Feline sporotrichosis due to Sporothrix globosa in the Metropolitan region of Buenos Aires: A case study.

We describe here the first case of feline sporotrichosis caused by Sporothrix globosa, occurring outside the epizootic area of Buenos Aires province, Argentina. Unlike cases reported with Sporothrix brasiliensis, on this occasion there was no clinical or serological evidence of zoonotic transmission through scratches or bites from the sick cat to the attending veterinarian or the person responsible for its care. This report aimed to improve the knowledge about the pathogenic profile of S. globosa.

Use of carrion fly iDNA metabarcoding to monitor invasive and native mammals.

Severely fragmented habitats increase the risk of extirpation of native mammal populations through isolation, increased edge effects, and predation. Therefore, monitoring the movement of mammal populations through anthropogenically altered landscapes can inform conservation. We used metabarcoding of invertebrate-derived DNA (iDNA) from carrion flies (Calliphoridae and Sarcophagidae) to track mammal populations in the wheat belt of southwestern Australia, where widespread clearing for agriculture has removed most of the native perennial vegetation and replaced it with an agricultural system. We investigated whether the localization of the iDNA signal reflected the predicted distribution of 4 native species-echidna (Tachyglossus aculeatus), numbat (Myrmecobius fasciatus), woylie (Bettongia penicillata), and chuditch (Dasyurus geoffroii)-and 2 non-native, invasive mammal species-fox (Vulpes vulpes) and feral cat (Felis catus). We collected bulk iDNA samples (n = 150 samples from 3428 carrion flies) at 3 time points from 3 conservation reserves and 35 road edges between them. We detected 14 of the 40 mammal species known from the region, including our target species. Most detections of target taxa were in conservation reserves. There were a few detections from road edges. We detected foxes and feral cats throughout the study area, including all conservation reserves. There was a significant difference between the diversity (F3, 98  = 5.91, p < 0.001) and composition (F3, 43  = 1.72, p < 0.01) of taxa detections on road edges and conservation reserves. Conservation reserves hosted more native biodiversity than road edges. Our results suggest that the signals from iDNA reflect the known distribution of target mammals in this region. The development of iDNA methods shows promise for future noninvasive monitoring of mammals. With further development, iDNA metabarcoding could inform decision-making related to conservation of endangered taxa, invasive species management, and impacts of habitat fragmentation.

Caracterización genética del ADNi de la mosca carroñera para monitorear mamíferos invasores y nativos Resumen Los hábitats con mucha fragmentación aumentan el riesgo de extirpación de las poblaciones de mamíferos nativos debido al aislamiento, el aumento de los efectos de borde y la depredación. Por lo tanto, el monitoreo del movimiento de las poblaciones de mamíferos a través de paisajes alterados antropogénicamente puede guiar a la conservación. Utilizamos la caracterización genética del ADN derivado de invertebrados (ADNi) de moscas de la carroña (Calliphoridae y Sarcophagidae) para rastrear poblaciones de mamíferos en la región de Wheatbelt del suroeste de Australia, en donde la tala generalizada ha sustituido la mayor parte de la vegetación perenne nativa por un sistema agrícola. Investigamos si la localización de la señal de ADNi reflejaba la distribución prevista de cuatro especies autóctonas: equidna (Tachyglossus aculeatus), numbat (Myrmecobius fasciatus), rata canguro (Bettongia penicillata) y cuol occidental (Dasyurus geoffroii), y dos especies de mamíferos invasores no autóctonos: el zorro (Vulpes vulpes) y el gato feral (Felis catus). Recogimos muestras masivas de ADNi (n = 150 muestras de 3,428 moscas de la carroña) en tres puntos temporales de tres reservas ecológicas y 35 bordes de carreteras entre ellas. Detectamos 14 de las 40 especies de mamíferos conocidas en la región, incluidas nuestras especies objetivo. La mayoría de las detecciones de los taxones objetivo se produjeron en las reservas ecológicas. Pocas detecciones ocurrieron en los bordes de las carreteras. Detectamos zorros y gatos ferales en toda la zona de estudio, incluidas todas las reservas ecológicas. Hubo una diferencia significativa entre la diversidad (F3, 98 = 5.91, p<0.001) y la composición (F3, 43 = 1.72, p<0.01) de los taxones detectados en los bordes de las carreteras y en las reservas ecológicas. Las reservas ecológicas albergaron más biodiversidad nativa que los bordes de las carreteras. Nuestros resultados sugieren que las señales de ADNi reflejan la distribución conocida de los mamíferos objetivo en esta región. El desarrollo de métodos de ADNi es prometedor para el futuro monitoreo no invasivo de mamíferos. Con un mayor desarrollo, la caracterización genética del ADNi podría servir de base para decidir sobre la conservación de taxones amenazados, la gestión de especies invasoras y los impactos de la fragmentación del hábitat.

[Bartonella henselae: Serological evidence in pediatric patients with clinical suspicion of cat scratch disease]. / Bartonella henselae: evidencia serológica en pacientes pediátricos con sospecha clínica de enfermedad por arañazo de gato.

