RESUMEN
Background & objectives: Bartonella henselae causes infections which closely resemble febrile illness and chronic diseases such as tuberculosis and haematological malignancies. There are not many studies on Bartonella infections from India. The present study was undertaken to diagnose B. henselae infection in diverse clinical conditions in a tertiary care hospital in north India. Methods: A total of 145 patients including those with fever and lymphadenopathy, infective endocarditis and neuroretinitis were enrolled in the study. Whole blood, serum and lymph node aspirate and valvular vegetations if available, were obtained. Samples were plated on chocolate agar and brain-heart infusion agar containing five per cent fresh rabbit blood and were incubated at 35°C for at least four weeks in five per cent CO2with high humidity. Immunofluorescent antibody assay (IFA) was done for the detection of IgM antibodies in the serum using a commercial kit. Whole blood was used to perform polymerase chain reaction (PCR) for the citrate synthase gene (gltA). Results: IFA was positive in 11 of 140 (7.85%) patients and PCR was positive in 3 of 140 (2.14%) patients. Culture was negative in all the cases. A higher incidence of Bartonella infection was seen in patients with fever and lymphadenopathy (n=30), seven of whom were children. In ophthalmological conditions, four cases were IFA positive. Interpretation & conclusions: The present study shows that the threat of Bartonella infection is a reality in India. It is also an important treatable cause of fever and lymphadenopathy in children. Serology and PCR are useful tests for its diagnosis. Clinicians should consider Bartonella infection in the differential diagnosis of febrile illnesses and chronic diseases.
RESUMEN
El NBI (Narrow Band Imaging) o imagen de banda angosta es una herramienta de visualización endoscópica desarrollada en Japón en el National Cancer Center por los doctores Gono K. y Sano Y., en el año 2001. Esta cromoendoscopia digital, aunada a los sistemas de magnificación endoscópicos permite una valoración más detallada de la superficie mucosa y de su patrón vascular, facilitando de esta manera el diagnóstico y seguimiento de lesiones tempranas del tracto gastrointestinal, así como el de patologías premalignas como el esófago de Barrett, el cáncer, los pólipos y la enfermedad inflamatoria intestinal, entre otras. En el presente artículo se expone una revisión de los principios ópticos del NBI y de la utilidad del mismo en la endoscopia diagnóstica y terapéutica de rutina y la experiencia con la misma en nuestra institución (Hospital Cardiovascular del niño de Cundinamarca).
The NBI (Narrow Band Imaging) or image of narrow band is a tool of endoscopic visualization developed in Japan in the National Cancer Center for the Drs. Gono K. and Sano Y. in the year 2001. This digital Chromoendoscopy linked to the systems of magnification endoscope allows a more detailed evaluation of the mucous surface and of its vascular net, facilitating hereby the diagnosis and follow-up of early injuries of the gastrointestinal tract, as well as of pathologies as Barretts oesophagus, the cancer, the polyps and the inflammatory intestinal disease, among others. In this article we expose a review of the optical principles of the NBI and of the utility of the same one in the routine diagnoses and therapeutic endoscopy and the experience with the same one in our institution (Cardiovascular Hospital of the child of Cundinamarca).