[Parotitis and influenza: unusual association during 2017, in Santa Fe, Argentina]. / Parotiditis e influenza: inusual asociación durante 2017, en Santa Fe, Argentina.

BACKGROUND: Parotitis is an acute viral disease characterized by swelling and pain in one or both salivary glands, submaxillary or submental, fever, headache, muscle ache and/or fatigue. AIM: To investigate the occurrence of influenza virus infection in parotitis cases in a population of Santa Fe during 2017 and analyze clinical and epidemiological characteristics of the cases. METHODS: We studied patients with diagnosis of mumps without age restriction, who came for examination from week 26 to the network of clinicians forming the Sentinel Influenza Unit in Santa Fe. RESULTS: Between epidemiological weeks 26 and 44, 22 clinical parotitis cases we enrolled. The influenza virus was detected in 68.2%, influenza A (H3N2) 93%, and influenza B, 7%. The clinical signs of cases were mild, with an average swelling development of 5 days and no complications. 74% presented with influenza-like illness in tandem with parotitis. CONCLUSIONS: This study provides evidence that a proportion of children presenting with parotitis had influenza A(H3N2) virus infection. It is necessary to implement systematic surveillance of parotitis associated with influenza and differential diagnosis even in the absence of respiratory symptoms.

Parotiditis e influenza: inusual asociación durante 2017, en Santa Fe, Argentina / Parotitis and influenza: unusual association during 2017, in Santa Fe, Argentina

Resumen Introducción: La parotiditis es una enfermedad vírica aguda caracterizada por tumefacción y dolor en una o ambas glándulas salivales, submaxilar o submentoniana, fiebre, dolor de cabeza, dolor muscular y/o fatiga. Objetivos Investigar la ocurrencia de infección por el virus influenza en casos de parotiditis en una población de Santa Fe, durante 2017 y analizar las características clínicas y epidemiológicas de los casos. Materiales y Métodos: Se estudiaron pacientes con diagnóstico de parotiditis, que acudieron a la consulta desde la semana 26 en la red de médicos que forman la Unidad Centinela de Influenza en Santa Fe. Resultados: Entre las semanas epidemiológicas 26 y 44, se incluyeron 22 casos de parotiditis clínica. El virus influenza se detectó en 68,2%, influenza A (H3N2) 93% e influenza B 7%. Los síntomas clínicos de los casos fueron leves, con una tumefacción de cinco días y sin complicaciones. El 74% presentó una enfermedad tipo influenza en conjunto con la parotiditis. Conclusiones: Este estudio evidencia que niños que presentaban parotiditis tenían una infección por el virus de la influenza A (H3N2). Es necesario implementar una vigilancia sistemática de las parotiditis asociadas con influenza y el diagnóstico diferencial, incluso en ausencia de síntomas respiratorios.

Background: Parotitis is an acute viral disease characterized by swelling and pain in one or both salivary glands, submaxillary or submental, fever, headache, muscle ache and/or fatigue. Aim: To investigate the occurrence of influenza virus infection in parotitis cases in a population of Santa Fe during 2017 and analyze clinical and epidemiological characteristics of the cases. Methods: We studied patients with diagnosis of mumps without age restriction, who came for examination from week 26 to the network of clinicians forming the Sentinel Influenza Unit in Santa Fe. Results: Between epidemiological weeks 26 and 44, 22 clinical parotitis cases we enrolled. The influenza virus was detected in 68.2%, influenza A (H3N2) 93%, and influenza B, 7%. The clinical signs of cases were mild, with an average swelling development of 5 days and no complications. 74% presented with influenza-like illness in tandem with parotitis. Conclusions: This study provides evidence that a proportion of children presenting with parotitis had influenza A(H3N2) virus infection. It is necessary to implement systematic surveillance of parotitis associated with influenza and differential diagnosis even in the absence of respiratory symptoms.

Reactivation of Chagas disease with central nervous system involvement in HIV-infected patients in Argentina, 1992-2007.

OBJECTIVES: The objective of this study was to evaluate clinical and microbiological characteristics of Chagas disease (ChD) with central nervous system (CNS) involvement in AIDS patients. METHODS: This was a retrospective study of clinical and laboratory findings of HIV-infected patients with a confirmed diagnosis of ChD involving the CNS during the period 1992-2007 at the "Francisco J. Muñiz" Infectious Diseases Hospital, Buenos Aires, Argentina. RESULTS: Of a total of 15 patients, 14 were male and the median age was 33 years (range 25-54 years). Seven out of nine had lived in a Chagas endemic area and 7/10 were intravenous drug users (IDUs). The disease was reactivated during corticosteroid therapy in three patients. Clinical manifestations were: headache (11/15), focal neurological deficits (9/15), fever (9/15), meningismus (7/15), seizures (7/15), altered mental status (5/15), and cardiac involvement (3/10). The median CD4 T-cell count at the time of reactivation was 64cells/microl (range 1-240). Twelve of 14 had positive serology for Trypanosoma cruzi; the two negative were IDUs. Cerebrospinal fluid (CSF) findings (median (range)): cell count 5/mm(3) (2-90), protein level 0.68g/l (0.1-1.84), and glucose level 0.45g/l (0.13-0.73). CSF direct examination for T. cruzi was positive in 11/13. Neuroimaging findings showed a single hypodense lesion in 7/14 and normal images in 2/14. Twelve patients were treated with benznidazole. The global mortality was 79% (11/14). CONCLUSIONS: ChD reactivation should be considered as a differential diagnosis of meningoencephalitis in HIV patients with low CD4 T-cell counts, previous residency in an endemic area, and/or IDUs. Whenever possible, lumbar puncture should be performed because of the high accuracy for early diagnosis.

Leptospirosis en Corrientes, Argentina / Leptospirosis in Currents, Argentina

Se realizó una investigación epidemiológica de Leptospirosis en 92 personas procedentes de la Ciudad de Corrientes, personal de Gendarmería Nacional en su mayoría y pobladores civiles minoritariamente y sin antecedentes de enfermedad. Se utilizó Test de Microaglutinación o MAT y serología antileptospiras humanas (Bio Rad). Uno de ellos resultó positivo a grippotyphosa (1) lo que se destaca por la baja frecuencia de su relato en Argentina. Se completó el estudio con búsqueda de leptospiras en cultivos de riñones de roedores, estudiando a 73 (100) Rattus rattus resultando positivos 23 (31) de ellos.