Cyclosporiasis: a point source outbreak acquired in Guatemala.

BACKGROUND: Cyclosporiasis is a disease due to Cyclospora cayetanensis, an emerging coccidian parasite first described in 1979. It is an orally transmitted disease that is more frequent in tropical and subtropical areas. Cyclospora cayetanensis has been mainly described as a cause of travelers' diarrhea. This pathogen has given rise to a number of epidemic outbreaks attributable to ingestion of imported foods, particularly from tropical areas. METHODS: Descriptive study of clinical and epidemiological data of a small epidemic outbreak of C cayetanensis-induced gastroenteritis. RESULTS: Seven confirmed cases of C cayetanensis among Spanish nationals who had traveled to Antigua Guatemala are described. The incubation period was 6 days. Diarrhea, asthenia, anorexia, borborygmi, flatulence, and abdominal distension were present in all cases. Fever and heart burn in 85.7%. Weight loss in 71.4%. Abdominal pain, rectal tenesmus, and nausea in 42.8%. Vomiting and eructation in 14.2%. Heart burn was a frequent symptom, a finding not often previously described. The infection was probably acquired from raspberry juice. All cases improved with trimethoprim/sulphametoxazol. CONCLUSIONS: Cyclosporiasis is a cause of travelers' diarrhea. Parasitology laboratories must be advised of clinical suspicion of cyclosporiasis so that they can conduct a suitable targeted study; otherwise, false negative results may arise.

Malaria: conceptos clínicos y terapéuticos / No disponible

La malaria es una enfermedad parasitaria con una amplia distribución en zonas tropicales y subtropicales, endémica en más de 100 países, producida por cuatro especies de plasmodios. Cada año se producen300-500 millones de nuevos casos, de los que 1,5-2 millones fallecen, principalmente niños de menos de 5 años de edad de África Subsahariana. También es un proceso potencialmente mortal en viajeros sin ningún grado de inmunidad. Es una enfermedad que debe ser considerada como una urgencia médica por su potencial capacidad de producir la muerte rápidamente. El diagnóstico se ha basado en la microscopía, gota gruesa y extensión sanguínea, pero en los últimos años se han introducido otros métodos diagnósticos, como la detección de anticuerpos monoclonales frente antígenos parasitarios o la detección de ADN del parásito por medio de la reacción en cadena de la polimerasa (PCR).El tratamiento se ha visto dificultado por la aparición de resistencias a los antimaláricos, lo que ha llevado a la investigación de nuevas drogas y a la combinación de los antipalúdicos, tanto con fines terapéuticos como para retrasar la aparición de dichas resistencias (AU)

Malaria is a parasitic infection widely distributed in tropical and subtropical areas. It is endemic in more than 100 countries and it may be caused by four plasmodium species. Each year an average of 300 to 500 million new cases are diagnosed, resulting in 1.5 to 2 million deaths (most of which occur in Sub-Saharan Africa in children under 5 years old). Malaria is potentially lethal in travelers as they don't have any immunity against the parasite. It must be considered an emergency because it may present as a rapid severe disease that leads to death. The diagnosis of malaria is based in microscope, thick and thin blood smears. However, different new diagnostic procedures have been recently used. So is the identification of monoclonal antibodies against parasitic antigens, and the detection of DNA of the parasite by the polymerase chain reaction (PCR).The treatment of malaria has been hampered by the development of resistance against different antimalarials. This fact has led to the investigation of new drugs and to the use of combination regimens in order to control both disease and resistance appearance (AU)