Hidatidosis pancreática en una niña de 5 años / Pancreatic echinococcosis in a 5-year-old girl

La hidatidosis pancreática representa el 0,2-0,6 % de los casos, siendo la población pediátrica la de mayor riesgo. Las lesiones suelen localizarse en cabeza del páncreas (50-58 %); la localización en cuerpo y cola del páncreas se encuentra en el 24-34 % y el 19 %, respectivamente. Dada la posibilidad de complicaciones, suele realizarse tratamiento quirúrgico. Se sugiriere indicar albendazol antes y después del acto quirúrgico por los riesgos de ruptura y diseminación de los protoescólices. Se presenta el caso de una niña de 5 años de edad con dolor abdominal progresivo y lesión quística en páncreas compatible con hidatidosis en la ultrasonografía. En la tomografía computada se observa compresión de la vía biliar. La hemoaglutinación indirecta fue negativa. Presentó elevación de la bilirrubina total, con franco predominio de bilirrubina directa, y aumento de enzimas hepáticas. Se realizó laparotomía exploradora, colecistectomía y destechamiento del quiste. Evolucionó favorablemente, continuó con albendazol durante 3 meses luego de la cirugía.

Pancreatic echinococcosis accounts for 0.2­0.6% of cases, with the pediatric population being at a higher risk. Most commonly, pancreatic lesions occur in the head of the pancreas (50­58%); and in the body and tail in 24­34% and 19% of cases, respectively. Given the potential complications, surgery is usually performed. Albendazole is recommended before and after the surgery due to the risks for rupture and dissemination of protoscolices. Here we describe the case of a 5-year-old girl with progressive abdominal pain and cystic lesion in the pancreas compatible with echinococcosis in the ultrasound. The computed tomography showed bile duct compression. Indirect hemagglutination was negative. She had elevated total bilirubin, with a clear predominance of direct bilirubin, and high liver enzymes. Exploratory laparotomy, cholecystectomy, and unroofing of the cyst were performed. The patient had a favorable course and continued with albendazole for 3 months after the surgery.

Quiste hidático esplénico, una rara topografía de una rara enfermedad / Splenic hydatid cyst, a rare topography of a rare disease / Cisto hidatico esplénico, uma topografia rara de uma doença rara

Primary splenic hydatid cyst is a rare entity even in endemic areas. In most cases it presents asymptomatically being diagnosed by imaging findings. Treatment is multimodal and individualized, being surgical treatment the one that allows an integral solution of the disease. Conventional surgery continues to be the "Gold standard" in its approach. We present the case of a patient with this condition and the resolution approached by the surgical team.

O cisto hidatides esplénico primário é uma entidade rara mesmo em áreas endémicas. Na maioria dos casos apresenta-se de forma assintomática, sendo diagnosticada através de resultados de imagem. O tratamento é multimodal e individualizado, com um tratamento cirúrgico que proporciona uma solução abrangente para a condição. A cirurgia convencional continua a ser a abordagem "padrão de ouro". Apresentamos o caso de um paciente com esta condição e a resolução abordada pela equipa cirúrgica.

El quiste hidático primario esplénico es una entidad poco frecuente aún en áreas endémicas. Se presenta en la mayoría de los casos de forma asintomática, siendo diagnosticado por hallazgo imagenológico. El tratamiento es multimodal e individualizado, siendo el tratamiento quirúrgico el que permite una solución integral de la dolencia. La cirugía convencional sigue siendo el "Gold estándar" en su abordaje. Presentamos el caso de una paciente con esta afección y la resolución abordada por el equipo de cirugía.

Presentación atípica de toxocariasis infantil: a propósito de un caso / Atypical presentation of infant toxocariasis: about a case

Resumen Se presenta el caso de una niña de 8 años, procedente de la Amazonia peruana, con una presentación atípica de una toxocariasis. El cuadro clínico, de un mes de evolución, fue caracterizado por dolor abdominal crónico, palidez y geofagia, asociado a una masa abdominal y linfoadenopatías generalizadas. No hubo sintomatología respiratoria, dérmica, ocular o neurológica. En el hemograma se encontró una anemia y eosinofilia periférica acentuada y una eosinofilia moderada en el aspirado medular. El diagnóstico fUe confirmado por serología por el método de enzimoinmunoanálisis (ELISA), que mostró la presencia de anticuerpos anti-Toxocara de tipo IgG e IgM. Se administró tratamiento con albendazol 400 mg al día, durante cinco días, con una evolución favorable.

