An acute schistosomiasis case in Wuhan City imported from another province of China in 2020 / 中国血吸虫病防治杂志

An imported case of acute schistosomiasis was reported in Wuhan City in 2020. The case was infected with Schistosoma by contact with the infested water due to playing water in the Yangtze River when working out of Hubei Province. The patient visited four medical institutions and the duration from onset to definitive diagnosis was 20 days. The patient’s low awareness of schistosomiasis prevention and control knowledge and lack of diagnosis and treatment awareness for schistosomiasis among medical institutions were considered as main causes of the development of acute schistosomiasis and progression to severe case. Intensifying schistosomiasis health education among mobile populations and improving the awareness and capability of early diagnosis of schistosomiasis among clinicians are recommended.

Pathogenesis of Bovine alphaherpesvirus 2 in calves following different routes of inoculation / Patogênese do alfaherpesvírus bovino 2 em bezerros inoculados por diferentes vias

Bovine alphaherpesvirus 2 (BoHV-2) is the agent of herpetic mammilitis (BHM), a cutaneous and self-limiting disease affecting the udder and teats of cows. The pathogenesis of BoHV-2 is pourly understood, hampering the development of therapeutic drugs, vaccines and other control measures. This study investigated the pathogenesis of BoHV-2 in calves after inoculation through different routes. Three- to four-months seronegative calves were inoculated with BoHV-2 (107TCID50.mL-1) intramuscular (IM, n=4), intravenous (IV, n=4) or transdermal (TD) after mild scarification (n=4) and submitted to virological, clinical and serological monitoring. Calves inoculated by the IV route presented as light increase in body temperature between days 6 to 9 post-inoculation (pi). Virus inoculation by the TD route resulted in mild inflammatory lesions at the sites of inoculation, characterized by hyperemia, small vesicles, mild exudation and scab formation, between days 2 and 8pi. Virus or viral DNA was detected by PCR in the crusts/swabs collected from lesions of 3 out of 4 animals inoculated TD from day 2 to 8pi. Viremia was detected in 3/4 animals of the IM group (from day 4 to 8pi); in 2/4 animals of the IV group (days 6 and 8pi) but not in the TD group. Calves from all inoculated groups seroconverted to BoHV-2 in titers from 4 to 64, as indicated by virus-neutralizing (VN) assays performed in sera collected at day 15pi. Administration of dexamethasone (Dex) to the inoculated calves at day 48pi, did not result in virus reactivation as indicated by lack of virus detection in the blood and/or in inoculation sites and no increase in VN antibody titers. These results demonstrated that BoHV-2 was able to replicate efficiently in calves following different routes of exposure, produced viremia after IM and IV inoculation and was not reactivated by Dex treatment.(AU)

O alfaherpesvírus bovino 2 (BoHV-2) é um agente etiológico da mamilite herpética (BHM), uma doença cutânea e autolimitante do úbere e tetos de vacas. Pouco se sabe sobre a patogênese do BoHV-2, dificultando o desenvolvimento de medicamentos terapêuticos e vacinas. Este estudo investigou a patogênese do BoHV-2 em bezerros após a inoculação por diferentes vias. Bezerros soronegativos de três a quatro meses foram inoculados com BoHV-2 (107TCID50.mL-1) por via intramuscular (IM, n=4), por via intravenosa (IV, n=4) ou transdérmica (TD, n=4) após escarificação leve e submetidos a monitoramento virológico, clínico e sorológico. Os bezerros inoculados pela via IV apresentaram aumento leve da temperatura corporal entre os dias 6 a 9 pós-inoculação (pi). A inoculação do vírus pela via TD resultou em lesões inflamatórias leves nos locais de inoculação, caracterizadas por hiperemia, pequenas vesículas, exsudação leve e formação de crostas, entre os dias 2 e 8pi. O vírus ou DNA viral foi detectado por PCR nas crostas/swabs coletados de lesões de 3 de 4 animais inoculados TD do dia 2 ao 8pi. Viremia foi detectada em 3/4 dos animais do grupo IM (do dia 4 ao 8pi); em 2/4 animais do grupo IV (dias 6 e 8pi), mas não no grupo TD. Bezerros de todos os grupos inoculados soroconverteram o BoHV-2 em títulos de 4 a 64, conforme indicado por ensaios de vírus-neutralização (VN) realizados em soro coletado no dia 15pi. Administração de dexametasona (Dex) nos bezerros inoculados no dia 48pi, não resultou em reativação do vírus, como indicado pela falta de detecção de vírus no sangue e/ou nos locais de inoculação e pela ausência de aumento nos títulos de anticorpos. Estes resultados demonstraram que o BoHV-2 foi capaz de replicar eficientemente em bezerros seguindo diferentes vias de inoculação, produziu viremia após a inoculação IM e IV e não foi reativado pelo tratamento com Dex.(AU)

