Inmunodeficiencia variable común: afectación digestiva de un trastorno sistémico / [Common variable immunodeficiency: digestive involvement of a systemic disease].

Common variable immunodeficiency is characterized by a primary deficiency in antibody production that is clinically manifested by respiratory recurrent infections and gastrointestinal diseases (infectious, inflammatory and neoplastic). Above 50

of the patients have diarrhea and 10

develop idiopathic malabsorption and weight loss. We present the case of a 34-year-old woman submitted to our service for chronic diarrhea, abdominal pain and bloating and history of recurrent respiratory infections since childhood. The laboratory assessment showed severe hypoproteinemia and confirmed low IgG, IgA and IgM levels. Upper gastrointestinal endoscopy and videocapsule endoscopy showed a nodular duodenum with multiple polypoid-like formations all through the small bowel. Histology confirmed chronic duodenitis and Giardia lamblia infection. With the diagnosis of common variable immunodeficiency, monthly intravenous gammaglobulin infusion was initiated and metronidazole was indicated for Giardia lamblia infection achieving excellent clinical and laboratory response.

Prevalencia y factores de riesgo de Cryptosporidium spp. y Giardia spp. en terneros de ganado lechero de la zona noroccidental de la Sabana de Bogotá / Cryptosporidium spp. and Giardia spp. prevalence and risk factors in dairy calves of the north-western zone of the Bogota Savanna

Objetivo Estimar la prevalencia de Cryptosporidium spp. y Giardia spp. en terneros de 0 a 2 meses de ganado lechero de la zona noroccidental de la Sabana de Bogotá. Se estimaron los factores de riesgo de la producción lechera que puedan incurrir en la infección de personas y animales. Métodos Estudio de corte transversal, mediante la toma de materia fecal de terneros. Se determinó la prevalencia de punto para Giardia spp. y Cryptosporidium spp. a través los resultados de los coprológicos (Ritchie para Giardia spp. y Ziehl-Neelsen modificada para Cryptosporidium spp.). Se calcularon Odds Ratio para establecer los factores de riesgo asociados entre estos dos géneros de protozoarios y el manejo de las Buenas Prácticas Ganaderas. Resultados Se evaluaron 33 fincas dedicadas a la producción lechera, donde se muestrearon 308 terneros. La prevalencia para Giardia spp. fue de 37,3 %, 115 animales positivos y para Cryptosporidium spp. fue de 4,9 % 15, animales positivos. Conclusión Existe un foco de Giardia spp. y Cryptosporidium spp. en el noroccidente de la Sabana de Bogotá, del cual no se tenía conocimiento previo. La prevalencia de Giardia spp. para la región estudiada, está en el límite alto del rango reportado para Sudamérica. En el caso de Cryptosporidium spp. la situación es distinta, la prevalencia se encuentra en el limite bajo del rango reportado para Sudamérica. Los factores de riesgo asociados a Giardia spp. y Cryptosporidium spp. en las explotaciones lecheras del noroccidente de la Sabana de Bogotá, dependen de Buenas Prácticas Ganaderas.

Objective The present study was aimed to establishing Cryptosporidium spp. and Giardia spp. prevalence in 0 to 2 months old dairy calves of the north-western zone of the Bogota Savanna. In addition, associated factors related to a failure in Good Practices of Livestock could incur in human and animal infection. Methods This was a cross-sectional study; calves' fecal samples were used. Farms' Good Practices of Livestock were observed by means of an observation blank. Giardia spp. and Cryptosporidium spp. prevalence was determinate by means of laboratory results (Ritchie for Giardia spp. and modified Ziehl-Neelsen for Cryptosporidium spp.). Odds Ratios (OR) were calculated in association between this two genera of protozoa and Good Practices of Livestock. Results Thirty three dairy farms were evaluated, where fecal samples of 308 calves were taken. Giardia spp. prevalence was 37.7 %, 115 infected animals; Cryptosporidium spp. prevalence was 4.9 %, 15 infected animals. Conclusion There is an important Giardia spp. and Cryptosporidium foci in the north-western zone of the Bogota Savanna, without a previous knowledge. Giardia spp. prevalence for this zone is in the highest rank reported for South-America and Cryptosporidium spp. prevalence is in en the lowest one. Associated risk factors of Giardia spp. and Cryptosporidium spp. in dairy farms of the north-western zone of the Bogota Savanna depend of a Good Practices of Livestock performance.

