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1.
Rev Chilena Infectol ; 35(4): 445-447, 2018 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-30534933

RESUMO

Infection with Strongyloides stercoralis is a common parasitic infection in tropical and subtropical regions, including the Peruvian Amazon. The clinical manifestations are varied in patients with immunocompromised disease, and the systemic spread of the disease is frequent, compromising different organs and systems. Cutaneous manifestations are infrequent, being described in patients with some degree of immunosuppression. We present the case of an immunocompetent patient who developed a reactive purpura due to chronic Strongyloides stercoralis infection. Thus, skin involvement is possible in immunocompetent patients with systemic exacerbation due to this parasite.


Assuntos
Púrpura/etiologia , Púrpura/imunologia , Estrongiloidíase/complicações , Estrongiloidíase/imunologia , Adulto , Animais , Antiparasitários/classificação , Antiparasitários/uso terapêutico , Antipruriginosos/uso terapêutico , Clorfeniramina/uso terapêutico , Humanos , Hospedeiro Imunocomprometido , Ivermectina/uso terapêutico , Masculino , Púrpura/tratamento farmacológico , Strongyloides stercoralis/isolamento & purificação , Adulto Jovem
2.
Rev Peru Med Exp Salud Publica ; 35(2): 326-332, 2018.
Artigo em Espanhol | MEDLINE | ID: mdl-30183909

RESUMO

Infections caused by rare micro-organisms are the subject of research, as researchers are encouraged to find the necessary health measures to prevent and treat the disease, as well as the search for new insights into human-microbial interactions. This report describes the case of a newborn boy diagnosed with hydrocephalus and myelomeningocele who developed ventriculitis and sepsis from resistant Empedobacter brevis. This case highlights the unexpected identification of this bacterium in the cerebrospinal fluid and its multi-resistant pattern, which was crucial for proper therapeutic management. This bacterium shows a mixture of different etiologies in the analysis of cerebrospinal fluid.


Las infecciones causadas por microorganismos poco comunes son objeto de investigación, ya que animar a los investigadores a encontrar las medidas sanitarias necesarias para prevenir y tratar la enfermedad, así como la búsqueda de nuevas luces sobre las interacciones humano-microbios. En este informe se describe el caso de un recién nacido varón diagnosticado de hidrocefalia y mielomeningocele, que desarrolló ventriculitis y sepsis por Empedobacter brevis resistente. Este caso pone de manifiesto la inesperada identificación de esta bacteria en el líquido cefalorraquídeo y su patrón multirresistente, que fue crucial para dar un manejo terapéutico adecuado. Esta bacteria evidencia una mezcla de diferentes etiologías en el análisis del líquido cefalorraquídeo.


Assuntos
Ventriculite Cerebral/microbiologia , Infecções por Flavobacteriaceae , Flavobacterium , Ventriculite Cerebral/diagnóstico , Ventriculite Cerebral/tratamento farmacológico , Infecções por Flavobacteriaceae/diagnóstico , Infecções por Flavobacteriaceae/tratamento farmacológico , Humanos , Recém-Nascido , Masculino , Peru
3.
Rev. chil. infectol ; 35(4): 445-447, ago. 2018. graf
Artigo em Espanhol | LILACS | ID: biblio-978056

RESUMO

Resumen La infección por Strongyloides stercoralis es una parasitosis frecuente en las regiones tropicales y subtropicales, incluyendo la Amazonía peruana. En pacientes con inmunocompromiso, las manifestaciones clínicas son variadas y es frecuente la diseminación sistémica de la enfermedad, con compromiso de diversos órganos. Las manifestaciones cutáneas son infrecuentes y se describen en pacientes con algún grado de inmunosupresión. Se presenta el caso de un paciente inmunocompetente que desarrolló una púrpura reactiva por una infección por Strongyloides stercoralis crónica. Ante ello, es posible el compromiso cutáneo en pacientes inmunocompetentes con reagudización sistémica por este parásito.


Infection with Strongyloides stercoralis is a common parasitic infection in tropical and subtropical regions, including the Peruvian Amazon. The clinical manifestations are varied in patients with immunocompromised disease, and the systemic spread of the disease is frequent, compromising different organs and systems. Cutaneous manifestations are infrequent, being described in patients with some degree of immunosuppression. We present the case of an immunocompetent patient who developed a reactive purpura due to chronic Strongyloides stercoralis infection. Thus, skin involvement is possible in immunocompetent patients with systemic exacerbation due to this parasite.


