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1.
Acta Haematol ; 145(4): 384-393, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34839289

RESUMO

INTRODUCTION: There is no consensus on the management of the coronavirus disease (COVID-19) in patients with secondary immunosuppression due to either an underlying hematological disease or to the effects of immunochemotherapy (ICT). Some of them may present persistent infection with multiple relapses of COVID-19, requiring several admissions. This study evaluated the clinical characteristics and outcomes after treatment of 5 patients with follicular lymphoma (FL), previously treated with ICT, who developed several episodes of COVID-19. METHODS: We analyzed the clinical evolution and response to treatment with antiviral agent, steroids, and convalescent plasma in 5 patients with FL and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) persistent infection. Reverse transcriptase polymerase chain reaction tests and peripheral blood immunophenotype were performed for all patients. RESULTS: All patients required hospitalization due to pneumonia with severity criteria and were re-admitted after a median of 22 days (13-42) from the previous discharge. They all showed B-cell depletion by immunophenotyping, and no traces of immunoglobulin antibodies against SARS-CoV-2 were detected in any of the cases. The survival rate was 80%. CONCLUSION: The combination therapy evidenced clinical benefits, demonstrating its capacity to control infection in immunosuppressed FL patients treated with ICT.


Assuntos
COVID-19 , Linfoma Folicular , COVID-19/complicações , COVID-19/terapia , Humanos , Imunização Passiva , Hospedeiro Imunocomprometido , Linfoma Folicular/complicações , Linfoma Folicular/tratamento farmacológico , Recidiva , SARS-CoV-2 , Soroterapia para COVID-19
2.
Viruses ; 12(2)2020 01 29.
Artigo em Inglês | MEDLINE | ID: mdl-32013149

RESUMO

We report the first human case of West Nile virus (WNV) lineage 2 infection imported to Spain by a traveler returning from Romania. Serum, cerebrospinal fluid and urine samples were analyzed and West Nile virus infection was identified by PCR and serological tests. The patient developed fever, diarrhea and neurological symptoms, accompanied by mild pancreatitis, described previously in very few cases as a complication of WNV infection and by alithiasic cholecystitis. Viral RNA was detected in urine until 30 days after the onset of symptoms and neutralizing antibodies were detected at very low titers. The phylogenetic analysis in a fragment of the NS5 gene of the virus showed a homology with sequences from WNV lineage 2 belonging to the monophyletic Central/Southern European group.


Assuntos
Anticorpos Antivirais/sangue , Doenças Transmissíveis Importadas/virologia , Gastroenteropatias/virologia , Doenças do Sistema Nervoso/virologia , Febre do Nilo Ocidental/complicações , Vírus do Nilo Ocidental/genética , Anticorpos Neutralizantes/sangue , Doenças Transmissíveis Importadas/complicações , Doenças Transmissíveis Importadas/diagnóstico , Surtos de Doenças , Humanos , Masculino , Pessoa de Meia-Idade , Filogenia , RNA Viral/urina , Romênia , Espanha , Proteínas não Estruturais Virais/genética , Febre do Nilo Ocidental/diagnóstico , Vírus do Nilo Ocidental/classificação
3.
Malar J ; 18(1): 242, 2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31315624

RESUMO

BACKGROUND: The importance of submicroscopic malaria infections in high-transmission areas could contribute to maintain the parasite cycle. Regarding non-endemic areas, its importance remains barely understood because parasitaemia in these afebrile patients is usually below the detection limits for microscopy, hence molecular techniques are often needed for its diagnosis. In addition to this, the lack of standardized protocols for the screening of submicroscopic malaria in immigrants from endemic areas may underestimate the infection with Plasmodium spp. The aim of this study was to assess the prevalence of submicroscopic malaria in afebrile immigrants living in a non-endemic area. METHODS: A prospective, observational, multicentre study was conducted. Afebrile immigrants were included, microscopic observation of Giemsa-stained thin and thick blood smears, and two different molecular techniques detecting Plasmodium spp. were performed. Patients with submicroscopic malaria were defined as patients with negative blood smears and detection of DNA of Plasmodium spp. with one or both molecular techniques. Demographic, clinical, analytical and microbiological features were recorded and univariate analysis by subgroups was carried out with STATA v15. RESULTS: A total of 244 afebrile immigrants were included in the study. Of them, 14 had a submicroscopic malaria infection, yielding a prevalence of 5.7% (95% confidence interval 3.45-9.40). In 71.4% of the positive PCR/negative microscopy cases, Plasmodium falciparum alone was the main detected species (10 out of the 14 patients) and in 4 cases (28.6%) Plasmodium vivax or Plasmodium ovale were detected. One patient had a mixed infection including three different species. CONCLUSIONS: The prevalence of submicroscopic malaria in afebrile immigrants was similar to that previously described in Spain. Plasmodium vivax and P. ovale were detected in almost a third of the submicroscopic infections. Screening protocols for afebrile immigrants with molecular techniques could be useful for a proper management of these patients.


