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1.
Arq. ciências saúde UNIPAR ; 25(1): 37-42, jan-abr. 2021.
Article in Portuguese | LILACS | ID: biblio-1151406

ABSTRACT

As infecções ocasionadas pelos vírus da Dengue (DENV), Zika (ZIKV) e Chikungunya (CHIKV) em gestantes são de grande preocupação pelos possíveis danos causados pelos mesmos às mães e fetos. O ZIKV está relacionado à microcefalia e outras anomalias cerebrais graves em neonatos e a infecção por CHIKV em gestantes no período intraparto pode levar à transmissão vertical, com possibilidade de agravamento no quadro do neonato. E, apesar de ainda não haver relatos de ocorrência de malformações congênitas associadas à infecção por DENV em gestantes, as mesmas são consideradas um grupo de risco, pois apresentam maiores chances de evolução para formas graves ou óbito e aumento no risco de partos prematuros decorrente da infecção materna perinatal. Neste estudo, foi realizada uma análise retrospectiva dos resultados envolvendo os vírus DENV, ZIKV e CHIKV para determinar a taxa de positividade destas arboviroses em gestantes no município de São José do Rio Preto-SP, nos anos de 2018 e 2019. Para isso, foram coletados resultados de PCR em tempo real (RT-PCR) para DENV, ZIKV e CHIKV de amostras de soro e urina obtidas de 557 gestantes com histórico de febre, bem como 93 amostras de recém-nascidos (RN). Na análise dos resultados foi verificado que o sorotipo-2 de Dengue (DENV-2) foi detectado em 106/557 correspondendo a 19% das amostras, o sorotipo-1 (DENV-1) foi detectado em apenas uma amostra e o ZIKV foi detectado em duas amostras. CHIKV não foi detectado. Não foi detectado arbovírus nas amostras de RN testadas pela técnica de RT-PCR. Quanto à idade, 40% das gestantes pertenciam à faixa etária de 25 a 32 anos, seguidas pelas faixas de 33 a 40 anos e 17 a 24 anos com percentuais de 31 e 29%, respectivamente. No período, uma gestante que estava na 13ª semana de gestação foi a óbito por DENV-2. Os resultados obtidos evidenciam a importância do diagnóstico precoce das arboviroses neste grupo, viabilizando a assistência adequada às gestantes. Nesse sentido, o monitoramento da circulação simultânea de arboviroses responsáveis por causarem complicações em gestantes e infecções congênitas deve continuar em áreas endêmicas como a de São José do Rio Preto, visando um diagnóstico materno precoce e manejo adequado de gestantes testadas positivas verificando a presença de sinais de alerta e de dengue grave.


Infections caused by Dengue (DENV), Zika (ZIKV) and Chikungunya (CHIKV) viruses in pregnant women represent great concern because of the possible damage that can be caused by these viruses to both mothers and fetuses. ZIKV is related to microcephaly and other severe brain abnormalities in neonates, while CHIKV infection in pregnant women in the intrapartum period can lead to vertical transmission, with the possibility of worsening in the neonate. And although there are no reports of congenital malformations associated with DENV infection in pregnant women, they are also considered of risk group, since they have greater probability to progress to severe forms or even death. In addition, there is an increased risk of premature childbirth. In this study, a retrospective result analysis involving DENV, ZIKV and CHIKV viruses was carried out to determine the positivity rate of those arboviruses in pregnant women in the city of São José do Rio Preto-SP, in the years 2018 and 2019. For this purpose, real-time PCR results (RT-PCR) were collected for DENV, ZIKV and CHIKV from serum and urine samples obtained from 557 pregnant women with a history of fever, as well as samples from 93 newborns (NB). Dengue serotype-2 (DENV-2) was detected in 106/557, which corresponds to 19% of the samples; dengue serotype-1 (DENV-1) was detected in only one sample, and the ZIKV was detected in two samples. CHIKV was not detected. Arboviruses were not detected in the NB samples tested by the RT-PCR technique. In relation to age groups, 40% of pregnant women were between 25 to 32 years old, followed by the groups of 33 to 40 years old, and 17 to 24 years old, with 31% and 29%, respectively. In the period, a pregnant woman who was in the 13th week of pregnancy died due to DENV-2. The results obtained emphasize the importance of the early diagnosis of arboviruses in this group, thus enabling adequate assistance to pregnant women. In this sense, the monitoring of arboviruses circulation responsible for causing complications and congenital infections in pregnant women should continue in endemic areas such as São José do Rio Preto, aiming at an early maternal diagnosis and adequate management of the patients who tested positive, checking for the presence of any alert signs and severe dengue.


Subject(s)
Humans , Female , Pregnancy , Adult , Arbovirus Infections , Pregnant Women , Infant, Newborn/growth & development , Chikungunya virus , Dengue/complications , Early Diagnosis , Zika Virus , Zika Virus Infection/complications , Vector Borne Diseases/virology , Microcephaly/virology
2.
Gac. méd. Méx ; 157(1): 61-66, ene.-feb. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1279075

