ABSTRACT
Objetivos: Determinar prevalencia y perfil clínico de infección por agentes atípicos en niños con Neumonía Adquirida en la Comunidad en el Hospital de Emergencias Grau Essalud, período 2008. Material y Métodos: Estudio prospectivo, de corte transversal, durante el año 2008, con una muestra de 70 pacientes, entre 1 mes a 14 años de edad, con diagnóstico clínico y radiológico de Neumonía Adquirida en la Comunidad (NAC), hospitalizados en el Servicio de Pediatría del Hospital Emergencias Grau; se les realizó Inmunoensayo Indirecto: ELISA Ig M para Chlamydia pneumoniae y Mycoplasma pneumonaie. Resultados: El 31.4% (22/70) de los niños con NAC presentaron serología positiva para agentes atípicos, correspondiendo a Chlamydia pneumoniae 17.1 % (12/70), Mycoplasma pneumoniae 7.1% (5/70) e infección mixta (ambos gérmenes) el 7.1% (5/70). Tendencia al aumento de la infección según la edad (p= 0,01): en lactantes fue 14,29%, preescolares 27,27%, escolares y adolescentes 48,15%. No hubo diferencia significativa en relación a sexo (p= 0,242), antecedente de asma 54,5% (p=0,131), presencia de sibilancias 72,7% (p= 0,141), ni estancia hospitalaria 8,1±3,1 (p= 0,198). En hemograma destacan: Segmentados 77,41 ± 12,43% (p= 0,037) y Linfocitos 12,59 ± 7,01% (p= 0,001). PCR fue 3,40 ± 2,11 UI/dL (p= 0,138). La radiografía mostró Infiltrado intersticial 59,09%, Hiperinflación 40,91 %, consolidación lobar 40,91%, y Atelectasia en 18,18%. Conclusiones:Este estudio sugiere un rol importante de C. pneumoniae y M. pneumoniae, en la etiopatogenia de la neumonía adquirida en la comunidad en niños, en nuestro medio. Debemos sospechar en escolar levemente febril, con neumonía con predominio del componente espástico y radiografía con infiltrado intersticial o signos de atrapamiento aéreo. ...
Objective: The objective of the present study was to determine the clinical-serological profile of atypical agent in children with community-acquired pneumonia at Emergency Hospital "Grau" period 2008. Material and Methods: The present study has a prospective design of cross sectional, was carried out during the year 200S, including a sample of 70 patients between 1 month to 14 years old with clinical and radiological diagnosis of community-acquired pneumonia, hospitalized at the Service of Paediatrics, Emergency Hospital "Grau ". They were screened by IgM ELlSA for acute M. pneumoniae C and pneumoniae infection. Results: We obtained that 31.4 % (22/70) of the children with community-acquired pneumonia presented positive serology for atypical agents, corresponding to Mycoplasma pneumoniae 7.1 %(5/70), for Chlamydia pneumoniae 17.1% (12/70), and a mixedinfection (M. pneumoniae and C. pneumoniae) in 7.1 % (5/70), we alsofound that infection for atypical agents increased with age (p= 0.01)thus it has a frequency of infants aged 1 months- 2 years was 14,29% preschool-aged children, 27,27% school-aged children and adolescents, 48,15%; no statistically significant difference was found between both sex (p=0,242). History of asthma was found in 54,5 %(12/22), (p=0, 131). The clinical examination revealed wheezing in 72,7% of positive serologically patient (p=0,141). About complete blood count we found a mean leukocytes count of 14,61 +-8,53 x 1000 cel/dL, Neutrophil in 77,41+-12,43% (p=0,037) and Lymphocytes in 12,59+-7,01%(p=0,001). PCR mean of 3, 40+-2,11 UI/dL(p=0,138). Chest x-rays were classified into Interstitial infiltrations (59,09%), followed by Hyperaereation (40,91%), Lobar consolidation(40,91%) and Atelectasis in 18,18%.Conclusions: The results of this study suggest the important role of C. ...