Cat scratch disease (CSD) is caused by Bartonella henselae, which mainly affects children. The cat is the reservoir. The laboratory diagnosis is based on the detection of antibodies by the Indirect Immunofluorescence (IFI) assay. The objective of this study was to analyze the serological evidence of B. henselae infection in pediatric patients that met the clinical/epidemiological criteria for suspected CSD. We studied 92 patients, who were categorized into four serological groups: 1) IgG (+)/IgM(+), 31,5% (n=29); 2) IgG (-)/IgM(+), 10,9% (n=10); 3) IgG (+)/IgM(-), 9,8% (n=9); 4) IgG (-)/IgM(-), 47,8% (n=44). These findings aim to promote future works for investigating the seroprevalence of Bartonella spp. in Argentina, which will allow us to know the importance of this zoonosis in our population and to evaluate new cut-off points of the technique.

Habitat as a mediator of mesopredator-driven mammal extinction.

A prevailing view in dryland systems is that mammals are constrained by the scarcity of fertile soils and primary productivity. An alternative view is that predation is a primary driver of mammal assemblages, especially in Australia, where 2 introduced mesopredators-feral cat (Felis catus) and red fox (Vulpes vulpes)-are responsible for severe declines of dryland mammals. We evaluated productivity and predation as drivers of native mammal assemblage structure in dryland Australia. We used new data from 90 sites to examine the divers of extant mammal species richness and reconstructed historic mammal assemblages to determine proportional loss of mammal species across broad habitat types (landform and vegetation communities). Predation was supported as a major driver of extant mammal richness, but its effect was strongly mediated by habitat. Areas that were rugged or had dense grass cover supported more mammal species than the more productive and topographically simple areas. Twelve species in the critical weight range (CWR) (35-5500 g) that is most vulnerable to mesopredator predation were extirpated from the continent's central region, and the severity of loss of species correlated negatively with ruggedness and positively with productivity. Based on previous studies, we expect that habitat mediates predation from red foxes and feral cats because it affects these species' densities and foraging efficiency. Large areas of rugged terrain provided vital refuge for Australian dryland mammals, and we predict such areas will support the persistence of CWR species in the face of ongoing mammal declines elsewhere in Australia.

First record of Hydatigera taeniaeformis in Geoffroy's cat (Leopardus geoffroyi) in Brazil.

Leopardus geoffroyi (Geoffroy's cat) is a neotropical feline considered globally threatened. In Brazil, it occurs exclusively in the Pampa biome. Its predatory habits contribute to the infection, dispersion, and continuation of the life cycle of various pathogens, including helminths, within ecosystems. However, few studies involving cestodes in wild felines are found in the literature, especially in Brazil. Therefore, we aimed to report the first case of parasitism by Hydatigera taeniaeformis in L. geoffroyi. The helminths were found in the small intestine of the necropsied feline. Specimens were analyzed morphometrically and subjected to molecular analyses for taxonomic identification. The molecular phylogeny based on the analysis of the mitochondrial gene (COX1) allowed the identification of these parasites. Thus, this is the first description of H. taeniaeformis parasitizing L. geoffroyi in Brazil. Consequently, the number of known host species parasitized by this helminth in the country and the world is increased. Additionally, a new molecular sequence is being provided, contributing to the knowledge of Hydatigera in South America.

Neuroretinitis caused by Bartonella henselae in Gipuzkoa, 2014-2019.

INTRODUCTION: Bartonella henselae causes cat scratch disease (CSD), spread by a cat scratch or bite. Cats are its main reservoir. This sometimes results in optic neuritis or neuroretinitis. OBJECTIVE: To review these conditions in Gipuzkoa (Spain), 2014-2019. METHODS: A retrospective review of serology registries and clinical registries, selecting those with consistent clinical signs, contact with cats and positive serology for B. henselae (IgG-IFA ≥1/256). RESULTS: Sixty-four patients had CSD. Of these, one had optic neuritis and 3 had neuroretinitis (4/64; 6.3%). In 3 patients, flu-like symptoms preceded eye symptoms. Two suffered from loss of visual acuity at discharge, despite prolonged treatment with antibiotics and corticosteroids. CONCLUSION: Optic neuritis and neuroretinitis caused by B. henselae are severe complications with a non-negligible incidence among patients with CSD in Gipuzkoa. We recommend ruling out CSD in patients with symptoms of optic neuritis or neuroretinitis (sudden vision loss, etc.) and contact with cats.

A pediatric case of Bartonella henselae and Epstein Barr virus disease with bone and hepatosplenic involvement.

