RESUMO
BACKGROUND: African tick-bite fever occurs after contact with ticks that carry Rickettsia africae and that parasitize cattle and game. Sporadic reports suggest that this infection has specific clinical and epidemiologic features. METHODS: We studied patients who were tested for a rickettsial disease after returning from a visit to Africa or Guadeloupe. To assess the value of the microimmunofluorescence assay, Western blotting, and cross-adsorption assays, we compared the results of these tests in 39 patients in whom African tick-bite fever had been confirmed by the polymerase-chain reaction assay, cell culture, or both; 50 patients with documented R. conorii infection; and 50 blood donors. These diagnostic criteria were then applied to 376 additional patients who had returned from southern Africa and 2 who had returned from Guadeloupe and whose serum was being tested for rickettsial disease. RESULTS: In the 39 patients with direct evidence of R. africae infection, the combination of microimmunofluorescence assay, Western blotting, and cross-adsorption assays showing antibodies specific for R. africae had a sensitivity of 0.56; however, each test had a positive predictive value and a specificity of 1.0. An additional 80 patients were found to have an R. africae infection on the basis of these serologic criteria. Infections with R. africae were acquired by visitors to 11 African countries and Guadeloupe. The illness was generally mild and was characterized by a rash in 46 percent of the patients; the rash was usually maculopapular or vesicular and rarely purpuric. Ninety-five percent of patients had an inoculation eschar or eschars, and 54 percent of these patients had multiple eschars, a finding that is unusual in patients with rickettsial infection. CONCLUSIONS: In this series, R. africae was the cause of nearly all cases of tick-bite rickettsiosis in patients who became ill after a trip to sub-Saharan Africa.
Assuntos
Anticorpos Antibacterianos/sangue , Infecções por Rickettsia/diagnóstico , Rickettsia/imunologia , Doenças Transmitidas por Carrapatos/diagnóstico , Viagem , Adolescente , Adulto , África Subsaariana , Idoso , Western Blotting , Feminino , Imunofluorescência , Guadalupe , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Valor Preditivo dos Testes , Rickettsia/classificação , Rickettsia/isolamento & purificação , Infecções por Rickettsia/epidemiologia , Infecções por Rickettsia/parasitologia , Sensibilidade e Especificidade , Doenças Transmitidas por Carrapatos/epidemiologia , Doenças Transmitidas por Carrapatos/parasitologiaRESUMO
One hundred twenty-two wild red howler monkeys (Alouatta seniculus) were translocated during flooding of the forest at a hydroelectric dam site in French Guiana. Blood samples from 103 animals were evaluated for 13 hematologic and/or 22 serum chemistry parameters. Significant age-specific variation was found for white blood cell (WBC), lymphocyte, and platelet counts and for alkaline phosphatase values. Adult males and females had significant differences in red blood cell count, packed cell volume, and hemoglobin, creatinine, cholesterol, and calcium values. In juveniles, amylase and cholesterol levels were significantly lower in males than in females. Significant differences associated with reproductive status were also observed; i.e., lower cholesterol level in pregnant females and higher packed cell volume in lactating females. Chronic stress due to habitat disappearance may have been responsible for significant differences between thin animals and those in good condition. Thin animals had lower WBC, eosinophil, basophil, and monocyte counts and higher platelet counts. Capture stress was probably responsible for high and variable levels of creatine kinase, aspartate aminotransferase, and lactate dehydrogenase.
Assuntos
Alouatta/sangue , Animais Selvagens/sangue , Fatores Etários , Animais , Análise Química do Sangue/veterinária , Feminino , Guiana Francesa , Testes Hematológicos/veterinária , Masculino , Gravidez , Valores de Referência , Fatores SexuaisRESUMO
We describe a family in which the mother has progressive external ophthalmoplegia with the common 4977 base pair deletion, and her son has a syndrome similar to the Pearson marrow-pancreas syndrome with the identical deletion. This case extends the clinical phenotype of the Pearson syndrome and raises the possibility that developmentally regulated tissue-specific nuclear factors are responsible for the differential phenotypic expression of these two mitochondrial disorders.
Assuntos
Anemia Sideroblástica/genética , DNA Mitocondrial/genética , Insuficiência Pancreática Exócrina/genética , Oftalmoplegia Externa Progressiva Crônica/genética , Deleção de Sequência/genética , Adulto , Composição de Bases/genética , Southern Blotting , Feminino , Humanos , Lactente , Masculino , Reação em Cadeia da Polimerase , SíndromeRESUMO
Una de las principales causas de ingreso y defuncion en las Unidades de Cuidados Intensivos son los procesos infecciosos en su mayoria causados por germenes gramnegativos, particularmente Escherichia coli.Pseudomonas y Proteus. En el presente estudio se trato de demostrar el efecto terapeutico de la sulbenicilina sodica en pacientes infectados por estos germenes y la buena tolerancia o posible alteracion de las funciones hepaticas o renales.Se valoraron 30 pacientes, de los cuales 25 cursaban con infeccion grave sin estado de hipoperfusion: la respuesta anti-bacteriana y terapeutica se catalogo de excelente por la evolucion clinica, de laboratorio y gabinete. Sin embargo, en cinco pacientes con falla organica multiple, a pesar de la negativizacion de los cultivos, la muerte fue inevitable, lo cual indica que el control de la bacteremia, aunque es muy importante, no detiene el proceso citoquimico alterado en la hipoperfusion celular
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Infecções Bacterianas , Sulbenicilina , Unidades de Terapia IntensivaRESUMO
Se presentan dos casos de envenenamiento por picadura de arana los que corresponden al llamado aracnoidismo general provocado por la arana viuda negra (Latrodectus mactans), y el otro al llamado necrotico causado por Loxosceles reclusa (arana violinista o reclusa parda). Se refiere la fisiopatologia de cada uno de ellos y se correlaciona con el cuadro clinico y se propone que, al no existir en nuestro medio tratamiento especifico se deben aplicar medidas que bloqueen el veneno a nivel de su sitio de accion, asi como las complicaciones generalizadas inherentes al mismo.Para el aracnoidismo general se propone utilizar esteroides del tipo de la metilprednisolona, relajantes musculares y respiracion asistida, y para el necrotico esteroides, anticoagulantes y antitromboticos, con lo que se logra evitar la muerte de estos pacientes, como se describe en estos dos casos. Como en muchos casos es dificil o imposible identificar al agente agresor, cuando los antecedentes sugieran picadura debera actuarse como si lo fuera
Assuntos
Adolescente , Adulto , Humanos , Masculino , Picada de Aranha , Venenos de AranhaRESUMO
Se estudiaron 384 pacientes que ingresaron por pancreatitis aguda en el Hospital General del Centro Medico Nacional del Instituto Mexicano del Seguro Social durante el periodo comprendido entre enero de 1978 y diciembre de 1980.Se analizaron los factores etiopatogenicos, la presencia de falla organica y la correlacion entre la mortalidad y el numero de fallas organicas Se hacen algunas consideraciones breves sobre los posibles mecanismos fisiopatologicos que presentan los pacientes de este tipo