ABSTRACT

Resumen Introducción: La distinción clínica entre infecciones arbovirales y las provocadas por rickettsias es crucial para iniciar el tratamiento médico apropiado. Objetivo: Comparar las diferencias entre fiebre manchada de las Montañas Rocosas (FMMR) y otras enfermedades transmitidas por vector (dengue y chikungunya) con presentación clínica similar e identificar los datos que pudieran ayudar al diagnóstico rápido de esas enfermedades. Métodos: Se evaluaron datos sociodemográficos, clínicos y de laboratorio de 399 pacientes de cinco hospitales y clínicas en Sonora, México, entre 2004 y 2016, con el diagnóstico confirmado por laboratorio de FMMR, dengue o chikungunya. Resultados: El grupo con FMMR presentó la mayor letalidad (49/63 muertes, 77.8 %), seguido por el de chikungunya (3/161, 1.9 %) y el de dengue (3/161, 1.9 %). Las diferencias clínicas consistieron en la presencia de exantema, edema y prurito; además, se documentaron diferencias en múltiples biomarcadores como plaquetas, hemoglobina, bilirrubina indirecta y niveles de sodio sérico. Conclusión: El exantema en palmas y plantas, edema y ausencia de prurito, aunados a niveles altos de bilirrubina directa y trombocitopenia severa pudieran ser indicadores útiles para diferenciar a pacientes con FMMR en etapas avanzadas de aquellos con dengue y chikungunya.


Abstract Introduction: Clinical distinction between arbovirus infections and those caused by rickettsia is crucial to initiate appropriate medical treatment. Objective: To compare the differences between Rocky Mountain spotted fever (RMSF) and other vector-borne diseases (dengue and chikungunya) with similar clinical presentation, and to identify data that could aid rapid diagnosis of these diseases. Methods: Sociodemographic, clinical and laboratory data of 399 patients from five hospitals and clinics of Sonora, Mexico, with laboratory-confirmed diagnosis of RMSF, dengue, or chikungunya between 2004 and 2016 were evaluated. Results: The RMSF group had the highest lethality (49/63 deaths, 77.8 %), followed by the chikungunya group (3/161, 1.9 %) and the dengue group (3/161, 1.9 %). Clinical differences included the presence of rash, edema, and pruritus; in addition, differences in multiple biomarkers such as platelets, hemoglobin, indirect bilirubin, and serum sodium levels were documented. Conclusion: Rash on the palms and soles, edema and absence of pruritus, together with high levels of direct bilirubin and severe thrombocytopenia could be useful indicators to differentiate patients at RMSF advanced stages from those with dengue and chikungunya.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Rocky Mountain Spotted Fever/diagnosis , Dengue/diagnosis , Chikungunya Fever/diagnosis , Rocky Mountain Spotted Fever/complications , Rocky Mountain Spotted Fever/mortality , Cross-Sectional Studies , Dengue/complications , Dengue/mortality , Diagnosis, Differential , Symptom Assessment , Chikungunya Fever/complications , Chikungunya Fever/mortality , Mexico/epidemiology
3.
Medicina (B.Aires) ; 80(supl.6): 94-96, dic. 2020.
Article in Spanish | LILACS | ID: biblio-1250324

ABSTRACT

Resumen El dengue es una arbovirosis confinada a las áreas geográficas donde habitan sus vectores, los mosquitos Aedes aegypti y Aedes albopictus. La transmisión ocurre principalmente durante el verano, pero la persistencia del insecto en el ambiente puede extenderla hasta el otoño en climas templados y cálidos. En nuestro país, este año la trasmisión estacional del dengue se superpuso temporalmente con la pandemia de COVID-19, producida por el SARS-CoV-2, un coronavirus causante de afecciones respiratorias graves con eventual desenlace fatal. Por otro lado, el HIV es un retrovirus que debilita el sistema inmune favoreciendo las infecciones por numerosos patógenos oportunistas. Presentamos el caso de un paciente con infección HIV sin tratamiento que desarrolló infección simultánea por dengue y SARS-CoV-2 con evolución favorable.


Abstract Dengue is a mosquito-borne viral disease confined to the geographical areas where its vectors Aedes aegypti and Aedes albopictus are present. The transmission occurs mainly during the summer but it can extend to autumn months in warm climates. In our country, this year the seasonal transmission of dengue overlapped with the COVID-19 pandemic, caused by SARS-CoV-2, a novel coronavirus responsible of serious respiratory conditions with eventual fatal outcomes. On the other hand, the HIV is a retrovirus that causes disease by weakening the immune system, favoring infections by numerous opportunistic pathogens. We present the case of an untreated HIV patient who developed simultaneous infection with dengue and SARS-CoV-2 with favorable evolution.


Subject(s)
Humans , Animals , Aedes , Dengue/complications , Dengue/diagnosis , Dengue Virus , Coinfection , COVID-19 , HIV Infections/complications , Dengue/epidemiology , Pandemics , Mosquito Vectors , SARS-CoV-2
4.
Rev. cuba. med ; 59(4): e1162, oct.-dic. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1144507

ABSTRACT

Introducción: Los trastornos neurológicos asociados al dengue es un tema que cobra vital importancia en estos tiempos debido a que el espectro clínico del dengue ha cambiado y las manifestaciones atípicas están reportándose con mayor frecuencia. Los serotipos 2 y 3 son los más frecuentemente relacionados a manifestaciones neurológicas como la encefalitis, mielitis y síndrome de Guillain-Barré. Objetivo: Reportar una serie de casos con trastornos neurológicos asociados a la infección por DENV y sus variables clínicas, humorales e imagenológicas. Casos clínicos: Todos los pacientes cursaron en primera instancia con un cuadro clínico de dengue no complicado dado por fiebre de 38,5º C y escalofríos de aparición brusca, exantema maculo-papuloso céfalo-caudal que respeta palmas y plantas, artralgias, mialgias, cefalea frontal y retro-ocular, esta última a la contracción del músculo recto superior del globo ocular. Todos confirmados con anticuerpos específicos anti-virus del dengue. Un paciente desarrolló síndrome de Guillain-Barré, otro curso con encefalitis, bicitopenia y compromiso del nivel de conciencia. El resto cursó con mielitis transversa, meningoencefalitis y encefalitis autoinmune. Conclusiones: Los trastornos neurológicos asociados al virus del dengue deben ser sospechados en todo paciente que ingrese con esta infección y manifieste cualquiera de las alteraciones aquí descritas(AU)