Abstract We present the case of an 8-year-old girl with an atypical presentation of toxocariasis, from the Peruvian Amazon. A month ago, the clinical presentation was characterized by the presence of abdominal pain, paleness and geophagia, associated with an abdominal mass and generalized lymphadenopathy. There were no respiratory, dermal, ocular or neurological symptoms. Marked peripheral eosinophilia was found in the blood count, and moderate eosinophilia in the spinal cord aspírate. The diagnosis was confirmed by serology with the enzyme-linked immunosorbent assay (ELISA), which showed the presence of IgG and IgM anti- Toxocara antibodies. Treatment with albendazole 400 mg once daily was administered for five days with favorable evolution.

Brote familiar por el nematodo Trichostrongylus colubriformis en una zona rural de la provincia de Valdivia: una zoonosis de rara ocurrencia / Family outbreak caused by the nematode Trichostrongylus colubriformis in a rural area of the province of Valdivia: a rare occurrence zoonoses

Resumen La trichostrongylosis es una zoonosis de rara ocurrencia causada por nematodos intestinales, favorecida por el consumo de vegetales crudos o agua contaminada con larvas infectantes de Trichostrongylus spp. En 2015, se registró un brote familiar transmitido por alimentos en una zona rural de Valdivia, afectando a una mujer de 51 años de edad y su pareja e hija de 56 y 12 años; respectivamente. Solo la mujer adulta, el caso índice, presentó síntomas como diarrea, dolor abdominal, astenia y náuseas. Los pacientes eliminaron huevos de Trichostrongylidae gen. sp. en sus deposiciones, identificándose en dos de ellos, adultos de Trichostrongylus colubriformis. Tuvieron una buena respuesta a albendazol. En Chile, se han registrado prevalencias de infección de 0,1 a 3,5%, incluyendo un total de 93 casos diagnosticados entre las provincias de Concepción y Llanquihue.

Abstract Trichostrongylosis is a rare occurrence zoonosis caused by intestinal nematodes, favored by the consumption of raw vegetables or water contaminated with infective larvae of Trichostrongylus spp. In 2015, a family outbreak of foodborne disease was registered in a rural zone of Valdivia, affecting to 51-year-old woman and her 56-year-old partner and her 12-year-old daughter. Only the adult woman, the index case, presented symptoms such as diarrhea, abdominal pain, asthenia, and nausea. The patients revealed Trichostrongylidae gen. sp. eggs in their stools, identifying Trichostrongylus colubriformis adults in two of them. They had a good response to treatment with albendazol. In Chile, 0.1 to 3.5% prevalence of infection has been reported, including a total of 93 cases recorded between the provinces of Concepción and Llanquihue.

Tratamento farmacológico da estrongiloidíase em pacientes transplantados / Pharmacological treatment of strongilloidiasis in transplanted patients

O objetivo deste artigo foi comparar o uso da ivermectina e do albendazol em pacientes transplantados e relatar os respectivos sucessos terapêuticos nessa população. Foram analisados artigos que abordassem relatos de casos publicados nos últimos 4 anos no PubMed® relacionando os descritores "transplante de órgãos", "estrongiloidíase" e "tratamento". Foram encontrados e analisados dez relatos de caso que abordaram a estrongiloidíase em situa- ção pós-transplante contemplando 13 indivíduos. Desses, cinco (38,5%) utilizaram ambos os medicamentos, dos quais quatro (80%) se curaram, tendo recebido albendazol e ivermectina por via subcutânea (50%) ou albendazol e ivermectina por vias oral/ subcutânea (50%). O paciente que morreu recebeu albendazol e ivermectina por via subcutânea. Sete (53,8%) indivíduos utiliza- ram apenas ivermectina, dos quais três (42,8%) se curaram tendo recebido o medicamento oral (dois pacientes) ou subcutâneo (um paciente); dois (28,6%) morreram recebendo o medicamento via oral, dois (28,6%) usaram profilaticamente via oral e apenas um não manifestou sintomas. Apenas um (7,7%) indivíduo utilizou somente albendazol via oral tendo sobrevivido à infecção. A uti- lização combinada dos medicamentos ivermectina e albendazol parece ter efeito positivo no tratamento da estrongiloidíase. A administração da ivermectina por via subcutânea apresentou resultados promissores, contudo estudos controlados de siner- gia medicamentosa e vias de administração devem ser realizados para efetiva avaliação.

