RESUMO
La diarrea del viajero (DV) afecta a 34 millones de personas que viajan a países en desarrollo todos los años. El destino representa el factor de riesgo más importante para el desarrollo de DV. Por mucho, los agentes etiológicos más frecuentes son bacterias patógenas (Escherichia coli enterotoxigénica, Escherichia coli enteroagregativa, Campylobacter, Salmonella). La reducción en la tasa de diarrea sería posible al evitar el consumo de alimentos y bebestibles contaminados. Una estrategia preventiva más eficaz consiste en administrar antibióticos todos los días durante viajes a áreas en que el riesgo de DV es alto. Rifaximina, antibiótico no absorbible recientemente aprobado, puede ser usado para el tratamiento de la DV en regiones donde la E. coli no invasora es el patógeno predominante. En áreas donde un organismo invasivo como el Campylobacter y Shigella son comunes, las fluoroquinolonas sigue siendo el medicamento escogido. La azitromicina es recomendada en áreas con Campylobacter resistente a las quinolonas y para el tratamiento de niños y mujeres embarazadas.
Travelers diarrhea (TD) affects 34 millions of people who travel to developing countries each year. Destination represents the single most important risk factor for developing TD. By far, the most frequent etiologic agents are bacterial pathogens (enterotoxigenic Escherichia coli, enteroaggregative E. coli, Campylobacter, Salmonella). Reduction in the rate of diarrhea maybe possible by avoiding contaminated foods and beverages. A more effective preventive strategy is daily administration of antibiotics during trips to areas where the risk of TD is high. Rifaximine, a recently approved non-absorbable antibiotic, can be used for the treatment of TD in regions where non invasive E. coli is the predominant pathogen. In areas where invasive organism such as Campylobacter and Shigella are common, fluoroquinolones remain the drug of choice. Azythromycin is recommended in areas with quinolone-resistant Campylobacter and for treatment of children and pregnant women.
Assuntos
Humanos , Diarreia/epidemiologia , Diarreia/microbiologia , Diarreia/tratamento farmacológico , Viagem , Antibacterianos/administração & dosagem , Bactérias Gram-Negativas/patogenicidade , Diarreia/prevenção & controle , Eucariotos/patogenicidade , Fatores Etários , AntibioticoprofilaxiaRESUMO
Chronic myeloid leukemia is a myeloproliferative disorder caused by a clonal disturbance of the trunk cell and the accumulation of granulocytic series in the marrow, blood and other organs. We report a 63 years old male, carrier of a chronic myeloid leukemia whose clinical condition was complicated by the appearance of a T cell lymphoma. He was subjected to chemotherapy, that reduced the size of adenopathies and improved his general condition. Further studies are required to determine if there is a relationship between these two clinical entities