Background: Cat scratch disease (CSD) is an infectious disorder caused by Bartonella henselae. The infection usually presents as local lymphadenopathy, fever, and mild constitutional symptoms. Systemic or severe disease is reported in 5-20% of patients with CSD. We report a case of disseminated CSD with osteomyelitis and hepatosplenic disease and a review of the literature. Case report: A previously healthy 5-year-old male presented with prolonged fever and abdominal pain, followed by low back pain. The serologic test showed positive IgG for B. henselae and IgM and IgG for Epstein Barr virus (EBV). The abdominal ultrasound showed hepatic and splenic hypoechoic lesions, and the magnetic resonance imaging (MRI) revealed spondylitis of the D6 vertebra. He received treatment with azithromycin for 4 weeks and rifampicin for 6 weeks. The symptoms disappeared, and the abdominal ultrasound was normal nine months later. Conclusions: Disseminated CSD is infrequent. The diagnosis requires a high rate of suspicion. Laboratory findings of Bartonella infection are often non-specific. Serologic test, polymerase chain reaction of B. henselae in blood or biopsied material of the site of involvement and imaging test can be performed to confirm the diagnosis. The diagnosis of disseminated B. henselae was based on significantly elevated blood titers, radiologic findings, and epidemiologic history. Treatment of CSD depends on the disease presentation. Azithromycin is used as a first-line agent for lymphadenopathy. The optimum treatment and its duration have not been established in atypical or complicated CSD, including patients with osteomyelitis and hepatosplenic disease.

Introducción: La enfermedad por arañazo de gato (EAG) es una patología infecciosa originada por Bartonella henselae. Habitualmente se presenta como linfadenopatía local, fiebre y síntomas constitucionales leves. El 5-20% de los pacientes con EAG manifiestan una afectación sistémica. Se presenta un caso de EAG diseminada, con osteomielitis y enfermedad hepatoesplénica, y se hace una revisión de la literatura sobre la EAG. Caso clínico: Paciente de sexo masculino de 5 años, previamente sano, que presentó fiebre prolongada y dolor abdominal, seguidos de dolor en la parte baja de la espalda. En la serología, presencia de IgG frente a B. henselae y de IgM e IgG frente al virus de Epstein-Barr. En la ecografía abdominal se observaron lesiones hipoecoicas en el hígado y el bazo, y la resonancia magnética mostró espondilitis de D6. Recibió tratamiento con azitromicina 4 semanas y rifampicina 6 semanas. Los síntomas desaparecieron y la ecografía abdominal a los 9 meses fue normal. Conclusiones: La EAG diseminada es infrecuente. El diagnóstico requiere un alto grado de sospecha. Los hallazgos de laboratorio en la infección por Bartonella suelen ser poco específicos. Para confirmar el diagnóstico pueden hacerse serología, reacción en cadena de la polimerasa para B. henselae en sangre o en biopsia de tejidos afectados, y estudios de imagen. El diagnóstico de EAG diseminada se basa en títulos elevados en la sangre, hallazgos radiológicos e historia epidemiológica. El tratamiento depende de la forma de presentación. En los casos de linfadenopatía se utiliza azitromicina. En la EAG atípica o complicada, que incluye osteomielitis y afectación hepatoesplénica, no están bien establecidos el tratamiento ni su duración.

Neuroretinitis caused by Bartonella henselae in Gipuzkoa, 2014-2019. / Neurorretinitis por Bartonella henselae en Gipuzkoa, 2014-2019.

INTRODUCTION: Bartonella henselae causes cat scratch disease (CSD), spread by a cat scratch or bite. Cats are its main reservoir. This sometimes results in optic neuritis or neuroretinitis. OBJECTIVE: To review these conditions in Gipuzkoa (Spain), 2014-2019. METHODS: A retrospective review of serology and clinical records, selecting those with consistent clinical signs, contact with cats and positive serology for B. henselae (IgG-IFA≥1/256). RESULTS: Sixty-four patients had CSD. Of these, one had optic neuritis and 3 had neuroretinitis (4/64; 6.3%). In 3 patients, flu-like symptoms preceded eye symptoms. Two suffered from loss of visual acuity at discharge, despite prolonged treatment with antibiotics and corticosteroids. CONCLUSION: Optic neuritis and neuroretinitis caused by B. henselae are severe complications with a non-negligible incidence among patients with CSD in Gipuzkoa. We recommend ruling out CSD in patients with symptoms of optic neuritis or neuroretinitis (sudden vision loss, etc.) and contact with cats.

Características clínicas de pacientes adultos con enfermedad por arañazo de gato / Cat-scratch disease, clinical features in adults

Resumen Introducción : La enfermedad por arañazo de gato (EAG) es producida por Bartonella henselae y debido a que afecta principalmente niños, es poco reconocida en adultos. El cua dro evolutivo es generalmente benigno y autolimitado, aun que ocasionalmente puede haber compromiso sistémico. Métodos : Estudio observacional, descriptivo y re trospectivo realizado en un hospital de tercer nivel del conurbano bonaerense. Se incluyeron pacientes mayores de 15 años con diagnóstico de EAG en un período de 5 años (2016-2021). Resultados : Se analizaron 30 pacientes adultos, con una mediana de edad de 20.5 años (17-29), el 73% (n = 22) fueron varones. El 96% (n = 27) presentó contacto estre cho con gatos. La presentación clínica más frecuente fue adenopatías periféricas (90%); el porcentaje de compli caciones fue de 33% (n = 10). La indicación de antibio ticoterapia fue de 86.7% (n = 26), con una mediana de duración de 5 días (5-10). La evolución fue favorable en el 83% (n = 25), en el 16% (n = 5) se perdió seguimiento. Discusión : La EAG es poco reconocida en adultos; las características clínicas de este grupo etario se en cuentran poco descriptas en la literatura. Es un desafío diagnóstico debido a que su forma de presentación más frecuente es la adenopatía localizada.