Epidemiological profile of acute Chagas disease in individuals infected by oral transmission in northern Brazil

Abstract INTRODUCTION: Oral infection by Trypanosoma cruzi is currently the most important route of transmission of acute Chagas disease (ACD) in the North region of Brazil, and the reported outbreaks are usually related to ingestion of contaminated food, especially unprocessed açaí pulp. METHODS A retrospective cohort study was performed to analyze the epidemiological profile of individuals with suspected cases of ACD in the municipality of Breves, located in the state of Pará, Brazil. Therefore, notifications of suspected cases of ACD were collected from the Municipal Health Department of Breves from January 2007 to December 2017. RESULTS A total of 265 individuals were registered, and the majority were male (54.7%; 145/265). Age ranged from nine months to 79 years, with a greater number of notifications for individuals aged between 1 and 39 years (71.3%; 189/265). Most of them had a low level of education (74.3%, 197/265), were living in rural and urban areas (58.9%; 156/265 and 37.7%; 100/265, respectively). Infection occurred mainly in the domestic environment (96.2%; 255/265) through oral transmission (98.1%; 260/265). There were a greater number of notifications in November, December and January. CONCLUSIONS These data showed that oral transmission of T. cruzi has become increasingly high in the study region, and health education programs need to be implemented as strategies to ensure good manufacturing practices of unprocessed food.

Debridement antibiotics irrigation and implant retention for the treatment of acute infection after total knee arthroplasty / 中国组织工程研究

BACKGROUND: Compared with revision surgery, debridement antibiotics irrigation and implant retention for treatment of periprosthetic joint infection has the advantages of fewer traumas, shorter time, and lower cost. However, the indications and perioperative management are still controversial. OBJECTIVE: To review the application of preoperative indication, intraoperative operation and postoperative antibiotic application of debridement antibiotics irrigation and implant retention for the periprosthetic joint infection. METHODS: PubMed, Web of Science, Embase, and The Cochrane Library database were retrieved from 2000 to 2018. The key words were “total knee arthroplasty, periprosthetic joint infection, diagnose, treatment”. Chinese literature was searched in the Wanfang database and CNKI from 2000 to 2018, and the keywords were “arthroplasty, postoperative infection, debridement antibiotics irrigation and implant retention”. Relevant literatures were screened, and the success rate of retained prosthesis in the treatment of infection after joint replacement was counted. The most accurate diagnostic criteria and the most effective treatment methods were summarized. RESULTS AND CONCLUSION: At present, there is no unified international standard for the diagnosis of periprosthetic joint infection after joint replacement. Many organizations have put forward some consensus and guidelines. Parvizi et al. proposed new diagnostic criteria for periprosthetic joint infection based on other consensus and guidelines, which is highly sensitive and specific, and has been accepted by most people. Debridement antibiotics irrigation and implant retention is suitable for patients with stable and well-fixed prosthesis, short symptom duration, good soft tissue, and no sinus tract formation. During the operation, the infected necrotic tissue and the suspected infected tissue should be thoroughly removed. The iodine-blood water should be soaked for half an hour; the new gasket should be replaced; and the sterilized towel should be replaced with a new set of surgical tools. According to the results of postoperative culture, sensitive antibiotics were combined and rifampin was taken orally out of hospital for 4 months. Debridement antibiotics irrigation and implant retention is the best method for the treatment of periprosthetic joint infection, and has the advantages of less pain, less cost, high acceptance and avoiding revision.

Debridement, Antibiotics and Implant Retention for Early Periprosthetic Infections of the Hip: Outcomes and Influencing Factors / 대한고관절학회지

PURPOSE: Debridement, antibiotics and implant retention (DAIR) is commonly performed and widely accepted for the treatment of acute infections following hip arthroplasty. The aims of this study were to: i) determine the DAIR success rate in treating acute postoperative and hematogenous periprosthetic infections of the hip at a tertiary hospital, ii) identify possible outcome predictors, and iii) analyze clinical and radiological outcomes. MATERIALS AND METHODS: We retrospectively reviewed cases of acute postoperative (≤3 months from index procedure) and hematogenous periprosthetic infections following total hip arthroplasty treated with DAIR at our hospital between 2004 and 2015. Overall, 26 hips (25 patients) were included in the study, with a mean age of 72.5 years (standard deviation [SD], 9.4). The mean follow-up was 48.5 months (SD, 43.7). Several variables (e.g., patient characteristics, infection type, surgery parameters) were examined to evaluate their influence on outcomes; functional and radiographic outcomes were assessed. RESULTS: The overall success rate of DAIR was 26.9%. The male sex was associated with treatment failure (P=0.005) and debridement performed by a surgeon in hip unit with success (P=0.028). DAIR failure increased in patients with chronic pulmonary disease (P=0.059) and steroid therapy (P=0.062). Symptom duration of <11 days until DAIR yielded a better infection eradication rate (P=0.068). The mean postoperative Harris Hip Score was 74.2 (SD, 16.6). CONCLUSION: DAIR, despite being used frequently, had a high failure rate in our series. Outcomes improved if an experienced hip arthroplasty surgeon performed the surgery. Patient comorbidities and symptom duration should be considered for decision-making.

