Cyclic recovery of adenovirus in a stem cell transplant recipient: an inverse association with graft-versus-host disease.

Adenovirus (AdV) infections have been increasingly recognized as significant pathogens that may cause severe morbidity and mortality among stem cell transplant (SCT) recipients. AdV can cause localized infections such as hemorrhagic cystitis (HC), pneumonia, hepatitis and also disseminated disease that can lead to death. We report a case of severe hemorrhagic cystitis in a SCT recipient who died 83 days after transplant. In this patient, AdV recovery was not constantly detected. In fact, fluctuations of the AdV detection in leukocytes and urine were observed by culture and PCR. When analyzing this viral cyclic recovery with different signs or symptoms in the patient, we observed an inverse association with the presence of acute graft-versus-host disease (GVHD). Whether these fluctuations represent donor-derived reactivity, indirectly manifested by the presence of GVHD, requires further study. This is the first case describing a dynamic pattern of AdV replication in leukocytes and urine samples from a patient with severe HC and the temporal correlation with GVHD.

Strategies for malaria control in Colombia.

Attempts at malaria eradication this century have been highly effective but early successes have not been sustained. This has been ascribed to the lack of community involvement in these campaigns. Colombia has put huge effort into malaria control on a number of fronts, from vaccine development to the evaluation of the integrated use of more traditional methods. William Rojas, Fernando Peñaranda and Mouricio Echavarria describe a pilot programme for integrated malaria control in Colombia whose success they attribute to committed community participation.

Reduction of malaria prevalence after introduction of Romanomermis culicivorax (Mermithidae: Nematoda) in larval Anopheles habitats in Colombia.

The worldwide resurgence of malaria has become a major public health problem. New methods of controlling the vectors of the disease are required, and we therefore studied the biological control of Anopheles albimanus by Romanomermis culicivorax in Colombia. The investigation was carried out in El Valle and Nuquí, two towns on the northern Pacific coast of the country. All of the mosquito larval habitats surrounding El Valle were seeded with the eggs and adults of R. culicivorax. The nematode established itself in the new habitat and recycled over 27 months. The larval population of A. albimanus, the only malarial vector detected in the two towns, decreased in El Valle. In contrast, no change in the larval populations of the vector was detected in ponds located near Nuquí, the untreated control town. A rapid and progressive decrease of the prevalence of malaria among schoolchildren in El Valle was observed during the 2-year evaluation period.

[Cellulitis in pediatrics. Diagnostic and therapeutic considerations]. / Celulitis en pediatría. Consideraciones diagnósticas y terapéuticas.

The clinical histories of 180 cases of cellulitis or phlegmona diffusa were studied at the Hospital de Pediatría del Centro Medico Nacional. The disease prevailed in infants and preschool children. Staphylococcus aureus was the etiological agent most frequently found, but with the presence of enterobacteriaceae in 39% of patients under 2 years of age. One third of the children with cellulitis showed one or several complications. Lethality reached 5% (9 cases), but always related to septicemia from S. aureus. In 14.4%, osteoarthritis was present; frequently there was: fever for over 5 days in spite of adequate treatment, a history of late initiation of the antimicrobial drug (over 1 week) and phlogosis or functional limitation. The radiological picture that shows the bony lesion was evident only after two weeks. One half these cases remained with sequelae. Considerations are made on the adequate plans for antibiotic treatment and the early diagnosis of the osteoarticular complication.