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2.
J Med Virol ; 2020 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-32558962

RESUMEN

Coronavirus Disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has rapidly spread throughout Latin America, a region swept by multiple previous and ongoing epidemics. There are significant concerns that the arrival of COVID-19 is currently overlapping with other viruses, particularly dengue, in various endo-epidemic regions across South America. In this report, we analyzed trends for both viral infections in Colombia during the first 20 epidemiological weeks of 2020. From January 1st to May 16th, 2020 (epidemiological weeks, EW, 1-20), a total of 52,679 cases of dengue and 14,943 cases of COVID-19 have been confirmed in Colombia. As both conditions may potentially lead to fatal outcomes, especially in patients with chronic co-morbidities, overlapping infections and co-occurrence may increase the number of patients requiring intensive care and mechanical ventilation. In regions such as Valle del Cauca, intensified preparation for such scenarios should be pondered, and further studies should be performed to address this critical issue in a timely matter. This article is protected by copyright. All rights reserved.

5.
Travel Med Infect Dis ; 34: 101623, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32179124

RESUMEN

INTRODUCTION: An epidemic of Coronavirus Disease 2019 (COVID-19) began in December 2019 in China leading to a Public Health Emergency of International Concern (PHEIC). Clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews on COVID-19 have been published to date. METHODS: We performed a systematic literature review with meta-analysis, using three databases to assess clinical, laboratory, imaging features, and outcomes of COVID-19 confirmed cases. Observational studies and also case reports, were included, and analyzed separately. We performed a random-effects model meta-analysis to calculate pooled prevalences and 95% confidence intervals (95%CI). RESULTS: 660 articles were retrieved for the time frame (1/1/2020-2/23/2020). After screening, 27 articles were selected for full-text assessment, 19 being finally included for qualitative and quantitative analyses. Additionally, 39 case report articles were included and analyzed separately. For 656 patients, fever (88.7%, 95%CI 84.5-92.9%), cough (57.6%, 95%CI 40.8-74.4%) and dyspnea (45.6%, 95%CI 10.9-80.4%) were the most prevalent manifestations. Among the patients, 20.3% (95%CI 10.0-30.6%) required intensive care unit (ICU), 32.8% presented with acute respiratory distress syndrome (ARDS) (95%CI 13.7-51.8), 6.2% (95%CI 3.1-9.3) with shock. Some 13.9% (95%CI 6.2-21.5%) of hospitalized patients had fatal outcomes (case fatality rate, CFR). CONCLUSION: COVID-19 brings a huge burden to healthcare facilities, especially in patients with comorbidities. ICU was required for approximately 20% of polymorbid, COVID-19 infected patients and hospitalization was associated with a CFR of >13%. As this virus spreads globally, countries need to urgently prepare human resources, infrastructure and facilities to treat severe COVID-19.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Betacoronavirus , Infecciones por Coronavirus/patología , Tos/virología , Fiebre/virología , Hospitalización , Humanos , Unidades de Cuidados Intensivos , Pandemias , Neumonía Viral/patología , Síndrome de Dificultad Respiratoria del Adulto/virología
7.
Travel Med Infect Dis ; : 101565, 2020 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-32004732

RESUMEN

Over the past two decades, several countries in Latin American, particularly Brazil, Venezuela, and Colombia, have experienced multiple outbreaks of oral Chagas disease. Transmission occurs secondary to contamination of food or beverages by triatomine (kissing bug) feces containing infective Trypanosoma cruzi metacyclic trypomastigotes. Orally transmitted infections are acute and potentially fatal. Oral Chagas transmission carries important clinical implications from management to public health policies compared to vector-borne transmission. This review aims to discuss the contemporary situation of orally acquired Chagas disease, and its eco-epidemiology, pathogenesis, and clinical management. We also propose preventive public health interventions to reduce the burden of disease and provide important perspectives for travel medicine. Travel health advisors need to counsel intending travellers to South America on avoidance of "deadly feasts" - risky beverages such as fruit juices including guava juice, bacaba, babaçu and palm wine (vino de palma), açai pulp, sugar cane juice and foodstuffs such as wild animal meats that may be contaminated with T. cruzi.

