ABSTRACT
INTRODUCTION: Human intestinal spirochetosis (HIE) is a poorly studied clinical entity with variable clinical manifestations. However, in recent years it has gained special relevance because an increasing number of cases have been described in people living with HIV (PWH) and in patients with a history of sexually transmitted infections (STI) or immunosuppression. METHODS: Retrospective review of all HIE cases identified in a tertiary level hospital (Hospital Universitario la Paz, Madrid) between 2014 and 2021. RESULTS: 36 Cases of HIE were identified. Most cases corresponded to males (94%) with a median age of 45 years. 10 patients (29.4%) were PWH and 20 (56%) were men who had sex with men. Although the clinical manifestations were very heterogeneous, the most frequent was chronic diarrhea (47%), and up to 25% of the subjects had clinical proctitis. 39% percent of patients had been diagnosed with an STI in the previous two years, this characteristic being more frequent in PWH (90% vs. 28%; pâ¯<â¯0.01) than in patients without HIV infection. The STI most frequently associated with a diagnosis of HIE was syphilis (31%). CONCLUSION: HIE is frequently diagnosed with other STIs and affects mostly men who have sex with men, which supports that this entity could be considered as a new STI.
ABSTRACT
Bioterrorism and the potential use of biological weapons has become an important concern of governments and responsible authorities. An example of this threat occurred in 2001 in the USA, when letters were sent containing spores of the agent that produces anthrax; this resulted in some deaths, and caused panic and negative effects on the world economy. If this small-scale event was able to cause such a huge impact, the repercussions of a massive attack could be catastrophic. In many countries, these events have resulted in the implementation of measures directed toward preventing and responding to bioterrorist threats and acts. As a whole, these measures are known as biodefense. This article briefly analyzes several aspects related to detecting and identifying acts of bioterrorism, and considers the biological agents that are implicated. The microbiological diagnosis that allows identification of the causal agent, a key point for taking suitable control measures, is also included.
Subject(s)
Bioterrorism , Civil Defense/trends , Disaster Planning , Infection Control/trends , Microbiology/trends , Public Health , Anthrax/prevention & control , Civil Defense/methods , Communicable Diseases/diagnosis , Communicable Diseases/transmission , Early Diagnosis , Government Agencies , Humans , Infection Control/methods , Medical History Taking , Population Surveillance , Spain , Toxins, Biological/analysis , Toxins, Biological/poisoningABSTRACT
El bioterrorismo y el uso potencial de armas biológicas se ha convertido en una preocupación importante de los gobiernos y autoridades competentes. Como ejemplo, el envío de cartas con esporas del agente causante del carbunco en Estados Unidos en 2001 ocasionó varias muertes, causó pánico y tuvo repercusiones negativas en la economía mundial. Si este incidente, a pequeña escala, produjo semejante impacto, los efectos de un ataque masivo podrían ser catastróficos. En muchos países éste fue el punto que marcó el inicio de la toma de medidas encaminadas a prevenir y responder ante amenazas y actos bioterroristas, acciones que, en su conjunto, se conocen como biodefensa. Este artículo pretende analizar someramente algunos aspectos relacionados con la detección e identificación de este tipo de acciones y los agentes biológicos implicados. Se considera el diagnóstico microbiológico que permite la identificación del agente causal, punto clave para la toma de medidas de control adecuadas (AU)
Bioterrorism and the potential use of biological weapons has become an important concern of governments and responsible authorities. An example of this threat occurred in 2001 in the USA, when letters were sent containing spores of the agent that produces anthrax; this resulted in some deaths, and caused panic and negative effects on the world economy. If this small-scale event was able to cause such a huge impact, the repercussions of a massive attack could be catastrophic. In many countries, these events have resulted in the implementation of measures directed toward preventing and responding to bioterrorist threats and acts. As a whole, these measures are known as biodefense. This article briefly analyzes several aspects related to detecting and identifying acts of bioterrorism, and considers the biological agents that are implicated. The microbiological diagnosis that allows identification of the causal agent, a key point for taking suitable control measures, is also included (AU)
Subject(s)
Humans , Bioterrorism , Civil Defense/trends , Disaster Planning , Infection Control/trends , Microbiology/standards , Public Health , Civil Defense/methods , Communicable Diseases/diagnosis , Communicable Diseases/transmission , Infection Control , Infection Control/methods , Early Diagnosis , Carbuncle/prevention & controlABSTRACT
No disponible
Subject(s)
Male , Middle Aged , Humans , Tularemia/diagnosis , Ticks/pathogenicity , Francisella tularensis/isolation & purification , Diagnosis, DifferentialSubject(s)
Bites and Stings/complications , Ticks , Tularemia/transmission , Animals , Humans , Male , Middle AgedABSTRACT
BACKGROUND AND OBJECTIVE: The aim of this study was to describe an outbreak of Q fever in a group of people (day care centre for mental-handicapped individuals) previously exposed to animals in a school-farm. PATIENTS AND METHOD: A retrospective cohort study among the 25 mental-handicapped individuals and the 30 workers of the centre was performed. The information about symptoms and signs and antecedents of exposition was obtained by an epidemiological survey and a clinical-epidemiological case definition was established. Serum samples from 29 people (5 mental-handicapped individuals and 24 workers) were processed for serology (Indirect Immunofluorescence against Coxiella burnetii). RESULTS: Twenty two cases of Q fever were detected. Ten were confirmed by serology (6 of them asymptomatic). More frequent symptoms were fever (100%), anorexia (81.3%), asthenia (68.8%) and non-productive cough (56.3%) among the 16 clinical cases. The risk of acute infection was 8.6 times higher in individuals of the centre that visited the school-farm (95% CI, 1.26-58.27). CONCLUSIONS: The investigation of the epidemiological antecedents allowed to detect and confirm a Q fever outbreak, to identify the probable source of exposition and to orientate the clinical and serological diagnosis.