Protozoos intestinales en un asentamiento precario: manifestaciones clínicas y ambiente / Intestinal protozoa in a marginal settlement: clinical manifestations and environment

Los objetivos de este trabajo fueron conocer la distribución de Blastocystis hominis y Giardia lamblia en un asentamiento del Partido de La Plata (Buenos Aires), evaluar si su infección tiene manifestaciones clínicas y si su asociación con especies comensales es indicadora de la influencia de factores ambientales. Se tomaron 194 muestras fecales en 78 familias, que se analizaron mediante las técnicas de Ritchie, Carles Barthelemy y Willis. Se completaron encuestas con datos ambientales, sociales y del entorno de las viviendas. Se buscaron parásitos intestinales en muestras de agua. El 69,1% de los analizados (85,8% de las familias) estuvo parasitado con protozoos. En el 87% de los hogares positivos, hubo casos de poliparasitismo. Las especies más frecuentes fueron Blastocystis hominis y Giardia lamblia, que no se hallaron asociadas entre sí, ni con los síntomas digestivos estudiados. Blastocystis hominis se asoció con Endolimax nana (p<0,01), Entamoeba coli (p<0,01) y Enteromonas hominis (p<0,05). Ambas especies patógenas fueron más frecuentes entre las familias numerosas que viven en condiciones de hacinamiento (p≤0,05). Giardia lamblia se asoció con la promiscuidad (p<0,05) y la convivencia con caninos (p<0,01). La presencia de quistes de amebas comensales en el agua de las viviendas analizadas demuestra que ésta puede ser un factor de riesgo de infección parasitaria si no es debidamente purificada. Son necesarios mayores controles sanitarios que procuren una disposición segura de las excretas humanas y animales.

The aims of this study were to know the distribution of Blastocystis hominis and Giardia lamblia in a suburban settlement of La Plata district, Buenos Aires province, to evaluate if infections have clinical manifestations, and to determine if the association with commensal species is influenced by environmental factors. A hundred and ninety-four faecal samples of 78 families were examined using Ritchie, Carles Barthelemy and Willis techniques, and also water samples were analyzed for intestinal protozoans. Environmental and social questionnaires were fulfilled. Of the analyzed persons, 69.1% (85.8% of the families) were infected with protozoans. Eighty-seven per cent of the positive families were poli-parasitized. Blastocystis hominis and Giardia lamblia were the most frequent species and they were not associated with each other, neither with the digestive symptoms. Blastocystis hominis was associated with Endolimax nana (p<0.01), with Entamoeba coli (p<0.01) and with Enteromonas hominis (p<0.05). Giardia lamblia was associated with promiscuity (p<0.05) and the coexistence of dogs (p<0.01). The presence of cysts of commensal amoebas in the water analyzed demonstrates it could be a risk factor of parasitic infection. More strict sanitary controls are needed to avoid the faecal contamination of the environment.

Prevalencia de giardia lamblia, su detección en aguas y su relación con factores ambientales en Gualeguaychú, Argentina / Prevalence of giardia lamblia, isolation in water and the relationship with envionmental factors in Gualeguaychú, Argentina

The increasing environmental contamination affects the water quality, and is going to raise the waterborne intestinal infections such as giardiosis. This study determined the prevalence of g. lamblia infection in 1.201 persons of Gualeguaychú, Argentina. It was observed the relationship between giardiosis and the detection of g. lamblia in the recreational and drinking water and with homes environmental factors. General rate of infection was 19,7 percent. The group 2-11 years old was the highest (28,0 percent). No cysts of g. lamblia were found in drinking water, but recreational water was contaminated. Higher rate of infected persons lived in suburban dwellings with dirt floor, latrine, ground-water and close contact with dogs. It is concluded that to drink water is no risk-infection at present, but it will be if this community continues discharging excretsa into the river because this is the source of water for the habitants

Giardia lamblia and chronic gastritis

One hundred and two patients suffering from giardiasis and/or chronic gastritis were subjected to upper gastrointestinal endoscopy. Purified immune rabbit's serum against Giardia lamblia was used in ELISA and immunoperoxidase [IIP] techniques for detection of Giardia antigen in the stomach. Results showed that out of 70 cases with intestinal giardiasis, 8 [11.4%] by ELISA and 6 [8.6%] by IIP showed gastric giardiasis. Higher percentage of gastric giardiasis [14%] was encountered in cases with both giardiasis and chronic gastritis [50] than in cases with giardiasis alone [5%] but with statistically insignificant difference. None of the cases with chronic gastritis alone [without giardiasis] was positive for gastric giardiasis. Dyspepsia was the main presenting symptom in cases with gastric giardiasis with significant association. Helicobacter pylori was encountered in 6 out of 8 cases [75%] with gastric giardiasis with significant association. Duodenogastric reflux was detected in 4 out of 8 cases [50%]. Histopathological changes in antral mucosa were detected in all cases of gastric giardiasis

