[Monoclonal antibodies for anti-infective therapy]. / Monoklonale Antikörper zur antiinfektiven Therapie.

Sera of animal origin and hyperimmunoglobulins have dominated serum therapy for a century. Although numerous monoclonal antibodies (MABs) have been developed since the end of the 1980s, particularly for the treatment of immunological and oncological diseases, it will take 20 years before the first anti-infective MAB is approved in the European Union. Interestingly, to combat the COVID-19 pandemic, numerous MABs, which are approved in particular for immunological indications, are currently being used to treat the consequences of SARS-CoV­2 infection, such as pneumonia or hyperimmune reactions.The approved monoclonal antibodies for the treatment of infectious diseases are presented here. In addition, an overview of the current developments, in particular in the treatment of SARS-CoV­2 infection, is provided.

Cystic echinococcosis in unaccompanied minor refugees from Afghanistan and the Middle East to Germany, July 2016 through June 2017.

Cystic echinococcosis (CE) is not covered by current refugee screening protocols. After we had detected CE among several refugees attending our clinic from Afghanistan and the Middle East, serological examinations for CE were performed for apparently healthy unaccompanied minor refugees from these regions.

Screening for infectious diseases among unaccompanied minor refugees in Berlin, 2014-2015.

Infectious diseases (except tuberculosis) were screened among 1248 unaccompanied minor refugees (UMRs) arriving in Berlin in 2014-2015; 40 % originated from Syria. More than half of the refugees presented without any pathologic finding. Infections requiring treatment were diagnosed in 19.6 %, mainly infections with Giardia and intestinal helminths as well as schistosomiasis, while potentially contagious diseases were diagnosed in 15.3 % of all screened UMRs.

Enseñanza de la medicina tropical mediante la discusión de casos clínicos / Teaching tropical medicine through discussion of clinical cases

En los últimos años se han propuestos cambios en la enseñanza de la medicina tropical, basando la docencia en el estudiante. El objetivo de la investigación fue utilizar la metodología de la discusión organizada y razonada de casos clínicos, con la participación activa del estudiante, a fin de llegar a un diagnóstico prsuntivo de las patologías presentadas. Se describe el proceso de discusción con los estudiantes de medicina tropical, de cinco pacientes con enfermedades infecciosas bacterianas (fiebre tifoidea, brucelosis, leptospirosis, cólera y shigellosis), diagnósticados y tratados en la consulta de Endemias Rurales del Instituto de Medicina Tropical y en los servicios de Pediatría Médica Infecciosa y de Enfermedades Infecciosas del Adulto del Hospital Universitario de Caracas, Universidad Central de Venezuela, relacionado sus manifestaciones clínicas y de laboratorio con sus antecedentes epidemiológicos para establecer los diagnósticos e iniciar el tratamiento específico. En cada uno de los casos, siguiendo la metodología descrita se llegó al diagnóstico definitivo permitiendo el tratamiento oportuno de los pacientes de acuerdo a los agentes etiológicos. Mediante la discusión de casos clínicos y la utilización de la medicina basada en evidencia incluyendo al estudiante como ente activo es posible transmitir el conocimiento de la medicina tropical, llegando a los diagnósticos etiológicos de las enfermedades.

In recent years changes have been proposed in the teaching of tropical medicine, basing the teaching on the student. To use the methodology of organized and reasoned discussion of clinical cases, with active student participation in order to reach a presumptive diagnosis of pathology present. We describe the process of discussion with students of tropical medicine, five patients with baceterial infectious diseases (typhoid fever, brucellosis, leptospirosis, cholera and shigellosis), diagnosed and treated at the Outpatient Clinic of Rural Endemic Disease, Institute of Tropical Medicine, and Services of Pediatrics and Adult Infectious Diseases, Hospital Universitario de Caracas, Universidad Central de Venezuela, Relating clinicial manifestations and laboratory findings to epidemiological background to establish the diagnosis and initiate specific treatment. In each case, following the methodology described definitive diganosis was reached allowing timely tratment of tatients accoring to etiologic agents. Trough discussion of clinical cases and the use of evidence-based medicine including the student as an active entity the knowledge of tropical medicine may be transmitted, reaching the etiologic diagnosis of disease, and getting publications of articles.