Clinical characteristics of forty-four cases of acute HIV-1 infection / 中华实验和临床病毒学杂志

Objective@#To investigate the clinical, immunological and virological characteristics of HIV-1 infected patients in the acute phase, for the sake of improving the diagnosis of acute infection with HIV-1.@*Methods@#We retrospectively analyzed the clinical manifestation and laboratory data of patients with acute HIV-1 infection who were admitted to the Center of Infectious Diseases, Guangzhou Eighth People’s Hospital from January 2012 to June 2017.@*Results@#Forty-four patients were enrolled into the study, 86.4% of them were male. 59.1% patients were homosexually transmitted. Clinical symptoms and signs mostly consisted of fever (84.1%), lymphadenopathy (56.8%) and so on, while 15.9% patients had central nervous system symptoms. Most common opportunistic infection included lung infection (50.0%) and oropharyngeal candidiasis (22.7%). Leucopenia (10 patients, 22.7%), and decreased CD4+ T cell count (267.5 cells/μl), inverted CD4+ /CD8+ ratio (86.4%) was mostly seen. Compared to patients who had HIV RNA load less than 6 lg copies/ml, the group of patients who had HIV RNA load more than 6 lg copies/ml had lower levels of CD4+ T cells (t=-3.724, P=0.001).@*Conclusions@#Patients with acute HIV infection have many different kinds of clinical symptoms and can be accompanied by opportunistic infection, and with high viremia.

Study on acute HIV-1 infection in men who have sex with men in Tianjin / 中华流行病学杂志

Objective To understand the immunological and virological characteristics of HIV-1 infected men who have sex with men (MSM) in the acute phase in Tianjin and evaluate the effects of the fourth generation HIV ELISA and the P24 ELISA for acute HIV-1 infected samples.Methods From October 2015 to October 2016,MSM were recruited through the community-based organizations in Tianjin.All the participants received rapid HIV test,positive samples were confirmed by Western Blot and negative samples underwent pooled nucleic acid testing.The participants with HIV-1 RNA reactive result underwent testing for viral load and T-cell count after second blood collection.Acute HIV-1 infection was defined as negative rapid HIV test result and the positive results of two HIV RNA tests,then the sensitivity were compared between the fourth generation HIV ELISA and the P24 ELISA to detect the initial HIV-1 RNA positive samples.Results Among 3 016 MSM screened,193 were positive in rapid HIV test.Western blot testing indicated that 179 cases were HIV positive,7 cases were HIV indeterminate and 7 eases were negative.Of 2 823 sero-negative cases,17 were acute HIV-1 infections.The HIV-1 infection rate was 6.53％ (197/3 016) and the acute HIV-1 infection rate was 0.56％ (17/3 016),with an average viral load of (5.63 ± 1.50) log10 copies/ml,an average CD4 count of (442.82 ± 268.17) cells/μl,an average CD8 count of (1 069.65 ± 668.22) cells/μl and an average CD4/CD8 ratio of (0.49 ± 0.25).Higher viral load,CD4 and CD4/CD8 ratio were seen in the acute HIV-1 infection group compared with the chronic HIV-1 infection group (U=148,P＜0.01;U=272,P=0.042 and t=3.147,P=0.005).Demographic characteristics were similar between two groups,except the occupation (x2=11.016,P=0.026).The sensitivity of P24 ELISA was higher than the fourth generation HIV ELISA in the H1V-1 detection for acute infection (Fisher's exact test,P=0.017).Conclusions MSM are at risk for acute HIV-1 infection.Screening for acute HIV-1 infection with P24 ELISA would increase the sensitivity of diagnosis and reduce HIV transmission in MSM.

Study on acute HIV-1 infection in men who have sex with men in Tianjin / 中华流行病学杂志