8.
Artículo en Inglés | MEDLINE | ID: mdl-31639115

RESUMEN

OBJECTIVE: The objective of this systematic review is to explore and discuss the latency duration among asymptomatic people with chronic Chagas disease. INTRODUCTION: Studies estimate the latency period of Chagas disease to be approximately 10-30 years. However, new findings may indicate that this latency period is shorter and depends on the presence of clinical factors. This systematic review protocol will explore the duration and factors affecting this latency period to inform treatment, with the potential of improving outcomes. INCLUSION CRITERIA: Eligible studies will include asymptomatic people with chronic Chagas disease or indeterminate Chagas disease confirmed through positive serologic testing and the absence of structural cardiomyopathy with no heart failure symptoms and normal electrocardiography results. Studies that involve a longitudinal observation period of participants will be considered. This period must start from the acute acquisition of the infection or an already established indeterminate form of the disease until the development of a primary or secondary cardiac outcome. METHODS: The following electronic databases will be searched: MEDLINE, Embase, Cochrane Library, Web of Science Core Collection and LILACS. The search will include the following concepts: Chagas disease, latency duration and determinants of the Chagas latency period. The languages will be restricted to English, Spanish and Portuguese. Two reviewers will review the selected studies for methodological quality using critical appraisal tools and conduct data extraction. Studies will, where possible, be pooled in a statistical meta-analysis. All data will be presented and synthesized through tables, summaries, figures and charts. Relevant quantitative data will be pooled with statistical meta-analysis. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42019118019.

10.
JBI Database System Rev Implement Rep ; 17(10): 2122-2128, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31335560

RESUMEN

OBJECTIVE: The objective of this systematic review is to explore and discuss the latency duration among asymptomatic people with chronic Chagas disease. INTRODUCTION: Studies estimate the latency period of Chagas disease to be approximately 10-30 years. However, new findings may indicate that this latency period is shorter and depends on the presence of clinical factors. This systematic review protocol will explore the duration and factors affecting this latency period to inform treatment, with the potential of improving outcomes. INCLUSION CRITERIA: Eligible studies will include asymptomatic people with indeterminate Chagas disease confirmed through positive serologic testing and the absence of structural cardiomyopathy with no heart failure symptoms and normal electrocardiography results. Studies that involve a longitudinal observation period of participants will be considered. This period must start from the acute acquisition of the infection or an already established indeterminate form of the disease until the development of a primary or secondary cardiac outcome. METHODS: The following electronic databases will be searched: MEDLINE, Embase, Cochrane Library, Web of Science Core Collection and LILACS. The search will include the following concepts: Chagas disease, latency duration and determinants of the Chagas latency period. The languages will be restricted to English, Spanish and Portuguese. Two reviewers will review the selected studies for methodological quality using critical appraisal tools and conduct data extraction. Studies will, where possible, be pooled in a statistical meta-analysis. All data will be presented and synthesized through tables, summaries, figures and charts. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42019118019.

11.
Int J Infect Dis ; 85: 54-56, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31129423

RESUMEN

This case report describes the clinical findings of a 22-year-old pregnant woman with confirmed Zika virus infection, at 16 weeks of gestation, in Sucre, Colombia. Her ultrasound revealed severe oligohydramnios, intrauterine growth restriction, and a complete absence of the urinary bladder of the fetus. The poor prognosis led to the decision to terminate the pregnancy. Autopsy of the fetus revealed severe bilateral renal hypoplasia.