Subject(s)
Coxiella burnetii/isolation & purification , Disease Outbreaks , Q Fever/epidemiology , Adult , Antibodies, Bacterial/blood , Cohort Studies , Confidence Intervals , Female , Humans , Male , Q Fever/blood , Q Fever/diagnosis , Retrospective Studies , Risk , Seroepidemiologic Studies , Serologic Tests , Spain/epidemiologyABSTRACT
Fundamento y objetivo: El objetivo del estudio ha sido describir un brote de fiebre Q en un colectivo (centro de día para discapacitados psíquicos) con antecedente de exposición a animales en una granja-escuela. Pacientes y método: Se ha realizado un estudio de cohortes retrospectivo entre los 25 usuarios y los 30 trabajadores del centro. Se recabó información referente a exposición, síntomas y signos de enfermedad y se estableció una definición clinicoepidemiológica de caso. En 29 personas (5 usuarios y 24 trabajadores del centro) se procesaron muestras para serología (inmunofluorescencia indirecta para Coxiella burnetii). Resultados: Se detectaron 22 casos de fiebre Q. Diez se confirmaron por serología (6 de ellos asintomáticos). Entre los 16 casos clínicos los síntomas más frecuentes fueron fiebre (100%), anorexia (81,3%), astenia (68,8%) y tos no productiva (56,3%). El riesgo de infección aguda se estimó en 8,6 veces mayor entre las personas del colectivo que acudieron a la granja-escuela (intervalo de confianza del 95%, 1,26-58,27). Conclusiones: La investigación de los antecedentes epidemiológicos permitió detectar y confirmar un brote de fiebre Q, identificar la probable fuente de exposición y orientar el diagnóstico clínico y serológico
Background and objective: The aim of this study was to describe an outbreak of Q fever in a group of people (day care centre for mental-handicapped individuals) previously exposed to animals in a school-farm. Patients and method: A retrospective cohort study among the 25 mental-handicapped individuals and the 30 workers of the centre was performed. The information about symptoms and signs and antecedents of exposition was obtained by an epidemiological survey and a clinical-epidemiological case definition was established. Serum samples from 29 people (5 mental-handicapped individuals and 24 workers) were processed for serology (Indirect Immunofluorescence against Coxiella burnetii). Results: Twenty two cases of Q fever were detected. Ten were confirmed by serology (6 of them asymptomatic). More frequent symptoms were fever (100%), anorexia (81.3%), asthenia (68.8%) and non-productive cough (56.3%) among the 16 clinical cases. The risk of acute infection was 8.6 times higher in individuals of the centre that visited the school-farm (95% CI, 1.26-58.27). Conclusions: The investigation of the epidemiological antecedents allowed to detect and confirm a Q fever outbreak, to identify the probable source of exposition and to orientate the clinical and serological diagnosis
Subject(s)
Male , Female , Humans , Q Fever/epidemiology , Disease Outbreaks , Retrospective Studies , Cohort Studies , Coxiella burnetii/pathogenicity , Animals, Domestic/microbiology , Risk Factors , Anti-Bacterial Agents/therapeutic useSubject(s)
Borrelia burgdorferi Group , Erythema Chronicum Migrans , Anti-Infective Agents/administration & dosage , Anti-Infective Agents/therapeutic use , Borrelia burgdorferi Group/genetics , Doxycycline/administration & dosage , Doxycycline/therapeutic use , Erythema Chronicum Migrans/diagnosis , Erythema Chronicum Migrans/drug therapy , Erythema Chronicum Migrans/epidemiology , Humans , Male , Middle Aged , Polymerase Chain Reaction , Spain/epidemiology , Time Factors , Treatment OutcomeABSTRACT
No disponible
Subject(s)
Male , Middle Aged , Humans , Erythema/microbiology , Borrelia Infections/diagnosis , Lyme Disease/epidemiology , Borrelia burgdorferi Group/pathogenicity , Doxycycline/therapeutic use , Borrelia Infections/drug therapyABSTRACT
Lyme borreliosis, caused by Borrelia burgdorferi sensu lato, is a multi-organ infection with dermatological, rheumatological, neurological, and cardiac manifestations. The main characteristic is a skin lesion, named erythema migrans. Relapsing fever, caused by numerous species of Borrelia, is characterized by a periodic cycle of acute and afebrile episodes. The serological diagnosis of these infections has limited value in sensitivity, specificity and predictive values. Lyme borreliosis is usually diagnosed by recognition of a characteristic clinical picture with serological confirmation, and the diagnosis of relapsing fever relies on direct observation of spirochetes in peripherical blood. The elected treatment is almost always tetracycline for the young or for adults but not for pregnant women, although betalactamic (such as penicillin or 3rd generation cephalosporin for the central nervous system) or macrolides are indicated in several situations. The prognosis, with adequate treatment, is good. In the majority of Spanish regions, due to the low incidence of these diseases, the prophylactic antimicrobial treatment after a tick bite is not indicated.
