RESUMEN
Objectives: To determine the diagnostic accuracy of polymerase chain reaction-baseddetection of sof gene compared to throat swab culture for S. pyogenes infection in patientswith acute rheumatic fever and those with recurrence of rheumatic activity. Methods: 40patients between 3 to 18 years of age, with clinical diagnosis of acute rheumatic fever or newactivity in established rheumatic heart disease were included. The amplicon of 228bp of sofgene was detected using a polymerase chain reaction-based technique and the results werecompared with throat swab culture for Streptococcus pyogenes. Results: 10 patients hada positive throat swab culture and 11 had sof gene detected. The sensitivity and specificityof the test was 100% and 96.7%, respectively compared to throat swab culture (P=0.001).The positive predictive value and the negative predictive value was 90.9% and 100%respectively. Conclusions: Polymerase chain reaction-based detection of sof geneprovides an alternative to throat swab culture in diagnosing activity in Acute RheumaticFever or established Rheumatic heart disease.
RESUMEN
Fulminant hepatic failure (FHF) is an unusual complication of visceralleishmaniasis (VL). Here, we present a 1.5-yr-old girl with VL developing rapidly progressive fatal FHF. In absence of established guidelines, additional use of immunomodulatory therapies has been discussed in reference to available information.
Asunto(s)
Progresión de la Enfermedad , Resultado Fatal , Femenino , Encefalopatía Hepática/etiología , Humanos , Lactante , Leishmaniasis Visceral/complicaciones , Fallo Hepático Agudo/etiologíaRESUMEN
Numerous antimicrobials including pentavalent antimonials are implicated in causing prolong QT-interval and ventricular tachycardia. Torsades de pointes is rarely documented with use of sodium stibogluconate. Here is described a 12-yr-old girl with visceral leishmaniasis, who developed syncopal attacks, prolong QT-interval, polymorphic ventricular tachycardia and torsades de pointes after completing a course of Stibogluconate (20 mg/kg/day for 30 days). Prolong lidocaine infusion and cardioversion were life saving.