Subject(s)
Humans , Male , Female , Adenocarcinoma , Neoplasm Staging , Gallbladder Neoplasms , Pneumonia, Bacterial/parasitology , Pneumonia, Mycoplasma/parasitology , Pneumonia/parasitology , Child , Prospective Studies , Cross-Sectional StudiesABSTRACT
A leptospirose é uma doença infecciosa caracterizada pelo envolvimento de múltiplos sistemas. O acometimento pulmonar é comum, geralmente leve e freqüentemente negligenciado. Quando os sintomas respiratórios são a principal manifestação da doença, existe grande possibilidade de confusão diagnóstica. Os autores apresentam um caso de pneumonia grave por leptospirose, com o objetivo de chamar a atenção para esta possibilidade etiológica no diagnóstico diferencial das pneumonias comunitárias, especialmente quando há um perfil epidemiológico suspeito
Subject(s)
Humans , Male , Adolescent , Leptospirosis/complications , Penicillins/therapeutic use , Pneumonia/parasitology , Diagnosis, Differential , Pneumonia/diagnosis , Pneumonia/drug therapyABSTRACT
Comunicamos la identificación, a nivel de especie, de un microsporidio aislado en cultivo celular a partir de un lavado broncoalveolar de un paciente con Sida y neumonía. La caracterización del aislado se realizó mediante: 1) estudio morfológico de microscopía óptica y electrónica, 2) estudio inmunológico con antisuero específicos, inmunofluorescencia indirecta (IFI) e inmunoblot (WB) y 3) estudio molecular tras reacción en cadena de la polimerasa (PCR) con iniciadores especie-específicos diseñados a partir de la región que codifica la subunidad menor del ARN ribosomal. Las características ultraestructurales del aislado permitieron su identificación en el género Encephalitozoon. La identificación específica del microsporidio como Encephalitozoon hellem se realizó mediante IFI y WB, empleando suero policlonal de conejo anti-E. hellem (CDC:0291:V213), y mediante la amplificación por PCR del fragmento diagnóstico utilizando el par de iniciadores EHELF/EHELR específicos para esta especie. El aislado ha sido denominado EHVS-96 y se mantiene en cultivo continuo en células Vero-E6. Este es el primer aislamiento en cultivo y caracterización de E. hellem en España
Subject(s)
Humans , Male , Adult , Encephalitozoon/isolation & purification , Pneumonia/parasitology , Acquired Immunodeficiency Syndrome/parasitology , Cell Culture Techniques , Encephalitozoon/pathogenicity , Fluorescent Antibody Technique, Indirect , Immune Sera , Microscopy, Electron , Microsporidiosis/diagnosis , Polymerase Chain ReactionABSTRACT
The first case was 7-month-old immunodeficiency girl in whom the diagnosis of Acanthamoeba pneumonia was established by culture of a bronchial washing. The patient had been ill for a month when she was admitted due to neonatal thrombocytopenia with respiratory difficulty and treated with gammaglobulin and steroid. Her chest X-ray showed diffuse alveolar consolidation on the left lung with interstitial hazziness and a partial sign of hyperinflation on the right lung. Laboratory tests showed that the Candida antigen was negative and Pneumocystis carinii was not detected. Mycoplasma antigen was negative. All the immunoglobulin levels (IgG, IgA, IgM) were below the normal range. Five days later the patient expired. The second case was an immunosuppressed 7-year-old boy in whom Acanthamoeba trophozoites were found in the skin biopsy, followed by meningitis leading to death. About five days after a laceration on the region of the left eyebrow, a painful bean-sized nodule developed at the suture site and it was treated with antibiotics and corticosteroid. The skin biopsy showed severe inflammatory cell infiltration. Trophozoites were scattered near the blood vessels throughout the inflammatory zone. From one weak prior to admission, the patient had suffered from vomiting, indigestion and mild fever. Skin nodules with tenderness appeared all over his body surface. Examination of cerebrospinal fluid showed clear, Gram stain was negative, bacterial culture negative, India ink preparation negative, and organism on wet smear negaive. On admission day 10, focal seizure of the left extremity occurred. Brain CT revealed calcific density on the left parietal lobe area and hypodensity on the left basal ganglia. He became comatous and died immediately after discharge. Until now in Korea, two cases that are described in this paper, one Acanthamoeba meningoencephalitis case and seven Acanthamoeba keratitis cases including two unreported keratitis cases that are reported in this paper have been presented.
Subject(s)
Child , Female , Humans , Infant , Male , Acanthamoeba/isolation & purification , Amebiasis/parasitology , Animals , Immunocompromised Host , Korea , Meningitis/parasitology , Pneumonia/parasitologyABSTRACT
The cases of five patients with unusual manifestation of acute schistosomiasis mansoni are described in this paper. One patient developed skin lesions, three displayed diverse lung involvement, and one presented pyrogenic liver abscesses caused by Staphylococcus aureus.