Abstract Introduction : Cat-scratch disease (CSD) is caused by Bartonella henselae and it is under-recognized in adults because it mainly affects children. Clinical course is commonly benign and self-limited; occasionally, there may be systemic involvement. Methods : Case-series study carried out in a tertiary care hospital in Buenos Aires suburbs. Patients older than 15 years diagnosed with CSD over a 5-year period were included (2016-2021). Results : 30 adult patients were analyzed, with a median age of 20.5 years (IQR 17-29), 73% (n = 22) were male; 96% (n = 27) had history of exposure to cats. The most common clinical presentation of CSD was periph eral lymphadenopathy (90%), the average complication rate was 33% (n = 10), 86.7% (n = 26) received antimi crobial therapy, with a median duration of 5 days (IQR 5-10). Outcome was favorable in 83% (n = 25), 16% (n = 5) were lost to follow-up. Discussion : Clinical features of CSD in adults are poorly described in the worldwide literature. Diagnosis can be challenging because the clinical hallmark is re gional lymphadenopathy.

Feline sporotrichosis due to Sporothrix globosa in the Metropolitan region of Buenos Aires: A case study

Abstract We describe here the first case of feline sporotrichosis caused by Sporothrix globosa, occurring outside the epizootic area of Buenos Aires province, Argentina. Unlike cases reported with Sporothrix brasiliensis, on this occasion there was no clinical or serological evidence of zoonotic transmission through scratches or bites from the sick cat to the attending veterinarian or the person responsible for its care. This report aimed to improve the knowledge about the pathogenic profile of S. globosa.

Resumen En este trabajo se describe el primer caso de esporotricosis felina causada por Sporothrix globosa fuera del área epizoótica de Buenos Aires. A diferencia de los casos documentados de Sporothrix brasiliensis, en este no hubo evidencia clínica ni serológica de transmisión zoonótica por arañazos o mordeduras del gato enfermo a su dueño ni al veterinario que lo atendió. Con este reporte se espera contribuir a un mejor conocimiento sobre el perfil patogénico de S. globosa.

Presumed acute posterior multifocal placoid pigmentary epitheliopathy associated with Bartonella infection / Epiteliopatia pigmentar placoide multifocal posterior aguda presumível associada com infecção por Bartonella

ABSTRACT To report a unique case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) in a patient with positive serology for Bartonella, presenting with ocular signs and symptoms not attributable to other diseases. A 27-year-old woman presented with decreased visual acuity in both eyes. Multimodal fundus image analysis was performed. A color fundus photograph of both eyes revealed peripapillary and macular yellow-white placoid lesions. The fundus autofluorescence of both eyes demonstrated hypo- and hyperautofluorescence of the macular lesions. Fluorescein angiography showed early-stage hypofluorescence and late staining of placoid lesions in both eyes. Spectral domain optical coherence tomography (SD-OCT) of both eyes revealed irregular elevations in the retinal pigment epithelium with the disruption of the ellipsoid zone on the topography of macular lesions. At 3 months after the treatment initiation for Bartonella infection, the placoid lesions became atrophic and hyperpigmented, and SD-OCT revealed loss of both the outer retinal layers and retinal pigment epithelium on the topography of macular lesions in both eyes.

RESUMO Caso de epiteliopatia pigmentada placoide multifocal posterior aguda presumida em paciente com sorologia positiva para Bartonella. Paciente feminina de 27 anos apresentou diminuição da acuidade visual em ambos os olhos. Análise multimodal de imagem foi realizada. A retinografia mostrou revelou lesões placoides amarelo-esbranquiçadas nas áreas peripapilar e macular de ambos os olhos. A autofluorescência demonstrou hipo e hiperautofluorescência em ambos os olhos, na mesma topografia das lesões detectadas na retinografia. A angiofluoresceínografia mostrou hipofluorescência na fase inicial do exame e hiperfluorescência tardia das lesões placoides em ambos os olhos. A tomografia de coerência óptica de domínio espectral de ambos os olhos revelou elevações irregulares do epitélio pigmentado da retina com descontinuação da zona elipsoide na área macular. Três meses após o início do tratamento para infecção por Bartonella, as lesões placoides tornaram-se atróficas e hiperpigmentadas, e a tomografia de coerência óptica revelou perda das camadas externas da retina e do epitélio pigmentado da retina na topografia das lesões maculares em ambos os olhos.