Objective To understand the immunological and virological characteristics of HIV-1 infected men who have sex with men (MSM) in the acute phase in Tianjin and evaluate the effects of the fourth generation HIV ELISA and the P24 ELISA for acute HIV-1 infected samples.Methods From October 2015 to October 2016,MSM were recruited through the community-based organizations in Tianjin.All the participants received rapid HIV test,positive samples were confirmed by Western Blot and negative samples underwent pooled nucleic acid testing.The participants with HIV-1 RNA reactive result underwent testing for viral load and T-cell count after second blood collection.Acute HIV-1 infection was defined as negative rapid HIV test result and the positive results of two HIV RNA tests,then the sensitivity were compared between the fourth generation HIV ELISA and the P24 ELISA to detect the initial HIV-1 RNA positive samples.Results Among 3 016 MSM screened,193 were positive in rapid HIV test.Western blot testing indicated that 179 cases were HIV positive,7 cases were HIV indeterminate and 7 eases were negative.Of 2 823 sero-negative cases,17 were acute HIV-1 infections.The HIV-1 infection rate was 6.53％ (197/3 016) and the acute HIV-1 infection rate was 0.56％ (17/3 016),with an average viral load of (5.63 ± 1.50) log10 copies/ml,an average CD4 count of (442.82 ± 268.17) cells/μl,an average CD8 count of (1 069.65 ± 668.22) cells/μl and an average CD4/CD8 ratio of (0.49 ± 0.25).Higher viral load,CD4 and CD4/CD8 ratio were seen in the acute HIV-1 infection group compared with the chronic HIV-1 infection group (U=148,P＜0.01;U=272,P=0.042 and t=3.147,P=0.005).Demographic characteristics were similar between two groups,except the occupation (x2=11.016,P=0.026).The sensitivity of P24 ELISA was higher than the fourth generation HIV ELISA in the H1V-1 detection for acute infection (Fisher's exact test,P=0.017).Conclusions MSM are at risk for acute HIV-1 infection.Screening for acute HIV-1 infection with P24 ELISA would increase the sensitivity of diagnosis and reduce HIV transmission in MSM.

Protective effect of interferon-γ on Chlamydia psittaci acute infection / 中国人兽共患病学报

We investigated the effects of IFN-γ on Chlamydia psittaci (Cps) infection.HeLa cells were treated with different concentrations of recombinant human IFN-γ (5 ng/mL,25 ng/mL,50 ng/mL) after infecting with C.psittaci 6BC,then the number and morphology of C.psittaci inclusion bodies were examined after 48 hours.C57BL/6J mice were intranasally infected with 2 × 106 IFUs C.psittaci 6BC,and intraperitoneally administrated with 10 μg recombinant murine interferon-γ 24 hours prior or post infection,then body weight,activity and survival rate were recorded.The histopathology of mice livers and lungs was analyzed by HE staining on day 5 or day10 post infection.And the chlamydial inclusion bodies were titrated in the lung homogenates of mice sacrificed on day 5 after infection.The inclusion body numbers of recombinant human IFN-γ treated groups (by 5ng/mL,25ng/mL,50ng/mL) were significantly less than that in the control group (23.8±5.1)× 106,(10± 3.58) × 106,(8.0±2.22) × 106,(43.3±11.05)× 106,respectively).And the morphology of inclusion bodies in IFN-γ treated HeLa cells was irregular and much smaller.We also found that IFN-γ could significantly improve the survival rate,reduce acute clinical manifestations and pathological injurery of lung and liver in C.psittaci respiratory tract infected mice model.So we summarized that IFN-γ can mediate strong immunological protection during acute C.psittaci early infection.

Acute Delayed or Late Infection of Revision Total Hip Arthroplasty Treated with Debridement/Antibiotic-loaded Cement Beads and Retention of the Prosthesis / 대한고관절학회지

PURPOSE: The treatment of infected revision total hip arthroplasty (THA) is very challenging due to retained revision prosthesis, poor bone stock and soft tissue condition derived from previous revision surgeries, and comorbidities. The purpose of this study was to investigate the effectiveness and short-term outcomes of aggressive debridement and use of antibiotic-loaded cement beads with retention of the prosthesis for acute delayed or late infection of revision THAs. MATERIALS AND METHODS: Ten consecutive patients with symptoms or signs of less than one-week evolution and well-fixed prostheses, were treated with this procedure and a postoperative course of organism-specific antibiotics for a minimum of 6 weeks. All hips presented with acute delayed or late infection of revision THAs. Patients with a mean age of 68.1 years (range, 59-78 years) underwent an average of 1.9 previous revision THAs (1-4) before the index surgery. The minimal follow-up was 2 years with a mean of 46.2 months (range, 24-64 months). RESULTS: There were 8 cures (80.0%) and 2 failures with no mortality during the study period. The 2 failures involved the same and resistant bacteria implicated in the primary infection (methicillin-resistant Staphylococcus aureus and Prevotella oralis, respectively). The mean Harris hip score was 65.2 (range, 26-83) and the mean visual analogue scale was 2.6 (range, 1-4) at final follow-up. CONCLUSION: With a favorable success rate and no mortality, our procedure may be considered a safe and effective alternative for the treatment of acute delayed or late infection of revision THAs with well-fixed prostheses.