The objective of this article was to compare the use of ivermec- tin and albendazole in transplanted patients and to report the respective therapeutic successes in this population.Articles ad- dressing case reports published in the last 4 years in the PubMed relating the descriptors "organ transplantation", "strongyloidia- sis", and "treatment" were analyzed. Ten case reports addres- sing strongyloidiasis in a post-transplant situation, covering 13 individuals, were found and analyzed. Of these, five (38.5%) used both drugs of which 4 (80%) were cured having received subcu- taneous albendazole and ivermectin (50%) or oral/subcutaneous albendazole and ivermectin (50%). The patient who died received subcutaneous albenzadole and ivermectin. Seven (53.8%) indi- viduals used only ivermectin, of which three (42.8%) were cured having received the oral (2/3) or subcutaneous (1/3) medication, two (28.6%) died receiving the oral medication, and two (28.6%) used oral medication prophylactically, and only one did not show symptoms. Only one (7.7%) individual used only oral albenzadole and survived the infection. The combined use of the drugs iver- mectin and albendazole seems to have a positive effect on the treatment of strongyloidiasis. The administration of subcuta- neous Ivermectin has shown promising results; however, con- trolled studies of drug synergy and administration routes shall be performed for effective evaluation.

Hidatidosis pulmonar en el niño: presentación un caso clínico residente en Marruecos / Pulmonary hydatid cyst in childhood: case report from Morocco

Hydatid disease is a zoonosis caused by Echinococcus granulosus, and represents a global public health problem. In children the pulmonary location is the most frequent. The hydatid cyst can be asymptomatic and present symptoms when breaking into the bronchial tree or pleura. We present a case of complicated pulmonary hydatid cyst in a 14-year-old girl from Morocco, where this disease is endemic. The initial clinical picture simulated a lung abscess. The management was surgical, associated with albendazole treatment, with a good clinical evolution.

La enfermedad hidatídica es una zoonosis producida por el Echinococcus granulosus, y representa un problema mundial de salud pública. En niños la localización pulmonar es la más frecuente. El quiste hidatídico puede ser asintomático y presentar síntomas al romperse hacia el árbol bronquial o pleura. Presentamos un caso de quiste hidatídico pulmonar complicado en una niña de 14 años residente en Marruecos, donde esta enfermedad es endémica. El cuadro clínico inicial simuló un absceso pulmonar. El manejo fue quirúrgico, asociado a tratamiento con albendazol, con una buena evolución clínica.

Anisakiasis gastro-alérgica, primera descripción de un caso en Colombia y revisión bibliográfica / Gastro-allergic anisakiasis: The first case reported in Colombia and a literature review

Resumen La anisakiasis es una enfermedad parasitaria zoonótica causada por el consumo de pescados o mariscos crudos o poco cocidos infectados con nematodos de los géneros Anisakis, Pseudoterranova y Contracaecum. Se describe el primer caso de anisakiasis en Colombia y se resume la literatura médica disponible. Una mujer de 52 años de edad consultó por dolor epigástrico agudo de inicio abrupto, náuseas, vómitos, diarrea y urticaria después de consumir pescado. El examen físico reveló sensibilidad moderada en el epigastrio. El examen de laboratorio evidenció leucocitosis, en tanto que la radiografía simple y el electrocardiograma no reflejaron ninguna anormalidad. El diagnóstico se hizo mediante una endoscopia de vías digestivas altas, la cual reveló engrosamiento de la pared gástrica y un parásito en movimiento. Se encontró una larva de Anisakis y se la extrajo por endoscopia, lo que alivió el dolor de la paciente. Clínicamente, la anisakiasis puede presentarse como una enfermedad gástrica, intestinal, en otros sistemas o alérgica. El diagnóstico se hace con base en la elaboración del historial alimentario del paciente y la visualización directa de las larvas; el único tratamiento efectivo consiste en su extracción endoscópica.

