People living with HIV co-infected with the Kaposi Sarcoma-associated Herpes Virus have a distinct HIV Tat profile and higher rates of antiretroviral virologic failure, more evident among those with Kaposi's sarcoma.

Kaposi sarcoma (KS) is a neoplasm of vascular origin that promotes angiogenesis and the growth of endothelial cells triggered by the Kaposi Sarcoma-associated Herpes Virus (KSHV). When associated with HIV, KSHV becomes more aggressive and rapidly evolves. The HIV-1 TAT protein can be essential in developing AIDS-associated KS by promoting angiogenesis and increasing KSHV replication. Therefore, we evaluated the genetic profile of the first exon of tat gene among groups of people living with HIV (PLHIV) with (case group, n = 36) or without KS, this later with (positive control group, n = 46) and without KSHV infection (negative control group, n = 24); all individuals under antiretroviral therapy. The genetic diversity, the DN/DS ratio, and the genetic entropy of the first exon of tat were higher in the case group, followed by the positive control group, which was higher than the negative control group. The number of tat codons under positive selection was seven in the case group, six in the positive control group, and one in the negative control group. The prevalence of HIV viral loads below the detection limit was equal in the case and positive control groups, which were lower than in the negative control group. The mean CD4+ T cell counts were higher in the negative control group, followed by the positive control group, and followed by the case group. These results emphasize the negative influence of KSHV in antiretroviral treatment, as well as the HIV-specific TAT profile among PLHIV who developed KS.

High silent prevalence of human herpesvirus 1 (HSV-1) infection affecting the indigenous reservation of the municipality of Dourados, Central-West Brazil.

BACKGROUND: The indigenous population located in the central region of Brazil, is the second largest in terms of population size in the country. The Indigenous Reserve of Dourados has risk factors that increase the vulnerability of the indigenous population to infectious diseases, especially Human alphaherpesvirus (HSV-1), a neglected disease with high prevalence in priority populations in developing countries. The virus can also cause many more severe diseases, including widespread neonatal infections, herpetic keratitis, and herpes encephalitis, which can be fatal if left untreated. We estimated the prevalence of anti-HSV-1 antibodies and correlated it with the demographic and behavioral characteristics of the Indigenous population of the Jaguapirú and Bororó villages (Dourados, Mato Grosso do Sul (MS), Brazil). METHODS: Our approach was cross-sectional. From March 2017 to November 2018. Using anti-HSV-1 (Gg1) IgM and anti-HSV-1 (gG1) IgG Euroimmun and the detection and quantification of HSV-1 viral load in plasma samples, through real-time PCR. The maps were constructed using QGIS and the statistical analyses using R Studio software. RESULTS: A total of 1138 individuals (> 18 years old) were enrolled. The prevalence of anti-HSV-1 IgM and IgG were 20% and 97.5%, respectively. The prevalence of anti-HSV-1 antibodies for IgG was higher in both sexes. Anti-HSV-1 IgM antibodies were present in 17.1%, 21.2%, 12.5%, and 22% of the participants with urinary problems, genital wounds, genital warts, and urethral discharge, respectively. Real-time PCR was used for confirmatory testing; HSV-1 DNA was detected in 25.6% (54/211) of anti-HSV1 IgM-positive samples. Viral loads ranged from 5.99E + 02 to 3.36E + 13. CONCLUSIONS: The seroprevalence of HSV-1 IgM and detection of HSV-1 DNA in the Indigenous population confirmed high silent prevalence. Furthermore, the seroprevalence of HSV-1 in the Indigenous population was higher than that reported in the general adult Brazilian population. Various socioeconomic factors, drug use, and health and sexual behaviors could contribute to the facilitation of HSV-1 transmission in the Indigenous population. Our results may help develop culturally appropriate intervention programs that eliminate health access barriers and improve the implementation of public health policies aimed at promoting information regarding the prevention, treatment, and control of HSV-1 infection in Brazilian Indigenous populations.