Case control study of giardiasis in diarhoeas versus non diarrhoeal children aging 6-12 years

The aim of this work is to study the prevalence, the clinical presentation and the different methods of diagnosis of giardiasis among school children aging 6-12 years suffering from acute diarrhea. The prevalence of giardiasis was 26% and 6% in diarrheal and non- diarrheal children, respectively. Children with giardiasis were younger, without sex difference and in lower socioeconomic status that those without giardiasis. Simple stool analysis detected 43.8%, simple flotation method detected 68.8% while, duodenal aspiration detected 81.3% of giardia cases. Stools in giardiasis was offensive, pale whitish and not bloody. Offensive stool was the commonest manifestation [87.5%] followed by diarrhea [81.3%]. It was concluded that the clinical picture of giardiasis is suggestive and duodenal aspiration is a good diagnostic methods. Large scale study and duodenal biopsy are recommended

Control de giardiasis en una zona suburbana de la provincia de la Habana / Control of giardiasis in province ciudad de la habana

Se asignaron aleatoriamente 250 personas (49 familias) y 230 personas (52 familias) a grupos I y II respectivamente, que son objeto de dos intervenciones diferentes. Los grupos tenían en común las condiciones de saneamiento básico, eran atendidos por el mismo grupo de atención primaria y una prevalencia de G. lamblia de 21 por ciento en cada uno de ellos. Al grupo I se les administró quimioterápia con tinidazol a 50 mg/Kg de peso sin pasar de 2 gramos en dosis repetidas por 3 días y a sus miembros se les orientó con medidas de higiene que se verificaron en el hogar en un período de 30 días por dos años. Al grupo II se les indicó recetas médicas con tinidazol a igual dosis y a sus miembros se les orientó con medidas higiénicas desde la porta médica pero no se efectuaron los controles de su aplicación en el hogar. En 1992 se observó un importante descenso en la prevalencia de GH. lamblia y no se observó reinfección e incidencia en el grupo I; en cambio en el grupo II estos indicadores no se redujeron significativamente. Se recomienda que la estrategia de dispensarización del equipo médico de atención primaria unido a la quimioterapia controlada sea el método adecuado para reducir esta parasitosis en la comunidad.

Survey study of intestinal parasites in Kirkuk paediatric hospital

This paper reports the prevalence of intestinal parasites in kirkuk paediatric hospital patients A total of 770 stool samples were collected and examined by both direct and concentration techniques. Intestinal parasites were found in 223 children [116 males and 106 females]. The parasites were Giardia lamblia 91[40.81%]. Entamoeba histolytica 109 [49.37%], Hymenolepis nana 5 [2.24%], Trichomonis hominis 7 [3.14%]. Mixed infections were Giardia lamblia and Entamoeba histolytica 7[3.14%], and Giardia lamblia and hvmenolepis nana 1[0.45%]. The nematodes were Ascaris lumbricoides 2[0.9%], and Enterobius vermicularis 1[0.45%] The highest prevalence [50%] was in the 10-12 years age groups. The rate of infection in males [27.15%] was lower than females [31.27%]. The scotch tape method was more efficient than direct and concentration techniques for detection of eggs of Enterobius vermicularis. The main clinical symptoms observed in infected children were diarrhea and abdominal pain

study of enteropathogenic microbial agents of diarrhoea disease in Rawalpindi/Islamabad areas

Acute diarrhoea has a world wide distribution and is one of the leading causes of morbidity and mortality in children in many developing countries. A total of 1200 stool specimens from the patients suffering from diarrhoea were analyzed for enteropathogenic microbial agents. A significant number [49.3%] revealed microbial agents as causative agent, while in 50.6% cases no pathogenic organism could be isolated. The main causative agents were bacteria [60.3%]. The viruses [21.96%] and parasites [17.74% contributed relatively less number of cases. Out of the bacterial pathogens, E. coli was the predominant organism 135 [37.81%] followed by Shigella spp, 87 [24.4%]. The Salmonella spp. constituted 79 [22.12%] and Vibrio app 40 [11.20%]. Out of the 105 parasite infected cases, Giardia lamblia comprised 95 [90.5%] followed by E. histolytica 10 [9.5%]. Among the viral causes, Rota virus was found in 130 [12.96%] of all diarrhoeal stools. The mixed infection due to enteropathogenic E. coli and Rota viruses was also found in a few children. Therefore we conclude that diarrhoneal diseases are prevalent in the population of Rawalpindi/Islamabad areas. Bacteria are the main causative agents as compared to viruses and parasites. The cause of diarrhoea should be established well before treatment and no diarrhoeal case should go undiagnosed