Subject(s)
Borrelia Infections , Adult , Amoxicillin/therapeutic use , Animals , Arachnid Vectors/microbiology , Birds/parasitology , Bites and Stings/complications , Borrelia/classification , Borrelia/isolation & purification , Borrelia Infections/diagnosis , Borrelia Infections/drug therapy , Borrelia Infections/epidemiology , Borrelia Infections/microbiology , Borrelia Infections/transmission , Child , Doxycycline/therapeutic use , Enzyme-Linked Immunosorbent Assay , Female , Humans , Lyme Disease/diagnosis , Lyme Disease/drug therapy , Lyme Disease/epidemiology , Lyme Disease/therapy , Lyme Disease/transmission , Male , Mammals/parasitology , Parasitemia/diagnosis , Parasitemia/microbiology , Polymerase Chain Reaction , Pregnancy , Pregnancy Complications, Infectious/drug therapy , Pregnancy Complications, Infectious/microbiology , Serologic Tests/methods , Tick-Borne Diseases/diagnosis , Tick-Borne Diseases/drug therapy , Tick-Borne Diseases/epidemiology , Tick-Borne Diseases/microbiology , Tick-Borne Diseases/therapy , Tick-Borne Diseases/transmission , Ticks/microbiologyABSTRACT
La borreliosis de Lyme, producida por Borrelia burgdorferi sensu lato (s.l.), es una enfermedad multisistémica con manifestaciones dermatológicas, reumáticas, neurológicas y cardíacas. Su característica principal es una lesión cutánea denominada eritema migratorio. Las fiebres recurrentes producidas por diversas especies de Borreliase caracterizan desde el punto de vista clínico por ciclos de fiebre y apirexia. El diagnóstico serológico de estas enfermedades tiene limitaciones de sensibilidad, especificidad y valores predictivos. El diagnóstico se basa en la sintomatología apoyada en la serología en la borreliosis de Lyme, y en la visualización de borrelia en sangre periférica en las fiebres recurrentes. El tratamiento casi siempre es la tetraciclina en jóvenes o adultos y mujeres no embarazadas, aunque los betalactámicos (como penicilina o cefalosporinas de tercera generación para infección del sistema nervioso central) o los macrólidos están indicados en diversas situaciones. El pronóstico, con tratamiento adecuado, es bueno. En la mayoría de las regiones españolas, por la baja incidencia de la enfermedad, no está indicada la profilaxis con antimicrobianos después de una picadura de garrapata (AU)
Lyme borreliosis, caused by Borrelia burgdorferi sensu lato, is a multi-organ infection with dermatological, rheumatological, neurological, and cardiac manifestations. The main characteristic is a skin lesion, named erythemamigrans. Relapsing fever, caused by numerous species of Borrelia, is characterized by a periodic cycle of acute and afebrile episodes. The serological diagnosis of these infections has limited value in sensitivity, specificity and predictive values. Lyme borreliosis is usually diagnosed by recognition of acharacterisic clinical picture with serological confirmation, and the diagnosis of relapsing fever relies on direct observation of spirochetes in peripherical blood. The elected treatment is almost always tetracycline for the young or for adults but not for pregnant women, although betalactamic (such as penicillin or 3rd generation cephalosporin for the central nervious system) or macrolides are indicated in several situations. The prognosis, with adequate treatment, is good. In the majority of Spanish regions, due to the low incidence of these diseases, the prophylactic antimicrobial treatment after a tick bite is not indicated (AU)