Immune Deficiency/Dysregulation Associated Lymphoid Proliferations, EBV+ In Persons Living With HIV

ABSTRACT Background: The 5th edition of the World Health Organization Classification of Hematolymphoid Tumors recently defined immune deficiency/dysregulation (IDD)-associated-lymphoid-proliferations in HIV settings, where information is scarce, often gone under or misdiagnosed. Objectives: To describe the clinical picture, histopathology, and outcomes of IDD-associated-lymphoid-proliferations Epstein-Barr virus+ (EBV) in people living with HIV without organ transplantation, antiretroviral therapy (ART) treated. Methods: HIV+ patients diagnosed with IDD-associated-lymphoid-proliferations seen at an academic medical center in Mexico from 2016 to 2019 were included. Immunohistochemical studies, in situ hybridization, and polymerase chain reaction analysis for EBV and LMP1 gene deletions were performed and correlated with clinical data. Results: We included 27 patients, all men who have sex with men, median age 36 years (interquartile range [IQR] 22-54). The median baseline CD4+ T cells were 113/mL (IQR 89-243), the CD4+/CD8+ ratio was 0.15 (IQR: 0.09-0.22), and the HIV viral load was 184,280 copies/mL (IQR: 76,000-515,707). Twenty patients (74.07%) had IDD-associated-lymphoid-proliferations hyperplasia plasma cell type EBV+, 3 (11.1%) had hyperplasia mononucleosis-like type (IM-type), 1 patient (3.70%) had florid follicular hyperplasia, 3 (11.1%) IDD-associated-lymphoid-proliferations polymorphic type, and there were 22 cases (81.4%) of synchronic Kaposi Sarcoma. Two patients were diagnosed with Hodgkin lymphoma following a second positron emission tomography-computed tomography scan-guided biopsy. The median follow-up was 228 weeks (IQR 50-269); 6 patients died (22.2%) of causes unrelated to IDD-associated-lymphoid-proliferations related. Conclusion: IDD-associated-lymphoid-proliferations EBV+ occured in severely immunosuppressed HIV+ patients, a high percentage of whom had concomitant Kaposi sarcoma. The prognosis was good in patients treated only with ART.

Immune Deficiency/Dysregulation Associated Lymphoid Proliferations, EBV+ In Persons Living With HIV.

Background: The 5th edition of the World Health Organization Classification of Hematolymphoid Tumors recently defined immune deficiency/dysregulation (IDD)-associated-lymphoid-proliferations in HIV settings, where information is scarce, often gone under or misdiagnosed. Objectives: To describe the clinical picture, histopathology, and outcomes of IDD-associated-lymphoidproliferations Epstein-Barr virus+ (EBV) in people living with HIV without organ transplantation, antiretroviral therapy (ART) treated. Materials and Methods: HIV+ patients diagnosed with IDD-associated-lymphoid-proliferations seen at an academic medical center in Mexico from 2016 to 2019 were included. Immunohistochemical studies, in situ hybridization, and polymerase chain reaction analysis for EBV and LMP1 gene deletions were performed and correlated with clinical data. Results: We included 27 patients, all men who have sex with men, median age 36 years (interquartile range [IQR] 22-54). The median baseline CD4+ T cells were 113/mL (IQR 89-243), the CD4+/CD8+ ratio was 0.15 (IQR: 0.09-0.22), and the HIV viral load was 184,280 copies/mL (IQR: 76,000-515,707). Twenty patients (74.07%) had IDD-associated-lymphoid-proliferations hyperplasia plasma cell type EBV+, 3 (11.1%) had hyperplasia mononucleosis-like type (IM-type), 1 patient (3.70%) had florid follicular hyperplasia, 3 (11.1%) IDD-associated-lymphoid-proliferations polymorphic type, and there were 22 cases (81.4%) of synchronic Kaposi Sarcoma. Two patients were diagnosed with Hodgkin lymphoma following a second positron emission tomography-computed tomography scan-guided biopsy. The median follow-up was 228 weeks (IQR 50-269); 6 patients died (22.2%) of causes unrelated to IDD-associated-lymphoid-proliferations related. Conclusion: IDD-associated-lymphoid-proliferations EBV+ occured in severely immunosuppressed HIV+ patients, a high percentage of whom had concomitant Kaposi sarcoma. The prognosis was good in patients treated only with ART.

Características de recién nacidos hijos de madre con IgM positiva para el Virus Herpes Simplex

