[Septic shock by Vibrio vulnificus at the coast Gulf of Mexico]. / Choque séptico por Vibrio vulnificus en las costas del Golfo de México.

Vibrio vulnificus is a Gram-negative bacterium which is found in marine environments and where there is a partly enclosed coastal body of water with one or more rivers or streams flowing into it, and with a free connection to the open sea. The infection by these bacteria can cause primary septicemia by two mechanisms: upon consuming crustaceans, mollusks and some fish (filtering shellfish) raw or barely cooked or by an open injury in contact with seawater. The patients with infections of the primary injury by Vibrio vulnificus developed contaminated painful cellulitis that progresses quickly as well as a marked local inflammation with signs of hemorrhaging. We described a case of Vibrio vulnificus sepsis, with emphasis on the clinical picture, the epidemiological background and lab findings; finally we did a brief review of the literature related to the case.

Meningococcal disease: is it a latent disease in Mexico?

Infection by Neisseria meningitidis occurs frst as an asymptomatic carrier before the disease with serious manifestations like meningitis, with or without expressions of fulminating purpura. This disease is caused by different serogroups, A, B, C, Y and W-135 being the most prevalent. Over time they have undergone epidemiological changes in different regions of the world. There is scant information in our country concerning both the carrier and the invading forms; however, it has been proven in some Mexican states that the incidence of carrier status and of invading forms is signifcant. Accordingly, the possibilities of invading and secondary cases derived from the carrier and through contact with invading forms are feasible. Therefore, increasing the epidemiological surveillance and determining the actual burden of meningococcal disease is required. As far as preventive measures are concerned, prophylaxis of contacts with the index case and vaccination to control outbreaks or in high-risk specific cases is recommended. It would be reasonable as well to establish the indications of the vaccines available in our country.

[Hysteroscopy findings in patients with postmenopausal genital bleeding]. / Hallazgos histeroscópicos en pacientes con sangrado genital posmenopáusico.

OBJECTIVE: To describe morphological and histological findings in postmenopausal patients with abnormal uterine bleeding. PATIENTS AND METHODS: An open, descriptive, observational, retrospective and cross sectional study was done at Clinica de Histeroscopia at Hospital Dr. Manuel Gea Gonzalez, in Mexico City. There were included 372 patients with postmenopausal abnormal uterine bleeding diagnosis without hormone replacement therapy. Hysteroscopy study was made with a 5 mm surgical hysteroscope using warm saline solution (280C) as a medium of distension, and a trans-hysteroscopy endometrial biopsy was taken for histopathological correlation. Statistic analysis was obtained using SPSS program version 10 for windows with a kappa test. In order to analyze more than two samples, we used the chi-square test. RESULTS: Endometrial atrophy was the most frequent hysteroscopic diagnosis (202 patients, 54.3%), followed by polyps (93 patients, 25%), cancer (14 patients, 4%) and hyperplasia (11 patients, 2.95%). Correlated results between hysteroscopic findings and hystopathological biopsy diagnosis obtained were: atrophy (157 cases, 63.3%), polyps (76 cases, 77.55%), endometrial cancer (14 cases, 93.05%), endometrial hyperplasia (10 cases, 90.63%) and miomatosis (three cases, 16.20%). CONCLUSION: It can be stated that there is a high level of concordance between findings of hysteroscopic studies and the directed endometrial biopsy. So, we recommend initially the use of hysteroscopy for diagnosis and treatment of endometrial cavity malignant and benign pathology.

Epidemiologic and ultrasonographic study of echinococcosis in a community in the state of Mexico.

No epidemiologic study for cystic echinococcosis in México has yet been described. The objective of this work was to determine the prevalence and distribution of human echinococcosis in a community of the state of México and its probable risk factors. A cross-sectional study was performed; household census was used to randomly select houses. The larval stage of Echinococcus was searched by ultrasound in liver, spleen, and kidney. A questionnaire was used for the investigation of risk factors. The study was performed with 401 persons, 64% were female. The prevalence of echinococcosis was 0.75%. Cases were distributed in the same sector of the community. The close distribution of cases suggests the same exposure source. There were 426 dogs in the community; feces were collected from 414 of these in search of cestode eggs. After treatment, 3 dogs had Taenia pisiformis but none had Echinococcus. This paper pioneers the search of human echinococcosis in México because it provides evidence of the presence of this tissue parasite at the community level.

Laboratory animal models for human Taenia solium.

Human beings are the only hosts of adult Taenia solium; thus, many aspects of the host-parasite relationship are unknown. The development of successful experimental models of taeniasis allows in-depth investigations of the host-parasite relationship. We established experimental models in hamsters, gerbils and chinchillas. Here we review our findings regarding the characteristics of the tapeworms, their anchoring site and development, as well as the humoral and cellular immune response they elicit. We also used statistics to analyze the data obtained in different infections performed along several years. Furthermore, we compared the size of T. solium rostellum and strobila recovered from hamsters and gerbils to those obtained from humans. Our data indicate that these rodents are adequate experimental models for studying T. solium in its adult stage; that parasites induce immune responses and that hamsters seem to be more permissive hosts than gerbils, since parasites survive for longer times, grow longer and develop more, and the inflammatory response in the intestinal mucosa against T. solium is moderate. Finally, chinchillas are the most successful experimental definitive model for adult T. solium, since tapeworms with gravid proglottids are obtained, and the life cycle can be continued to the intermediate host.

Echinococcus granulosus cattle strain identification in an autochthonous case of cystic echinococcosis in central Mexico.

Echinococcosis is a frequent hepatic parasitic disease in several countries but it is practically absent in Mexico. A cattle strain of Echinococcus granulosus was identified by RAPD, PCR-RFLP and mitochondrial CO1 gene analysis in an autochthonous case. The parasite was obtained after a laparoscopic excision of a liver cyst from a patient that was symptomatic for 6 years but mis-diagnosed before hospitalization.

[Identification and integral management of a case of autochthonous hydatidosis in Mexico]. / Identificación y manejo integral de un caso autóctono de hidatidosis en México.

OBJECTIVE: To describe a case of hydatid disease in Mexico. BACKGROUND: Liver hydatid disease is the most frequent hepatic parasitic disease in developed countries and is considered practically absent in Mexico. METHODS: In this paper we report identification, clinical management, and epidemiologic parasitologic, and molecular biological studies of an autochthonous case of hydatid disease in Mexico. RESULTS: Hepatic cyst was identified by imaging techniques. The patient received cestocidal treatment and the parasite was excised by laparoscopy. It was not possible to identify the origin of the Echinococcus strain neither by epidemiologic studies performed in the patient's household nor by RAPD pattern obtained with DNA of the protoscolices. Infection of a dog with protoscolices was not successful probably because they were damaged by the cestocidal drug. CONCLUSIONS: Care should be taken in the future to identify other possible autochthonous patients harboring liver hydatid cysts to treat them in an adequate and timely fashion, and to identify the strain of Echinococcus granulosus that infects patients in Mexico.