Phimosis in a cat: diagnosis, treatment, and complications / Fimosis en un gato: diagnóstico, tratamiento y complicaciones

ABSTRACT Phimosis is the inability to move the penis through the preputial orifice. This condition, in its congenital form, is infrequent in cats and has a low prevalence compared to canines. Diagnosis is based on the physical exam and the treatment of choice is often preputioplasty. The following case describes a six-week-old feline patient with signs of strangury, pollakiuria, excessive licking, and vocalizations when urinating. The physical examination showed significant stenosis of the preputial orifice. Circular preputioplasty is performed as a therapeutic approach, and after three days the patient shows a recurrence of the initial signs due to the presence of excessive granulation tissue because the surgical margins were not wide enough. Consequently, the patient undergoes corrective surgery to enlarge the preputial orifice and reduce the manifestation of clinical signs. This time the patient showed immediate resolution of the signs of distress that after 1 year have not recurred. The objective of this study is to provide information about clinical-surgical decisions and the main complications in cats with phimosis.

RESUMEN La fimosis es la incapacidad para exponer el pene por el orificio prepucial. La fimosis congénita en gatos es poco común y presenta baja prevalencia en comparación con la presentación en perros. El diagnóstico se basa en el examen físico y el tratamiento de elección es la prepucioplastía. Se describe el caso de un paciente felino de seis semanas de edad con signos de estranguria, polaquiuria, lamido excesivo y vocalización al realizar la micción. En el examen físico se aprecia una marcada estenosis del orificio prepucial. Como abordaje terapéutico se realiza prepucioplastía circular y al cabo de tres días el paciente presenta recidiva de los signos iniciales por la presencia de excesivo tejido de granulación, esto debido a que los márgenes quirúrgicos no fueron lo suficientemente amplios. En consecuencia, es sometido a cirugía correctiva con el fin de ampliar el orifico prepucial y reducir la manifestación de los signos clínicos. El paciente muestra resolución de los signos después de la cirugía y posterior al seguimiento durante un año no vuelve a presentar evidencias de recidiva. El objetivo de este reporte es contribuir con información en cuanto a las decisiones clínico-quirúrgicas y las principales complicaciones en gatos con fimosis.

Postioplastía circunferencial en gatitos con fimosis adquirida. Reporte de caso / Circumferential postioplasty in kittens with acquired phimosis. Case report

RESUMEN A pesar de que la fimosis no se presenta con frecuencia en gatos, una causa probable es el chupeteo entre gatitos huérfanos de la misma camada. Se presenta el caso de un gatito macho con fimosis adquirida a edad temprana, cuyos principales signos clínicos fueron disuria, poliaquiuria y abultamiento del prepucio. A los tres meses de edad, se decidió realizar una postioplastía circunferencial para corregir el defecto, procedimiento tras el cual los signos remitieron sin complicaciones. El objetivo del presente reporte es brindar información para la resolución de casos similares. El procedimiento es seguro y asequible.

ABSTRACT Although phimosis doesn't occur frequently in cats, one likely cause is sucking between orphaned kittens from the same litter. This report presents the case of a male kitten with acquired phimosis at an early age, whose main clinical signs were dysuria, polla-kiuria and bulging of the foreskin. At three months of age, it was decided to perform a circumferential postioplasty to correct the defect, a procedure after which the signs remitted without complications. The aim of this report is to provide information for the resolution of similar cases. The procedure is safe and affordable.

First record of melanism in the critically endangered Pampa cat (Leopardus munoai), an endemic species of the Pampa grasslands / Primeiro registro de melanismo no criticamente ameaçado gato-pampeano (Leopardus munoai), uma espécie endêmica das áreas abertas do Pampa

Abstract We report the first record of a melanistic individual of the critically endangered Pampa cat (Leopardus munoai), from July 8th, 2021, at 10:45 am (coordinates 30.096288° S; 54.941139° W) in the area of the Brazilian army, known as Campo de Instrução Barão de São Borja (CIBSB), popularly known as Saicã.

Resumo: Este trabalho reporta o primeiro registro de melanismo do criticamente ameaçado de extinção gato-pampeano (Leopardus munoai), realizado em 8 de julho de 2021, às 10:45 da manhã. O registro foi obtido nas coordenadas 30.096288° S; 54.941139° W na área do exército brasileiro Campo de Instrução Barão de São Borja (CIBSB), popularmente conhecida como Saicã.

Uncária Tomentosa (Wild.) D.C. em processos inflamatórios na doença de Alzheimer / Uncária Tomentosa (Wild.) D.C. en procesos inflamatorios en la enfermedad de Alzheimer / Uncária Tomentosa (Wild.) D.C. in inflammatory processes in Alzheimer's disease

