Detection of Leishmania RNA Virus 1 in Leishmania (Viannia) panamensis Isolates, Panama.

We detected Leishmania RNA virus 1 (LRV1) in 11 isolates of Leishmania (Viannia) panamensis collected during 2014-2019 from patients from different geographic areas in Panama. The distribution suggested a spread of LRV1 in L. (V.) panamensis parasites. We found no association between LRV1 and an increase in clinical pathology.

Intervenciones en infecciones del tracto urinario, neumonías, COVID-19 y bacteriemias por programas de uso optimizado de antimicrobianos (PROA): enfoque síndrome específico

Introducción: El uso de los antibióticos ha logrado curar infecciones anteriormente letales. Como profilaxis ha mejorado el pronóstico de pacientes en múltiples escenarios; sin embargo, estos fármacos tienen efectos adversos los cuales pueden ocurrir en 1 de cada 5 pacientes hospitalizados que los reciben, algunos de estos eventos son potencialmente mortales. Los programas de Antimicrobial Stewardship (ASP), conocidos en español como Programas de Uso Optimizado de Antibióticos (PROA), son intervenciones coordinadas, diseñadas para mejorar y medir el uso apropiado de antibióticos, promoviendo la selección del régimen óptimo, incluyendo dosis, duración de la terapia y su ruta de administración. Objetivo: describir el beneficio de las intervenciones síndrome específico en infecciones del tracto urinario, neumonías, bacteriemias y COVID-19, realizadas por programas de uso optimizado de antimicrobianos (PROA). Metodología: se realizó una búsqueda en PubMed y se seleccionó aquellos artículos donde se realizaron intervenciones que mostraron beneficios clínicos en infecciones del tracto urinario, neumonías, bacteriemias y COVID-19 por parte de programas de uso optimizado de antimicrobianos. Síntesis de los datos: se seleccionaron 18 estudios, de los cuales 3 mostraron intervenciones con beneficios en el tratamiento de Infecciones del tracto urinario, 9 en neumonías, 1 en COVID-19 y 5 en bacteriemias. Conclusión: Las intervenciones síndrome específicas, en Infecciones del tracto urinario (ITU), neumonías COVID-19 y bacteriemias, de los programas de uso optimizado de antibióticos (PROA) se han asociado con disminución de los costos de atención y mejores resultados clínicos. (provisto por Infomedic International)

First Case of Diffuse Leishmaniasis Associated With Leishmania panamensis.

Leishmania panamensis is the most common species of Leishmania in Panama, and it is known to cause cutaneous leishmaniasis, disseminated cutaneous leishmaniasis, and mucocutaneous leishmaniasis; however, it not associated with diffuse cutaneous disease. In this study, we report the first case of diffuse cutaneous leishmaniasis caused by L panamensis.

Zika Virus-Associated Cerebellitis with Complete Clinical Recovery.

Zika virus (ZIKV) was first detected in the Americas in Brazil in 2015, with a rapid spread to surrounding countries. In Panama, the outbreak began in November 2015 in an indigenous community located on the Caribbean side of the country. Zika virus is typically associated with a diffuse rash, fever, and conjunctivitis. It can rarely cause neurologic manifestations, most commonly microcephaly and Guillain-Barré syndrome. Encephalitis and acute encephalomyelitis are known complications, but ZIKV-associated cerebellitis has yet to be reported in the literature. Herein, we report a case of cerebellitis in a patient infected with ZIKV. This patient developed severe frontal headache and vertigo on the third day of illness, and dysarthria and ataxia on the fifth day. After 1 week of hospitalization, the patient completely recovered. The laboratory serological diagnosis was complicated because of the detection of antibodies against dengue, suggesting a secondary flavivirus infection.

Descriptive epidemiology of snakebites in the Veraguas province of Panama, 2007-2008.

Background: Panama has the highest incidence of snakebites in Central America, however, few studies have looked at the epidemiology of human snakebites in Panama. Methods: This retrospective, single-center study reviewed individuals who sustained a snakebite from 2007-2008. Demographic data, disease severity, species of snake, treatment, infectious complications and antibiotic usage were collected from the hospital records. Results: Data were collected over a 2-y period, with a total of 390 records of snakebites. Bothrops asper was responsible for 43.8% of cases and the majority of the cases occurred during the rainy season. The majority of bites (74.7%) occurred on the hands, feet or toes. Antivenom was used in 55% of patients and 67% of patients received tetanus toxoid. Only 8.7% of individuals presented to the hospital within 1 h of envenomation and more than 25% presented >6 h after envenomation. Conclusions: B. asper is responsible for the majority of snakebites in the Veraguas province of Panama. Snakebites tend to occur during the rainy season, with the majority of bites occurring on the feet. Several management factors need to improve in Panama: time to presentation, which is prolonged in the majority of cases, and antivenom, antibiotic and tetanus toxoid delivery should be standardized to optimize care.

The reintroduction of DENV-2 in 2011 in Panama and subsequent outbreak characteristic.

The circulation of the South-east Asian/American (AS/AM) dengue 2 virus (DENV-2) genotype in the Americas has been associated with a high rate of severe disease. From 1993, the year DENV was reintroduced in Panama, until 2011 there were 29 dengue-associated deaths, 17 of which occurred in 2011, the most severe outbreak with a case fatality rate (CFR) of 44% (17 deaths out of 38 severe dengue cases). During this outbreak DENV-2 was reintroduced into the country, whereas over the prior five years DENV-1 and -3 were predominant. Herein, we describe the 2011 Panama outbreak and genetically characterize the Panamanian DENV-2 strains, which were associated with severe dengue disease in Panama. Our results suggest that the DENV-2 isolates from this outbreak belonged to the AS/AM genotype sub-clade 2BI and were genetically close to viruses described in the outbreaks in Nicaragua, Honduras, Guatemala and Mexico from 2006-2011. Sub-clade 2BI has previously been associated with severe disease in Nicaragua during outbreaks from 2005-2007.

Clinical Manifestations of Punta Toro Virus Species Complex Infections, Panama, 2009.

An investigation in Panama found that Punta Toro virus species complex (PTVs) may contribute to febrile illnesses with symptoms mirroring those of dengue fever. However, further studies are needed to determine if PTV infection causes only a mild disease or if it can have more serious manifestations in some patients.