Assuntos
Humanos , Animais , Masculino , Adulto , Adulto Jovem , Púrpura/etiologia , Púrpura/imunologia , Estrongiloidíase/complicações , Estrongiloidíase/imunologia , Púrpura/tratamento farmacológico , Ivermectina/uso terapêutico , Clorfeniramina/uso terapêutico , Hospedeiro Imunocomprometido , Strongyloides stercoralis/isolamento & purificação , Antiparasitários/classificação , Antiparasitários/uso terapêutico , Antipruriginosos/uso terapêutico
4.
Rev Peru Med Exp Salud Publica ; 35(1): 145-149, 2018.
Artigo em Espanhol | MEDLINE | ID: mdl-29924261

RESUMO

Cytomegalovirus infection after a heart transplant is a recurrent medical condition. Its frequency increases when the donors are serum-positive, and the recipients are serum-negative to this virus. In the pediatric population, the infection only develops in a small percentage and the patients rarely present resistance to conventional treatment with ganciclovir and valganciclovir. We presented the first report of a pediatric case of the cytomegalovirus infection resistant to ganciclovir and valganciclovir after a heart transplant in a Peruvian public hospital with an unusual presentation. The resistance to these drugs was evident after 277 days of evolution of the disease considering the non-remission of the symptomatology and the persistence of an elevated viral load. The administration of foscarnet led to a clinical and laboratory improvement until remission of the disease.


La infección por citomegalovirus postrasplante cardiaco es una condición médica recurrente. Su frecuencia se incrementa cuando los donantes poseen serología positiva y los receptores presentan serología negativa para el virus. En la población pediátrica, la enfermedad solo se desarrolla en un porcentaje pequeño y raramente presentan resistencia al tratamiento convencional con ganciclovir y valganciclovir. Presentamos el primer reporte de caso pediátrico de enfermedad por citomegalovirus resistente a ganciclovir y valganciclovir postrasplante cardiaco en un hospital público peruano, con una presentación inusual. La resistencia a estos fármacos fue evidente luego de 277 días de evolución de la enfermedad, ante la no remisión de la sintomatología y la persistencia de una carga viral elevada. La posterior administración de foscarnet condujo a una mejora clínica y de laboratorio, hasta la remisión de la enfermedad.


Assuntos
Antivirais/uso terapêutico , Infecções por Citomegalovirus/tratamento farmacológico , Farmacorresistência Viral , Ganciclovir/uso terapêutico , Transplante de Coração , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/virologia , Criança , Humanos , Masculino
5.
Rev. peru. med. exp. salud publica ; 35(2): 326-332, abr.-jun. 2018. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-961870

RESUMO

RESUMEN Las infecciones causadas por microorganismos poco comunes son objeto de investigación, ya que animar a los investigadores a encontrar las medidas sanitarias necesarias para prevenir y tratar la enfermedad, así como la búsqueda de nuevas luces sobre las interacciones humano-microbios. En este informe se describe el caso de un recién nacido varón diagnosticado de hidrocefalia y mielomeningocele, que desarrolló ventriculitis y sepsis por Empedobacter brevis resistente. Este caso pone de manifiesto la inesperada identificación de esta bacteria en el líquido cefalorraquídeo y su patrón multirresistente, que fue crucial para dar un manejo terapéutico adecuado. Esta bacteria evidencia una mezcla de diferentes etiologías en el análisis del líquido cefalorraquídeo.


ABSTRACT Infections caused by rare micro-organisms are the subject of research, as researchers are encouraged to find the necessary health measures to prevent and treat the disease, as well as the search for new insights into human-microbial interactions. This report describes the case of a newborn boy diagnosed with hydrocephalus and myelomeningocele who developed ventriculitis and sepsis from resistant Empedobacter brevis. This case highlights the unexpected identification of this bacterium in the cerebrospinal fluid and its multi-resistant pattern, which was crucial for proper therapeutic management. This bacterium shows a mixture of different etiologies in the analysis of cerebrospinal fluid.


