[Strokes caused by infection in the tropics]. / Ictus de causa infecciosa en el trópico.

INTRODUCTION: Almost three out of every four people in the world who suffer a fatal stroke live in developing countries. A number of different tropical diseases may appear in Europe in the coming years as a consequence of the demographic change that is being brought about by migratory flows. We review the main infectious causes of strokes in the tropics. DEVELOPMENT: There are estimated to be 500 million cases of malaria every year. Cerebral malaria can cause cerebral oedema, diffuse or focal compromise of the subcortical white matter and cortical, cerebellar and pontine infarctions. Chagas disease is an independent risk factor for stroke in South America. At least 20 million people have the chronic form of Chagas disease. The main prognostic factors for Chagas-related stroke are the presence of apical aneurysms, arrhythmia and heart failure. Vascular complications of neurocysticercosis include transient ischemic attacks, ischemic strokes due to angiitis and intracranial haemorrhages. The frequency of cerebral infarction associated with neurocysticercosis varies between 2% and 12%. Gnathostomiasis is a cause of subarachnoid haemorrhage in south-east Asia. Other less common causes of stroke are viral haemorrhagic fevers due to arenavirus and flavivirus. CONCLUSIONS: Several diseases that are endemic in the tropics can be responsible for up to 10% of the cases of strokes in adults.

Dengue haemorrhagic fever/dengue shock syndrome: an unwelcome arrival in Trinidad

This is the first report of dengue haemorrhagic fever and dengue shock syndrome in Trinidad. Dengue infection was confirmed serologically or by viral isolation in five patients, aged 15 to 33 years, who presented with fever, thrombocytopenia and haemoconcentration. Three patients developed dengue shock syndrome, which was fatal; although there was no haemorrhagic tendency among these patients, bleeding occurred shortly before death in one of them. Two patients who had dengue haemorrhagic fever survived. The co-circulation of dengue virus serotypes 1, 2 and 4 in the Caribbean facilitates the development of dengue shock syndrome (DSS) or dengue haemorrhagic fever (DHF). Clinicans should therefore be aware of their clinical features, laboratory diagnosis and clinical management. Appropriate public health interventions and improved surveillance should be implemented to reduce the risk of DHS/DSS associated mortality in Trinidad and Tobago.

Dengue haemorrhagic fever/dengue shock syndrome: an unwelcome arrival in Trinidad

This is the first report of dengue haemorrhagic fever and dengue shock syndrome in Trinidad. Dengue infection was confirmed serologically or by viral isolation in five patients, aged 15 to 33 years, who presented with fever, thrombocytopenia and haemoconcentration. Three patients developed dengue shock syndrome, which was fatal; although there was no haemorrhagic tendency among these patients, bleeding occurred shortly before death in one of them. Two patients who had dengue haemorrhagic fever survived. The co-circulation of dengue virus serotypes 1, 2 and 4 in the Caribbean facilitates the development of dengue shock syndrome (DSS) or dengue haemorrhagic fever (DHF). Clinicans should therefore be aware of their clinical features, laboratory diagnosis and clinical management. Appropriate public health interventions and improved surveillance should be implemented to reduce the risk of DHS/DSS associated mortality in Trinidad and Tobago.(AU)

Anatomía patológica de órganos de cobayo inoculados con virus Junín / Pathological anatomy of inoculated organs of guinea pig with Junin virus

El examen anatomopatológico de los órganos procedentes de cobayos inoculados con virus Junín, reveló la existencia de lesiones en casi la totalidad de los mismos, mostrando además a la enfermedad emparentada por su morfología histológica con las diversas fiebres hemorrágicas descriptas (p.ej.: Omsk, Uzbekistan, Crimea, Rift Valley, Kyasanur, nefroso-nefritis hemorrágica del sector europeo de la Unión Soviética, Corea). Se estudiaron mediante autopsia los órganos procedentes de cobayos inoculados con virus Junín por vía intramuscular y que fueron sacrificados los días 1, 3, 6, 9, 10, 11, 12, 14 y 20 posteriores al de la inoculación, a los que se suman los muertos en otras etapas de la enfermedad. La patología general del padecimiento, que consideramos síntesis de la patología de órganos y sistemas expuesta, puede agruparse en: Disturbios circulatorios; Procesos degenerativos-necróticos; Procesos proliferativos; Reacción inflamatoria mononuclear... (TRUNCADO)(AU)

Anatomía patológica de órganos de cobayo inoculados con virus Junín / Pathological anatomy of inoculated organs of guinea pig with Junin virus

El examen anatomopatológico de los órganos procedentes de cobayos inoculados con virus Junín, reveló la existencia de lesiones en casi la totalidad de los mismos, mostrando además a la enfermedad emparentada por su morfología histológica con las diversas fiebres hemorrágicas descriptas (p.ej.: Omsk, Uzbekistan, Crimea, Rift Valley, Kyasanur, nefroso-nefritis hemorrágica del sector europeo de la Unión Soviética, Corea). Se estudiaron mediante autopsia los órganos procedentes de cobayos inoculados con virus Junín por vía intramuscular y que fueron sacrificados los días 1, 3, 6, 9, 10, 11, 12, 14 y 20 posteriores al de la inoculación, a los que se suman los muertos en otras etapas de la enfermedad. La patología general del padecimiento, que consideramos síntesis de la patología de órganos y sistemas expuesta, puede agruparse en: Disturbios circulatorios; Procesos degenerativos-necróticos; Procesos proliferativos; Reacción inflamatoria mononuclear... (TRUNCADO)