[Human Metapneumovirus (hMPV) associated to severe bronchial asthmatic crisis]. / Metapneumovirus humano (hMPV) asociado con exacerbación de asma aguda bronquial severa.

Human Metapneumovirus (hMPV) is a recently reported agent of acute infection in the respiratory tract. It has been found in children as well as in young adults and elders. The clinical manifestations produced by hMPV are indistinguishable from those by common respiratory virus, and can evolve from asymptomatic infection into severe pneumonia. On the other hand, some authors have described cases of bronchial asthma exacerbation associated with hMPV infection. In this work we report a case of a child who presented a severe bronchial asthmatic crisis with a suspected viral associated infection. Immunofluorescence tests yielded negative results for sincitial respiratory virus, adenovirus, a-b influenza virus and parainfluenza 1, 2, 3, virus. In an attempt to detect the presence of hMPV, a RT-PCR was carried out to amplify sequences from both N and F genes. Using this approach, a positive result for hMPV was obtained. To our knowledge, this is the first description of a case of asthma exacerbation associated to hMPV in our region. In addition, these results are similar to previous reports where it was hypothesized that, like RSV, hMPV can trigger a respiratory chronic disease as asthma.

Quality assessment of smear microscopy for acid-fast bacilli in the Argentine tuberculosis laboratory network, 1983-2001.

SETTING: Tuberculosis Laboratory Network, Argentina. OBJECTIVES: 1) To evaluate the technical quality of smear microscopy for acid-fast bacilli (AFB) supervised in 1983-2001, and 2) to analyse the effect of procedural errors on the results. DESIGN: Registers of technical evaluation results for AFB microscopy were analysed. The quality of specimens, smears, staining and readings were evaluated, as was the relationship between these parameters. RESULTS: The proportion of good quality specimens was considered acceptable. A direct relationship was demonstrated between positivity in results and mucopurulent sputum. The proportion of thin smears was relatively high. Positivity and bacillary count were lower in thin smears. Staining quality was considered good. The average agreement in readings throughout the country was 98%. Nevertheless, the false-positive rate was considered significant, and 46% of false-positive results were associated with defective staining. CONCLUSIONS: The technical quality and agreement in the laboratory network were satisfactory. Nevertheless, improvements need to be made in the following: the quality of the smears, staining and reading, coverage, decentralisation of supervision, the slide selection method and data registration. Operational research on the storage and preservation of slides is also necessary.