Hepatitis por Rotavirus: A propósito de un caso / Rotavirus hepatitis: About a case

Introducción: La infección por rota virus se ha reconocido como un patógeno en el humano y causante de enfermedad diarreica grave; la infección se ha asociado con meningitis aséptica, enterocolitis necrotizante, miositis aguda , abscesos hepáticos, neumonía, enfermedad de Kawasaki , síndrome de muerte súbita y enfermedad de Crohn. En este caso se informa la asociación con hepatitis infecciosa. Caso Clínico: Masculino, con colitis alérgica a las proteínas de la leche de vaca y de la soya, desde el nacimiento. Al mes y medio presenta enfermedad diarreica por rota virus asociada a hepatitis. Conclusiones: Tradicionalmente se ha considerado que es una infección del intestino delgado y que todos los eventos fisiopatologicos son el resultado de este tipo de lesión y de la intolerancia alimentaria que provoca a nivel local, sin embargo se han informado enfermedades que se presentan en otros órganos, como respuesta a la infección viral del sistema digestivo. En esta ocasión la invasión por el virus provoca daño hepático.

We describe a 3- month-old infant that was diagnosed with hepatitis secondary to infection by the rotavirus. The rotavirus has been recognized as a human pathogen that has been associated with severe diarrhea, aseptic meningitis, necrotizing enterocolitis, acute miositis, hepatic abscesses, pneumonia, Kawasaki disease, sudden infant death syndrome, and inflammatory bowel disease such as Crohn’s. To our knowledge, only three reports have associated the rotavirus with acute hepatitis, however, one of the three reports was in an immunodeficient patient. In this report we present another case of acute hepatitis secondary to the rotavirus, in an immunocompetent patient.

[Inflammatory cloacogenic polyp]. / Pólipo cloacogénico inflamatorio. (Presentación de un caso clínico).

INTRODUCTION: Cloacogenic Polyps are characterized by the presence of inflammatory lesions in the lower rectum, and the anal transition zone. The polyps can prolaps; this is due to the malfunction of the internal anal sphincter; and the smooth muscle that covers the rectum. This is the result of the chronic inflammatory process. The lesions are more common in women during the third and fourth decade of life, however lesion have been described in 10 and 83 year olds. 85% lesions are located above the anal border and predominantly in the anterior lateral wall. The polyps vary in size from 3-4 cm in diameter, and have a sessile appearance. CASE REPORT: 10-year-old female presents with a 3-month history of irregular abdominal pain, with occasional vomiting, constipation, and occasional diarrhea. CONCLUSIONS: This entity of colon polyps is somewhat rare, and is seen in young adults; however its presence in infancy requires that we think of this entity when we formulate our differential diagnosis. Due to the character of the lesions, this entity could be confused with colorectal malignant tumors. All children and infants with a rectal mass, and blood in their stools should get a biopsy sent for histopathology. This technique can aid in analyzing the origin of the lesion.

[Prevalence and risk faactors of Helicobacter pylori infection in three populations of children in Puebla, Mexico]. / Prevalencia del Helicobacter pylori en tres poblaciones de ni- ños, de la Ciudad de Puebla, México, y sus factores de riesgo.

INTRODUCTION: The infection by Helicobacter pylori affects approximately 50% of the world population, in average, nevertheless the geographical area and the socioeconomic conditions are determining for the infection in earlier ages, not even that, only 20% of these patients will develop gastroduodenal disease. The infection is distributed universally, concerning more to the countries in routes of development, where he appears with major frequency in the infantile and young population. In Mexico the seroprevalence studies founded that 20% of the children of one year old already had developed antibodies Ig G against Helicobacter pylori and 50% of them are positive 10 years after The major prevalence is reached between 25 and 30 years of age. In our community we do not know the prevalence of active infection. MATERIAL AND METHODS: The study group became from three different communities: Group A. Formed with children from half-low socioeconomic level, which they come habitually to a school placed in the conurban zone of the city of Puebla, Mexico and that inhabit a marginal area of asistential services of sanitary attention. Group B. Formed with children from the rural zone, of socioeconomic rural way, which habitually they come to a school placed in the surroundings of the City of Puebla, Mexico and that live in a rural zone, with regular services of sanitary attention. Group C. Formed with children from high socioeconomic level, which they come habitually to a private school placed in the city of It Populates, Mexico and that inhabit in zones with all the sanitary services. RESULTS: The group A was formed by 94 children, 23 of them was positive to Hp antigen (24.46%) and negatives 71 (75.54%). The group B was formed by 94 children, 17 of them was positive to Hp antigen (18.08%) and negatives 77 (81.92%). The group C was formed by 94 children, two of them was positive to Hp antigen (2.12%) and 92 negatives (97.88%). Statistically significant differences was found in: The days that eat meat, the drainage in the domicile, in the prevalence of antigen, if they have breakfast every day, the number of persons who live in the room, if there is drinkable water in the domicile, if they have drainage in the domicile, if they present diarrheic stools, if they possess wild animals. And no relation with the age, the kind (genre), the existence of domestic animals and the presence of abdominal pain. CONCLUSIONS: It is a question of three different populations in the same territory, the first one located in a conurban zone of regular services of health demonstrates a prevalence of almost 25%. The second from a rural zone, who live and study out of the circle of the city and in this one found 18% of positive results and the third group living in the city but with all the sanitary services that reported 2%. Only the drainage presence intra domiciliary and the fact that they were eating meat a week demonstrated to have statistic importance in three groups. To have drinkable water and the number of persons who coexist in the house demonstrated the sanitary conditions that also prevailed statistically in the group A and B in relation to the control group; The presence of diarrheic stools in the group A statistically significant make us suspect that one hand the sanitary environmental conditions to that these children are submitted are not the bestones.