RESUMEN
OBJECTIVE: To determine the diagnostic accuracy of polymerase chain reaction-based detection of sof gene compared to throat swab culture for S. pyogenes infection in patients with acute rheumatic fever and those with recurrence of rheumatic activity. METHODS: 40 patients between 3 to 18 years of age, with clinical diagnosis of acute rheumatic fever or new activity in established rheumatic heart disease were included. The amplicon of 228bp of sof gene was detected using a polymerase chain reaction-based technique and the results were compared with throat swab culture for Streptococcus pyogenes. RESULTS: 10 patients had a positive throat swab culture and 11 had sof gene detected. The sensitivity and specificity of the test was 100% and 96.7%, respectively compared to throat swab culture (P=0.001). The positive predictive value and the negative predictive value was 90.9% and 100% respectively. CONCLUSION: Polymerase chain reaction-based detection of sof gene provides an alternative to throat swab culture in diagnosing activity in Acute Rheumatic Fever or established Rheumatic heart disease.
Asunto(s)
Técnicas de Tipificación Bacteriana/métodos , Péptido Hidrolasas/genética , Fiebre Reumática/diagnóstico , Infecciones Estreptocócicas/diagnóstico , Streptococcus pyogenes , Adolescente , Niño , Preescolar , Estudios Transversales , ADN Bacteriano/análisis , ADN Bacteriano/genética , Humanos , India , Faringe/microbiología , Reacción en Cadena de la Polimerasa , Fiebre Reumática/microbiología , Sensibilidad y Especificidad , Infecciones Estreptocócicas/microbiología , Streptococcus pyogenes/genética , Streptococcus pyogenes/aislamiento & purificaciónRESUMEN
Fulminant hepatic failure (FHF) is an unusual complication of visceralleishmaniasis (VL). Here, we present a 1.5-yr-old girl with VL developing rapidly progressive fatal FHF. In absence of established guidelines, additional use of immunomodulatory therapies has been discussed in reference to available information.
Asunto(s)
Leishmaniasis Visceral/complicaciones , Fallo Hepático Agudo/etiología , Progresión de la Enfermedad , Resultado Fatal , Femenino , Encefalopatía Hepática/etiología , Humanos , Lactante , Fallo Hepático Agudo/terapiaRESUMEN
Numerous antimicrobials including pentavalent antimonials are implicated in causing prolong QT-interval and ventricular tachycardia. Torsades de pointes is rarely documented with use of sodium stibogluconate. Here is described a 12-yr-old girl with visceral leishmaniasis, who developed syncopal attacks, prolong QT-interval, polymorphic ventricular tachycardia and torsades de pointes after completing a course of Stibogluconate (20 mg/kg/day for 30 days). Prolong lidocaine infusion and cardioversion were life saving.