Objetivo: explorar os mecanismos envolvidos no desencadeamento e progressão da Doença de Alzheimer (DA) de forma a embasar a sugestão da planta Uncaria Tomentosa (Wild.) como mais uma possiblidade terapêutica coadjuvante para prevenção e tratamento da DA. Método: Trata-se de uma revisão narrativa da literatura realizada com busca de artigos publicados em bases indexadas e diretamente nas revistas de interesse, utilizando-se como descritores "Uncária Tomentosa", "Doença de Alzheimer", e os respectivos termos em inglês. Resultados: com os avanços para a compreensão dos mecanismos moleculares que desencadeiam os efeitos apresentados no desenvolvimento da DA, os diversos mecanismos dos fitocompostos presentes na planta sugerem sua utilização como neuroprotetor, por mecanismos anti-inflamatórios, imunomoduladores e antioxidantes, cujas evidências em literatura são apresentadas para defesa de sua utilização nesta patologia. Conclusão: foram encontradas evidências para sugerir a inclusão da Uncaria tomentosa (Wild.) como possível terapêutica complementar no tratamento da DA. Sua utilização deve ser melhor explorada para aplicação como tratamento complementar as terapêuticas convencionais para a DA

Objective: to explore the mechanisms involved in the triggering and progression of Alzheimer's disease (AD) in order to support the suggestion of the Uncaria Tomentosa (Wild.) plant as another adjuvant therapeutic possibility for the prevention and treatment of AD. Method: This is a narrative review of the literature conducted with a search for articles published on indexed bases and directly in the journals of interest, using as descriptors "Uncária Tomentosa", "Alzheimer's disease", and the respective terms in English. Results: with advances to understand the molecular mechanisms that trigger the effects presented in the development of AD, the various mechanisms of phytocompounds present in the plant suggest its use as neuroprotector, by anti-inflammatory, immunomodulatory and antioxidant mechanisms, whose evidence in the literature is presented to defend its use in this pathology. Conclusion: evidence was found to suggest the inclusion of Uncaria tomentosa (Wild.) as a possible complementary therapy in the treatment of AD. Its use should be better explored for application as a complementary treatment to conventional therapies for AD.

Objetivo: explorar los mecanismos implicados en el desencadenamiento y progresión de la enfermedad de Alzheimer (EA) con el fin de apoyar la sugerencia de la planta Uncaria Tomentosa (silvestre) como otra posibilidad terapéutica adyuvante para la prevención y tratamiento de la EA. Método: Se trata de una revisión narrativa de la literatura realizada con una búsqueda de artículos publicados en bases indexadas y directamente en las revistas de interés, utilizando como descriptores "Uncária Tomentosa", "Alzheimer's disease", y los términos respectivos en inglés. Resultados: con los avances para comprender los mecanismos moleculares que desencadenan los efectos presentados en el desarrollo de la EA, los diversos mecanismos de fitocompuestos presentes en la planta sugieren su uso como neuroprotector, por mecanismos antiinflamatorios, inmunomoduladores y antioxidantes, cuya evidencia en la literatura se presenta para defender su uso en esta patología. Conclusión: se encontró evidencia que sugiere la inclusión de Uncaria tomentosa (Silvestre) como una posible terapia complementaria en el tratamiento de la EA. Su uso debe explorarse mejor para su aplicación como tratamiento complementario a las terapias convencionales para la EA.

Cat scratch disease during etanercept therapy in a rheumatoid arthritis patient. / Enfermedad por arañazo de gato en paciente con artritis reumatoidea tratado con etanercept.

Cat scratch disease (CSD) is an infectious disorder caused by Bartonella henselae and characterized by fever and granulomatous lymphadenopathy. Immunosuppression is a risk factor for the development of atypical forms of the disease. We report the case of a 52-year-old woman who presented with fever and bilateral inguinal lymph node enlargement. She did not have apparent contact with animals. The patient was receiving etanercept therapy for rheumatoid arthritis. Lymph node biopsy demonstrated granulomatous lymphadenitis. She was successfully managed by discontinuing etanercept and by treatment with minocycline. She developed clinical remission and typical seroconversion. Infection with Bartonella should be considered in the differential diagnosis in rheumatoid arthritis patients with lymphadenopathy of unknown origin.

Infección por bartonella henselae en pacientes pediátricos. Lesión pseudotumoral de calota. Reporte de caso

Los tumores de calota en pacientes pediátricos poseen múltiples etiologías. Dentro de las causas pseudotumorales, las infecciones juegan un rol importante, siendo la osteomielitis por Bartonella henselae (Enfermedad por Arañazo de Gato) una posibilidad diagnóstica rara, pero que debe ser estudiada y descartada. Se presenta el caso de una lactante de 1 año, con lesión expansiva de calota, a nivel frontal derecho, hipervascularizada e infiltrativa. Se realizó estudio con ultrasonido, tomografía cerebral y cintigrama óseo. Se realizó resección quirúrgica completa de la lesión, con preservación de la duramadre y zona fontanelar, además de un cuidadoso trato con el seno sagital superior. Evolucionó sin complicaciones perioperatorias. El resultado de la biopsia fue compatible con proceso inflamatorio crónico, osteomielitis supurada. Tinción de Warthin Starry positiva sugerente de Bartonella henselae. Se descartó etiología tuberculosa y fúngica. Serología positiva para Bartonella henselae. La paciente completó antibioticoterapia, azitromicina y cotrimoxazol, con evolución clínica favorable.

