ABSTRACT
BACKGROUND: Oral anaphylaxis due to food intake contaminated with mites (OMA, oral mite anaphylaxis) is an allergic reaction that can represent life risk for patients. There are reports of cases from different parts of the world and they involve mainly processed foods based on wheat flour contaminated with mites of several families of the Astigmatina cohort. However, it remains as a little known and difficult to diagnose syndrome. The objective of this study was to describe the first clinical case of OMA due to the consumption of oat flakes in Panama City, Panama. CLINICAL CASE: Female patient of 39-years-old was entered an emergency room with allergic cutaneous and respiratory symptoms one hour after ingesting granola and oatmeal with milk at breakfast. After antiallergic treatment, the cause of allergy was determined by applying skin prick tests for ingested food and house mites. Results indicated a negative reaction for food and positive for mites. The mite analysis of the food samples directed in the identification of the species Blattisocius keegani and Suidasia pontifica, with a high density of the latter in flaked oats. CONCLUSION: This work is the first worldwide report of anaphylaxis due to consumption of oats contaminated with mites.
Antecedentes: La anafilaxia oral por ingesta de alimentos contaminados con ácaros (OMA) es una reacción alérgica que puede representar riesgo de vida para los pacientes. Aun cuando se tienen reportes de casos de diversas partes del mundo que involucran principalmente alimentos elaborados con harina de trigo contaminada con ácaros de varias familias de la cohorte Astigmatina, OMA permanece como un síndrome poco conocido y de difícil diagnóstico. El objetivo del estudio fue describir el primer caso de OMA por consumo de avena en hojuelas ocurrido en la ciudad de Panamá, Panamá. Caso clínico: Mujer de 39 años que ingresó a urgencias de un hospital con cuadro alérgico cutáneo y respiratorio una hora después de ingerir granola y avena con leche en el desayuno. Después del tratamiento antialérgico se procedió a determinar la causa de la alergia mediante aplicación de pruebas de punción cutánea para los alimentos ingeridos y ácaros domésticos. Los resultados indicaron reacción negativa para alimentos y positiva para ácaros. El análisis acarológico de las muestras de alimentos resultaron en la identificación de las especies Blattisocius keegani y Suidasia pontifica, con alta densidad de la última en la muestra de avena. Conclusiones: El presente reporte constituye el primero en el mundo de anafilaxia por consumo de avena contaminada con ácaros.
Subject(s)
Anaphylaxis/parasitology , Avena/parasitology , Mites , Adult , Animals , Female , Humans , PanamaABSTRACT
INTRODUCTION: Contact dermatitis due to Paederus is a particular form of accident by animal contact. It is characterized by the sudden onset of erythematous and vesicular lesions with burning sensation on exposed areas of the body. The aim of this study was to describe the epidemiological and clinical findings of an outbreak of Paederus dermatitis in Panama. METHODS: Clinical and epidemiological findings of an outbreak of contact dermatitis caused by Paederus sp. in the province of Darien in eastern Panama is reported. After reviewing the clinical records, a clinical-epidemiological questionnaire was developed and used in 20 communities where reported cases were found. We captured and collected the specimens for species characterization for three consecutive days using three different methods of capture. RESULTS: During May-July, 2014, 68 cases of Paederus irritant contact dermatitis occurred in 20 communities of the Darien. Fifty-three percent were females. The age group of zero to five years had the highest number of cases, 15 (22%). The most common clinical presentation was the classical linear dermatitis (58%); 42% of the subjects had mirror image lesions, multiple vesicular-pustular lesions, and crust lesions. Symptoms were most commonly reported as a burning sensation (65%), followed by pruritus in 60%, pain (25%), and fever (nine percent). A total of 81 specimens of Paederus were collected, 68% in peridomiciliary areas. CONCLUSIONS: This Paederus sp. dermatitis report represents one of the largest outbreak described in Latin America and the diagnosis could be confused with others skin diseases like pyodermitis or other contact dermatitis.
