The isolation of Balamuthia mandrillaris from environmental sources from Peru.

Balamuthia mandrillaris is an opportunistic free-living amoeba that has been reported to cause skin lesions and the fatal Balamuthia amoebic encephalitis (BAE) in humans and other animals. Currently, around 200 human BAE cases have been reported worldwide, although this number is considered to be underestimated. The highest number of BAE cases has been reported in the American continent, mainly in the southwest of the USA. Peru seems to be another hotspot for BAE with around 55 human cases having been identified, usually involving cutaneous infection, especially lesions in the central face area. The isolation of Balamuthia from environmental sources has been reported on only three prior occasions, twice from Californian soils and once from dust in Iran and so it seems that this amoeba is relatively rarely encountered in samples from the environment. We investigated that possibility of finding the amoebae in soil samples from different regions where clinical cases have been reported in Peru. Twenty-one samples were cultured in non-nutrient agar plates and were checked for the presence of B. mandrillaris-like trophozoites and/or cysts. Those samples that were positive for these amoebae by microscopic criteria were then confirmed by PCR amplification and DNA sequencing of the mitochondrial 16S rDNA gene of B. mandrillaris. We have detected the presence of B. mandrillaris in four samples collected in the regions of Piura (3) and Lima (1) where infection cases have been previously reported. We hypothesize that B. mandrillaris is present in Peru in soil and dust which therefore constitutes a source of the infection for the BAE cases previously reported in this country. Further studies should be carried out in the area to confirm the generality of this finding.

Erucismo por Lonomia spp con síndrome cutáneo hemorrágico. Primer caso reportado en Perú. û 2006 / Erucism by Lonomia with hemorrhagic syndrome. The first case reported in Perú

Presentamos el caso de una mujer de 32 años, procedente de Satipo, Junín, Selva Central del Perú, quien en mayo del 2006, luego del contacto con una oruga de mariposa, presenta severo compromiso sistémico hemorragíparo, con equimosis, hematomas, hematemesis, melenas y hematuria, y desarrollo de coagulopatía de consumo. El manejo fue de soporte con buena evolución y normalización de la coagulación al día doce. Es el primer caso de accidente probable por Lonomia sp con cuadro severo sistémico hemorrágico reportado en Perú.

We present the first case of Erucism by Lonomia spp. in Peru. A 32-year-old female patient was admitted with hematemesis, melena, hematuria and disseminated intravascular coagulation occurring after extensive skin contact with a caterpillar butterfly in Satipo, Junin. The patient was treated with supportive measures with complete recovery of the coagulopathy in twelve days.