Introducción: El herpes connatal es una entidad infrecuente asociada a elevada morbimortalidad. La probabilidad de transmisión al recién nacido va de 5% al 85%. El diagnóstico se dificulta por falta de clínica, serología no confiable y por la no disponibilidad de PCR en los servicios públicos de países en vías de desarrollo. La IgM en gestantes podría ser utilizada como un marcador de sospecha para evaluar al neonato. Objetivo: Caracterizar a los recién nacidos, hijos de gestantes con IgM positiva para HVS 1-2 y la frecuencia de encefalitis en los infantes. Materiales y métodos : Estudio observacional, descriptivo, prospectivo, realizado de mayo de 2020 a octubre de 2021. Se incluyeron recién nacidos (RN) de madres con IgM positiva para Herpes Virus Simplex (HVS) a partir de la segunda mitad del embarazo. En el RN se realizó serología IgG e IgM, y además, PCR- RT para HVS 1-2 en sangre y/o LCR, excluyéndose los nacidos en otras maternidades y/o sin datos de serología materna. Resultados: 36 pacientes. Edad materna 28 años (DS + 4), 5% con antecedentes de HVS, 61% cesárea. 36% prematuros, 13% RCIU. Síntomas agudos en el RN 22%. De ellos, 19% plaquetopenia, 44% alteración de GOT. 63% PCR HVS en sangre y 44% en LCR. Se encontró hemorragia, hidrocefalia, leucomalacia en 27%. No se encontró diferencias en la expresión clínica por tipo de parto. Conclusiones: Los RN hijos de gestantes con IgM positiva para VHS desde la segunda mitad del embarazo o periparto, presentaron infección por VHS determinada por PCR en sangre o LCR, independiente de la vía del parto. El diagnóstico serológico en embarazadas permite la pesquisa, diagnóstico y tratamiento temprano del RN.

Introduction: neonatal herpes is a rare entity associated with high morbidity and mortality. The probability of transmission to the newborn ranges from 5% to 85%. The diagnosis is difficult due to the lack of clinical signs, unreliable serology and the non-availability of PCR in public services in developing countries. IgM in pregnant women could be used as a suspected marker to evaluate the neonate. Objective: To characterize newborn children of pregnant women with positive IgM for HSV 1-2 and the prevalence of encephalitis in infants. Materials and methods: Observational, descriptive, prospective study, carried out from May 2020 to October 2021. Newborns (NB) of mothers with positive IgM for Herpes Virus Simplex (HSV) from the second half of pregnancy were included. In newborns, IgG and IgM were performed, and in addition, PCR-RT for HSV 1-2 in blood and/or CSF, excluding those born in other hospitales and/or without maternal serology data. Results: We included 36 patients. Maternal age was 28 years (DS + 4), 5% with a history of HSV. 61% were delivered via cesarean section, 36% were premature, 13% had IUGR. 22% of the newborns had acute symptoms. 19% had thrombocytopenia, 44% had GOT alteration. 63% were PCR positive for HSV in serum and 44% were CSF-positive. Hemorrhage, hydrocephalus and leukomalacia were found in 27%. No differences were found in clinical expression by type of delivery. Conclusions: Newborns born to pregnant women with positive IgM for HSV from the second half of pregnancy or peripartum, presented HSV infection as determined by PCR in blood or CSF, regardless of the route of delivery. Serological diagnosis in pregnant women allows early screening, diagnosis and treatment of the NB.

HIV with initial ocular Kaposi sarcoma / HIV com sarcoma de Kaposi ocular inicial

ABSTRACT We present an interesting case of a 62-year-old black female, presented to the ophthalmological hospital with a little "nevus" on the left eye previously visualized at the mirror, with one month of development. Physical examination with slit lamp (biomicroscopy) showed a group of painless veins, with vascular redness, and a mass nodular aspect in the mid temporal bulbar conjunctiva, of approximately 2mmx4mm.

RESUMO Apresentamos o interessante caso de uma mulher negra de 62 anos, que deu entrada no hospital oftalmológico com um pequeno nevo no olho esquerdo previamente visualizado ao espelho, com 1 mês de evolução. O exame físico com lâmpada de fenda (biomicroscopia) mostrou um grupo de veias indolor e vermelhidão vascular, com uma massa de aspecto nodular na conjuntiva bulbar temporal média, de aproximadamente 2mmx4mm.

Estudio de seroprevalencia de HVS 1-2 en gestantes y recién nacidos de 2017 a 2021

El virus herpes simple (VHS) pertenece a la subfamilia alfa virus, miembro de la familia Herpes viridae. Existen dos tipos de VHS íntimamente relacionados, el VHS tipo 1 (VHS1) y el VHS tipo 2 (VHS2), que causan enfermedades de diversa gravedad. El VHS1 se transmite principalmente por contacto de boca a boca y el VHS2 se transmite por vía sexual; ambos pueden causar herpes genital. La carga de morbimortalidad a nivel mundial derivada de patógenos de transmisión sexual compromete la vida, así como la salud sexual y reproductiva, y la salud del recién nacido. Objetivos: Determinar la seroprevalencia IgG e IgM por VHS1 y VHS2 de los recién nacidos y madres en el periodo de enero 2017 a julio 2021 en un hospital de tercer nivel. Materiales y Métodos: Estudio observacional, retrospectivo de corte transversal de enero 2017 a julio 2021. Se midió anticuerpos IgG e IgM en recién nacidos y gestantes de ultimo trimestre, utilizando el método de ELISA. Resultados: De un total de 4712 serologías IgG e IgM de madres y RN analizados la seroprevalencia de IgG en gestantes fue cercana al 100% con valor similar en los RN (87%), la seroprevalencia de IgM en las madres fue 0,23% y de los RN 0,36% con tendencia ascendente. Conclusión: la seroprevalencia de IgG para VHS es elevada, en cambio la seroprevalencia de IgM en gestantes y recién nacidos en el periodo de estudio es significativamente baja.