ABSTRACT
BACKGROUND: Oral mite anaphylaxis (OMA), or pancake syndrome, occurs in atopic individuals when eating starchy foods contaminated by mites, which induce moderate or severe, even fatal, allergic reactions. This syndrome is usually seen in tropical and subtropical environments,where conditions for the growth of domestic mites are given. Oral mite anaphylaxis has been associated with hypersensitivity to acetylsalicylic acid (ASA)-non-steroidal anti-inflammatory drugs (NSAID) and physical exercise. OBJECTIVE: To document the clinical and descriptive study of cases of OMA attended in City of Panama from 2011 to 2014. MATERIAL AND METHOD: A clinical descriptive and retrospective study was performed, including skin prick test to five species of domestic mites. Taxonomic identification of the mites was performed under microscope and its density per gram of food was calculated for three cases. RESULTS: Ten cases with clinical history compatible with OMA were studied, being the pancakes the most incriminated food. The onset of symptoms occurred between 25 and 60 minutes after ingestion of the food. All patients were atopic young adults. Four of the ten patients had hypersensitivity to ASA-NSAID. The patients were positive to Prick test mites: Blomia tropicalis, Dermatophagoides pteronyssinus and Suidasia pontifica. The three samples of wheat flour studied presented high densities of mites per gram. CONCLUSIONS: The pancakes were the most incriminated food in the cases of OMA in our study. Suidasia pontifica and Blomia tropicalis seem to be the mites species of greater relevance related with this syndrome in our country.
Antecedentes: la anafilaxia oral por ácaros, o síndrome de las panquecas, ocurre cuando individuos atópicos ingieren alimentos elaborados con harina de trigo contaminada con ácaros, lo que induce reacciones alérgicas moderadas o severas, incluso fatales. Los reportes provienen de ambientes tropicales y subtropicales, donde las condiciones para la proliferación de ácaros domésticos son favorables. Se ha encontrado una asociación importante con la hipersensibilidad a ácido acetilsalicílico (AAS)-antiinflamatorios no esteroides (AINES) y el ejercicio físico. Objetivo: documentar el estudio clínico y descriptivo de casos de anafilaxia oral por ácaros atendidos en Ciudad de Panamá durante los años 2011 a 2014. Material y método: estudio clínico descriptivo y retrospectivo, que incluyó pruebas cutáneas de punción para cinco especies de ácaros domésticos. La identificación taxonómica de los ácaros se realizó bajo microscopio y se calculó la densidad de ácaros por gramo de alimento en tres casos. Resultados: se estudiaron 10 casos compatibles con anafilaxia oral por ácaros, la panqueca fue el alimento implicado con más frecuencia. Los primeros síntomas aparecieron entre 25 y 60 minutos después de la ingestión del alimento. Todos los pacientes fueron adultos jóvenes atópicos, cuatro con hipersensibilidad a AAS-AINES. Los pacientes resultaron positivos a las pruebas cutáneas de punción para los ácaros: Blomia tropicalis, Dermatophagoides pteronyssinus y Suidasia pontifica. Tres muestras de harina de trigo estudiadas motraron altas densidades de ácaros. Conclusiones: la panqueca fue el alimento implicado con más frecuencia en los casos de anafilaxia oral por ácaros. Suidasia pontifica y Blomia tropicalis parecen ser los ácaros más importantes relacionados con este síndrome en nuestro país.
ABSTRACT
The genus Amblyomma is the most diverse and relevant among the Neotropical ticks. In Panama, this genus contains 19 species, including Amblyomma ovale. There is a lack of knowledge of the ecology of A. ovale in Panama, and thus the aim of this work is to report on its geographical distribution and its spectrum of vertebrate hosts. We reviewed data of ticks collected in different areas of Panama from 2007 to 2012 and found parasitism of A. ovale in 625 vertebrates, corresponding to 21 species (2 species of birds and 19 mammal species). A. ovale is present in different environments of Panama, from lowlands to places with 800m altitude, including rural towns, disturbed forests, and wilderness areas.
