Severe COVID-19 patients have severe vitamin D deficiency in Northeast Mexico / Los pacientes graves con COVID-19 tienen deficiencia grave de vitamina D en el noreste de México

Objective: the association between vitamin D and COVID-19 severity is not consistent. We compared prevalences and analyzed the association between vitamin D deficiency and COVID-19 severity in Northeast Mexico. Methods: this was a cross-sectional study with individuals consecutively included at a referral diagnostic center during March-September 2020 (n = 181). Concurrently, every patient admitted to intensive care was also consecutively included (n = 116). Serum 25(OH)D < 20 ng/mL was considered vitamin D deficiency. Descriptive, ANOVA, and multivariate ordinal regression analyses were performed. Results: vitamin D deficiency prevalence was 63.8 % (95 % CI, 54.7, 72.0) in severe COVID-19; 25.6 % (95 % CI, 17.4, 36.0) in mild COVID-19; and 42.4 % (95 % CI, 33.2, 52.3) in non-diseased individuals. Vitamin D deficiency increased 5 times the odds of severe COVID-19 (95 % CI, 1.1, 24.3), independently of sex, age, body mass index, and inflammatory markers. Conclusions: this study is the first report of vitamin D deficiency in Northeast Mexico. Vitamin D deficiency was associated with COVID-19 severity (AU)

Objetivo: la asociación entre la vitamina D y la gravedad de la COVID-19 no es consistente. Se comparó la prevalencia y se analizó la asociación de la deficiencia de vitamina D con la gravedad de los pacientes con COVID-19 en el noreste de México. Métodos: este fue un estudio transversal. Se incluyó consecutivamente a individuos de un centro de diagnóstico de referencia durante marzo-septiembre de 2020 (n = 181). Paralelamente, se reclutó a todos los pacientes que ingresaron a cuidados intensivos en ese mismo periodo (n = 116). Se consideró que había deficiencia de vitamina D ante cifras de 25(OH)D sérica < 20 ng/ml. Se realizaron un análisis descriptivo, un ANOVA y una regresión ordinal multivariante. Resultados: la prevalencia de la deficiencia de vitamina D fue del 63,8 % (IC del 95 %: 54,7; 72,0) en la COVID-19 grave, del 25,6 % (IC del 95 %: 17,4; 36,0) en la COVID-19 leve y del 42,4 % (IC del 95 %: 33,2; 52,3) sin COVID-19. La deficiencia aumentó 5 veces las probabilidades de una COVID-19 grave (IC del 95 %: 1,1; 23,9) independientemente del sexo, la edad, el índice de masa corporal y los marcadores inflamatorios. Conclusiones: este estudio es el primer informe de la deficiencia de vitamina D en el noreste de México. La deficiencia de vitamina D se asoció con la gravedad de la COVID-19 (AU)

Disseminated fusariosis in immunocompromised children: a case series and review of literature.

In the era of antifungal prophylaxis for cancer patients, Fusarium genus has become the second leading cause of invasive fungal infections and mortality in this group of patients. The intrinsic resistance to antifungal agents and the patient's risk factors are the most important variables for prognosis and survival. Currently, the use of monotherapy in comparison to combined antifungal treatment information is scarce. In this report, we present a series of three cases of children with acute lymphoblastic leukemia and disseminated fusariosis categorized according to the European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG). Furthermore, we present a current literature review focused on treatment using monotherapy or combined antifungal treatment.

Emerging of ptxP3 lineage in Bordetella pertussis strains circulating in a population in northeastern Mexico.

We determined the molecular epidemiology of Bordetella pertussis isolates to evaluate its potential impact on pertussis reemergence in a population of Mexico. Symptomatic and asymptomatic cases were included. Pertussis infection was confirmed by culture and real-time polymerase chain reaction (PCR). Selected B. pertussis isolates were further analysed; i.e. clonality was analysed by pulsed-field gel electrophoresis (PFGE) and ptxP-ptxA, prn, fim2 and fim3 typing was performed by PCR and sequencing. Out of 11 864 analysed samples, 687 (5.8%) were positive for pertussis, with 244 (36%) confirmed by both culture and PCR whereas 115 (17%) were positive only by culture and 328 (48%) were positive only by PCR. One predominant clone (clone A, n = 62/113; 55%) and three major subtypes (A1, A2 and A3) were identified by PFGE. All 113 selected isolates had the allelic combination ptxP3-ptxA1. The predominant clone A and the three major subtypes (A1, A2 and A3) corresponded to the emerging genotypes ptxP3-ptxA1-prn2-fim2-1-fim3-2 and ptxP3-ptxA1-prn2-fim2-1-fim3-1. In conclusion, the presence of an endemic clone and three predominant subtypes belonging to the genotypes ptxP3-ptxA1-prn2-fim2-1-fim3-2 and ptxP3-ptxA1-prn2-fim2-1-fim3-1 were detected. This finding supports the global spread/expansion reported for these outbreaks associated genotypes.

[Splenic abscesses. A case report and review of the literature]. / Abscesos esplénicos. Informe de un caso y revisión de la literatura.

This is a report of a case of a 3-year-old boy who developed splenic abscesses after a mild plantar wound. His initial complains were fever and several distal cutaneous abscesses (septic emboli). Multiple cultures for bacteria, fungi, mycobacterium and anaerobes were performed, but all were negative. In spite of an energetic antimicrobial treatment, he continued with high fever. Echocardiography was normal. Two weeks later, a thoracic radiography showed the left hemidiafragm was elevated and a small pleural effusion. An abdominal echosonography showed multiple hypoechoic splenic lesions, and this finding was confirmed by magnetic resonance imaging. After splenectomy, the patient healed and was discharged. Anatomopathological examination of the spleen showed eight pyogenic abscesses of different size. The causal agent was not isolated.

[Spinal epidural abscess. Diagnosis of a case using nuclear magnetic resonance]. / Absceso epidural espinal. Diagnóstico de un caso por resonancia magnética nuclear.

This is a case study of a six year old boy with a previous history of a contuse trauma of the cervical spinal region who later developed fever, stiffening of the neck, and signs of spinal compression. A descending myelography detected a lesion at C4. The Nuclear Magnetic Resonance study of the area showed an anterior epidural mass extending from C5 to T1 which displaced the spinal cord. Surgery revealed an epidural abscess which was drained. The patient received parenteral antibiotic therapy.

[Acute trichinosis in children. Intrafamilial epidemic outbreak in Mexico City]. / Triquinosis aguda en niños. Brote epidémico intrafamiliar en la ciudad de México.

Four cases of trichinosis found in a family living in Iztapalapa, Mexico, D.F. are reported. The family reported to frequently eat raw sausage originally from Villanueva, Zacatecas from which Trichinella spiralis larvae were isolated. Diagnosis was difficult in the first case since no epidemiological history was associated with the patient, besides the fact that the patient showed no signs of eosinophilia and blood tests were negative. The diagnosis in this case was confirmed through muscular biopsy. The predominating symptomatology consisted in the trilogy of fever, eyelid edema and myalgias.

[Cystic lymphangioma of epiploon simulating ascites. Presentation of a case and review of the literature]. / Linfangioma quístico de epiplón simulando ascitis. Presentación de un caso y revisión de la literatura.

We present a case of a 6 year old male who was admitted to the Hospital Infantil de México Federico Gómez with a history of previous management in a secondary care facility, during a three year period, with the diagnosis of recurrent ascites. We established the diagnosis of an omentum cystic lymphangioma and revised the international literature, emphasizing on the different of clinical presentations, study protocol, differential diagnosis and therapy.