The herpes simplex virus (HSV) belongs to the alpha virus subfamily, a member of the family Herpes viridae. There are two closely related types of HSV, HSV type 1 and HSV-2, which cause diseases of varying severity. HSV-1 is transmitted mainly by mouth-to-mouth contact and HSV-2 is transmitted sexually, both of which can cause genital herpes. The global burden of morbidity and mortality from sexually transmitted pathogens compromises life, as well as sexual and reproductive health, and the health of the newborn. Objective: To determine the IgG and IgM seroprevalence for HSV 1 - 2 of newborns and mothers in the period from January 2017 to July 2021 in a third level hospital. Materials and Methods: Observational, retrospective, cross-sectional study of January 2017 to July 2021. IgG and IgM antibodies were measured in newborns and pregnant women in the last trimester, using the ELISA method. Results: Of a total of 4712 IgG and IgM serologies of mothers and newborns analyzed the seroprevalence of IgG in pregnant women was close to 100% with similar value in newborns (87%), IgM seroprevalence in mothers was 0.23% and the RN 0.36% with an upward trend. Conclusion: The IgG seroprevalence for HSV is high, while the IgM seroprevalence in pregnant women and newborns during the study period is significantly low.

Estudios de Seguridad Preclínica del extracto hidroalcohólico de semillas de Opuntia soehrensii, una especie alto-andina con actividad anti-Herpes Virus, en ratas Sprague Dawley / Preclinical safety of the hydroalcoholic extract of Opuntia soehrensii seeds with anti-herpes virus activity, in SD rats

Introducción. Alrededor de 3700 millones menores de 50 años con infección por VHS-1 y 491 millones de personas de 15 a 49 años cursan con infección por VHS-2 en el mundo; sus síntomas, vesículas o ulceras dolorosas reaparecen periódicamente. El tratamiento convencional disminuyó su efectividad en cepas resistentes e inmunodeprimidos. Alternativas terapéuticas con extractos de plantas medicinales y potencial antiviral, como Opuntia soehrensii Brito conocida como "ayrampù" en Bolivia, utiliza infusión de sus semillas como analgésico, antidiabético, hipotensor y febrífugo. En vapores por inhalación para afecciones respiratorias; como tintura tópica en lesiones dérmicas de viruela, sarampión y herpes labial. Objetivo. Evaluar la seguridad preclínica de un gel que contiene el extracto hidro-alcohólico de semillas de Opuntia soehrensii en diferentes dosis, aplicado en la mucosa vaginal de ratas Sprague Dawley. Material y métodos. Se ejecutaron protocolos de toxicidad aguda y subaguda para evaluar la respuesta sistémica, a través de marcadores bioquímicos y de comportamiento, y la respuesta local en mucosa vaginal, mediante estudios histopatológicos, en grupos de animales a los que se aplicó el gel con diferentes concentraciones del extracto de Opuntia soehrensii, comparados con un grupo control y otro que recibió solo el vehículo. Resultados. Se encontró que los indicadores sistémicos de comportamiento y ganancia de peso no mostraron diferencias entre grupos. Los indicadores hematológicos y bioquímicos mostraron resultados fisiológicamente esperados y sin cambios en los grupos de estudio. La citología expuso conservación del fenotipo celular para las fases del ciclo estral en todos los grupos. Los indicadores histológicos de reacción local e integridad celular se distribuyeron de igual manera en los todos los grupos. Conclusión. La aplicación de un gel de Opuntia soehrensii no muestra niveles apreciables de toxicidad local y sistémica, lo que permite recomendar la iniciación de estudios de aplicación clínica.