Molecular diagnosis of dengue virus infections in samples collected on filter paper / Diagnóstico molecular de infecciones por virus Dengue en muestras colectadas en papel de filtro

Dengue virus infections (DENV) are a severe public health problem due to the high rates of morbidity and mortality involved, and the fact that no clinical treatment or vaccines are available. In order to strengthen the laboratory diagnosis for surveillance systems in tropical countries with low resources, we report an optimized method using filter paper for blood spotting and subsequent molecular diagnosis of DENV serotypes. Control strains of all serotypes, as well as 35 whole blood patient samples dispensed on filter paper, were stored at room temperature for as long as 36 months. RT-PCR of 5’UTR-C fragment was amplified through adapted protocols to diagnose all dengue serotypes. Results showed amplification for all four viral serotypes, including control viral strains and 88.6 % of the samples. These results allowed determining the utility of filter paper for the preservation of samples regularly obtained from patients with clinical suspicion of dengue in settings where low resources do not permit an immediate analysis of the samples. Likewise, this study evidence the possibility of molecular diagnosis of DENV from multiple areas of the world where there are no laboratories with the capacity to confirm DENV cases.

Las infecciones por virus Dengue (DENV) representan un grave problema de salud pública debido a las altas tasas de morbilidad y mortalidad que causan, además no cuentan con tratamiento clínico específico, ni vacuna. Con el fin de reforzar el diagnóstico de laboratorio para los sistemas de vigilancia epidemiológica en países tropicales con recursos económicos limitados, se optimizó una metodología utilizando papel de filtro para la recolección de muestras y el subsiguiente diagnóstico molecular de los serotipos de DENV. Se emplearon cepas controles correspondientes a todos los serotipos virales, así como 35 muestras de sangre total dispensadas en papel de filtro que fueron mantenidas a temperatura ambiente por 36 meses. Las muestras fueron analizadas mediante RT-PCR para la amplificación de la región del genoma correspondiente a 5´UTR-C de los DENV. Los resultados mostraron la amplificación de los mencionados fragmentos en 88,6% de las muestras analizadas, así como de las cepas controles. Estos resultados evidenciaron la utilidad del papel de filtro para conservación de muestras obtenidas de pacientes con sospecha clínica de dengue ubicados en zonas donde no es posible realizar análisis de laboratorio de forma inmediata, así como su uso para el diagnóstico molecular. De este modo se reforzaría la vigilancia en áreas, donde no hay laboratorios con capacidad para confirmar casos de DENV.

Differences in Rab protein expressions in McCoy cells with acute versus persistent Chlamydia trachomatis infection / 中华皮肤科杂志

Objective To investigate differences in Rab protein expressions in McCoy cells with acute versus persistent Chlamydia trachomatis (Ct) infection.Methods Cultured McCoy cells were infected with different amounts (400,500,550 μl/well) of Ct strain D suspensions,then cultured with the medium containing 100 U/ml penicillin G (persistent Ct infection groups) or that without penicillin G (acute Ct infection groups).Ct-uninfected McCoy cells receiving no penicillin G treatment served as the blank control group,and those receiving penicillin G treatment as the penicillin group.Mter 48-hour culture,McCoy cells were lysed,proteins were collected,and total RNA was extracted from the cells.Enzyme-linked immunosorbent assay (ELISA) was conducted to measure protein levels of Rab4A,Rab6A,Rab10,Rab11A and Rab14,and fluorescence-based quantitative PCR to quantify mRNA expressions of Rab4A and Rab14 (expressed as 2-ΔΔα).Results Protein levels of Rab4A,Rab6A,Rab10,Rab11A and Rab14 were all significantly lower in the acute than in the persistent Ct infection groups (all Z =3.621,P ＜ 0.001),and lower in the persistent and acute Ct infection groups than in the blank control group (all P ＜ 0.008 3),but insignificantly different between the blank control group and penicillin group (all P ＞ 0.05).In addition,the expressions of Rab4A and Rab14 mRNAs were consistent with those of their proteins in these groups.Conclusion The transcriptional and expression levels of Rab proteins are higher in McCoy cells persistently infected with Ct than in those acutely infected with Ct.

Aspectos tomográficos da órbita aguda infecciosa: revisão de literatura / Tomographic findings of acute infections of the orbit: literature review

As doenças que acometem a órbita de forma aguda e não traumática por vezes não são conhecidas por médicos em centros de emergência. Essas condições são decorrentes de diversos fatores, como desordens imunológicas, congênitas, infecciosas, vasculares, entre outras. As causas infecciosas correspondem a mais de 50% de todos os casos e requer rápido diagnóstico e conduta para minimização de sequelas. A tomografia computadorizada (TC) é o exame de imagem de primeira linha nesses casos, sendo geralmente disponível nos centros de emergência e capaz de fornecer auxílio diagnóstico de forma rápida, precisa e eficaz. Esse artigo de revisão visa descrever os principais aspectos tomográficos da órbita aguda infecciosa, correlacionando-os com os dados da literatura.

