Recurrent histoplasmosis in AIDS mimicking a colonic carcinoma.

The prevalence rate of lower gastrointestinal bleeding in patients with AIDS is around 2.6%. A 42-year-old woman with AIDS (CD(4) count 9/microL) and recently treated for disseminated histoplasmosis presented to the emergency room with melena, severe anaemia and fever. A colonoscopy showed an umbilicated colonic nodule mimicking a carcinoma of the colon. The biopsy showed intracytoplasmic microorganisms compatible with Histoplasma capsulatum. She had poor compliance to the itraconazole when discharge on previous admission. Despite the fact that colonic histoplasmosis is uncommon, the mortality rate is around 8% and clinicians should be aware of the clinical presentation of histoplasmosis when recur, especially in patients not taking the itraconazole for long-term treatment.

Detection of antibodies against Fasciola hepatica in cirrhotic patients from Peru.

The prevalence of Fasciola hepatica infection, in endemic countries, in patients with established cirrhosis is unknown. We hypothesized that, in endemic countries, the presence of fascioliasis may be detected in a serum pool of cirrhotic patients. Forty-four previously stored serum samples of patients with established liver cirrhosis, in the Hospital Nacional Cayetano Heredia in Lima, Peru, were collected from 1998 to 2003 and assessed for hepatitis B, C and fascioliasis antibodies (Fas2 ELISA). Hepatitis B surface antigen (HBsAg) was positive in 8.8% (n = 34), hepatitis B core antibody (anti-HBc) in 32.5% (n = 34), hepatitis C antibodies (anti-HCV) in 9.1% (n = 33), and 9.1% (n = 44) were Fas2 ELISA positive. This disease is an example of an emerging tropical infection which can be present in chronic liver diseases, requiring greater clinician awareness especially in endemic rural areas. Further clinical studies are warranted.

La infección por fasciola hepática en el Perú: una enfermedad emergente / The infection Fasciola Liver in Peru: an emerging disease

Objetivos: El objetivo del presente estudio es reportar el número de casos humanos con la infección por fasciola hepática en el Perú desde 1963 al 2005. Métodos: Se realizó una búsqueda electrónica en las bases de datos bibliográficas de MEDLINE, LILACS, en bibliotecas de las Facultades de Medicina, Veterinaria y Zootecnia, Filosofía y Ciencias de las principales universidades e institutos del Perú. Se incluyeron referencias en revistas nacionales e internacionales que reporten casos peruanos. Resultados: Un total de 1701 personas (1-71 años) infectadas fueron reportadas en el Perú entre 1963 y 2005. El género femenino fue significativamente más frecuente que el masculino. Del total de casos, 191 eran casos agudos (11por ciento); 1313 en fase crónica (77.1 por ciento); y 167, crónicos asintomáticos (9.8 por ciento). Los casos infectados procedían de 17 departamentos del Perú lo cual representa 71 por ciento (n=24) del territorio nacional. El número de sujetos infectados se presentan por décadas apreciándose un paulatino aumento alcanzando a 54.1 casos por año en la última década analizada. Conclusiones: Debido al significativo incremento de casos reportados en las últimas 4 décadas, la fasciolosis humana es una enfermedad infecciosa parasitaria emergente en el Perú y urgen programas de prevención y control para esta zoonosis.

Objetives: The study is a recompilation of the reported human cases of Fasciola hepatica infection in Peru since 1963 to 2005. Methods: We review the electronic documentation of bibliographic resources in MEDLINE, LILACS, libraries of the medical, veterinary, philosophy and sciences faculties of the main universities and scientific institutions from Peru. We include all the references from national and international journals who report Peruvian cases of fasciolosis. Results: 1701 subjects in total were report in Peru between 1963 and 2005. The range of the age of the reported cases goes from 1 year to 71 years. Females were significative more common than males. 191cases were acute (11 per cent); 1313 chronic (77.1 per cent); y 167, chronic asymptomatic (9.8 per cent). The reported cases came from 17/24 departments of Peru that represent 71 per cent of the; Peruvian territory. The number the reported cases are increasing during the last decade to reach 54.1 cases in the last decade.Conclusions. Due to the significative increase of reported cases in the last 4 decades, human fasciolosis is an emergent parasitary infective disease in humans in Peru and we need preventive and control national health programs for this zoonosis.

[Fasciola hepatica infection in Peru: an emergent disease]. / La infección por Fasciola hepatica en el Perú: una enfermedad emergente.

OBJECTIVE: [corrected] The study is a recompilation of the reported human cases of Fasciola hepatica infection in Peru since 1963 to 2005. METHODS: We review the electronic documentation of bibliographic resources in MEDLINE, LILACS, libraries of the medical, veterinary, philosophy and sciences faculties of the main universities and scientific institutions from Peru. We include all the references from national and international journals who report Peruvian cases of fasciolosis. RESULTS: 1701 subjects in total were report in Peru between 1963 and 2005. The range of the age of the reported cases goes from 1 year to 71 years. Females were significative more common than males. 191cases were acute (11%); 1313 chronic (77.1%); y 167, chronic asymptomatic (9.8%). The reported cases came from 17/24 departments of Peru that represent 71% of the; Peruvian territory. The number the reported cases are increasing during the last decade to reach 54.1 cases in the last decade. CONCLUSIONS. Due to the significative increase of reported cases in the last 4 decades, human fasciolosis is an emergent parasitary infective disease in humans in Peru and we need preventive and control national health programs for this zoonosis.