Infección vesical por Schistosoma haematobium / Bladder infection due to Schistosoma haematobium

La esquistosomiasis es una de las enfermedades parasitarias más extendidas en el mundo. La infección por Schistosoma haematobium es habitual en inmigrantes procedentes de áreas endémicas. El hombre se infecta por las larvas que penetran a través de la piel al realizar actividades relacionadas con el agua contaminada. La sintomatología más frecuente que aparece es una hematuria, incluso macroscópica. No debemos olvidar la existencia de enfermedades inusuales en nuestro medio. Presentamos el caso de un varón inmigrante (Mali) con hematuria por esquistosomiasis vesical. El estudio parasitológico en orina detectó huevos de Schistosoma. Actualmente, el paciente está asintomático tras tratamiento con Praziquantel (AU)

Schistosomiasis is one of the most widespread parasitic diseases in the world. Schistosoma haematobium infection is usually found in immigrants from endemic areas. Schistosoma species is acquired by exposure to fresh water that harbours cercariae released by infected snails and penetrating the skin. Haematuria is the most common symptom. We must not forget the existence of unusual diseases in our environment. We present a case of an immigrant male (from Mali) with haematuria caused by bladder schistosomiasis. Parasitological study reported Schimosoma´s eggs. The patient is currently asymptomatic after being treated with Praziquantel (AU)

Comparison of the clinical and laboratory features of muscle infections caused by Salmonella and those caused by other pathogens.

Muscle infections caused by Salmonella constitute an uncommon complication of extraenteric salmonellosis. The aim of this study was to compare the clinical features of Salmonella muscle infections with those reported in several large series of typical, both tropical and non-tropical, pyomyositis, caused mostly by Staphylococcus aureus. A literature survey of Salmonella muscle infections was carried out by using MEDLINE files 1966 through 2000, and cross-references from the selected articles, as well as major reviews of Salmonella infections and of pyomyositis. The survey yielded 32 cases suitable for analysis. The sex distribution, duration of symptom at presentation, degree of fever, involvement of multiple muscle groups, and leukocyte counts were not significantly different between patients with muscle infections caused by Salmonella and typical pyomyositis patients. In contrast, the median age of the patients with Salmonella muscle infections, and the rate of underlying conditions, were significantly higher than those in typical pyomyositis. Psoas muscle was involved more commonly in Salmonella infections than in typical pyomyositis, and the yield of positive blood cultures and, particularly, the mortality rate, were substantially higher in Salmonella muscle infections than in typical pyomyositis. We conclude that patients with Salmonella muscle infections seem to have some different characteristics with respect to typical pyomyositis, such as older age, and higher rates of associated conditions, psoas muscle involvement, bacteremia, and mortality.

Sequential evaluation of serum urate concentrations in AIDS patients with infections of the central nervous system.

To evaluate the serum urate levels in AIDS patients with infections of the central nervous system (CNS), 46 patients who had at least two measurements of urate were included. A maximum of four measurements per patient were considered: prior to the CNS involvement (U-PRIOR), at the time of CNS involvement (U-CNS), after treatment for the CNS infection (U-AFTER), and the last measurement before death (U-LAST). Serum U-CNS levels were significantly lower than U-PRIOR values (p=0.038). U-AFTER levels were higher than U-CNS in the patients who improved (p=0.25), and lower in the patients who did not improve (p=0.026). There were no significant differences among the four diagnostic groups in U-CNS measurement (p=0.29) but they were found in U-AFTER determinations (p=0.018), probably as a result of the different response to treatment. Hypouricemia seemed to be associated with lower survival periods. We conclude that hypouricemia is common in AIDS patients with CNS infections, probably as a result of increased renal losses of urate, and that it may have prognostic significance. CNS infections are associated with significant decreases in serum urate levels in comparison with previous values. The urate concentrations seem to increase after successful treatment of the CNS infections, whereas they decrease further in patients who do not improve.

Muscle infections caused by Salmonella species: case report and review.

We describe a patient with salmonella pyomyositis and review 30 other cases reported during the past 4 decades. Men outnumbered women by 2.9 to 1, and the median age of the patients was 51 years. Approximately one-half the cases were caused by Salmonella enteritidis. Infected vascular aneurysms were observed in seven patients. Prior salmonella infections and local trauma or lesions were common. Diverse underlying conditions, mainly diabetes and human immunodeficiency virus infection, were present in 81% of the patients, and the psoas muscle was involved in 55% of the cases. One-third of the patients died, and relapses were common after a median time of 5 weeks (range, 4.5-27 weeks) in those who survived. Most patients had anemia, and pathogens were recovered from blood samples from two-thirds of the patients. Salmonella should be considered as a causative agent of muscle infections in the appropriate clinical setting, particularly in patients with underlying diseases or preexisting vascular aneurysms.