Assuntos
Humanos , Recém-Nascido , Masculino , Flavobacterium , Infecções por Flavobacteriaceae , Ventriculite Cerebral/microbiologia , Peru , Infecções por Flavobacteriaceae/diagnóstico , Infecções por Flavobacteriaceae/tratamento farmacológico , Ventriculite Cerebral/diagnóstico , Ventriculite Cerebral/tratamento farmacológico
6.
Rev. peru. med. exp. salud publica ; 35(1): 145-149, ene.-mar. 2018. ilus
Artigo em Espanhol | LILACS | ID: biblio-1020771

RESUMO

La infección por citomegalovirus postrasplante cardiaco es una condición médica recurrente. Su frecuencia se incrementa cuando los donantes poseen serología positiva y los receptores presentan serología negativa para el virus. En la población pediátrica, la enfermedad solo se desarrolla en un porcentaje pequeño y raramente presentan resistencia al tratamiento convencional con ganciclovir y valganciclovir. Presentamos el primer reporte de caso pediátrico de enfermedad por citomegalovirus resistente a ganciclovir y valganciclovir postrasplante cardiaco en un hospital público peruano, con una presentación inusual. La resistencia a estos fármacos fue evidente luego de 277 días de evolución de la enfermedad, ante la no remisión de la sintomatología y la persistencia de una carga viral elevada. La posterior administración de foscarnet condujo a una mejora clínica y de laboratorio, hasta la remisión de la enfermedad.


Cytomegalovirus infection after a heart transplant is a recurrent medical condition. Its frequency increases when the donors are serum-positive, and the recipients are serum-negative to this virus. In the pediatric population, the infection only develops in a small percentage and the patients rarely present resistance to conventional treatment with ganciclovir and valganciclovir. We presented the first report of a pediatric case of the cytomegalovirus infection resistant to ganciclovir and valganciclovir after a heart transplant in a Peruvian public hospital with an unusual presentation. The resistance to these drugs was evident after 277 days of evolution of the disease considering the non-remission of the symptomatology and the persistence of an elevated viral load. The administration of foscarnet led to a clinical and laboratory improvement until remission of the disease.


Assuntos
Criança , Humanos , Masculino , Antivirais/uso terapêutico , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/virologia , Ganciclovir/uso terapêutico , Transplante de Coração , Infecções por Citomegalovirus/tratamento farmacológico , Farmacorresistência Viral
7.
Exp Clin Transplant ; 16(2): 191-198, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28952919

RESUMO

OBJECTIVES: Complications, which affect the morbidity and mortality of patients after heart transplant, can be divided into infectious and noninfections com-plications. Here, we analyzed both infectious and noninfectious complications and their relation to clinical, laboratory, and surgical characteristics in a Latin American heart transplant population. MATERIALS AND METHODS: Data were obtained from records of 35 heart transplant patients in the period from 2010 to 2015. Noninfectious and infectious complications were divided into 3 time intervals: within the first month, from month 2 to 6, and after month 6. Relations between complications and clinical, laboratory and surgical variables in different interval times were analyzed. RESULTS: In our patient group, 70 infectious and 133 noninfectious complications were reported after heart transplant. Infectious complications occurred more often between months 2 and 6 after heart transplant, whereas noninfectious complications occurred more often during the first month. Bacteria were the most common microorganism, and acute graft rejection was the most common noninfectious complication. Moreover, infectious complications were statistically related to 5 factors at month 1 (intraoperative bleeding, normal postsurgery leukocyte level, mild malnutrition, severe malnutrition, and graft rejection), to 3 factors between months 2 and 6 (diabetes mellitus, stage 2 chronic kidney disease, and cryoprecipitate trans-fusions), and to 2 factors after month 6 (prothrombin time and psychologic diagnosis). CONCLUSIONS: Our results demonstrated that noninfectious complications should be anticipated first in patients after heart transplant. In addition, there are characteristics associated with infectious complications that can be seen during a specific time period.