Introduction: Neurological disorders associated with dengue is an issue of vital importance in these times because the clinical spectrum of dengue has changed and atypical manifestations are being reported much frequently. Serotypes 2 and 3 are the most frequently related to neurological manifestations such as encephalitis, myelitis and Guillain-Barré syndrome. Objective: To report a series of cases with neurological disorders associated with DENV infection and its clinical, humoral and imaging variables. Clinical case report: All patients had, in the first instance, uncomplicated dengue clinical status due to 38.5º C fever and chills of sudden appearance, Cephalo-caudal maculo-papular rash that spares palms and soles, arthralgias, myalgias, frontal and retro-ocular headache, the latter due to the contraction of the superior rectus muscle of the eyeball. All confirmed with specific anti-dengue virus antibodies. One patient developed Guillain-Barré syndrome, another had encephalitis, bicytopenia, and compromised level of consciousness. The rest had transverse myelitis, meningoencephalitis and autoimmune encephalitis. Conclusions: Neurological disorders associated with dengue virus should be suspected in every patient who is admitted with this infection and manifests any of the alterations described here(AU)


Subject(s)
Humans , Male , Female , Dengue/complications , Nervous System Diseases/complications
6.
Rev. pediatr. electrón ; 17(1): 1-12, abr 2020.
Article in Spanish | LILACS | ID: biblio-1099829

ABSTRACT

Introducción: El dengue representa un importante problema de salud pública en países como Colombia. Usualmente se trata de una patología autolimitada con buena respuesta a manejo sintomático ambulatorio, sin embargo, cuadros con síntomas atípicos pueden complicar el diagnóstico dando lugar a manifestaciones inusuales que comprometen la vida del paciente. Objetivo: Describir la información del tema expuesto resaltando aspectos relevantes como diagnóstico y manejo. Metodología: Se efectuó una revisión bibliográfica con búsqueda electrónica en las siguientes bases de datos: PubMed, MEDLINE, Medscape, Scopus; en inglés y español incluyéndose diferentes tipos de artículo (artículos originales, revisiones de temas y guías de manejo que abordaran síntomas inusuales de dengue en pediatría desde el año 2009 al 2019. Resultados: Se obtuvo 414 referencias después de una revisión de artículos, donde se describe el tema de complicaciones relacionadas con esta patología en pediatría, se seleccionaron 50 artículos en texto completo que cumplían los requisitos de búsqueda. Conclusiones: El tema de manifestaciones atípicas del dengue tiene poca revisión registrada en el área de pediatría, son complicaciones poco frecuentes por lo cual la evidencia es escasa, estas se deben tener en cuenta para manejo y tratamiento oportuno.


Introduction: Dengue represents a major public health problem in countries like Colombia. Usually it is a self-limited pathology with good response to outpatient symptomatic management, however, pictures with atypical symptoms can complicate the diagnosis resulting in unusual manifestations that compromise the patient's life. Objective: Describe the information on the exposed topic highlighting relevant aspects such as diagnosis and management. Methodology: A bibliographic review was carried out with electronic search in the following databases: PubMed, MEDLINE, Medscape, Scopus; in English and Spanish including different types of article (original articles, review of topics and management guides that will address unusual symptoms of dengue in pediatrics from 2009 to 2019. Results: 414 references were obtained after an article review, which describes the topic of complications related to this pathology in pediatrics, 50 articles were selected in full text that met the search requirements. Conclusions: The issue of atypical manifestations of dengue has little revision registered in the area of pediatrics, they are rare complications, so the evidence is scarce, these should be taken into account for timely management and treatment.


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Dengue/complications , Dengue/diagnosis , Dengue/pathology , Dengue Virus , Disease Progression , Acute Kidney Injury/etiology , Gastrointestinal Diseases/etiology , Nervous System Diseases/etiology
8.
Rev. cuba. med. trop ; 71(1): e281, ene.-abr. 2019. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1093551

ABSTRACT

Introducción: La infección por virus dengue es considerada una de las arbovirosis de mayor prevalencia en los países tropicales. La encefalomielitis diseminada aguda es un trastorno inflamatorio desmielinizante y multifocal que afecta al sistema nervioso central, de inicio agudo y curso clínico monofásico. El proceso inflamatorio se encuentra mediado por mecanismos inmunológicos y su relación con infecciones por el virus dengue aún no se establece con claridad. Objetivo: Describir un caso clínico con manifestaciones del sistema nervioso central después de una probable infección por el virus dengue. Presentación del caso: Paciente femenina de 50 años, con antecedentes de hipertensión arterial controlada. Quince días después de un cuadro de fiebre de 4 días de duración, que posiblemente fue por una infección por el virus dengue, comienza con síntomas y signos de afectación neurológica caracterizadas por ligera irritabilidad, dificultad para la concentración en una actividad específica de la vida cotidiana. Progresivamente se nota dificultad motora en el hemicuerpo izquierdo además de encontrarse agitada y distraída, motivo por el cual se decide su ingreso hospitalario. Se realiza el diagnóstico a través de los hallazgos en el examen físico, los estudios positivos de resonancia magnética nuclear y el resultado positivo de la IgM de dengue en sangre. Tanto la evolución clínica como la respuesta al tratamiento con esteroides fueron favorables. Conclusiones: El evento ocurrido en este caso sugiere que los facultativos deben tener presente el diagnóstico de encefalomielitis diseminada aguda en pacientes que han tenido infección previa o alta sospecha de esta por el virus dengue(AU)


