ABSTRACT
BACKGROUND: Different epidemiological studies have demonstrated that specific anti-Toxocara antibodies are detected in the serum of a high percentage of the Spanish population. But very few clinical cases of visceral larva migrans are being confirmed. METHODS AND RESULTS: Two cases of visceral toxocarosis, in two sisters, are described. In the first, the prevailing clinic was swelling of joints and upper respiratory tract symptoms; and asthma and cutaneous allergic manifestations in the second patient. Both cases presented with an elevated blood eosinophil count, high levels of total IgE and high titlers of anti-Toxocara antibodies. All symptoms disappeared after treatment with diethylcarbamazine and they remain asymptomatic several months after. CONCLUSIONS: In pediatric population, toxocarosis should be ruled out in every patient with respiratory symptoms, allergic cutaneous manifestations and elevated blood eosinophil count. The anti-Toxocara antibodies assay is of great value in establishing the diagnosis of this parasitic disease.
Subject(s)
Larva Migrans, Visceral/diagnosis , Adolescent , Child , Diethylcarbamazine/therapeutic use , Female , Filaricides/therapeutic use , Humans , Larva Migrans, Visceral/blood , Larva Migrans, Visceral/complications , Larva Migrans, Visceral/drug therapyABSTRACT
BACKGROUND: Zygomycosis (mucormycosis or phycomycosis) is the infection caused by zygomycetes (non partitioned mycelial fungi, usually saprophytes). All cases of zygomycosis diagnosed in the Hospital 12 de Octubre in Madrid, Spain, from 1976 to 1994 were reviewed. METHODS: The underlying diseases of the patients, the factors favoring infection (alteration of the cutaneous barrier and administration of antimicrobians and corticosteroids) and the possible nosocomial origin of infection were analyzed. RESULTS: Over this period of time, 16 cases of zygomycosis were diagnosed with different clinical forms depending on the route of entry (rhino-orbital-cerebral, cutaneous or disseminated). The species isolated were Rhizopus oryzae, Rhizomucor pusillus, Absidia corymbifera and Rhizopus stolonifer. The species could not be determined in two cases. CONCLUSIONS: The diagnosis of zygomycosis should be based on a combined histological and microbiological study which allows both, differentiation between colonization and infection and isolation of the implicated species. Treatment is that of the underlying diseases, extensive surgical resection and amphotericin B.
Subject(s)
Mucorales/isolation & purification , Mucormycosis/epidemiology , Adolescent , Adult , Aged , Antifungal Agents/therapeutic use , Child , Combined Modality Therapy , Comorbidity , Cross Infection/epidemiology , Diabetes Mellitus/epidemiology , Disease Susceptibility , Fatal Outcome , Female , Humans , Immunocompromised Host , Leukemia/epidemiology , Liver Diseases/epidemiology , Male , Middle Aged , Mucormycosis/microbiology , Mucormycosis/therapy , Postoperative Complications/epidemiology , Retrospective Studies , Rhizopus/isolation & purification , Spain/epidemiology , Wound Infection/epidemiologyABSTRACT
BACKGROUND: The incidence of typhoid fever has greatly fallen in Spain although sporadic cases and limited outbreaks may be observed. The usefulness of the serum agglutinin studies for the diagnosis of this disease has been questioned by many authors. However, this diagnosis criteria continues to be used in Spain. The usefulness of blood cultures, stool cultures, urinecultures and serological test is herewith compared. METHODS: Three groups were prospectively studied: 18 patients with typhoid fever from one single outbreak, 50 blood donors, and 24 patients with other infections. Blood, stool culture, urinecultures and serology (agglutination) were carried out in the first group and in the other two groups serological test were used to determine the cut-off points and study cross reactions. RESULTS: Blood culture was found to be the most sensitive technique (94%) followed by stool culture (53%). No positive urineculture of seroconvesrion were observed. The cut off points accepted following the study of the donors were 1/160 or greater for the O antigen and 1/320 or greater for the H antigen. Two false positive for the O antigen and 3 for the H antigen were observed in the 24 patients with other infections. CONCLUSIONS: When suspecting typhoid fever, the combined use of blood culture and stool culture is recommended. The usefulness of serological test in our area lays in the observation of seroconversion associated to a compatible clinical picture. Its performance should not being considered as adequate in unspecific febrile syndromes.