Calvarial tumors in pediatric patients have multiple etiologies. Among the pseudotumoral causes, infections play an important role, being Bartonella henselae osteomyelitis (Cat Scratch Disease) a rare diagnostic possibility, but it should be studied and ruled out. We present the case of a 1 year old infant, with an expansive lesion of the calvaria, at right frontal level, hypervascularized and infiltrative. Ultrasound, brain tomography and bone scintigram were performed. Complete surgical resection of the lesion was performed, with preservation of the dura mater and fontanel area, in addition to a careful treatment with the superior sagittal sinus. The patient evolved without perioperative complications. The biopsy result was compatible with a chronic inflammatory process, suppurative osteomyelitis. Positive Warthin Starry stain suggestive of Bartonella henselae. Tuberculous and fungal etiology was ruled out. Positive serology for Bartonella henselae. The patient completed antibiotic therapy, azithromycin and cotrimoxazole, with favorable clinical evolution.

Pork-cat syndrome as cause of anaphylactic reaction to well-cooked meat / Síndrome gato-porco como causa de reação anafilática à carne cozida

Pork-cat syndrome is a rare clinical syndrome that can cause lifethreatening reactions. Occuring in patients allergic to cat dander, it involves cross-reactivity between cat and pig serum albumin. Cat allergy usually precedes food allergies, suggesting primary sensitization to cat serum albumin. Since these proteins are thermolabile, the reaction tends to be more severe in undercooked meat. A 27-year-old woman with persistent moderate-to-severe rhinoconjunctivitis since childhood reported 2 immediate mucocutaneous reactions after eating small amounts of pork. Skin prick tests with commercial extracts showed sensitization to pork, and prick-to-prick tests confirmed sensitization to raw pork and raw beef. Specific IgE was positive for pork, and ISAC microarray also showed sensitization to Fel d 2. SDS-PAGE and IgE immunoblotting assays were performed with raw and cooked pork extract and detected in a 60 kDa band. In the immunoblotting-inhibition assays, cat serum albumin completely inhibited IgE binding to pork extract. The patient underwent 2 oral food challenges with well-cooked pork and beef, both causing an anaphylactic reaction. The patient's history and in-vivo and in-vitro tests led to a diagnosis of pork-cat syndrome with clinical cross-reactivity to another mammalian serum albumin. This case should stimulate oral food challenges with other well-cooked mammalian meats in patients with this syndrome to establish a tolerance threshold and avoid possible unexpected anaphylactic reactions.

A síndrome gato-porco é rara e ocorre em doentes alérgicos ao pêlo de gato, envolvendo reatividade cruzada entre as albuminas séricas (AS) de gato e de porco. Normalmente, a doença respiratória a pêlo de gato precede a alergia alimentar, sugerindo uma sensibilização primária à albumina sérica de gato. Uma vez que estas proteínas são termolábeis, as reações tendem a ser mais graves com carnes menos cozidas. Mulher de 27 anos com rinoconjuntivite persistente moderada a grave desde a infância que refere duas reações imediatas mucocutâneas após ingestão de pequenas quantidades de carne de porco. Os testes cutâneos por picada com extratos comerciais mostraram sensibilização à carne de porco e os testes prick-to-prick confirmaram sensibilização à carne de porco e de vaca cruas. A IgE específica (sIgE) foi positiva para carne de porco, e o ensaio ISAC mostrou sensibilização a Fel d 2. Foram realizados ensaios de immunoblotting SDS-PAGE IgE com extratos de carne de porco crua e cozidas que detectaram uma banda de 60 kDA. Nos ensaios de inibição por immunoblotting a albumina sérica de gato produziu uma inibição total da ligação da IgE ao extrato de carne de porco. A doente realizou duas provas de provocação oral com carne de porco e de vaca cozidas, ambas positivas com desenvolvimento de reação anafilática. A história clínica, os testes in-vivo e in-vitro levaram ao diagnóstico de síndrome gato-porco com reatividade cruzada clínica a outras albuminas séricas de mamíferos. A síndrome gato-porco é rara e pode causar reações fatais. Este caso frisa a importância da realização de provas de provocação oral com outras carnes de mamíferos bem cozidas em doentes com esta síndrome, de forma a estabelecer um limiar de tolerância e evitar possíveis reações anafiláticas inesperadas.

Variantes en la presentación clínica de la enfermedad por arañazo de gato en niños del hospital Garrahan / Variants in the clinical presentation of cat scratch disease in children at Garrahan Hospital