Introduction: Dengue virus infection is one of the most prevalent arboviruses in tropical countries. Acute disseminated encephalomyelitis is an inflammatory demyelinating multifocal disorder affecting the central nervous system. Its onset is acute and its clinical course monophasic. The inflammatory process is mediated by immunological mechanisms, and its relationship to dengue virus infections is still not clear. Objective: Describe a clinical case of central nervous system manifestations after probable dengue virus infection. Case presentation: Female 50-year-old patient with a history of controlled hypertension. Fifteen days after a 4-day fever episode, possibly due to dengue virus infection, the patient starts presenting neurological signs and symptoms, such as slight irritability and difficulty to concentrate on a specific activity of daily living. The patient notices progressive motor difficulty in her left hemibody and she feels agitated and distracted. It is therefore decided for her to be hospitalized. A diagnosis is made based on physical examination findings, positive nuclear magnetic resonance studies, and the positive result of the dengue IgM blood test. Both the patient's clinical evolution and her response to treatment with steroids were favorable. Conclusions: The event herein described suggests that physicians should consider the diagnosis of acute disseminated encephalomyelitis in patients with previous infection or high suspicion of infection with dengue virus(AU)


Subject(s)
Humans , Female , Middle Aged , Dengue/complications , Encephalomyelitis, Acute Disseminated/complications , Encephalomyelitis, Acute Disseminated/diagnosis , Clinical Evolution , Encephalomyelitis, Acute Disseminated/diagnostic imaging
9.
Rev. méd. hondur ; 86(1/2): 7-10, ene-. jul. 2018.
Article in Spanish | LILACS | ID: biblio-1007044

ABSTRACT

Introducción: El dengue es la enfermedad viral transmitida por mosquitos con la propagación más rápida en el mundo. En Honduras constituye un importante problema de salud pública debido a su alta incidencia. Bacillus thuringiensis var israelensis (Bti) es un agente de control biológico aplicado en el control de vectores, se ha utilizado recientemente como parte de la estrategia contra el Aedes aegypti en Honduras. El presente estudio tiene como objetivo evaluar la susceptibilidad de la larva de Ae. aegypti a Bti en Tegucigalpa, Honduras para el año 2014. Métodos: Una muestra de 960 larvas de Ae. aegypti se recogieron de recipientes de almacenamiento en viviendas de las colonias La Cañada y Nueva Suyapa, ubicados en Tegucigalpa, Honduras. Los bioensayos se realizaron de acuerdo con las directrices emitidas por la Organización Mundial de la Salud y la Red Latinoamericana de Control de Vectores. Se llevaron a cabo 12 bioensayos por cada concentración estudiada. Se utilizaron cuatro concentraciones de Bti: 0,5 mg/L, 1 mg/L, 2,5 mg/L y 5 mg/L. La mortalidad se registró a las 24 h. Resultados: Se encontraron valores de mortalidad larvaria de 98.734 % para la dosis de 0.5 mg/L; 99.375 % para 1 mg/L; 100 % para 2,5 mg/L y 100 % para 5 mg/l. Conclusiones: Bti ha probado ser efectivo contra las larvas de Ae. aegytpi, se recomienda su evaluación sistemática y de manera periódica para mejorar su aplicación y posible desarrollo de resistencia...(AU)


Subject(s)
Animals , Bacillus thuringiensis , Aedes , Dengue/complications , Vector Control
10.
Rev. Soc. Bras. Med. Trop ; 51(3): 347-351, Apr.-June 2018. tab, graf
Article in English | LILACS | ID: biblio-1041465

ABSTRACT

Abstract INTRODUCTION Dengue has affected Rio de Janeiro City since the 1980s. The sequential Zika and chikungunya virus introductions during 2015 aggravated the health scenario, with 97,241 cases of arboviral diseases reported in 2015-2016, some with neurological disorders. METHODS Arbovirus-related neurologic cases were descriptively analyzed, including neurological syndromes and laboratory results. RESULTS In total, 112 cases with non-congenital neurologic manifestations (Guillain-Barré syndrome, 64.3%; meningoencephalitis, 24.1%; acute demyelinating encephalomyelitis, 8%) were arbovirus-related; 43.7% were laboratory-confirmed, of which 57.1% were chikungunya-positive. CONCLUSIONS Emerging arbovirus infections brought opportunities to study atypical, severe manifestations. Surveillance responses optimized case identification and better clinical approaches.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Dengue/complications , Chikungunya Fever/complications , Zika Virus Infection/complications , Nervous System Diseases/virology , Brazil/epidemiology , Disease Notification , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/virology , Dengue/epidemiology , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiology , Middle Aged , Nervous System Diseases/epidemiology
11.
Rev. bras. enferm ; 71(2): 451-456, Mar.-Apr. 2018. graf
Article in English | LILACS, BDENF | ID: biblio-898437

ABSTRACT

ABSTRACT Objective: to describe the experience of clinical teaching on dengue and the practice of epidemiological surveillance using problematization methodology. Method: report of experience on educational activity with undergraduate nursing students, held in March 2016, at a public university in the city of São Paulo, conceived in four stages: dialogic lecture, active search of Aedes aegypti, case study and simulation of nursing consultation to individuals with dengue. Results: The activity allowed to retrieve previous knowledge about the disease, respond to exercises that addressed different clinical situations and epidemiological surveillance, including in situ evaluation of possible mosquito outbreaks, and discuss the need to expand prevention and health of the individual and the community, the impact of the media in the dissemination of cases and the coping difficulties experienced in the different levels of attention. Conclusion: the methodology adopted enabled qualified training of students to cope with dengue.