The acute and nontraumatic diseases that involve the orbit are often little known by most physicians. These conditions are due to several factors, such as immune disorders, congenital, infections, vascular, among others disorders. The infectious causes correspond to more than 50% of all cases and require rapid diagnosis and management in order to minimize sequels. Computed tomography (CT) is the first line imaging method on these cases, generally being available in emergency centers and capable to provide an accurate, quick and effective diagnostic information. This review article aims to describe the main tomographic findings in acute orbit infections, correlating them with the literature data.

NATURAL INFECTION BY Trypanosoma cruzi IN ONE DOG IN CENTRAL WESTERN BRAZIL: A CASE REPORT / Infecção natural por Trypanosoma cruzi em um cão na região central do Brasil: relato de caso

SUMMARY It is estimated that about 10 million people are infected with Trypanosoma cruzi worldwide, mostly in Latin America and more than 25 million are at risk of acquiring this infection in endemic areas. Dogs are an important reservoir for this pathogen and thus, considered a risk factor for human populations. This report describes one case of Chagas disease in a dog from Cuiabá, Mato Grosso State, Brazil. The diagnosis was obtained by direct examination of trypomastigote forms in blood smears. Amastigotes forms were visualized in microscopy of the bone marrow, lymph nodes, kidneys, liver and brain. The T. cruzi (ZIII) infection was confirmed by Polymerase Chain Reaction, and sequencing. The animal presented multisystemic failure and died. Although acute Chagas disease in humans is not reported in Cuiabá, this is the first report of a canine case in this region. This case represents a warning, to health professionals and authorities, to the possibility of transmission of this zoonosis in Cuiabá. .

RESUMO Trypanosoma cruzi, infecta cerca de 10 milhões de pessoas, principalmente na América Latina e mais de 25 milhões apresentam-se em risco de adquirir a doença nas áreas endêmicas. Os cães são considerados importantes reservatórios representando fator de risco para a população humana. Este relato descreve caso de doença de Chagas em cão na cidade de Cuiabá. O diagnóstico foi feito a partir do exame direto, apresentando inúmeras formas tripomastigotas em esfregaço sanguíneo. Amastigotas foram visualizadas na microscopia de medula óssea, linfonodo, rins, fígado e cérebro. A infecção por T. cruzi (ZIII) foi confirmado através do sequenciamento de produtos amplificados pela PCR. O animal apresentou sinais multissistêmicos, evoluindo para óbito. Apesar da doença de Chagas aguda em humanos não ser descrita em Cuiabá, este é o primeiro relato de um caso canino nessa região, fato que, constitui alerta aos profissionais da saúde e autoridades sanitárias para a possibilidade da transmissão desta zoonose em Cuiabá. .

Presencia del virus de la diarrea viral bovina y su asociación con otros cuadros patológicos en ganado en corral de engorda / Presence of bovine virus diarrhea in association with other pathologies in feedlot cattle

Bovine feedlots are intensive production systems of significant importance in Mexico. The present study describes the presence of bovine virus diarrhea (BVD) causing subacute to chronic lesions in feedlot cattle, associated with other pathologies. Animals included in this study were discarded after they received therapy several times due to chronic pneumonia, or anaplamosis. Bovine virus diarrhea antigen was identified by immunohistochemistry in small intestine and myocardium in six cases of chronic suppurative bronchopneumonia with extensive areas of casseous necrotic bronchiectasis, previously diagnosed as Mycoplasma bovis pneumonias (retrospective group, n = 6). Furthermore, based on characteristic histopathologic lesions other nine cases were included (prospective group, n = 9). Bovine virus diarrhea antigen was recognized in two animals with pneumonic lesions, including a case with fibrinous bronchopneumonia as well as suggestive lesions of infectious bovine rinotracheitis (1/9), and another one with suppurative bronchopneumonia and myocarditis suggestive of Histophilus somni (1/9). In addition, one positive case was associated to anaplasmosis (1/9). Other two positive cases showed a conspicuous fibrinous peritonitis (2/9). The rest of the animals in this group resulted negative (4/9). Histopathological characteristics of the lesions and their association with the antigen in situ confirm the presence of BVD. This presentation is compatible with the acute infection syndrome. This is the first report of BVD infection and concomitant pathologies in feedlot cattle in Mexico.