La infección por Bartonella henselae (BH) adopta diversas formas de presentación clínica en pediatría. Según la bibliografía la forma de presentación más frecuente en pacientes inmunocompetentes es la linfadenopatía única asociada a fiebre. En el 85 % de los casos se compromete un solo ganglio siendo los axilares y los epitrocleares los más frecuentemente involucrados. Existen otras formas de presentación menos frecuentes que debemos tener en consideración, para poder realizar un diagnóstico precoz e indicar un tratamiento adecuado si así lo requiere. El diagnóstico requiere de la sospecha clínica del equipo de salud tratante, junto al antecedente epidemiológico, los hallazgos clínicos del examen físico y la realización de serologías que incluyan el dosaje de inmunoglobulina M y G. Los objetivos del presente trabajo fueron reconocer las manifestaciones clínicas típicas y atípicas de la EAG por Bartonella henselae, describir la epidemiología, características clínicas y evolución de esta enfermedad que se presentaron en nuestro hospital. Se estudiaron un total de 187 pacientes. La media de edad fue de 7.6 años (rango 1-14); siendo 53.5% de género masculino. Las formas de presentación más frecuentes en nuestro trabajo fueron la adenitis y la fiebre. La mayoría recibió diversos esquemas de tratamiento antibiótico, secundario al retraso en el diagnóstico. La tasa de hospitalización fue muy baja, remitió con tratamiento ambulatorio con antibióticos o sin ellos (AU)

Bartonella henselae infection has different clinical presentations in pediatrics. According to the literature, the most common form of presentation in immunocompetent patients is single lymphadenopathy associated with fever. In 85 % of the cases a single lymph node is involved, with the axillary and epitrochlear nodes being the most commonly involved. There are other, less frequent, forms of presentation that should be taken into consideration in order to make an early diagnosis and indicate appropriate treatment if required. Diagnosis relies on clinical suspicion by the treating healthcare team, together with the epidemiological history, clinical findings on physical examination, and serology including immunoglobulin M and G dosage. The objectives of this study were to identify both the typical and atypical clinical manifestations of Bartonella henselae cat scratch disease, to describe the epidemiology, clinical characteristics, and outcomes of cases presenting at our hospital. A total of 187 patients were studied. The mean age was 7.6 years (range 1-14); 53.5% were male. The most frequent forms of presentation in our study were adenitis and fever. Most of them received different antibiotic treatment regimens due to delayed diagnosis. The hospitalization rate was very low and the disease typically resolved with outpatient treatment, with or without antibiotics (AU)

Enfermedad por arañazo de gato: experiencia en unhospital pediátrico de tercer nivel / Cat-scratch disease: Experience in a tertiary care children's hospital

Introducción. Bartonella henselae es el agente etiológico de la enfermedad por arañazo de gato. Afecta a niños y a adultos jóvenes. El espectro clínico es amplio; la forma de presentación más frecuente es la linfadenopatía única. El objetivo de este estudio fue analizar epidemiología, características clínicas y evolución de esta enfermedad en un hospital de alta complejidad de Argentina. Población y métodos. Estudio retrospectivo, descriptivo y observacional realizado en un hospital pediátrico de tercer nivel, desde el 01 de enero de 2019 hasta el 30 de junio de 2021. Se incluyeron niños de 0 a 16 años con clínica compatible y serología positiva. Resultados. Se incluyeron 150 niños, con una media de edad de 7,9 años ± 3,68. El 68,7 % refirió tener contacto con gatos. El motivo de consulta más frecuente fueron las adenopatías únicas (84,7 %) localizadas en cabeza y cuello. El síndrome febril sin foco motivó la consulta en el 15,5 % de los casos, con ecografía abdominal patológica en el 85,7 %. Presentó IgM e IgG positivas el 88 %. Con el resultado de la serología positiva, el 44 % recibió tratamiento antibiótico. Las adenopatías prolongadas fueron la principal causa de su instauración; el más utilizado fue la azitromicina (42,4 %). El 14 % (n = 21) requirió internación. Conclusiones. El diagnóstico implica sospecha clínica, nexo epidemiológico y exámenes complementarios. Su forma típica son las adenomegalias únicas localizadas en cabeza y cuello. Debido a la alta frecuencia de compromiso hepatoesplénico, la realización de ecografía abdominal estaría indicada en niños con fiebre.

Introduction. Bartonella henselae is the etiologic agent in cat-scratch disease. It affects children and young adults. The clinical spectrum is wide; the most common clinical presentation is a solitary lymphadenopathy. The objective of this study was to analyze the epidemiology, clinical features, and course of this disease in a tertiary care hospital in Argentina. Population and methods. Retrospective, descriptive, and observational study conducted at a tertiary care pediatric hospital from January 1st, 2019 to June 30 th, 2021. Children aged 0 to 16 years with compatible clinical signs and symptoms and positive serology were included. Results. A total of 150 patients were included; their mean age was 7.9 years ± 3.68. Of them, 68.7% reported having contact with cats. The most common reason for consultation was the presence of solitary lymphadenopathies (84.7%) in the head and neck. Febrile syndrome without source was the reason for consultation in 15.5% of cases, with a pathological abdominal ultrasound scan in 85.7%. IgM and IgG were positive in 88%. With the result of a positive serology test, 44% received antibiotic treatment. Protracted lymphadenopathy was the main reason for antibiotic treatment; the agent most commonly used was azithromycin (42.4%). Fourteen percent (n = 21) required hospitalization. Conclusions. Diagnosis is based on clinical suspicion, epidemiological history, and complementary testing. Its typical presentation is a solitary enlarged lymph node in the head and neck. Due to the high frequency of hepatosplenic involvement, an abdominal ultrasound scan would be indicated in children with fever.