Abstract Anisakiasis is a zoonotic parasitic disease caused by consumption of raw or undercooked fish or seafood infected with nematodes of the Anisakis, Pseudoterranova or Contracaecum genera. Here, we describe the first case of anisakiasis in Colombia and summarize the available literature. A 52-year-old female with a history of abrupt-onset sharp epigastric pain, nausea, vomit, diarrhea, and urticaria following fish consumption consulted the health service. The physical examination revealed moderate tenderness of the epigastric region; the laboratory evaluation showed leukocytosis and a simple X-ray and ECG showed no abnormalities. The diagnosis was made by endoscopic examination, which revealed a thickened gastric wall and a moving larval worm. An Anisakis larva was found and extracted endoscopically, which relieved the pain of the patient. Clinically, anisakiasis may present as a gastric, intestinal, extragastrointestinal or allergic disease. Diagnosis and treatment of anisakiasis are made by a dietary history, direct visualization and endoscopic extraction of possible larvae, which is the only effective therapy.

Effect of Albendazole Treatment in an Experimental Model of Neurocysticercosis-Induced Hydrocephalus

Hydrocephalus is a major concern in neurocysticercosis (NCC), and its management is more challenging than that of hydrocephalus caused by other etiologies. Even though albendazole is a well-established drug for the treatment of NCC, the death of the parasites may worsen the clinical symptoms and eventually, deteriorate the course of hydrocephalus. The aim of this study was to analyze the effects of treatment with albendazole on the course of hydrocephalus as well as on animal behavior in a ratmodel of NCC-induced hydrocephalus in order to verify whether the course of hydrocephalus and the animal behavior were changed. Ventricle volumes before and after treatment showed a slight but non-statistically significant difference (168.11 mm3 versus 184.98 mm3, p » 0.45). The distribution and location of the cysts were unaffected. In addition, the behavioral patterns before and after the treatment were not significantly different, as assessed by the open field test. On histologic assessment, mononuclear leukocyte infiltration was present in diverse sites, such as the perivascular and peri-ependymal regions, choroid plexus, and meningeal membranes. A positive correlation was found between the degree of ventricle enlargement and tissue damage. Further studies with long-term comparisons are required.

Estrongiloidiasis gastrointestinal en paciente inmunocompetente: a propósito de un caso / Gastrointestinal strongyloidosis in an immunocompetent patient: a case report

Intestinal parasitic infections cause a not insignificant number of chronic diarrhea in children, however, with the sociodemographic change that our country has experienced, the number of cases and new parasites (immigration from tropical endemic areas) could increase. We report the case of an immunocompetent patient who presents with chronic diarrhea associated with Strongyloides stercoralis infection. The patient migrated two years ago from an endemic area for this helminth. The diagnosis is challenging, and the chances of a successful outcome depend on the administration of the antiparasitic.

Las infecciones parasitarias intestinales provocan un número no despreciable de causas de diarrea crónica en niños, sin embargo, con el cambio sociodemográfico que ha vivido nuestro país se podría incrementar el número de casos y de nuevos parásitos (inmigración de áreas endémicas tropicales). Reportamos el caso de un paciente inmunocompetente, que presenta cuadro de diarrea crónica asociada a infección por Strongyloides stercoralis. El paciente habría migrado hace dos años desde zona endémica para este helminto. El diagnóstico es desafiante y las posibilidades de un resultado exitoso dependen de la administración del antiparasitario.