Assuntos
Academias e Institutos , Doenças Transmissíveis/epidemiologia , Rejeição de Enxerto/epidemiologia , Transplante de Coração/efeitos adversos , Doenças não Transmissíveis/epidemiologia , Transplantados , Adulto , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/mortalidade , Doenças Transmissíveis/diagnóstico , Feminino , Rejeição de Enxerto/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
8.
Rev. chil. infectol ; 33(6): 675-679, dic. 2016. tab
Artigo em Espanhol | LILACS | ID: biblio-844421

RESUMO

Introduction: Heart transplantation remains as the treatment of choice when the heart failure is refractory to the medical or surgical therapy. Therefore, cytomegalovirus disease is an important post-heart-transplant infectious complication. Aims: To describe the prevalence and clinical characteristics of the cytomegalovirus disease after heart transplant surgery. Materials and Methods: A retrospective, descriptive study was conducted. It enrolled 35 heart-transplant patients attended in the Cardiovascular National Institute (INCOR), between 2010 and 2015. The information was obtained through the review of medical records. The demographic and relevant clinical variables were analyzed for the cytomegalovirus disease cases. Results: The population mean age was 39.49 ± 15.07 years and most of them were male patients (63%). The prevalence of the cytomegalovirus disease was 5.7% (two patients), both were seronegative for cytomegalovirus before transplantation. One of the patients had the disease before finishing the valganciclovir prophylaxis and the other after the end of it. Conclusion: The prevalence of the cytomegalovirus disease is slightly lower than in other studies. Moreover, the cytomegalovirus disease can remit with a prompt diagnosis and the proper medical treatment.


Introducción: El trasplante cardiaco es el tratamiento de elección ante la falla cardiaca refractaria a la terapia médica o quirúrgica. En base a ello, la enfermedad por citomegalovirus (CMV) es una importante complicación infecciosa post-trasplante de corazón. Objetivos: Describir la prevalencia y las características clínicas de los pacientes que desarrollaron enfermedad por CMV posttrasplante de corazón. Materiales y Métodos: Se realizó un estudio retrospectivo y descriptivo, donde se incluyó a los 35 pacientes que recibieron trasplante de corazón en el Instituto Nacional Cardiovascular entre el período 2010-2015. La información se obtuvo mediante la revisión de historias clínicas. Se analizaron las variables demográficas y clínicas relevantes de los casos con enfermedad por CMV. Resultados: La edad media de la población fue de 39,49 ± 15,07 años, siendo la mayoría de sexo masculino (63%). La prevalencia de la enfermedad por CMV fue de 5,7%, -dos pacientes-, ambos con serología negativa para CMV previa al trasplante. Uno de ellos presentó la enfermedad antes de terminar la profilaxis con valganciclovir y el otro luego del cese de la misma. Conclusión: La prevalencia de la enfermedad por CMV es ligeramente menor que en otros estudios. Asimismo, ésta puede remitir con un pronto diagnóstico y el adecuado tratamiento médico.


Assuntos
Humanos , Masculino , Feminino , Adulto , Transplante de Coração/efeitos adversos , Infecções por Citomegalovirus/prevenção & controle , Ganciclovir/análogos & derivados , Ganciclovir/uso terapêutico , Estudos Retrospectivos , Infecções por Citomegalovirus/etiologia , Valganciclovir , Imunossupressores/uso terapêutico
9.
Rev Chilena Infectol ; 33(6): 675-679, 2016 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-28146193

RESUMO

INTRODUCTION: Heart transplantation remains as the treatment of choice when the heart failure is refractory to the medical or surgical therapy. Therefore, cytomegalovirus disease is an important post-heart-transplant infectious complication. AIMS: To describe the prevalence and clinical characteristics of the cytomegalovirus disease after heart transplant surgery. MATERIALS AND METHODS: A retrospective, descriptive study was conducted. It enrolled 35 heart-transplant patients attended in the Cardiovascular National Institute (INCOR), between 2010 and 2015. The information was obtained through the review of medical records. The demographic and relevant clinical variables were analyzed for the cytomegalovirus disease cases. RESULTS: The population mean age was 39.49 ± 15.07 years and most of them were male patients (63%). The prevalence of the cytomegalovirus disease was 5.7% (two patients), both were seronegative for cytomegalovirus before transplantation. One of the patients had the disease before finishing the valganciclovir prophylaxis and the other after the end of it. CONCLUSION: The prevalence of the cytomegalovirus disease is slightly lower than in other studies. Moreover, the cytomegalovirus disease can remit with a prompt diagnosis and the proper medical treatment.


Assuntos
Infecções por Citomegalovirus/prevenção & controle , Transplante de Coração/efeitos adversos , Adulto , Infecções por Citomegalovirus/etiologia , Feminino , Ganciclovir/análogos & derivados , Ganciclovir/uso terapêutico , Humanos , Imunossupressores/uso terapêutico , Masculino , Estudos Retrospectivos , Valganciclovir
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