Encefalitis amebiana granulomatosa por Balamuthia mandrillaris en Chile confirmada con secuenciación de ADN / Granulomatous amoebic encephalitis due to Balamuthia mandrillaris in Chile confirmed with DNA sequencing

Las enfermedades causadas por amebas de vida libre son infecciones oportunistas que pueden tener un curso fatal. Pueden producir afecciones diseminadas graves con compromiso del sistema nervioso central, como la encefalitis amebiana granulomatosa. Esta infección es cada vez más frecuente en América Latina, aunque se reconocen tardíamente debido a la similitud con otras patologías o porque es inusual incluirla en el diagnóstico diferencial. Comunicamos un caso fatal de una encefalitis amebiana granulomatosa por Balamuthia mandrillaris en una niña de 10 años. Destacamos la gravedad de la afectación cerebral y la falta de esquemas antimicrobianos validados para su tratamiento. Hoy en el mundo esta infección es considerada una enfermedad emergente, influenciada por el cambio climático, lo que llama a estar atentos a su presencia.

Diseases caused by free-living amoebae are opportunistic infections that can have a fatal course. They can cause very serious disseminated conditions with involvement of the central nervous system such as granulomatous amoebic encephalitis. This infection has become more common in Latin America, although its recognition is late due to the similarity with other pathological conditions or because it is unusual to include it in the differential diagnosis. We report a fatal case of granulomatous amoebic encephalitis due to Balamuthia mandrillaris in a 10-year-old girl. We highlight the severity of the brain involvement and the lack of validated schemes for its treatment. Today in the world this infection is considered an emerging disease, influenced by climate change, which calls for being attentive to its presence.

Riesgo y distribución geográfica de neurocisticercosis en Chile según egresos hospitalarios (2002-2019) / Epidemiology of cysticercosis in Chile

BACKGROUND: Neurocysticercosis is the most prevalent parasitic disease of the central nervous system in Chile, where sporadic cases are reported, without information about the epidemiology or distribution of the disease. AIM: To identify the main risk zones for cysticercosis in Chile. MATERIAL AND METHODS: Analysis of hospital discharge databases between 2002 and 2019, available at the website of the Chilean Ministry of Health. Cases with B69 code of the tenth international classification of diseases were identified. RESULTS: In the study period, there were 1752 discharges with the diagnoses of neurocysticercosis, ocular cysticercosis and cysticercosis of other sites. The ages of patients ranged from 0 to 89 years with a clustering between 30 and 59 years. Sixty two percent were males. The zone between the regions of Maule and Araucania concentrated 82% of cases. CONCLUSIONS: We identified the zone with the greatest concentration of cysticercosis in Chile, where preventive strategies should eventually be directed.

La enfermedad de Chagas en Chile: componente vectorial y serología en menores de 5 años durante el período 2005-2010 / Chagas disease in Chile: vector component and serology in children below 5 years old during period 2005-2010

La enfermedad de Chagas afecta a más de 18 millones de personas en el mundo, incluyendo a cerca de 120.000 en el país. El principal vector de esta enfermedad en Chile es Triatoma infestans. En el laboratorio de entomología médica del ISP se han analizado 2.193 ejemplares de triatominos. Las Secretarías Regionales Ministeriales (SEREMIS) de Atacama, Valparaíso y Metropolitana reúnen en conjunto al 93,84 por ciento del total de triatominos + hemípteros (2.058) capturados en el período. La SEREMI con el mayor número de capturas y envíos es la de Valparaíso, específicamente la oficina provincial de Aconcagua, con un 49,15 por ciento del total. Al analizar, la totalidad de triatominos en laboratorio desde el año 2005 hasta 2010 y considerando el índice tripano/triatomineo, se observa un índice de infestación final de 28,5 por ciento. Paralelamente a los estudios con el vector, se realizaron una serie de estudios de tamizaje serológico en niños menores de 5 años y sus familias entre las regiones de Arica y Parinacota y O’Higgins. Se realizaron 5.111 tamizajes, encontrando 28 casos positivos con una positividad del 0,55 por ciento, valor cercano al 0,7 por ciento de prevalencia obtenida por la Encuesta Nacional de Salud (ENS) 2009-2010.

Chagas’ disease affects over 18 million people including about 150,000 in the country. The main vector of this disease in Chile is Triatoma infestans. The medical entomology laboratory ISP, analyzed 2 193 samples of triatomine. The Regional Ministerial Secretariats (SEREMIS) of Atacama, Valparaiso and Metropolitana gather together a 93.84 percent of triatomine + hemiptera (2 058) captured in the period. The SEREMI with the highest number of catches and services is Valparaiso, specifically the Aconcagua provincial office with 49.15 percent of the total. The analysis of all triatomines in the laboratory from 2005 to 2010 and considering the trypan / triatominae index, there is a final infestation rate of 28.5 percent. Parallel to the studies with the vector, there was a series of studies for serological screening in children under 5 and their families between the regions of Arica and Parinacota and O’Higgins. Five thousand one hundred and eleven screenings have been conducted and found 28 positive cases with a positivity of 0.55 percent, a value close to 0.7 percent prevalence obtained by the National Health Survey (NHS) 2009-2010.