Subcutaneous nodules of cysticercosis as a sign of asymptomatic neurocysticercosis in an HIV positive patient

Abstract Cysticercosis is caused by the hematogenous dissemination of the larval form (cysticercus) of Taenia solium. It can affect any organ or tissue in the body but commonly affects the subcutaneous tissue, central nervous system, eyes, and skeletal muscle. Skin lesions can assist as a marker in the diagnosis of asymptomatic neurocysticercosis in endemic areas. A 49-year-old HIV positive man presented with multiple cutaneous nodules confirmed as cysticercomas which led to the diagnosis of asymptomatic neurocysticercosis. He was successfully treated with albendazole and steroids at recommended doses with no adverse effects.

[Treatment of cell phthriase by albendazole per OS]

Background: Potential irritation and ocular damage can result from topical treatment of phthiriasis palpebrarum

Case: We report the case of a 7-year-old boy who presented a phthiriasis palpebrarum infection showing no response to classic treatments, treated successfully with albendazole per os

Conclusion: Albendazole could be considered a therapeutic option for phthiriasis palpebrarum

Hidatidosis pulmonar bilateral: Reporte de caso / 0 BILATERAL PULMONARY HYDATID DISEASE: CASE REPORT AND REVISION

La hidatidosis es una zoonosis de distribución mundial producida por cestodos del género Echinococcus. Afecta principalmente regiones agrícolas y ganaderas. Es una enfermedad endémica en nuestro país, las mayores incidencias reportadas en Sudamérica corresponden Argentina, Chile, Uruguay y Brasil. El hígado es el principal órgano en el humano, le sigue en frecuencia el pulmón. La clínica suele ser inespecífica. Los síntomas más frecuentes son la tos y el dolor torácico, siendo un hallazgo en estudios imagenológicos. El diagnóstico de sospecha es a través de imágenes, apoyado en antecedentes epidemiológicos y serológicos. La radiografía de tórax asociada a la clínica permite el diagnóstico certero en hasta el 95% de los casos, sin embargo, los avances en la TC y su capacidad de caracterización la han hecho parte habitual del estudio preoperatorio. El tratamiento de la hidatidosis pulmonar es quirúrgico y consiste en la erradicación de los quistes, la corrección de los efectos de la presencia del quiste en el órgano (periquística y cavidad residual) y tratar las complicaciones que el quiste ha provocado en su evolución (fístulas bronquiales y siembra pleural). El tratamiento médico está reservado para quistes múltiples, únicos univesiculares menores de 5cm, pacientes de alto riesgo quirúrgico o inoperables y como quimioprofilaxis pre y postoperatoria. Existe consenso en que la cirugía con preservación de parénquima pulmonar es la elección, reservándose las resecciones pulmonares para aquellos casos en los que el tejido adyacente se encuentra seriamente dañado o infectado o cuando las aéreas de atelectasias son presumiblemente irrecuperables

Hydatidosis is a worldwide distribution zoonosis caused by Cestodes of the genus echinococcus. Mainly affects agricultural and livestock regions. Is an endemic disease in our country, the highest reports in South America correspond to Argentina, Chile, Uruguay and Brazil. The liver is the main target of the parasite, followed in frequency by the lungs. The clinical signs are usually non-specific. Most common symptons are cough and pain chest, being a finding in imaging studies. The presumptive diagnosis is made trough images, support by epidemiological and serological records. The chest x-Ray associated with the clinical symptons allows 95% of accuracy, however advances in CT allows to visualize the difference between the cyst and the normal tissue, this has turned it into a usual step in preoperative studies. The treatment of pulmonary hydatidosis is surgical and consists of the elimination of the cysts, the correction of the effects made by the presence of them in the organ (pericysts and residual cavity) and heal the complications the cysts may have done during the evolution (bronchial fistulas and pleural seeding). The medical treatment (non surgical) is only indicated in multiple cysts or unique uni vesiculares cysts under 5 cm, high risk surgical or inoperable patients and as pre and postoperative chemoprophylaxis. There is general agreement that lung parenchymal preservation surgery is the choice, reserving the pulmonary resections in cases that adjacent tissue is severely damaged of infected or when areas of atelectasis are presumably lost

Quiste esplénico gigante. A propósito de un caso / GIANT SPLENIC CYST. CASE REPORT

La hidatidosis o equinococosis quística es una zoonosis causada por el cestode Echinococcus granulosus, responsable de importante morbilidad y mortalidad en todo el mundo. La presentación esplénica aislada tiene escasos reportes en la literatura mundial.