Introduction. Around 3.7 billion people under 50 years of age are infected with HSV-1 and 491 million people between the ages of 15 and 49 are infected with HSV-2 in the world; his symptoms, vesicles or painful ulcers recur periodically. Conventional treatment decreased its effectiveness in resistant and immunosuppressed strains. Therapeutic alternatives with extracts of medicinal plants and antiviral potential, such as Opuntia soehrensii Brito known as "ayrampù" in Bolivia, uses infusion of its seeds as an analgesic, antidiabetic, hypotensive and febrifuge. In vapors by inhalation for respiratory conditions; as a topical tincture in skin lesions of smallpox, measles and cold sores. Objectives . To evaluate the preclinical safety of a gel containing the hydroalcoholic extract of Opuntia soehrensii seeds in different doses, applied to the vaginal mucosa of Sprague Dawley rats. Material and Methods. Acute and sub-acute toxicity protocols were carried out to evaluate local response in the vaginal mucosa, through histo pathological studies, and systemic responses, through biochemical and behavioral markers, in groups of animals to which the gel with different concentrations of the extract of Opuntia soehrensii was applied, compared with a control group and another that received only the vehicle. Results. It was found that the histological indicators of local reaction and cell integrity were equally distributed in all groups. Cytology showed conservation of the cell phenotype for the phases of the estrous cycle in all groups. The systemic indicators of behavior and weight gain did not show differences between groups. Hematological and biochemical indicators showed results ranged in physiologic parameters, without changes in the study groups. Conclusion. The application of a gel from Opuntia soehrensii does not show appreciable levels of local and systemic toxicity, which makes it possible to recommend the initiation of clinical application studies.

Herpes Simplex Virus Esophagitis in an Immunocompetent Patient

We present the case of a 17-year-old patient with no known comorbidity or history who was admitted due to dysphagia. Endoscopy revealed ulcerated lesions in the distal esophagus that were positive for herpes simplex virus type 1 (HSV-1) on immunohistochemistry. An examination of HSV-1 esophagitis in the immunocompetent patient is made.

Se presenta el caso de un paciente de 17 años sin ninguna comorbilidad ni antecedente conocido que ingresó por disfagia. La endoscopia reveló lesiones ulceradas en el esófago distal que resultaron positivas para virus del herpes simple tipo 1 (VHS-1) en la inmunohistoquímica. Se hace una revisión de la esofagitis por VHS-1 en el paciente inmunocompetente.

Epidemiological Survey of Human Alphaherpesvirus 2 (HSV-2) Infection in Indigenous People of Dourados Municipality, Central Brazil.

Sexually transmitted Human alphaherpesvirus 2 (HSV-2) causes genital ulcers, especially among sexually active adolescents and adults. We estimated the exact prevalence of anti-HSV-2 antibodies and correlated it with the demographic and behavioral aspects of the Indigenous population of the Jaguapirú and Bororó villages (Dourados, Mato Grosso do Sul (MS), Brazil). In total, 1360 individuals (>18 years old) were administered serologic tests. The prevalence of anti-HSV-2 IgM was 12.9%, that of anti-HSV-2 IgG was 57.2%, and 8.5% cases tested positive for both HSV-2 IgM and IgG. The prevalence of anti-HSV-2 antibodies was higher in females (59.5%) compared to males (49%), with an OR of 0.64 (0.49-0.83). Anti-HSV-2 antibodies were found in 14.2%, 12.3%, 15.4%, and 14.5% of participants with urinary problems, genital wounds, genital warts, and urethral discharge, respectively. In summary, the seroprevalence of HSV-2 in the Indigenous population was five times higher than that reported in the general adult Brazilian population. Educational level, income level, smoking, condom use, incarceration, illicit drug abuse, the sharing of used needles and syringes without adequate disinfection, homosexual relationships, prostitution, the sexual practices among drug users, and avoidance of contraceptive methods could contribute to the facilitation of HSV-2 transmission in the Indigenous population. Our results may help develop culturally appropriate intervention programs that eliminate health-access barriers and improve the implementation of public health policies aimed at promoting information regarding and preventing, treating, and controlling HSV-2 infection in Brazilian Indigenous populations.

Infección por Herpes virus Humano tipo 6 relacionado con manifestaciones dermatológicas y fatiga crónica: serie de casos / Human Herpesvirus type 6 infection related to dermatological manifestations and chronic fatigue: case series