Asunto(s)
Retardo del Crecimiento Fetal/virología , Riñón/anomalías , Complicaciones Infecciosas del Embarazo/virología , Vejiga Urinaria/anomalías , Infección por el Virus Zika/virología , Adulto , Colombia , Femenino , Retardo del Crecimiento Fetal/diagnóstico , Humanos , Riñón/virología , Embarazo , Vejiga Urinaria/virología , Adulto Joven , Virus Zika/fisiología
14.
Emerg Infect Dis ; 25(2): 379-380, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30666955

RESUMEN

Pin-site myiasis is an underreported complication of surgical interventions. We present a case of myiasis caused by the New World screwworm fly (Cochliomyia hominivorax) in a pin site of a chronic nonhealed wound 12 years after the intervention. This infection apparently was the result of poor perfusion of the leg.


Asunto(s)
Dípteros , Miasis/diagnóstico , Miasis/etiología , Infección de Heridas , Anciano , Animales , Antiinfecciosos/uso terapéutico , Coinfección , Colombia , Humanos , Larva , Masculino , Miasis/tratamiento farmacológico , Resultado del Tratamiento
16.
Clin Microbiol Rev ; 32(1)2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-30429139

RESUMEN

Humans encounter mycobacterial species due to their ubiquity in different environmental niches. In many individuals, pathogenic mycobacterial species may breach our first-line barrier defenses of the innate immune system and modulate the activation of phagocytes to cause disease of the respiratory tract or the skin and soft tissues, sometimes resulting in disseminated infection. Cutaneous mycobacterial infections may cause a wide range of clinical manifestations, which are divided into four main disease categories: (i) cutaneous manifestations of Mycobacterium tuberculosis infection, (ii) Buruli ulcer caused by Mycobacterium ulcerans and other related slowly growing mycobacteria, (iii) leprosy caused by Mycobacterium leprae and Mycobacterium lepromatosis, and (iv) cutaneous infections caused by rapidly growing mycobacteria. Clinically, cutaneous mycobacterial infections present with widely different clinical presentations, including cellulitis, nonhealing ulcers, subacute or chronic nodular lesions, abscesses, superficial lymphadenitis, verrucous lesions, and other types of findings. Mycobacterial infections of the skin and subcutaneous tissue are associated with important stigma, deformity, and disability. Geography-based environmental exposures influence the epidemiology of cutaneous mycobacterial infections. Cutaneous tuberculosis exhibits different clinical phenotypes acquired through different routes, including via extrinsic inoculation of the tuberculous bacilli and dissemination to the skin from other sites, or represents hypersensitivity reactions to M. tuberculosis infection. In many settings, leprosy remains an important cause of neurological impairment, deformity, limb loss, and stigma. Mycobacterium lepromatosis, a mycobacterial species related to M. leprae, is linked to diffuse lepromatous leprosy of Lucio and Latapí. Mycobacterium ulcerans produces a mycolactone toxin that leads to subcutaneous tissue destruction and immunosuppression, resulting in deep ulcerations that often produce substantial disfigurement and disability. Mycobacterium marinum, a close relative of M. ulcerans, is an important cause of cutaneous sporotrichoid nodular lymphangitic lesions. Among patients with advanced immunosuppression, Mycobacterium kansasii, the Mycobacterium avium-intracellulare complex, and Mycobacterium haemophilum may cause cutaneous or disseminated disease. Rapidly growing mycobacteria, including the Mycobacterium abscessus group, Mycobacterium chelonei, and Mycobacterium fortuitum, are increasingly recognized pathogens in cutaneous infections associated particularly with plastic surgery and cosmetic procedures. Skin biopsies of cutaneous lesions to identify acid-fast staining bacilli and cultures represent the cornerstone of diagnosis. Additionally, histopathological evaluation of skin biopsy specimens may be useful in identifying leprosy, Buruli ulcer, and cutaneous tuberculosis. Molecular assays are useful in some cases. The treatment for cutaneous mycobacterial infections depends on the specific pathogen and therefore requires a careful consideration of antimicrobial choices based on official treatment guidelines.


Asunto(s)
Dermatitis/diagnóstico , Dermatitis/microbiología , Infecciones por Mycobacterium/diagnóstico , Infecciones por Mycobacterium/microbiología , Mycobacterium , Animales , Humanos , Mycobacterium/clasificación , Mycobacterium/fisiología
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