ABSTRACT
Dengue fever is the world's most important arboviral disease, presenting a wide clinical spectrum. We report for the first time in Peru, a case caused by dengue virus serotype 4 with significant gastrointestinal involvement (acute acalculous cholecystitis and acute hepatitis). In addition we carried out a review of the literature atypical presentation illustrating the importance of the characteristics of abdominal pain (right upper quadrant); presence of Murphy's sign, ultrasound, and liver enzymes levels, for appropriate diagnosis and clinical management.
Subject(s)
Acalculous Cholecystitis/virology , Dengue Virus/classification , Dengue/virology , Hepatitis/virology , Acute Disease , Dengue/complications , Female , Humans , Young AdultABSTRACT
Plasmodium vivax causes 81% of all malaria cases and is the most common species in the Peruvian Amazon. We present the case of a male patient with cerebral malaria caused by Plasmodium vivax, who had general malaise and fever, and then presented seizures more than twice a day with loss of consciousness and motor functional limitation. Plasmodium vivax trophozoites were detected by thick blood smear, besides, we also observed low counts of all three blood cell types. Treatment began with artesunate and clindamycin for five days, then one unit of packed red blood cells was transfused; treatment continued with primaquine for seven days. The patient showed clinical improvement with neurological sequelae in one lower limb.
Plasmodium vivax es la especie más común en la Amazonía peruana y ocasiona el 81% del total de casos de malaria. Presentamos el caso de un paciente adulto varón con malaria cerebral por Plasmodium vivax, que inicia con malestar general y fiebre, luego presenta convulsiones más de dos veces al día con pérdida de consciencia y limitación funcional motora. Se le realiza gota gruesa donde se observa trofozoítos de Plasmodium vivax y depresión de las tres series sanguíneas. Se inicia tratamiento con artesunato y clindamicina por cinco días, se le transfunde un paquete globular, y continua con primaquina por siete días. El paciente muestra mejoría clínica con secuela neurológica en extremidad inferior izquierda.
Subject(s)
Malaria, Cerebral , Plasmodium vivax , Male , Humans , Malaria, Cerebral/complications , PeruSubject(s)
Dengue , Epidemics , Humans , Peru/epidemiology , Disease Outbreaks , Dengue/epidemiologyABSTRACT
Dengue has affected Iquitos since 1990 causing outbreaks of major impact on public health and for this reason great efforts have been made for its temporal control. Currently, with the expansion of the chikungunya virus in the Americas and the threat of the emergence of the virus in Iquitos, we reflect on lessons learned by way of the activities undertaken in the area of vector control; epidemiological surveillance, diagnosis and clinical management during periods of outbreaks of dengue, in a way that will allow us to better face the threat of an outbreak of chikungunya virus in the largest city in the Peruvian Amazon.
Subject(s)
Aedes , Chikungunya Fever/epidemiology , Chikungunya Fever/prevention & control , Dengue/epidemiology , Dengue/prevention & control , Disease Outbreaks , Mosquito Control/methods , Animals , Humans , Peru/epidemiologyABSTRACT
This study describes the clinical, parasitological and laboratory findings of four patients who lived in the district of Alto Nanay, Maynas, Loreto, Peru and were infected with Mansonella ozzardi microfilariae. Clinical examinations by ophthalmologists, cardiologists and nephrologists were performed. In case 1, the presence of 2 subcutaneous lumps was the most important finding, one at dorsal level and the other in the lower third of the left leg; in case 2, there was a sensation of tingling or coldness in the legs; in case 3, an associated chronic hepatitis B infection was found, and in case 4, a large lump was detected in the left lumbar region. All 4 patients were infected with Mansonella ozzardi and had eosinophilia, 3 of them in percentages of 20%. The lump found in case 4 was due to a herniation of bowel content. Further clinical studies and an evaluation of the actual pathogenic effect of microfilariae are to be performed. A study of the genetic diversity of filariae in the Peruvian Amazon would also be important.
Subject(s)
Mansonella , Mansonelliasis/diagnosis , Adult , Aged , Animals , Female , Humans , Male , Middle Aged , PeruABSTRACT
Dengue fever is the world's most important arboviral disease, presenting a wide clinical spectrum. We report for the first time in Peru, a case caused by dengue virus serotype 4 with significant gastrointestinal involvement (acute acalculous cholecystitis and acute hepatitis). In addition we carried out a review of the literature atypical presentation illustrating the importance of the characteristics of abdominal pain (right upper quadrant); presence of Murphy's sign, ultrasound, and liver enzymes levels, for appropriate diagnosis and clinical management.
El dengue es la arbovirosis más importante del mundo y causa un amplio espectro clínico. Presentamos el primer caso de dengue causado por el serotipo 4 (DENV-4) en Perú con compromiso gastrointestinal (colecistitis aguda alitiásica y hepatitis aguda moderada). Se presenta una revisión de la literatura médica sobre este tipo de presentación, enfatizando la importancia y características del dolor abdominal (hipocondrio derecho), el signo de Murphy, los hallazgos ultrasonográficos y la medición de las enzimas hepáticas para establecer el diagnóstico y manejo adecuado.