Resumen Introducción: Las manifestaciones clínicas más frecuentes causadas por el Herpes Virus Humano Tipo 6 (HHV-6) ocurren en niños menores de 2 años, presentan lesiones en piel tipo roséola o exantema súbito. En adultos, las manifestaciones clínicas relacionadas a HHV-6 son muy variables, y pueden sobreponerse con otras afecciones. Objetivo: Presentar una serie de casos de pacientes diagnosticados con infección activa por HHV-6, quienes mostraban manifestaciones neurológicas, dermatológicas y de fatiga crónica. Materiales y métodos: Se realizó análisis de historias clínicas de 6 pacientes que fueron diagnosticados con infección activa por HHV-6, a través de métodos moleculares. Resultados: Se reportan 6 pacientes que fueron diagnosticados con infección activa por HHV-6 mediante métodos moleculares, quienes presentaron manifestaciones clínicas comunes tales como: fiebre, cefalea, depresión, decaimiento, pérdida de memoria y concentración, dolor fibromuscular, dolor poliarticular, sueño no reparador, exantema, nevus rubí, liquen plano y parestesias. Conclusiones: A través de esta serie de casos se espera resaltar la importancia de identificar la infección activa por HHV-6 a través de métodos moleculares, y sensibilizar a la comunidad médica sobre el papel que juega el virus en la evolución de diversas patologías.

Abstract Introduction: The most frequent clinical manifestations of Human Herpesvirus 6 (HHV-6) in children under 2 years of age are roseola-like skin lesions and sudden rash. In adults, the clinical manifestations associated with HHV-6 are highly variable and can overlap with other conditions. Objective: To present a case series of patients diagnosed with active HHV-6 infection, who showed neurological, dermatological and chronic fatigue manifestations. Materials and methods: An analysis of medical records of 6 patients who were diagnosed with active HHV-6 infection through molecular methods was performed. Results: 6 patients were diagnosed with active HHV-6 infection using molecular methods, who had common clinical manifestations such as fever, headache, depression, tiredness, loss of memory and concentration, fibromuscular pain, polyarticular pain, nonrestorative sleep, rash, ruby nevus, lichen planus and paresthesia. Conclusions: This case series highlights the importance of identifying active HHV-6 infection through molecular methods and creating awareness in the medical community of the role that the virus plays on the development of diverse pathologies.

Proctitis infecciosa transmitida sexualmente: reto diagnóstico y recomendaciones de tratamiento / Sexually transmitted infectious proctitis: diagnostic challenge and treatment recommendations

RESUMEN La proctitis infecciosa (PI) transmitida sexualmente es un proceso inflamatorio del recto secundario a la infección por gérmenes de transmisión sexual. Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum y el virus herpes simple (VHS) son las causas más comunes. Es más prevalente en hombres que tienen sexo con hombres (HSH) y en pacientes con infección por el virus de inmunodeficiencia humana (VIH), sin embargo, también se diagnostica en heterosexuales por cambios en el comportamiento sexual. La urgencia fecal, el exudado purulento o sanguinolento, la proctalgia y el tenesmo son las manifestaciones clínicas más frecuentes. La historia clínica detallada y un alto índice de sospecha son importantes para establecer el diagnóstico de esta patología; apoyados en los estudios endoscópicos, histológicos, serológicos y microbiológicos. Se recomienda el tratamiento empírico, con antibióticos o antivirales, según la sospecha clínica y siempre deben descartarse otras infecciones de transmisión sexual (ITSs).

ABSTRACT Sexually transmitted infectious proctitis is an inflammatory process of the rectum secondary to infection by sexually transmitted germs. Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, and herpes simplex virus (HSV) are the most frequently pathogens. Infectious proctitis is more prevalent in men who have sex with men (MSM) and in patients with human immunodeficiency virus (HIV) infection, however, it is also diagnosed in heterosexuals by changes in sexual behavior. Fecal urgency, purulent or bloody exudate, proctalgia, and tenesmus are the most common clinical manifestations. Detailed clinical history and a high index of suspicion are important to establish the diagnosis of this pathology; supported by endoscopic, histological, serological, and microbiological studies. Empirical treatment with antibiotics or antivirals is recommended, depending on clinical suspicion, and other sexually transmitted infections (STIs) should always be ruled out.

Prevalencia del virus de la rinotraqueitis infecciosa bovina en el departamento del Caquetá, Amazonía Colombiana / Prevalence of bovine infectious rhinotracheitis virus in Caquetá department, Colombian Amazon