RESUMEN Objetivo: describir la experiencia de enseñanza clínica sobre la dengue y la práctica de vigilancia epidemiológica utilizando metodología de la problematización. Método: relato de experiencia sobre actividad educativa con graduandos de Enfermería, realizada en marzo de 2016, en una universidad pública de la ciudad de São Paulo, concebida en cuatro etapas: clase expositiva dialogada, busca activa del Aedes aegypti, estudio de caso y simulación de consulta de enfermería a individuos con dengue. Resultados: La actividad permitió rescatar conocimientos previos sobre la enfermedad, responder a ejercicios que abordaban distintas situaciones clínicas y de vigilancia epidemiológica, incluyendo evaluación "in loco" de posibles focos del mosquito, y discutir la necesidad de ampliación de las acciones de prevención y promoción de la salud del individuo y colectividad, el impacto del medio de comunicación en la divulgación de los casos y las dificultades de enfrentamiento vividas en los diferentes niveles de atención. Conclusión: la metodología adoptada posibilitó capacitación cualificada de los alumnos para enfrentamiento de la dengue.


RESUMO Objetivo: descrever a experiência de ensino clínico sobre a dengue e a prática de vigilância epidemiológica utilizando metodologia da problematização. Método: relato de experiência sobre atividade educativa com graduandos de Enfermagem, realizada em março de 2016, em uma universidade pública da cidade de São Paulo, concebida em quatro etapas: aula expositiva dialogada, busca ativa do Aedes aegypti, estudo de caso e simulação de consulta de enfermagem a indivíduos com dengue. Resultados: A atividade permitiu resgatar conhecimentos prévios sobre a doença, responder a exercícios que abordavam distintas situações clínicas e de vigilância epidemiológica, incluindo avaliação "in loco" de possíveis focos do mosquito, e discutir a necessidade de ampliação das ações de prevenção e promoção da saúde do indivíduo e coletividade, o impacto da mídia na divulgação dos casos e as dificuldades de enfrentamento vivenciadas nos diferentes níveis de atenção. Conclusão: a metodologia adotada possibilitou capacitação qualificada dos alunos para enfrentamento da dengue.


Subject(s)
Humans , Animals , Teaching/standards , Epidemiology/standards , Dengue/physiopathology , Brazil , Aedes/virology , Dengue/complications , Dengue/therapy , Dengue Virus/pathogenicity
12.
Medicina (B.Aires) ; 78(1): 37-40, feb. 2018. ilus, graf
Article in Spanish | LILACS | ID: biblio-894545

ABSTRACT

La infección por el virus del dengue constituye un problema de salud pública mundial. Causada por un virus de la familia Flaviviridae, presenta un amplio espectro clínico, desde formas asintomáticas frecuentes hasta las formas graves de fiebre hemorrágica y shock por fuga capilar. Existen cuatro serotipos; los serotipos 2 y 3 están asociados a las formas graves de la enfermedad. El diagnóstico definitivo de infección por dengue depende del aislamiento del virus en sangre, de la detección del antígeno viral o el ARN viral en suero o tejido, o detección de anticuerpos específicos. El síndrome hemofagocítico se produce ante la desregulación del sistema inmune que lleva a la activación macrofágica descontrolada, y se manifiesta con alteraciones clínicas, hematológicas, bioquímicas e histológicas. La asociación entre ambas entidades se encuentra descripta como una forma inusual y grave de presentación que responde a la tormenta de citocinas liberadas durante la enfermedad. Presentamos el caso de un paciente adulto con dengue, hemofagocitosis y valores inusualmente elevados de ferritina en sangre que evolucionó favorablemente con tratamiento de soporte.


Dengue virus infection constitutes a major public health problem worldwide. It is caused by a virus belonging to the Flaviviridae family. It produces a wide range of clinical presentations, from asymptomatic infection to severe forms of the disease with hemorrhagic fever or shock secondary to capillary leak syndrome. Four serotypes have been described; serotype 2 and serotype 3 are associated with the most severe forms of the disease. The diagnosis is based on laboratory tests aimed to detect antibodies, viral RNA, or antigens in serum. The hemophagocytic syndrome is generated by a dysfunction of the immune system with clinical, hematological, biochemical and histological manifestations. The association between these two entities is described as an unusual and severe presentation of dengue fever. We present a case of an adult patient with this association and very high blood levels of ferritin, who responded favorably to supportive care.


