[Clinical approach to imported eosinophilia]. / Aproximación clínica a la eosinofilia importada.

Eosinophilia is a common finding in international travelers and immigrants, being an helmintic infection its main etiology. The positive predictive value of eosinophilia for an helmintosis is low in travellers. Eosinophilia may be an incidental finding, or symptomatic, and it represents a clinical challenge due to the low sensitivity and specificity of direct and indirect parasitological diagnostic tests, respectively. It requires a structured approach based on geographical areas, environmental exposures and behavioral risks, and associated symptoms. The initial assessment should include a comprehensive and tailored anamnesis and physical examination, basic laboratory tests, a complete parasitological examination of stool samples and a Strongyloides stercoralis serology, supplemented with other explorations guided by epidemiological and clinical suspicion. Empiric treatment with albendazole and/or ivermectin (plus praziquantel if risk of schistosomiasis) is an option for unidentified persistent eosinophilia after study, and in persons in whom a proper assessment or follow-up can not be assured. In patients at risk for estrongiloidosis who are candidates for immunosuppressive therapies, it is indicated a prior screening and treatment to prevent a future hyperinfestation syndrome.

[Clinical and epidemiological features of pertussis among hospitalized infants in Seville during 2007-2011]. / Características epidemiológicas y clínicas de la tos ferina en los lactantes hospitalizados en Sevilla durante el periodo 2007-2011.

INTRODUCTION: Despite routine pertussis immunization, pertussis burden remains high, especially among infants. The aim of this study was to describe epidemiologic, clinical and outcome features in pediatric patients admitted to a tertiary hospital in Andalusia (Southern Spain) with confirmed Bordetella pertussis infection. METHODS: Retrospective descriptive study based on a review of medical records for all pediatric patients admitted to Hospital Universitario Virgen del Rocío (Sevilla) between January 1, 2007 and December 31, 2011. RESULTS: Overall, 39 patients were diagnosed with pertussis during the study period with significant higher incidence rate in 2011 compared to 2007 (p=0.0003). Eleven children were admitted to the pediatric intensive care unit (ICU) in 2010 and 2011 and two of them died. Patients who were admitted to ICU presented with more atypical disease compared to controls in a conventional ward. They were less likely to have pertussoid cough and clinical diagnosis at admission and had a smaller percentage of lymphocytes. Creactive protein values were higher and they had a longer duration of hospital stay. CONCLUSION: The pertussis incidence rate increased significantly among hospitalized infants during the study period, and was associated with severe morbidity, including unusual complications, and mortality. A higher awareness of the clinical diagnosis of pertussis among infants admitted to ICU is required due to more atypical manifestations, and the risk of sudden deterioration associated to fatal outcome.

HPV Direct Flow CHIP: a new human papillomavirus genotyping method based on direct PCR from crude-cell extracts.

HPV Direct Flow CHIP is a newly developed test for identifying 18 high-risk and 18 low-risk human papillomavirus (HPV) genotypes. It is based on direct PCR from crude-cell extracts, automatic flow-through hybridization, and colorimetric detection. The aim of this study was to evaluate the performance of HPV Direct Flow CHIP in the analysis of 947 samples from routine cervical screening or the follow-up of abnormal Pap smears. The specimens were dry swab samples, liquid-based cytology samples, or formalin-fixed paraffin-embedded tissues. The genotype distribution was in agreement with known epidemiological data for the Spanish population. Three different subgroups of the samples were also tested by Linear Array (LA) HPV Genotyping Test (n=108), CLART HPV2 (n=82), or Digene Hybrid Capture 2 (HC2) HPV DNA Test (n=101). HPV positivity was 73.6% by HPV Direct Flow CHIP versus 67% by LA, 65.9% by HPV Direct Flow CHIP versus 59.8% by CLART, and 62.4% by HPV Direct Flow CHIP versus 42.6% by HC2. HPV Direct Flow CHIP showed a positive agreement of 88.6% with LA (k=0.798), 87.3% with CLART (k=0.818), and 68.2% with HC2 (k=0.618). In conclusion, HPV Direct Flow CHIP results were comparable with those of the other methods tested. Although further investigation is needed to compare the performance of this new test with a gold-standard reference method, these preliminary findings evidence the potential value of HPV Direct Flow CHIP in HPV vaccinology and epidemiology studies.