RESUMEN La rinotraqueitis infecciosa bovina (IBR) es una enfermedad ampliamente difundida en el mundo con gran repercusión socio-económica en las ganaderías bovinas. El objetivo del presente estudio fue determinar la prevalencia de IBR en 100 hatos del departamento del Caquetá, para lo cual, se muestrearon 960 bovinos mayores de 36 meses entre enero y marzo de 2016 en predios seleccionados a partir de los criterios: a) tamaño (50-180 hectáreas), b) con más de 10 vacas en ordeño, c) disponibilidad de los productores para cooperar y d) accesibilidad de las vías. Las muestras de suero sanguíneo se remitieron al Laboratorio de Diagnóstico Clínico Veterinario del ICA y se analizaron a través la prueba Elisa de bloqueo (BHV-1) gB. Los sueros con porcentaje de bloqueo superior al 55% se consideraron positivos a anticuerpos para IBR. Se encontró alta seroprevalencia (73,13%), mayor además en machos que en hembras (p < 0,05). A nivel municipal la seroprevalencia fue mayor en los municipios de El Doncello, Puerto Rico y San Vicente del Caguán y se encontró diferencia significativa (p < 0,05) entre los nueve municipios analizados. A nivel de hatos, la prevalencia fue del 99%. En conclusión, la prevalencia del virus de la rinotraqueitis infecciosa bovina (IBR) en bovinos de doble propósito del departamento del Caquetá fue muy alta.

ABSTRACT Infectious bovine rhinotracheitis (IBR) is a disease widely spread throughout the world with great socio-economic impact on bovine livestock. The objective of this study was to determine the prevalence of IBR in 100 herds in Caqueta department, for which 960 cattle older than 36 months between January and March 2016 were sampled in farms selected from the criteria: a) size (50-180 hectares), b) with more than 10 cows in milking, c) availability of producers to cooperate and d) accessibility of roads. Blood serum samples were sent to the ICA veterinary clinical diagnostic laboratory and analyzed using the Elisa blocking test (BHV-1) gB, where sera with blocking percentage greater than 55% were considered as positive for IBR antibodies. High seroprevalence was found (73.13%), being higher in males than in females (p < 0.05). At municipal level, seroprevalence was greater in El Doncello, Puerto Rico and San Vicente del Caguán municipalities, significant difference (p<0.05) was found between the nine municipalities analyzed. At herd level prevalence was of 99%. In conclusion the prevalence of Infectious Bovine Rhinotracheitis (IBR) virus in dual-purpose cattle of Caquetá department was very high.

Hemorragia intracerebral temprana como presentación atípica de encefalitis por herpes virus simple tipo 1 / Early intracerebral hemorrhage as an atypical presentation of herpes simplex-1 virus encephalitis

RESUMEN La encefalitis por herpes virus simple es la causa más común de encefalitis esporádica letal en el mundo. Una complicación poco usual es la hemorragia intracerebral. Se describe el caso de un preescolar de tres años que ingresa con cuadro clínico de encefalitis aguda, con hallazgos de hemorragia intracerebral temprana en región occipital y estudio en líquido cefalorraquídeo positivo para herpes virus tipo 1, que recibe tratamiento con aciclovir; sin embargo, cursa con evolución tórpida, incremento de hemorragias intracerebrales y desenlace fatal.

ABSTRACT Herpes simplex encephalitis is the most common cause of sporadic lethal encephalitis in the world. Intracerebral hemorrhage is an uncommon complication. The case of a 3-year-old preschooler who was admitted with acute encephalitis clinical picture is described. The patient presents findings of early in tracerebral hemorrhage in the occipital region and a positive cerebrospinal fluid study for herpes virus type 1, which is treated with acyclovir; however, it presents a torpid evolution, increased intracerebral hemorrhages and fatal outcome.

Diagnosis of elephantiasis nostras verrucosa as a clinical mani-festation of Kaposi's sarcoma.

Elephantiasis nostras verrucosa, a rare manifestation of Kaposis sarcoma, is a progressive cutaneous hypertrophy caused by chronic non-filarial lymphedema secondary to obstruction of the lymphatic system that can lead to severe disfigurement of parts of the body that have gravity-dependent blood flow, due to edema, fibrosis, and hyperkeratosis, especially lower extremities. Among the various conditions that can induce chronic lymphedema are tumors, trauma, radiotherapy, obesity, hypothyroidism, chronic venous stasis, and AIDS-related Kaposis sarcoma. Kaposis sarcoma is a vascular tumor associated with the presence of human gammaherpesvirus 8 that is predominantly cutaneous, locally aggressive, with metastasis, and is associated with the production of factors that favor inflammation, lymphatic obstruction, and lymphedema.

Anti-herpes activity of polysaccharide fractions from Stevia rebaudiana leaves.