Detección de quistes de Giardia lamblia en agua / Detection in water of Giardia lamblia cyst

Este trabajo tuvo por finalidad poner la técnica propuesta por la American Public Health Association, la American Water Works Association y la Water Pollution Control Federation, para la detección de parásitos en agua. Se utilizaron filtros de cartucho de polipropileno, de porosidad nominal de 5 *m. La reproducibilidad del método y la eficiencia del filtro, se evaluaron experimentalmente, con concentraciones conocidas de quistes de Giardia Lamblia con un muy buena tasa de recuperación. Sobre un total de 15 muestras de agua de distintas procedencias, se detectaron quistes de Giardia lamblia en una muestra de agua subterránea, de la localidad de City Bell, provincia de Buenos Aires. Se incluyen datos sobre características de los quistes y aspectos epidemiológicos de la giardiasis hídrica

Immunological status of women with prolonged oral contraceptives and occurrence of giardiasis.

Immunological status of 14 women taking oral contraceptive for prolonged period (more than 6 months, low dose pill) was studied. Phytohaemagglutinin induced lymphocytes stimulation (PILT) was found to be significantly depressed in these subjects though T-lymphocyte subpopulation was found to be normal. Serum IgA and IgG levels in these cases were found to be normal but IgM level was increased. Though incidence of G lamblia infection was reported to be high in immunocompromised subjects, it was found only one out of 14 subjects taking oral contraceptive harboured the protozoa.

Giardíase / Giardiasis

A Giardia lamblia é o protozoário mais comum do trato intestinal humano, causando infecçäo endêmica na maioria dos países do mundo, especialmente naqueles subdesenvolvidos, onde a taxa de prevalência pode superar 30%. Tal nível é mantido dentro da populaçäo através de reinfecçöes contínuas, via fecal-oral. A distribuiçäo e morbidade da infecçäo variam com as condiçöes econômicas, higiênicas e sanitárias das populaçöes atingidas

Eritema polimorfo: etiología, tratamiento y evolución de 67 pacientes / Polymorphous erithema: etiology, treatment and course of 67 patients

Se realizó un estudio en 67 niños afectados de eritema mulfiforme en el Servicio de Alergia del Hospital Pediátrico Provincial Docente de Villa Clara, Cuba, en el año 1985. El objetivo fundamental era realizar un diagnóstico etiológico, tratamiento y evolución de los casos. Dentro de los resultados obtenidos se observó que los factores etiológicos más frecuentes fueron: alimentarios, medicamentosos y parasitarios (giardiasis), encontrándose además un déficit de IgA asociado a los pacientes con parasitismo. El tratamiento fue individual, dinámico e integral, obteniéndose resultados satisfactorios

Giardiasis / Giardiasis

La giardiasis en una enfermedad universal causada por un protozoo que pertenece a la clase mastigophora denominado Giardia lamblia. Esta enfermedad constituye un problema de salud en nuestro país ya que afecta a cerca de nueve millones de pesonas, siendo la población infantil la más afectada, mientras que en la adulta por lo general cursa de manera asintomática. La patogenia del parásito fue puesta en duda durante mucho tiempo; sin embargo, hoy día se han dilucidado en gran parte los mecanismos de dinámica del daño tisular, correlacionando su cuadro clínico con dichos mecanismos. El cuadro clínico que de manera característica se ha descrito con evaluaciones diarreicas, meteorismo, flatulencia, dolor epigástrico, etc, se ha enriquecido con una variedad de manifestaciones de tipo alérgico. Asimismo se han reconocido nuevos procesos involucrados en la transmisión de la enfermedad tales como contacto sexual entre homosexuales que han producido como consecuencia nuevos cuadros y entidades como el síndrome intestinal del homosexual. Por otra parte, a pesar de los variados recursos diagnósticos con que se cuenta se ha hecho aparente la necesidad de crear métodos más sensibles ante infecciones leves o inaparentes en las cuales el parásito es muy difícil de descubrir. Esta enfermedad como otras transmitidas por el fecalismo requieren de un mejor manejo no sólo por parte del médico sino de un complicado sistema que sea capaz de detener la dinámica de transmisión, en el cual se lleve a cabo control de portadores humanos y de la fauna silvestre también involucrada em dicha transmisión