Relationship between malaria epidemiology and the human development index in Colombia and Latin America.

Central nervous system (CNS) tuberculosis includes three clinical entities: tuberculous meningitis, intracranial tuberculoma, and spinal tuberculous arachnoiditis. All three categories are encountered frequently in regions of the world where the incidence of TB is high. Meningeal tuberculosis is a medical emergency: it is the most severe, lethal and disabling form of tuberculosis. Early diagnosis and treatment can be lifesaving. Even, in developed countries the diagnosis of tuberculous meningitis is difficult, frequently delayed or missed, and is often not microbiologically confirmed. Here I report a case of miliary tuberculosis, in a patient with diabetes mellitus and chronic kidney disease, but without HIV infection. Although the patient had regular contact with healthcare staff (hemodialysis), miliary tuberculosis diagnosis was considerably delayed. This patient, subsequently evolved into tuberculous meningitis. In spite of quadruple anti-tuberculosis treatment, corticosteroids, and general supportive care, this case resulted in death.

Is Legionellosis Present and Important in Colombia? An Analyses of Cases from 2009 to 2013.

Infection due to Legionella pneumophila has been not studied in Colombia, although it is present. The observational, retrospective study in which the incidence of legionellosis in Colombia, 2009-2013, was estimated based on data extracted from the personal health records system (Registro Individual de Prestación de Servicios, RIPS) using the ICD-10 codes A48.1 (Legionnaires' disease) and A48.2 (Pontiac Fever). Using official population estimates of the National Administrative Department of Statistics (DANE), crude and adjusted incidence rates were estimated (cases / 100,000 pop). During the period, 206 cases were reported (mean of 41.2 per year) for the cumulated national rate of 0.45 cases / 100,000 pop. The clinical form of legionellosis with the highest incidence rates was the non-pneumonic Legionnaires' disease (0.39 cases / 100,000 pop) with women being the main affected (0.42 cases / 100,000 pop). The territory with the highest incidence rate was Bolivar department (1.94 cases / 100,000 pop), followed by La Guajira (1.7 cases / 100,000 pop). Finally, age groups with the highest morbidity were 0-9.999 years old (1.16 cases / 100,000 pop) and system of identification for social subsidies beneficiaries (SISBEN) category with the highest number of total cases was level one (88 cases). According to these results, we can show that legionellosis in Colombia is more common than it could be thought. Nevertheless, cross-sectional and prospective studies should be conducted in our country in order to improve the knowledge of incidence, prevalence, and burden of disease.