ABSTRACT
Ten children (7 males), aged between 6 and 13 years old, with histologically or serologically confirmed cat scratch disease are reported. Lympadenopathy location was pre auricular in four cases, axillary in two, inguinal in 2 and epitrochlear in 2. Three children had fever over 39ºC and 2 had a Parinaud syndrome. Nine children had a history of cat scratch and one of a cat byte. Six had an arythrocyte sedimentation rate over 40. Lymph node ultrasound examination was a useful diagnostic tool. Two patients had splenic granulomas. Lymph node biopsies were obtained in 4 cases, showing a suppurative granulomatous lymphadenitis in all and positive Warthin-Starry stain in 2. Serology, done in patients without histological confirmation was positive with titles ranging from 1:64 to 1:8192. All patients had a satisfactory outcome with regression of lymphadenopathy. Infection by bartonella henselae occur in the Chilean population and must be considered in the differential diagnosis of regional lymph node enlargement
Subject(s)
Humans , Male , Female , Adolescent , Cat-Scratch Disease/diagnosis , Bartonella henselae/pathogenicity , Cat-Scratch Disease/pathology , Immunocompetence/physiology , Lymphadenitis/microbiology , Lymphadenitis/pathologyABSTRACT
Lyme disease, caused by spirochete Borrelia burgdorferi, has several clinical manifestations and is transmitted to man by tick bites. In Chile and Latin America, several cases have been reported, but none with inmunoblot confirmation or isolation of the infecting organism. We report a 9 year old boy consulting with bilateral facila palsy, polyradiculoneuritis with tetraparesis and meningeal irritation. Cerebrospinal fluis analysis showed increased protein concentration without pleocytosis and negative viral or bacterial cultures. IgM antibodies against Borrelia burgdorferi, were positive by ELISA and were confirmed by immunoblot at the Reference Laboratory of the University of Connecticut. The child had a recent contact with hamsters brought from Germany. The substantiation of Lyme disease existence in Chile should prompt the search and isolation of the causal agent
Subject(s)
Humans , Male , Child , Lyme Disease/diagnosis , Borrelia burgdorferi/isolation & purification , Neurologic Manifestations , Enzyme-Linked Immunosorbent Assay , Immunoblotting , Tick-Borne Diseases/diagnosis , Animals, Domestic/parasitologyABSTRACT
Las pruebas disponibles para detección de rotavirus (RV) presentan diferente eficiencia en el diagnóstico. Se evaluaron aquí cuatro métodos de diagnóstico de RV en deposiciones. Con este objeto se analizaron 51 muestras de niños con diarrea aguda (21 RV positivos) por los métodos de electroforesis de ARN viral (Rotagel, ISP-Chile), aglutinación de látex (Rotavirus Antigen Látex Test, Meridian), ELISA (Pathfinder, Kallestad), e inmunoensayo ligado a aglutinación (RV-Test Pack, Abbott). Todas las muestras fueron corroboradas con un ensayo de ELISA confirmatorio y su resultado fue considerado el estándar para comnparaciones. La sensibilidad y específicidad para ELISA fue 100 y 90 por ciento; RV-Test Pack: 95 y 97 por ciento; electroforesis de ARN 81 y 100 por ciento; aglutinación de látex 71 y 100 por ciento. El tiempo de procesamiento de la muestra tuvo un rango entre 15 min (RV-Test Pack) a 120 min (Rotagel). El precio de costo por muestra (en US$) fue: RV-Test Pack 10,2; ELISA-Pathfinder; látex 2,4; y Rotagel 0,5. RV-Test Pack aparece como la prueba de elección para el diagnóstico de RV por su rapidez y confiabilidad, sin embargo su precio podría impedir su uso en numerosos centros clínicos. La prueba de ELISA mostró eficiencia diagnóstica similar, su precio es más bajo, pero tiene mayores requerimientos técnicos y un tiempo de procesamiento más largo