Subject(s)
Humans , Male , Aged , Dengue/complications , Renal Insufficiency/etiology , Lymphohistiocytosis, Hemophagocytic/etiology , Severity of Illness Index , Renal Insufficiency/diagnosis , Lymphohistiocytosis, Hemophagocytic/diagnosis
14.
Rev. Soc. Bras. Med. Trop ; 50(5): 585-589, Sept.-Oct. 2017. tab
Article in English | LILACS | ID: biblio-897019

ABSTRACT

Abstract Since the detection of the Chikungunya virus in America in 2013, two million cases of the disease have been notified worldwide. Severe cases and deaths related to Chikungunya have been reported in India and Reunion Island, estimated at 1 death per 1,000 inhabitants. Joint involvement in the acute and chronic phase is the main clinical manifestation associated with Chikungunya. The severity of the infection may be directly attributable to viral action or indirectly, owing to decompensation of preexisting comorbidities. In Brazil, the virus was identified in 2014, and recently, there has been a significant increase in the number of deaths caused by the Chikungunya virus infection, especially in Pernambuco. However, the numbers of fatalities are probably underreported, since for many cases, the diagnosis of Chikungunya infection may not be considered, for deaths by indirect causes. An increase in the mortality rate within months of epidemic occurrence, compared to previous years has also been reported and may be associated with Chikungunya virus infection. An in-depth investigation of reported mortality in Brazil is necessary, to measure the actual impact of the deaths, thereby, allowing the identification of possible causes. This will alert professionals about the risks, and hence, enable creation of protocols that target reducing mortality.


Subject(s)
Humans , Chikungunya Fever/mortality , Severity of Illness Index , Brazil/epidemiology , Chikungunya virus , Dengue/complications , Dengue/mortality , Epidemics , Chikungunya Fever/complications
15.
Arq. bras. oftalmol ; 80(4): 266-267, July-Aug. 2017. graf
Article in English | LILACS | ID: biblio-888134

ABSTRACT

ABSTRACT We report the case of a 46-year-old female patient who presented with bilateral acute angle closure during the course of dengue infection. Dengue diagnosis was confirmed by serological tests. The patient had plateau iris configuration identified by ultrasound biomicroscopy. This is the second reported case with this condition during dengue fever and the first to describe the characteristics of the angle.


RESUMO Os autores relatam o caso de uma mulher de 46 anos que teve fechamento agudo de ângulo bilateral durante a infecção por dengue. O diagnóstico de dengue foi confirmado por testes sorológicos. A paciente teve configuração de íris em platô confirmada pela biomicroscopia ultrassônica. Esse é o segundo caso descrevendo essa condição durante um episódio de dengue e o primeiro a descrever as características do ângulo.


Subject(s)
Humans , Female , Middle Aged , Glaucoma, Angle-Closure/etiology , Dengue/complications , Glaucoma, Angle-Closure/diagnostic imaging , Severe Dengue/complications , Microscopy, Acoustic
16.
Rev. habanera cienc. méd ; 16(3): 420-426, may.-jun. 2017. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-901735

ABSTRACT

Introducción: El Dengue es una infección viral aguda, causada por un virus de la familia Flaviviridaeque se transmite por la picadura del mosquito Aedes Aegypti. Se han descrito manifestaciones oculares asociadas a esta enfermedad como son: maculopatía, hemorragias retinales, neuritis óptica, retinitis y vasculitis, aunque son poco frecuentes. Objetivo: Presentar un caso con manifestaciones oculares después de ser diagnosticado con Dengue. Presentación del caso: Paciente masculino de 58 años de edad que 1 mes después de haber padecido Dengue comienza a presentar visión borrosa en ambos ojos, constatándose al examen oftalmológico del fondo de ojo, hemorragias maculares y exudados escasos en algunos cuadrantes en ambos ojos. Recibió tratamiento con antiinflamatorios sistémicos por 2 meses y mejoró su sintomatología inicial, así como el cuadro clínico fondoscópico. Conclusiones: El Dengue es una enfermedad con repercusión no solo sistémica sino también oftalmológica lo que, aunque no es muy frecuente, debe tenerse presente. Resultaron de considerable utilidad la clínica, la retinofoto y la tomografía de coherencia óptica (OCT) para el seguimiento de las alteraciones retinianas halladas posterior a su aparición. Los esteroides fueron utilizados con éxito para el tratamiento en este caso(AU)


Introduction: Dengue is an acute viral infection, caused by a virus of flaviviridae family that is transmitted by the Aedes Aegypti mosquito sting. Ocular manifestations associated to this illness have been described such as maculopathy, retinal hemorrhages, optic neuritis, retinitis and vasculitis, although they are not frequent. Objective: To present a case that is not frequently reported in own context. Case presentation: 58-year-old male patient that suffered from dengue and 1 month after that he began having blurred vision in both eyes. In the ophthalmic examination, it was detected that he had macular hemorrhages and exudates in some quadrants of both eyes. He was treated with systemic antiinflammatories for 2 months. There was an improvement of his initial symptoms and the clinical features of the ocular fundus with this treatment. Conclusions: Dengue is an illness that has not only a systemic impact but also causes ophthalmic damage that we should consider. The clinical manifestations, the retinophoto and the optical coherence tomography (OCT) were considerably useful for the follow-up of the retinal alterations found post-dengue. Steroids were used successfully for the treatment of this case(AU)


Subject(s)
Humans , Male , Middle Aged , Dengue/complications , Macular Degeneration/complications , Case Reports
17.
Rev. medica electron ; 39(3): 443-450, may.-jun. 2017.
Article in Spanish | LILACS, CUMED | ID: biblio-902184

