Amebiasis cutánea por ameba de vida libre, heraldo ignorado de encefalitis letal. Reporte de caso / Free-living cutaneous amebiasis, ignored herald of lethal encephalitis. Case report

Introducción: Las enfermedades por amebas de vida libre (AVL) son poco frecuentes pero con letalidad mayor al 90% cuando comprometen el sistema nerviosos central (SNC). El cuadro clínico puede confundirse con enfermedades más prevalentes. Reporte de caso: Agricultor de 32 años procedente de Poroto-Trujillo-La Libertad-Perú, inicia enfermedad con una placa eritematosa centrofacial que se diagnosticó como tuberculosis cutánea (TBC), sin mejoría pese a recibir esquema completo de quimioterapia antituberculosa. Siete meses después presenta encefalitis severa falleciendo a los tres días de su ingreso al hospital. En la biopsia de piel se encontraron trofozoitos de AVL. Se plantea el diagnóstico de dermatitis cutánea por AVL complicada con encefalitis granulomatosa amebiana (EGA). No se han documentado casos similares en su lugar de procedencia. Conclusión: En el norte del Perú, las placas cutáneas en personas expuestas al suelo o agua estancada, deben considerarse señales de alerta ante la probabilidad de infección por AVL.

ABSTRACT Introduction: Diseases caused by free-living amoebas (FLA) are rare but with a lethality greater than 90% when they affect the central nervous system (CNS). The clinical picture can be confused with more prevalent diseases. Case report: A 32-year-old farmer from Poroto-Trujillo-La Libertad-Peru, started the disease with a central facial erythematous plaque that was diagnosed as cutaneous tuberculosis (CTB), without improvement despite receiving a complete regimen of anti-tuberculous chemotherapy. Seven months later, he presented severe encephalitis and died three days after his admission to the hospital. FLA trophozoites were found in the skin biopsy. A diagnosis of cutaneous dermatitis due to FLA complicated with granulomatous amebic encephalitis (GAE) is proposed. Similar cases have not been documented in his place of origin. Conclusion: In northern Peru, skin plaques in people exposed to the ground or stagnant water should be considered warning signs of the probability of AVL infection.

Estudio comparativo de la capacidad denominativa y la memoria episódica de los pacientes con demencia degenerativa / Comparative Study of the Word Capacity and Episodic Memory of Patients with Degenerative Dementia

RESUMEN Introducción: Aunque la ausencia de deterioro de la memoria se consideró entre los criterios diagnósticos para diferenciar la enfermedad de Alzheimer (EA) de la demencia frontotemporal variante conductual (DFTvC), la evidencia actual, en aumento, sería la un importante porcentaje de casos de DFTvC con déficits de la memoria episódica. El presente estudio se diseñó con el fin de comparar el perfil de desempeño de la capacidad denominativa y de la memoria episódica de los pacientes con EA y DFTvC. Métodos: Estudio transversal y analítico con grupo de control (n = 32). Se incluyó a 42 sujetos con probable EA y 22 con probable DFTvC, todos mayores de 60 años. Se utilizaron instrumentos del Uniform Data Set validados en español: Multilingual Naming Test (MINT), historia de Craft-21 y Figura compleja de Benson, entre otros. Resultados: Se observó un mayor promedio de edad entre los pacientes con EA. La capacidad denominativa fue mucho menor en los pacientes con DFTvC que en aquellos con EA, medida según el MINT y el coeficiente de denominación sustantivos/verbos. Todos los pacientes con DFTvC, el 73,81% de aquellos con EAy solo el 31,25% de los controles no lograron reconocer la Figura compleja de Benson. Todas las diferencias fueron estadísticamente significativas (p< 0,001). Resultados: Este estudio confirma el perfil amnésico de los pacientes con EA y revela la disminución de la capacidad denominativa de los pacientes con DFTvC, un área del lenguaje que se afecta típica y tempranamente con las funciones ejecutivas, según recientes hallazgos. Conclusiones: Los pacientes con EA rinden peor en las tareas de memoria episódica verbal y visual, mientras que los pacientes con DFTvC rinden peor en tareas de denominación. Estos hallazgos abren la posibilidad de explorar los mecanismos de participación prefrontal en la memoria episódica, típicamente atribuida al hipocampo.