The antiviral potential of natural polysaccharide compounds has been demonstrated, especially against enveloped viruses and members of the Herpesviridae family. Two polysaccharide fractions obtained from Stevia rebaudiana (Bertoni) leaves, that were active against Herpes simplex virus type 1 (HSV-1) were studied to investigate their mode of action. Both polysaccharides - SFW (crude faction) and SSFK (homogeneous alkaline fraction) - exerted antiviral effects on the initial stages of HSV-1 infection by inhibiting viral adsorption and penetration. When added after virus internalization, both fractions decreased plaque size. The effect of the fractions was confirmed by investigating viral glycoprotein expression. Based on the mode of action of the polysaccharides demonstrated in the present work and on their selectivity index, the polysaccharides obtained from S. rebaudiana could be an alternative treatment of infections caused by HSV-1.

Herpes Zoster as a Differential Diagnosis for Ischemia after Facial Hyaluronic Acid Filler.

The use of hyaluronic acid (HA) fillers for facial rejuvenation has grown widely and is now one of the most performed noninvasive cosmetic procedures. Viral infections can occur, albeit rarely. This report describes a 65-year-old female patient with significant fat tissue loss in the malar region who developed herpes zoster after receiving HA filler for facial volumization. We performed volumization with a total of 2mL of HA in one session. Two days after the procedure, the patient began feeling mild pain in the malar region bilaterally and in the right side of the nasolabial fold. Upon physical examination, vesicles and erythema were observed. Due to the possibility of herpes zoster virus (HZV) infection, the patient was treated with valacyclovir. Ultrasonography with arterial and venous Doppler study revealed normal blood flow in the angular artery path and adequate positioning of the filler. After seven days of valacyclovir, the patient had complete resolution of the lesions. Herpes virus reactivation can be caused by direct axon damage by the needle, by tissue manipulation, and by inflammatory reaction. Herpes simplex virus (HSV) is the virus most commonly involved and its incidence does not exceed 1.45 percent of the complication cases, and HZV is even rarer. Reactivation of HZV might mimic tissue ischemia. Ultrasonography is a noninvasive, fast, and useful tool to evaluate vascular impairment and the positioning of the filler.

Diagnosis of elephantiasis nostras verrucosa as a clinical mani-festation of Kaposi's sarcoma / Diagnóstico de elefantiasis nostras verrucosa como mani-festación clínica del Sarcoma de Kaposi

Elephantiasis nostras verrucosa, a rare manifestation of Kaposi's sarcoma, is a progressive cutaneous hypertrophy caused by chronic non-filarial lymphedema secondary to obstruction of the lymphatic system that can lead to severe disfigurement of parts of the body that have gravity-dependent blood flow, due to edema, fibrosis, and hyperkeratosis, especially lower extremities. Among the various conditions that can induce chronic lymphedema are tumors, trauma, radiotherapy, obesity, hypothyroidism, chronic venous stasis, and AIDS-related Kaposi's sarcoma. Kaposi's sarcoma is a vascular tumor associated with the presence of human gammaherpesvirus 8 that is predominantly cutaneous, locally aggressive, with metastasis, and is associated with the production of factors that favor inflammation, lymphatic obstruction, and lymphedema.

Encefalitis por virus herpes humano tipo 6 en una adolescente con lupus eritematoso sistémico. Primer caso reportado en el ecuador / First case reported in ecuador: human herpes virus type 6 encephalitis in adolescents with systemic lupus erythematosus. First case reported in ecuador

Se describe el caso de una paciente de catorce años con Lupus Eritematoso Sistémico (LES) con índice de actividad severo y en tratamiento inmunosupresor. Acudió al servicio de Urgencias Pediátricas del Hospital de Especialidades Carlos Andrade Marín, por presentar fiebre, cefalea, náuseas, alucinaciones auditivas y paresia en extremidades inferiores. Se realizó estudio de líquido cefalorraquídeo por Reacción en Cadena de la Polimerasa, en el cual se detectó la presencia de Virus Herpes Humano tipo 6 o también llamado Roseolovirus. Se inició ganciclovir con respuesta clínica favorable en 72 horas. Conclusiones: Se debe considerar la presencia de encefalitis por HHV-6 en pacientes inmunocomprometidos con encefalopatía y el uso de ganciclovir como terapia dirigida.

The case of a fourteen-year-old patient with Systemic Lupus Erythematosus with severe activity index and immunosuppressive treatment is described. He went to the Pediatric Emergency Department of the Carlos Andrade Marín Specialty Hospital, for presenting fever, headache, nausea, auditory hallucinations and paresis in the lower extremities. Cerebrospinal fluid was studied by Polymerase Chain Reaction, in which the presence of Human Herpes Virus type 6 or also called Roseolovirus was detected. Ganciclovir was started with a favorable clinical response in 72 hours. Conclusions: The presence of HHV-6 encephalitis should be considered in immunocompromised patients with encephalopathy and use of ganciclovir as directed therapy.