ABSTRACT

Introducción: el dengue es una de las frecuentes infecciones por arbovirus que afectan al hombre en la mayoría de los países tropicales, donde las condiciones del medio ambiente favorecen el desarrollo y la proliferación del Aedes Aegypti. Objetivo: caracterizar clínica y epidemiológicamente a los pacientes enfermos de dengue. Materiales y Métodos: estudio observacional transversal, cuya población estuvo constituida por 89 pacientes con monosuero de captura de IgM para dengue positivo, ingresados en sala J del Servicio de Medicina Interna del Hospital Provincial "José Ramón López Tabrane" de Matanzas, durante el año 2014. Se utilizaron las variables: edad, sexo, manifestaciones clínicas, mes de presentación, municipio de procedencia, viajes a otras provincias u otros países, trombocitopenia, leucopenia y hematocrito. Se utilizó el porcentaje como medida de resumen y los resultados se presentaron en tablas. Los datos personales y de identificación de los pacientes no fueron publicados. Resultados: predominó el sexo femenino (51,7 %), edades entre 20 y 30 años (24,7 %). La fiebre y mialgias se presentaron en más de la mitad de los pacientes. El mes de agosto constituyó el de más ingresos, con un 24,7 %. La mayoría de los pacientes viajaron a la Habana, para un 78,9 %, seguido de Camagüey y Guantánamo para un 5,8 % y un 3,9 % respectivamente. Un 100 %, mostró trombocitopenia y la leucopenia estuvo presente en un 80 % aproximadamente. Conclusiones: no se presentó relación directa entre el sexo de los pacientes y la aparición de la enfermedad, se reportó más frecuentemente entre adultos jóvenes y en los meses de lluvia (AU).


Introduction: dengue is one of the most frequent infections caused by arbovirus affecting people in most of the tropical countries, where the environment conditions favor the development and proliferation of Aedes Aegypti. Objective: to characterize, clinically and epidemiologically, the patients with dengue. Materials and Methods: cross-sectional observational study in a population formed by 89 in-patients with positive IgM-capture monoserum for dengue who were admitted in the J ward of the Internal Medicine Service of the Provincial Hospital "José Ramón López Tabrane" of Matanzas during 2014. The used variables were: age, sex, clinical manifestations, month of presentation, municipality of origin, trips to other provinces or countries, thrombocytopenia, leucopenia, and hematocrit. The percentage was used as a summary measure and the results were given in charts. The patients' personal and identification data were not published. Results: the female sex (51,7 %) and ages between 20 and 30 years (24,7 %) predominated. More than half of a patients presented fever and myalgia. August was the month with more admissions, for 24,7 %. Most of the patients travelled to Havana (78,9 %), followed by Camaguey and Guantanamo, for 5,8 % and 3.9 % respectively. 100 % of the patients showed thrombocytopenia, and leucopenia was present in almost 80 %. Conclusions: there was not found a direct relation between the patients' sex and disease onset. It was more frequently reported in young adults and in the rainy months (AU).


Subject(s)
Humans , Male , Female , Patients , Arbovirus Infections/epidemiology , Dengue/epidemiology , Arbovirus Infections/diagnosis , Arbovirus Infections/prevention & control , Signs and Symptoms , Aedes/enzymology , Dengue/complications , Dengue/diagnosis , Dengue/pathology , Observational Studies as Topic
18.
Rev. Soc. Bras. Med. Trop ; 50(3): 379-382, May-June 2017. tab
Article in English | LILACS | ID: biblio-1041413

ABSTRACT

Abstract INTRODUCTION: The incidence of dengue has increased throughout the 2000s with a consequent global increase in atypical clinical forms. METHODS: This study reports a series of cases of neurological dengue out of 498 confirmed cases of laboratory dengue in Goiânia, Brazil. Cases were confirmed based on viral RNA detection via polymerase chain reaction or IgM antibody capture. RESULTS: Neurological symptoms occurred in 5.6% of cases, including paresthesia (3.8%), encephalitis (2%), encephalopathy (1%), seizure (0.8%), meningoencephalitis (0.4%), and paresis (0.4%). DENV-3 was the predominant circulating serotype (93%). CONCLUSIONS: We reported dengue cases with neurological manifestations in endemic area.


Subject(s)
Humans , Male , Female , Aged , Paresthesia/virology , Enzyme-Linked Immunosorbent Assay , Encephalitis, Viral/virology , Dengue/complications , Dengue/epidemiology , Meningoencephalitis/virology , Paresthesia/epidemiology , Brazil/epidemiology , RNA, Viral/genetics , Polymerase Chain Reaction , Encephalitis, Viral/epidemiology , Dengue Virus/genetics , Dengue Virus/immunology , Meningoencephalitis/epidemiology , Middle Aged , Antibodies, Viral/blood
19.
Arq. neuropsiquiatr ; 75(2): 123-126, Feb. 2017.
Article in English | LILACS | ID: biblio-838867

ABSTRACT

ABSTRACT Dengue, Zika and Chikungunya are emerging arboviruses and important causes of acute febrile disease in tropical areas. Although dengue does not represent a new condition, a geographic expansion over time has occurred with the appearance of severe neurological complications. Neglect has allowed the propagation of the vector (Aedes spp), which is also responsible for the transmission of other infections such as Zika and Chikungunya throughout the world. The increased number of infected individuals has contributed to the rise of neurological manifestations including encephalitis, myelitis, meningitis, Guillain-Barré syndrome and congenital malformations such as microcephaly. In this narrative review, we characterize the impact of the geographic expansion of the vector on the appearance of neurological complications, and highlight the lack of highly accurate laboratory tests for nervous system infections. This represents a challenge for public health in the world, considering the high number of travelers and people living in endemic areas.


