[Update on microsporidiosis in humans]. / Actualizaciones sobre microsporidiosis en el hombre.

The importance of microsporidium as an opportunistic agent in immunocompromised and AIDS patients is reviewed. Five strains of the agent have been described: Encephalitozoon, Enterocytozoon, Nosema, Pleistophora and Septata. The clinical presentation may be as 1) Generalized infections with multisystemic involvement, specially of the central nervous system; 2) Intestinal, that is the most important and frequent localization in man, and that may cause death in AIDS patients; 3) Ocular, that affects cornea, conjunctiva and may extend to paranasal sinuses; 4) Liver and biliary tract infection with granulomatous lesions, hepatic necrosis or sclerosing colangitis and 5) Muscular, affecting skeletal muscle. The diagnosis is difficult and is established finding spores in the affected tissues with light or electron microscopy. Lately, the diagnosis of intestinal microsporidiosis is made looking for faecal spores. The resistant wall of spores hampers treatment. However, good results are obtained with Albendazole in intestinal microsporidiosis.

[A case of congenital chagasic megaesophagus: evolution until death caused by esophageal neoplasm, at 27 years of age]. / Un caso de megaesófago chagásico congénito: evolución hasta su fallecimiento por cáncer del esófago, a los veintisiete años de edad.

A symptomatic megaesophagus was demonstrated in a three months old boy with Chagas disease. He had a difficult evolution with frequent aspiration pneumonias and progressive undernutrition. At 14 years old a cardiomyotomy (Heller's procedure) was performed, with good results that allowed a near normal life. At 27 years old, the patient started with progressive dysphagia due to an epidermoid esophageal carcinoma and died after surgery. Since a higher frequency of esophageal carcinoma is observed in achalasia, periodic endoscopic examinations are mandatory.

Hydatidosis diagnosis by double diffusion in agar with arc 5 detection.

To further assess the double diffusion arc 5 (DD5) test for human hydatidosis, the test was performed on sera from 45 patients with surgically confirmed hydatidosis and 54 with other pathologies in Santiago, Chile. Combined with tests reported previously, this brought the total number of study subjects with confirmed hydatidosis to 98 and the total with other pathologies to 128. Overall, the test yielded positive results with sera from 55 (56%) of the 98 serologically confirmed cases, the degree of seropositivity among patients with pulmonary hydatidosis (36%) being relatively low. The criteria adopted for a positive result were the presence of arc 5 or, in the absence of arc 5, the presence of three or more bands of precipitate. On the basis of these criteria, no false positive results were detected using sera from the 128 patients with other pathologies. It is concluded that using the DD5 test to diagnose hydatidosis in clinically selected individuals can provide results of high specificity; i.e., positive results can be taken as confirming presence of the infection. On the other hand, a negative DD5 result does not constitute definite proof that no hydatid cysts are present.

Characterization of glutathione S-transferase activity in Echinococcus granulosus.

1. Glutathione S-transferase activity has been characterized in protoscolices of Echinococcus granulosus. 2. The conjugation reaction was activated by treatment of protoscolices with phenobarbital and beta-naphthoflavone. 3. Protoscolices of E. granulosus contained the conjugation cofactor glutathione in the amount of 287 nmol/g fresh tissue. 4. Conjugation may represent an important factor in the resistance of the parasite to drugs.

Transmision congenita del Trypanossoma cruzy: investigacion en la maternidad del Hospital San Juan de Dios, de Santiago. / Congenital transmission of the Trypanosoma cruzi: research in the Maternity of the Hospital San Juan de Dios of Santiago

Se estudiaran 402 muestras de sangre de cordon tomadas al azar, en la Maternidad del Hospital San Juan de Dios de Santiago, mediante la reaccion de inmunofluorescente indireta con anti-IgG para enfermedad de Chagas (RIFI-IgG). Se obtuvieran ll resultados positivos (2,74%). De estos once recien nacidos sometidos a estudio, en dos se pesquisaron trypomastigotos circulantes (por examen microscopico de sangre y xenodiagnosticos) siendo tratados con nifurtimox. Uno de ellos fue un recien nacido de pre-termino, con discreto compromiso del sistema nervioso central y el otro, un recien nacido de termino, aparentemente sano. Los resultados sugieren que la transmision congenita del T. cruzi puede ocurrir mas frequentemente que lo generalmente aceptado. Si es asi, un estudio sistematico para enfermedad de Chagas en recien-nacidos, seria de gran utilidad para detectar las infecciones subclinicas. Como se demuestra en este estudio, el diagnostico y tratamiento temprano es importante en estos casos

El compromiso ocular en la enfermedad de Chagas congenita. / Eye involvement in congenital Chagas' disease

Se relatan los hallazgos fondoscopicos en 9 de 11 pacientes tratados por enfermedad de Chagas congenita, entre los anos 1968 y 1978. La complicacion ocular parece ser frecuente. Las alteraciones son inespecificas. Las estructuras comprometidas son coroide, retina, nervio optico y vitreo posterior. La respuesta al tratamiento es favorable, no parece haber relacion entre la gravedad de la enfermedad y las manifestaciones oculares. No debemos olvidar esta de coriorretinitis congenita, especialmente en aquellos ninos con bajo peso de nacimiento y hepatoesplenomegalia

Un caso clinico de loxoscelismo cutaneo visceral. / One case of cutaneous and visceral loxoscelism

El loxoscelismo cutaneo visceral es un accidente agudo y grave, que se produce con baja frecuencia. Se presenta la evolucion clinica de un paciente, de 37 anos, sin antecedentes de mordedura de arana, que ingresa con una placa livedoile en muslo izquierdo, ademas de la rapida aparicion de sintomas y signos de anemia hemolitica e insuficiencia renal aguda. Con las medidas terapeuticas de hidratacion, corticoides, diureticos y transfusiones no se obtiene respuesta satisfactoria. Se empleo hemodialisis repetidas, con lo cual se logra la mejoria del paciente, al cabo de un mes de hospitalizacion, llamando la atencion el periodo prolongado de la fase oligoanurica y la persistencia del fenomeno hemolitico. La lesion del muslo evoluciono en forma satisfactoria hacia una escara seca. Se comentan los mecanismos patogenicos del fenomeno tanto local como sistemico, provocado por el veneno de Loxosceles laeta postulados hasta el presente, junto a algunas indicaciones terapeuticas disponibles para este accidente