RESUMEN
Zika Virus (ZIKV), originally identified in 1947, is a re-emerging Flavivirus transmitted mainly through bites by Aedes mosquitos. Until the recent outbreaks in the Pacific islands and Central and South America, it was known to cause benign disease, in most cases asymptomatic or with mild and nonspecific symptoms (fever, rash, conjunctivitis, arthralgia, etc.). The unprecedented current epidemic has highlighted new modes of transmission (through blood, perinatally and sexually) as well as serious neurological complications such as congenital defects in the fetuses of infected mothers and Guillain-Barre syndrome in adults. This situation, coupled with the threat of worldwide spread, prompted the WHO to declare the ZIKV a public health emergency of international concern in February 2016.
Asunto(s)
Brotes de Enfermedades , Síndrome de Guillain-Barré/epidemiología , Microcefalia/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Infección por el Virus Zika/epidemiología , Virus Zika , Aedes , Animales , Brotes de Enfermedades/estadística & datos numéricos , Femenino , Salud Global/estadística & datos numéricos , Síndrome de Guillain-Barré/virología , Humanos , Microcefalia/virología , Vigilancia de la Población , Embarazo , Complicaciones Infecciosas del Embarazo/virología , América del Sur/epidemiología , Virus Zika/aislamiento & purificación , Infección por el Virus Zika/prevención & control , Infección por el Virus Zika/transmisiónRESUMEN
INTRODUCTION: Wells's cellulitis is a rare eosinophilic dermatose characterized by an inflammatory erythematous eruption, often associated with eosinophilia, and suggestive histologic features. The differential diagnosis with other eosinophilic dermatitis is problematic. The treatment is typically based on systemic steroids. CASE REPORT: We report a 63-year-old patient with an extensive pruritic maculo-papular eruption of the limbs and the trunk, forming large indurated and painful erythematous patches. Blood analysis revealed eosinophilia. Histologic examination showed perivascular eosinophilic inflammatory infiltration, also disposed around collagen fibers. The symptoms disappeared with topical corticosteroids. CONCLUSION: The diagnosis of Well's cellulitis is difficult because of the lack of specific sign; it is based on suggestive clinical, biological and histological features. Topical corticosteroids are efficient and well-tolerated, and should be used as first treatment.
Asunto(s)
Celulitis (Flemón)/diagnóstico , Eosinofilia/diagnóstico , Celulitis (Flemón)/tratamiento farmacológico , Diagnóstico Diferencial , Eosinofilia/tratamiento farmacológico , Femenino , Glucocorticoides/uso terapéutico , Humanos , Persona de Mediana EdadRESUMEN
Phaeohyphomycosis is a group of superficial and deep infections due to dematiaceous fungi. They are most common in tropical environments, especially in immunocompromised hosts. We describe the first case of phaeohyphomycosis due to Pleurostoma ootheca in a kidney transplant recipient in Martinique (French West Indies). A 59-year-old man with a kidney graft, treated with mycophenolate mofetil, tacrolimus, and prednisone, presented suppurative tumefaction of the left ankle. Cutaneous and osseous phaeohyphomycosis caused by P. ootheca was diagnosed, based on mycological, histological, and radiological testing. The patient's condition improved with posaconazole treatment. P. ootheca is a known environmental fungus. Immunocompromised hosts are more vulnerable to many infections, due to opportunistic pathogens. Bacteriological, histological, and mycological testing is required for accurate diagnosis and appropriate treatment. Treatment is not well defined and usually relies on antifungal agents or surgical resection or both. An important point to consider is that azole antifungal agents may cause major drug-drug interactions with immunosuppressive agents such as tracrolimus.
Asunto(s)
Huésped Inmunocomprometido , Trasplante de Riñón , Feohifomicosis/diagnóstico , Ascomicetos/aislamiento & purificación , Humanos , Masculino , Martinica , Persona de Mediana Edad , Infecciones Oportunistas/diagnósticoRESUMEN
Diaporthe phaseolorum (syn. Phomopsis phaseoli) is a frequent fungal parasite of plants, present on all continents around the world. It has rarely been involved in human diseases. We report a case of eumycetoma with osteomyelitis of the forefoot caused by this fungus and diagnosed by molecular biology. The patient had positive HTLV-1 serology and was a farmer from French Guiana who walked barefoot. He was successfully treated with long-term oral itraconazole (400 mg/day). A review of the literature underlines the essential roles of plants and host immunosuppression in this infection and the favourable outcome with a triazole antifungal treatment.