Hydatidosis or cystic echinococcosis is a zoonosis caused by the cestode of Echinococcus granulosus, responsible for significant morbidity and mortality worldwide. Isolated splenic presentation has few reports in the world literature. The aim of this report was to describe an unfrequent case of isolated splenic hydatidosis due to its etiologic value because of the inexistence of a simultaneous hepatic involvement

Hidatidosis Cardiaca Primaria / Primary cardiac hydatidosis

Cardiac hydatidosis without involvement of extracardiac organs is an uncommun condition. We report a case of a 20 years old female without any prior disease, she consult for progressive dyspnea and palpitations. Echocardiogram and cardiac MRI shows cystic lesion in apical intraventricular septum suggestive of hydatid cyst. No other organs were affected. The patient underwent surgery with successful removal of hydatid cyst and medical treatment with Albendazole, after that, the patient remains asymptomatic.

Neuropsychiatric manifestations and epidemiology of neurocysticercosis / Manifestações neuropsiquiátricas e epidemiologia de neurocisticercose

Neurocysticercosis (NCC) is the brain infection caused by larval stages of the helminth Taenia solium. The embryos of Taenia travel through the bloodstream and can reach the brain, muscles, eyes, and various organs. In the brain, the psychiatric manifestations are mood disorders, depression and anxiety, which are commonly associated with epilepsy and sensory-motor deficits. Neurocysticercosis is a frequent parasitic disease in the world population; it is endemic in Central and South America, Asia and Sub-Saharan Africa. In the present review, we report the major symptoms and signals of neurocysticercosis common to neurological and psychiatric illnesses. We briefly present Epidemiology of those manifestations and analyze the relationship between pathological changes and NCC symptomatology. OBJECTIVES AND METHODOLOGY: A literature review was conducted to characterize epidemiological, neurological and psychiatric manifestations of NCC. The final 90 papers were selected of a set of 937 publications from 2010 to 2016. RESULTS: NCC is a major cause of epilepsy in endemic areas; further- more, leads to a diversity of motor and sensitive deficits, manifestations vary from headache to severe intracranial hypertension. Potentially fatal conditions include arteritis, encephalitis and hydrocephalus. Depression and cognitive decline remain among the most important psychiatric manifestations. Neuropsychiatric manifestations, Epidemiology, and neuroimaging provide diagnostic criteria. Brain scans may reveal one or diverse cysts filled with fluid within a scolex (parasite's head). CONCLUSION: NCC's diversity of presentations encourage health professionals to consider it in diagnoses, especially in endemic countries, and also in non-endemic areas because migrants and travelers are subject to contagious. Treatment consists in use of antiparasitic drugs (albendazol, praziquantel) and drugs to treat associated conditions (anticonvulsants, corticosteroids). Surgery is reserved to extirpate the parasite from particular locations (eyes, spinal cord, cerebral ventricles) or to differentiate NCC from tumors, tuberculosis, mycosis, etc. Prevention includes treatment of intestinal helminthiasis, sanitation in animal farming, food preparing hygiene, quality control of water and food.