El ganado en corral de engorda es un sistema de producción intensivo de gran importancia en México. En este trabajo se describe la infección por diarrea viral bovina (DVB), ocasionado por lesiones subagudas y crónicas en bovinos en corral de engorda, y su asociación con otras patologías. Los animales de este estudio fueron considerados de rechazo después de ser tratados en diferentes ocasiones por enfermedad respiratoria, o bien anaplasmosis. El antígeno de DVB fue identificado por inmunohistoquímica (IHQ) en intestino delgado y miocardio en seis casos de bronconeumonía supurativa crónica con extensas áreas de bronquiectasia con necrosis caseosa, los cuales habían sido previamente diagnosticados como neumonías por Mycoplasma bovis (grupo retrospectivo, n = 6). Además, se incluyeron otros nueve casos con base en las características histopatológicas de las lesiones (grupo prospectivo, n = 9). El antígeno de DVB se reconoció en dos animales con lesiones neumónicas, uno de ellos con bronconeumonía fibrinosa, incluyendo además lesiones probables de rinotraqueítis infecciosa bovina (1/9), y el otro con bronconeumonía supurativa y también miocarditis probable por Histophilus somni (1/9). Adicionalmente, un caso positivo estuvo asociado a anaplasmosis (1/9). Otros dos casos positivos presentaron una distintiva peritonitis fibrinosa (2/9). El resto de los animales de este grupo resultaron negativos a DVB (4/9). Las características histopatológicas de las lesiones y su asociación con el antígeno in situ, confirman la presencia de DVB. Esta presentación es compatible con el síndrome denominado infección aguda. Este es el primer informe de infección por DVB y otras patologías concomitantes en ganado de engorda en México.

Características clínicas da fase aguda da infecção experimental de felinos pelo vírus da imunodeficiência felina / Clinical characteristics of the acute phase of feline immunodeficiency virus experimental infection

A infecção dos felinos pelo Vírus da Imunodeficiência Felina (FIV) resulta no desenvolvimento da síndrome de imunodeficiência dos felinos. Gengivite, perda de peso, linfadenomegalia generalizada, anemia, insuficiência renal crônica, complicações neurológicas, diarréia crônica e infecções bacterianas são encontradas frequentemente. A fase aguda da infecção pode ser assintomática, retardando o estabelecimento do diagnóstico e a implantação de medidas profiláticas para restringir o contágio e a transmissão do agente aos felinos suscetíveis. Com a finalidade de estudar as características clínicas da fase aguda da infecção, dez felinos jovens, sem definição racial, com oito meses de idade foram inoculados por via endovenosa com 1mL de sangue venoso de um gato portador do FIV subtipo B. A confirmação da infecção foi obtida através de teste sorológico em quatro e oito semanas pós-inoculação (p.i.) e por nested-PCR. Foram realizados hemogramas semanais, exame ultrassonográfico do abdômen quinzenais e exame oftalmológico mensal, durante doze semanas p.i. Discreta tendência a linfopenia na segunda semana p.i. e a neutropenia entre a quinta e sétima semana p.i., febre intermitente em alguns gatos, linfadenomegalia e hepato-esplenomegalia entre a quarta e a 12ª semana p.i. foram as alterações clínicas observadas. Apenas um gato apresentou uveíte unilateral direita. A fase aguda da infecção transcorreu com alterações clínicas inespecíficas. A linfadenomegalia e a hepato-esplenomegalia observadas no decorrer da infecção, refletindo hiperplasia linfóide, sugerem a necessidade de se realizar o teste sorológico para o FIV, em todos os gatos que se apresentarem com essas alterações, o que permitirá o diagnóstico precoce da infecção e a adoção de medidas profiláticas no sentido de minimizar a propagação da infecção.

As a result of FIV infection of cats, feline immunodeficiency syndrome might be seen in the latter phase of infection. Gengivitis, weight loss, spread enlargement lymph nodes, anemia, chronic renal failure, neurological disturbances, chronic diarrhea, and oportunistic bacterial infections are commonly found. The acute phase of the infection might be unnoticed, making the diagnosis difficult and delaying the adoption of profilatic measures, in order to reduce FIV transmission for other susceptible cats. Aiming to study the clinical characteristics of the acute phase of FIV infection, ten young eight month old cats mixed breed were succesfully inoculated by intravenous route with one mL of blood obtained from one FIV-B positive cat. The infection was confirmed by ELISA test four and eight weeks p.i and nested-PCR. CBC counting, abdominal ultrasonography and ophtalmologic exams were done weekly, fortnightly and monthly during twelve weeks p.i. Mild tendency to lymphopenia at second week and neutropenia between fifth and seventh weeks p.i., fever in a few cats and lymph nodes, spleen and hepatic enlargements were the main clinical alterations found. The latters became evident starting on fourth week and remained throughout the twelve weeks observation period. Only one cat showed unilateral rigt uveitis. The acute phase of FIV infection elapsed with inespecific clinical manifestations. Lymph node, hepatic and spleen enlargements seen, though, suggest the needs for indication of tests for the diagnosis of FIV infection in all cats presenting those signs, thus allowing early diagnosis of FIV infection and the adoption of prophylatic measures.

Acute HIV infection with rapid progression to AIDS

Acute HIV infection is rarely recognized as the signs and symptoms are normally unspecific and can persist for days or weeks. The normal HIV course is characterized by a progressive loss of CD4+ cells, which normally leads to severe immunodeficiency after a variable time interval. The mean time from initial infection to development of clinical AIDS is approximately 8-10 years, but it is variable among individuals and depends on a complex interaction between virus and host. Here we describe an extraordinary case of a man who developed Pneumocisits jiroveci pneumonia within one month after sexual exposure to HIV-1, and then presented with 3 consecutive CD4 counts bellow 200 cells/mm³ within 3 months, with no other opportunistic disease. Although antiretroviral therapy (AZT+3TC+ATZ/r) was started, with full adherence of the patient, and genotyping indicating no primary antiretroviral resistance mutations, he required more than six months to have a CD4 restoration to levels above 200 cells/mm³ and 10 months to HIV-RNA to become undetectable.