ABSTRACT Introduction: Although the absence of memory impairment was considered among the Alzheimer's disease diagnostic criteria to differentiate Alzheimer's disease (AD) from Behavioural Variant of Frontotemporal dementia Frontotemporal Dementia (bvFTD), current and growingevidence indicates that a significant Neuropsychological assessment percentage of cases of bvFTD present with episodic memory deficits. In order to compare Memory the performance profile of the naming capacity and episodic memory in patients with AD and bvFTD the present study was designed. Methods: Cross-sectional and analytical study with control group (32 people). The study included 42 people with probable AD and 22 with probable bvFTD, all over 60 years old. Uniform Data Set instruments validated in Spanish were used: Multilingual Naming Test (MINT), Craft-21 history and Benson's complex figure, among others. Results: A higher average age was observed among the patients with AD. The naming capacity was much lower in patients with bvFTD compared to patients with AD, measured according to the MINT and the nouns/verbs naming coefficient. All patients with bvFTD, 73.81% of those with AD and only 31.25% of the control group failed to recognise Benson's complex figure. All differences were statistically significant (p < 0.001). Results:This study confirms the amnesic profile of patients with AD and reveals the decrease in naming capacity in patients with bvFTD, an area of language that is typically affected early on with executive functions, according to recent findings. Conclusions: Patients with AD perform worse in verbal and visual episodic memory tasks, while patients with bvFTD perform worse in naming tasks. These findings open the possibility of exploring the mechanisms of prefrontal participation in episodic memory, typically attributed to the hippocampus.

Comparative study of the word capacity and episodic memory of patients with degenerative dementia.

INTRODUCTION: Although the absence of memory impairment was considered among the diagnostic criteria to differentiate Alzheimer's disease (AD) from Behavioural Variant of Frontotemporal Dementia (bvFTD), current and growing evidence indicates that a significant percentage of cases of bvFTD present with episodic memory deficits. In order to compare the performance profile of the naming capacity and episodic memory in patients with AD and bvFTD the present study was designed. METHODS: Cross-sectional and analytical study with control group (32 people). The study included 42 people with probable AD and 22 with probable bvFTD, all over 60 years old. Uniform Data Set instruments validated in Spanish were used: Multilingual Naming Test (MINT), Craft-21 history and Benson's complex figure, among others. RESULTS: A higher average age was observed among the patients with AD. The naming capacity was much lower in patients with bvFTD compared to patients with AD, measured according to the MINT and the nouns/verbs naming coefficient. All patients with bvFTD, 73.81% of those with AD and only 31.25% of the control group failed to recognise Benson's complex figure. All differences were statistically significant (p < 0.001). RESULTS: This study confirms the amnesic profile of patients with AD and reveals the decrease in naming capacity in patients with bvFTD, an area of ​​language that is typically affected early on with executive functions, according to recent findings. CONCLUSIONS: Patients with AD perform worse in verbal and visual episodic memory tasks, while patients with bvFTD perform worse in naming tasks. These findings open the possibility of exploring the mechanisms of prefrontal participation in episodic memory, typically attributed to the hippocampus.

Comparative Study of the Word Capacity and Episodic Memory of Patients with Degenerative Dementia. / Estudio comparativo de la capacidad denominativa y la memoria episódica de los pacientes con demencia degenerativa.

INTRODUCTION: Although the absence of memory impairment was considered among the diagnostic criteria to differentiate Alzheimer's disease (AD) from Behavioural Variant of Frontotemporal Dementia (bvFTD), current and growing evidence indicates that a significant percentage of cases of bvFTD present with episodic memory deficits. In order to compare the performance profile of the naming capacity and episodic memory in patients with AD and bvFTD the present study was designed. METHODS: Cross-sectional and analytical study with control group (32 people). The study included 42 people with probable AD and 22 with probable bvFTD, all over 60 years old. Uniform Data Set instruments validated in Spanish were used: Multilingual Naming Test (MINT), Craft-21 history and Benson's complex figure, among others. RESULTS: A higher average age was observed among the patients with AD. The naming capacity was much lower in patients with bvFTD compared to patients with AD, measured according to the MINT and the nouns/verbs naming coefficient. All patients with bvFTD, 73.81% of those with AD and only 31.25% of the control group failed to recognise Benson's complex figure. All differences were statistically significant (p <0.001). RESULTS: This study confirms the amnesic profile of patients with AD and reveals the decrease in naming capacity in patients with bvFTD, an area of language that is typically affected early on with executive functions, according to recent findings. CONCLUSIONS: Patients with AD perform worse in verbal and visual episodic memory tasks, while patients with bvFTD perform worse in naming tasks. These findings open the possibility of exploring the mechanisms of prefrontal participation in episodic memory, typically attributed to the hippocampus.