, Bacterial/etiology , Acute Kidney Injury/etiology , Argentina/epidemiology , Community-Acquired Infections/epidemiology , Community-Acquired Infections/etiology , Leptospirosis/epidemiology , Polymerase Chain Reaction , Pneumonia, Bacterial/epidemiology , Severity of Illness IndexSubject(s)
Influenza, Human/complications , Influenza, Human/diagnosis , Influenza, Human/therapy , Influenza A virus , Antiviral Agents/therapeutic use , Respiratory Tract Infections/etiology , Respiratory Tract Infections/drug therapy , Oseltamivir/administration & dosage , Oseltamivir/therapeutic use , Severe Acute Respiratory Syndrome/diagnosis , Severe Acute Respiratory Syndrome/etiology , Severe Acute Respiratory Syndrome/drug therapy , Zanamivir/administration & dosage , Zanamivir/therapeutic useABSTRACT
Two patients who lived in Buenos Aires suburbs died from leptospirosis in July 2000 and March 2001. They developed a nonspecific febrile illness followed by hemorrhagic pneumonia and respiratory distress in absence of typical manifestations such as jaundice, nephropathy, thrombocitopenia or hemorrhages in other organs. In the house and surroundings of one patient rodents were captured and three strains of leptospira, serogroup Icterohaemorrhagiae were isolated. Laboratory guinea pigs were inoculated and they were sacrificed as soon as respiratory symptoms appeared. Necropsy showed primary lung injury, which was similar to the histopathological lesions found in one of the patients. Neither jaundice, nor renal damage was found. Pericardiac hemorrhages were considered as a possible cause of cardiopulmonary collapse. This clinical form has not been reported previously in this region, where conditions are indeed suitable for the human illness to appear.
Subject(s)
Humans , Animals , Male , Female , Adult , Rats , Respiratory Insufficiency/microbiology , Weil Disease/complications , Hemorrhage/microbiology , Lung Diseases/microbiology , Argentina , Weil Disease/pathology , Fatal Outcome , Hemorrhage/pathology , Lung Diseases/pathologyABSTRACT
The use of monodose (800 mg) per os of Norfloxacin was evaluated in 32 patients with cholera at Salvador Mazza's Hospital, Salta, Argentina. It was considered the celerity in negativization of stool culture (100 of cases: 12 hours post administration), it efficiency along time (24/24 controlled patients were negative at 10th day) and MIC of isolated strains (100 of strains were sensitive: range 0.008 to 0.016 micrograms/ml). It was included oral administration of sorbitol 70 in peanut oil in order to study patients at 10th day's control. This method could be an alternative one in the study of asymptomatic carrier. Norfloxacin monodose shows good performance in early negativization of stool culture and it was also effective along the whole observation period, suggesting it could prevent carriage.