Inmunopatogenia y fisiopatología de la hepatitis por virus B / Immunopathology and Physiopathology of Viral Hepatitis Type B

Virus B, familia Hepadnaviridae, no citopático directo. La lesión hepatocelular es por la respuesta inmunológica a los antígenos virales. Respuesta inmune muy agresiva da hepatitis fulminante. En los crónicos hay débil respuesta de los linfocitos T citotóxicos CD 8, predominante la respuesta humoral de sustancias Th-2 (IL4,5,10). Factores que afectan la evolución: a). mutación del virus; b) co-infección con otros virus; c) estado inmune del paciente. Fases de la evolución a cronicidad: a) fase inmunotolerante: mucho virus y Ag positivo, seroconversiόn dura años, seroconversiόn de e es de 15% en 20 años; b) fase de aclaramiento inmune: seroconversiόn de e de 10 20% por año; c) estado de portador inactivo: mayoría de pacientes crónicos, son Ag negativos, anti e positivos; d) hepatitis crónica e negativos: ADN alto con elevación de ALT, la mayoría son mutaciones core y pre core no produciendo antígeno. e) resolución de infección crónica, 0.5-2% aclaran el antígeno de superficie, pero podrían hacer carcinoma hepatocelular en el futuro, siendo anti-HBs positivos.

HBV, Hepadnaviridae family, not direct cytopathic. This hepatocellular lesion is the result of an immunological response to viral antigens. A very aggressive response causes fulminant hepatitis. In chronic cases there is a weak response from lymphocyte T cell CD 8 and predominates the humoral response of TH-2 (IL-4-5-10) substances. Factors that affect the evolution: virus mutation, co-infection with other viruses, immune status of the patient. Stages of the evolution towards chronicity: a) immunotolerant stage (abundance of virus and e positive, seroconversion lasts years; seroconversion of Ag is 15% in 20 years); b) immune clearance stage (seroconversion of Ag is 10-20% per year); c) inactive carrier stage (most patients are chronic, Antigen negative and anti e positive); d) chronic hepatitis e negative (high DNA with an increase of ALT, most of them are core and pre-core mutations and do not produce antigen); e. resolution of chronic infection (0.5-2% clear the surface antigen, but in the future they could cause liver cell carcinoma because they are anti-HB positive.

ROS in Patients with Acute Respiratory Infective Disease and Its Significance / 中华医院感染学杂志

OBJECTIVE To explore the change in ROS and its significance in diagnosis and therapy in patients with acute respiratory infective disease. METHODS By means of flow cytometer,the concentration of serum ROS was measured in 30 acute pneumonia patients and 24 acute upper respiratory tract infection patients before and after the stimulation on PMN with PMA and 21 controls. RESULTS The serum ROS was increased significantly in the acute pneumonia group(group A) and the acute upper respiratory infection group(group B) than in control group(groupC) before the stimulation of PMA(P

Exit site infection in continuous ambulatory peritoneal dialysis single center experience / 대한내과학회지

BACKGROUND: Catheter-related infection is one of the most important causes of technical failure in peritoneal dialysis patients. We have examined the incidence and etiology of exit-site infection (ESI) at Keimyung University Dongsan medical center. METHODS: Between January 2001 and December 2003, 292 new patients received peritoneal dialysis using double cuffed straight Tenckhoff catheter and were reviewed retrospectively. RESULTS: In 292 patients, 81 (27.7%) patients experienced ESI and a total of 97 episodes of ESI has occurred during study period. The overall incidence of peritonitis during peritoneal dialysis was 0.27 episodes/patient-year. According to Twardowski's classification, equivocal infection in 14.4%, acute infection in 68.1% and chronic infection in 17.5% were noted. Staphylococcus aureus was the most frequently isolated organism, followed by Staphylococcus epidermidis, and Pseudomonas aeruginosa. The duration of treatment was significantly longer in chronic infection group than acute infection group (44.6 days vs. 18.5 days, p<0.05). The rates of Pseudomonas infection (p<0.05) and catheter replacement (p<0.05) were significantly higher in the chronic infection group than in the acute infection group. There was one catheter loss due to refractory peritonitis and three deaths unassociated with ESI during mean follow-up of 20.3 months. CONCLUSIONS: Exit-stie infection is still a major causes of peritonitis and catheter failure. Because of suboptimal quality of practice guideline, additional studies on the definition, prevention and treatment of ESI are required.