RESUMO Dengue, Zika e Chikungunya são arbovírus emergentes e importante causa de doença febril aguda em áreas tropicais. Embora a dengue não represente uma doença nova, houve uma expansão geográfica ao longo do tempo, com o aparecimento de complicações neurológicas graves. A negligência desta situação permitiu a propagação do vetor (Aedes spp) em todo o mundo, que também é responsável pela transmissão de outras infecções pelos vírus Zika e Chikungunya. O grande número de casos infectados contribui para o aumento de manifestações neurológicas incluindo encefalite, mielite, meningite, síndrome de Guillain-Barré e má formações congênitas, como microcefalia. Nesta revisão narrativa, destaca-se o impacto da expansão geográfica do vetor no aparecimento de complicações neurológicas e a falta de testes laboratoriais de elevada acurácia para o diagnóstico da infecção neurológica. Estes aspectos representam desafio para a saúde pública mundial, considerando o grande número de indivíduos que moram ou viajam para áreas endêmicas.


Subject(s)
Humans , Animals , Dengue/complications , Chikungunya Fever/complications , Zika Virus Infection/complications , Insect Vectors/virology , Nervous System Diseases/virology , Dengue/transmission , Chikungunya Fever/transmission , Zika Virus Infection/transmission
20.
Cad. Saúde Pública (Online) ; 33(5): e00178915, 2017. tab, graf
Article in Portuguese | LILACS | ID: biblio-839716

ABSTRACT

Os efeitos da infecção por dengue na gestação são desconhecidos em Rio Branco, Acre, Brasil. O objetivo deste trabalho é determinar os riscos de complicações maternas, fetais e infantis decorrentes da infecção por dengue durante a gestação. Estudo de coorte de gestantes expostas e não expostas ao vírus do dengue no período 2007-2012. Foram estimadas incidências e razões de risco de complicações maternas, fetais e infantis. Na coorte exposta houve 3 óbitos fetais e 5 neonatais. Dois óbitos maternos foram identificados na coorte exposta, desfecho ausente no grupo não exposto (p = 0,040). A coorte exposta apresentou uma razão de riscos - RR = 3,4 (IC95%: 1,02-11,23) para óbito neonatal. Em relação ao desfecho óbito neonatal precoce, a razão de riscos observada foi de 6,8 (IC95%: 1,61-28,75). Dez óbitos infantis ocorreram nos filhos de gestantes expostas e 7 nos de não expostas (RR = 6,0; IC95%: 2,24-15,87). As mulheres infectadas com o vírus do dengue na gestação apresentaram uma razão de riscos maior em relação à ocorrência de óbitos maternos, neonatais e infantis.


Los efectos de la infección por dengue en la gestación son desconocidos en Río Branco, Acre, Brasil. El objetivo de este trabajo es determinar los riesgos de complicaciones maternas, fetales e infantiles, derivadas de la infección por dengue durante la gestación. Estudio de cohorte de gestantes expuestas y no expuestas al virus del dengue durante el período 2007-2012. Se estimaron incidencias y razones de riesgo de complicaciones maternas, fetales e infantiles. En la cohorte expuesta hubo 3 óbitos fetales y 5 neonatales. Dos óbitos maternos fueron identificados en la cohorte expuesta, desenlace ausente en el grupo no expuesto (p = 0,040). La cohorte expuesta presentó una razón de riesgos RR = 3,4 (IC95%: 1,02-11,23) para el óbito neonatal. En relación con el desenlace óbito neonatal precoz, la RR observada fue de 6,8 (IC95%: 1,61-28,75). Diez óbitos infantiles se produjeron en los hijos de gestantes expuestas y 7 en los de no expuestas (RR = 6,0; IC95%: 2,24-15,87). Las mujeres infectadas con el virus del dengue en la gestación presentaron una razón de riesgos mayor, en relación a la ocurrencia de óbitos maternos, neonatales e infantiles.


The effects of dengue infection during pregnancy have not been previously studied in Rio Branco, Acre State, Brazil. The aim of this study was to determine the risks of maternal, fetal, and infant complications resulting from dengue infection during pregnancy. The study compared two cohorts of pregnant women, exposed versus unexposed to dengue virus, from 2007 to 2012. Incidence rates and risk ratios were estimated for maternal, fetal, and infant complications. In the exposed cohort there were 3 fetal deaths and 5 neonatal deaths. Two maternal deaths were identified in the exposed cohort, as opposed to none in the unexposed group (p = 0.040). The exposed cohort showed a risk ratio (RR) of 3.4 (95%CI: 1.02-11.23) for neonatal death. The risk ratio for early neonatal death was 6.8 (95%CI: 1.61-28.75). Ten infant deaths occurred in children of exposed pregnant women and 7 in unexposed (RR = 6.0; 95%CI: 2.24-15.87). Women infected with dengue virus in pregnancy showed increased risk ratio for maternal, neonatal, and infant mortality.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant , Adolescent , Adult , Middle Aged , Young Adult , Pregnancy Complications, Infectious/mortality , Pregnancy Complications, Infectious/virology , Dengue/complications , Dengue/mortality , Socioeconomic Factors , Brazil/epidemiology , Case-Control Studies , Maternal Mortality , Retrospective Studies , Cohort Studies , Fetal Death , Perinatal Death
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