Assuntos
Doenças Assintomáticas/epidemiologia , Malária/epidemiologia , Plasmodium falciparum/isolamento & purificação , Plasmodium ovale/isolamento & purificação , Plasmodium vivax/isolamento & purificação , Adulto , Coinfecção/epidemiologia , Coinfecção/parasitologia , Emigrantes e Imigrantes , Feminino , Humanos , Malária/parasitologia , Malária Falciparum/epidemiologia , Malária Falciparum/parasitologia , Malária Vivax/epidemiologia , Malária Vivax/parasitologia , Masculino , Microscopia , Pessoa de Meia-Idade , Prevalência , Espanha/epidemiologia
4.
Malar J ; 17(1): 314, 2018 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-30157862

RESUMO

BACKGROUND: Malaria is currently the most important human parasitic disease in the world responsible for high morbidity and mortality. Appropriate diagnostic methods are essential for early detection. Microscopy examination remains the gold standard, although molecular techniques have higher sensitivity and are very useful in cases of low parasitaemia and mixed infections. The objective of this study was to evaluate a new commercial molecular diagnostic technique. METHODS: A prospective, observational, multicentre study was performed between January 2015 and April 2017. All participants were immigrants from malaria-endemic areas, who were divided into two groups: asymptomatic group and symptomatic. Samples from both groups were evaluated by a rapid diagnostic test (ImmunoQuick® Malaria + 4 RDT), microscopy examination, and two commercial molecular malaria tests (FTD Malaria and FTD Malaria Differentiation), then compared against an in-house reference PCR technique. RESULTS: In all, 250 patients were included: 164 (65.6%) in the asymptomatic group, and 86 (34.4%) in the symptomatic group. There were seven cases of asymptomatic parasitaemia (prevalence = 2.8%) that were detected only by molecular methods. In the symptomatic group, there were seven cases of submicroscopic malaria. The main species detected was Plasmodium falciparum (96.6%). The commercial molecular technique had higher sensitivity than the other methods (S = 96%) and a high rate of concordance with the in-house reference PCR technique (Kappa score = 0.93). CONCLUSIONS: The molecular techniques, although slower than microscopy, have adequate diagnostic accuracy and are very useful for the detection of P. falciparum in cases with low parasitaemia.


Assuntos
Testes Diagnósticos de Rotina/métodos , Malária Falciparum/epidemiologia , Malária Vivax/epidemiologia , Malária/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Parasitemia/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Cidades , Emigrantes e Imigrantes , Humanos , Malária Falciparum/parasitologia , Malária Vivax/parasitologia , Pessoa de Meia-Idade , Parasitemia/parasitologia , Plasmodium falciparum/isolamento & purificação , Plasmodium vivax/isolamento & purificação , Valor Preditivo dos Testes , Prevalência , Estudos Prospectivos , Espanha/epidemiologia , Adulto Jovem
5.
J Clin Microbiol ; 41(1): 512-3, 2003 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-12517910

RESUMO

Streptococcus pneumoniae is the major cause of bacterial meningitis. We report a case of meningitis due to a mixed infection with two distinct strains of S. pneumoniae: one penicillin-resistant strain of serotype 9V and one penicillin-susceptible strain of serotype 7. The two strains exhibited different pulsed-field gel electrophoresis profiles.


Assuntos
Meningites Bacterianas/microbiologia , Penicilinas/farmacologia , Infecções Pneumocócicas/microbiologia , Streptococcus pneumoniae/efeitos dos fármacos , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Resistência às Penicilinas , Streptococcus pneumoniae/classificação , Streptococcus pneumoniae/isolamento & purificação
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