Neurocisticercose é a infecção cerebral causada pelos estágios lar- vais do helminto Taenia solium. Os embriões da Taenia deslocam-se através da corrente sanguínea e podem atingir o cérebro, músculos, olhos e vários órgãos. No cérebro, as manifestações psiquiátricas são transtornos de humor, depressão e ansiedade, as quais estão comumente associados com epilepsia e deficiências sensório-motoras. Neurocisticercose é uma parasitose frequente na população mundial, é endêmica na América Central e do Sul, Ásia e África subsaariana. Na presente revisão, relatamos os principais sintomas e sinais de neurocisticercose pertinentes a doenças neurológicas e psiquiátricas. Nós brevemente apresentamos a Epidemiologia dessas manifestações, e analisamos a relação entre alterações patológicas e sintomatologia da NCC. OBJETIVOS E METODOLOGIA: Uma revisão da literatura foi conduzida para caracterizar a epidemiologia, as manifestações neurológicas e psiquiátricas de NCC. Os 90 artigos finais foram selecionados de um conjunto de 937 publicações entre 2010 a 2016. RESULTADOS: NCC é uma importante etiologia de epilepsia em áreas endêmicas, além disso causa uma diversidade de deficiências motoras e sensoriais, as manifestações variam de cefaleia a severa hipertensão intracraniana. Condições potencialmente fatais incluem arterites, encefalites e hidrocefalia. Depressão e declíneo cognitive permanecem entre as mais importantes manifestações psiquiátricas. Manifestações neuropsiquiátricas, epidemiologia e neuroimagem provêm os critérios de diagnóstico. As imagens cerebrais podem revelar um ou diversos cistos preenchidos com líquido e o escólex (cabeça) do parasito. CONCLUSÕES: A diversidade de apresentações da NCC encoraja os profissionais de saúde a considerá-la dentre os diagnósticos, especialmente em países endêmicos; e também em áreas não-endêmicas, pois migrantes e viajantes estão sujeitos ao contágio. O tratamento consiste no uso de antiparasíticos (albendazol, praziquantel) e medicamentos para tratar condições associadas (anticonvulsivantes, corticosteróides). Cirurgia é reservada para remoção do parasito de locais particulares (olhos, medula espinhal, ventrículos cerebrais) ou para diferenciar NCC de tumores, tuberculose, micose, etc. Prevenção inclui o tratamento de helmintíases intestinais, sanidade animal, higiene ao preparar alimentos, controle da qualidade da água e alimentos.

Estrongiloidiasis crónica y uso prolongado de corticoides / Chronic strongyloidiasis and extended use of corticoids

La infección causada por Strongyloides stercoralis puede permanecer asintomática o con síntomas ligeros en humanos por varios años. Sin embargo, algunos individuos inmunodeprimidos, entre ellos los pacientes tratados con esteroides por tiempo prolongado, pueden presentar hiperinfección con altas tasas de mortalidad. El objetivo es reportar por primera vez en Cuba el caso de una paciente con síntomas de estrongiloidiasis crónica asociada al uso de esteroides orales. Se trata de una paciente de 63 años, asmática con síntomas de estrongiloidiasis crónica y riesgo de hiperinfección por el uso de esteroides orales por tiempo prolongado. Se describen las manifestaciones clínicas y los análisis complementarios. Se discuten los factores predisponentes para la adquisición inicial y el desarrollo de la enfermedad. El laboratorio confirmó la presencia de larvas rabditoides de Strongyloides stercoralis en las heces de la paciente. Aunque existen evidencias de casos fatales de pacientes con strongiloidiasis asociada al uso prolongado de esteroides en la literatura internacional, hay escasez de esos reportes en Cuba. Adicionalmente, es probable que el diagnóstico y el tratamiento oportunos, hayan contribuido a evitar complicaciones fatales en esta paciente(AU)

The infection caused by Strongyloides stercoralis may remain asymptomatic or with slight symptoms in humans for decades. However, immunocompromised patients, particulary those receiving long-term steroid therapy, may face hyperinfection resulting in high mortality rates. The objective was to present the first report in Cuba about a patient with chronic strongyloidiasis associated to use of oral steroids. Here is a 63 years-old asthmatic woman, who showed chronic strongyloidiasis symptoms and hyperinfection risk due to the long-term use of oral steroids. The symptoms and physical examination were described as well as various diagnostic tests. Predisposing factors for the onset and development of the disease were discussed. Laboratory diagnosis confirmed the presence of Strongyloides stercoralis rabditoid larvae in the patient's feces. Although there has been evidence of fatal cases with chronic strongyloidiasis associated with long-term use of steroids in the international literature, such reports are rare in Cuba. Additionally, it is likely that timely diagnosis and treatment have contributed to avoid fatal complications in this patient(AU)