A screening of the MMV Pathogen Box® reveals new potential antifungal drugs against the etiologic agents of chromoblastomycosis.

Chromoblastomycosis (CBM) is a chronic subcutaneous mycosis caused by traumatic implantation of many species of black fungi. Due to the refractoriness of some cases and common recurrence of CBM, a more effective and less time-consuming treatment is mandatory. The aim of this study was to identify compounds with in vitro antifungal activity in the Pathogen Box® compound collection against different CBM agents. Synergism of these compounds with drugs currently used to treat CBM was also assessed. An initial screening of the drugs present in this collection at 1 µM was performed with a Fonsecaea pedrosoi clinical strain according to the EUCAST protocol. The compounds with activity against this fungus were also tested against other seven etiologic agents of CBM (Cladophialophora carrionii, Phialophora verrucosa, Exophiala jeanselmei, Exophiala dermatitidis, Fonsecaea monophora, Fonsecaea nubica, and Rhinocladiella similis) at concentrations ranging from 0.039 to 10 µM. The analysis of potential synergism of these compounds with itraconazole and terbinafine was performed by the checkerboard method. Eight compounds inhibited more than 60% of the F. pedrosoi growth: difenoconazole, bitertanol, iodoquinol, azoxystrobin, MMV688179, MMV021013, trifloxystrobin, and auranofin. Iodoquinol produced the lowest MIC values (1.25-2.5 µM) and MMV688179 showed MICs that were higher than all compounds tested (5 - >10 µM). When auranofin and itraconazole were tested in combination, a synergistic interaction (FICI = 0.37) was observed against the C. carrionii isolate. Toxicity analysis revealed that MMV021013 showed high selectivity indices (SI ≥ 10) against the fungi tested. In summary, auranofin, iodoquinol, and MMV021013 were identified as promising compounds to be tested in CBM models of infection.

Differentiating amoebic ulcero-haemorrhagic recto-colitis from idiopathic inflammatory bowel disease: still a diagnostic dilemma.

The colon responds monomorphically to a variety of insults thus making it difficult to differentiate invasive amoebic colitis and inflammatory bowel disease (IBD). The authors present a case with chronic dysentery, haematochezia, anaemia and hypoproteinaemia. The endoscopic findings were suggestive of IBD. The stool examination was negative for trophozoites or cysts of parasites. The recto-colonic biopsy specimens showed mucosal inflammation with exudates containing amoebic trophozoites. The patient was successfully treated with metronidazole and iodoquinol. He recovered within two weeks and repeat colonoscopy four weeks after the treatment showed a normal rectum and colon. Clinicians should have a high level of suspicion for amoebic colitis in cases of colitis especially in regions where amoebiasis is still present. Efforts should be made to find the amoebic trophozoites in multiple stool and colonic biopsy specimens.

Differentiating amoebic ulcero-haemorrhagic recto-colitis from idiopathic inflammatory bowel disease: still a diagnostic dilemma / Diferenciar la Rectocolitis Úlcero-hemorrágica Amebiana de la Enfermedad Inflamatoria Idiopática del Intestino: un Dilema Diagnóstico sin Resolver

The colon responds monomorphically to a variety of insults thus making it difficult to differentiate invasive amoebic colitis and inflammatory bowel disease (IBD). The authors present a case with chronic dysentery, haematochezia, anaemia and hypoproteinaemia. The endoscopic findings were suggestive of IBD. The stool examination was negative for trophozoites or cysts of parasites. The recto-colonic biopsy specimens showed mucosal inflammation with exudates containing amoebic trophozoites. The patient was successfully treated with metronidazole and iodoquinol. He recovered within two weeks and repeat colonoscopy four weeks after the treatment showed a normal rectum and colon. Clinicians should have a high level of suspicion for amoebic colitis in cases of colitis especially in regions where amoebiasis is still present. Efforts should be made to find the amoebic trophozoites in multiple stool and colonic biopsy specimens

El colon responde de manera monomórfica a una variedad de insultos, lo cual hace difícil distinguir entre la colitis amebiana invasiva y la enfermedad intestinal inflamatoria (EII). Los autores presentan un caso con disentería crónica, hematoquexia, anemia e hipoproteinemia. Los resultados endoscópicos apuntaban a una EII. El análisis de las heces fecales arrojó resultados negativos en cuanto a presencia de trofozoitos o quistes de parásitos. Esto condujo a un diagnóstico erróneo y el paciente fue tratado por una EII. Sin embargo, los especímenes de la biopsia rectocolónica mostraron una inflamación mucosal con exudados en los que se hallaban presentes trofozoitos amebianos. El paciente tuvo un tratamiento exitoso con metronidazol y iodoquinol. Se recuperó en dos semanas, y se le repitió la colonoscopia cuatro semanas después de que el tratamiento mostró un recto y colon normales. Los clínicos debían mostrar un alto nivel de sospecha ante la colitis amebiana, especialmente en aquellas regiones donde la amebiasis todavía está presente. Deben hacerse esfuerzos por encontrar trofozoitos amebianos en múltiples especímenes de heces fecales y biopsia colónica.

Blastocystis hominis: un parásito frecuente en Chile / Blastocystis hominis: a frequent parasite in Chile

Se seleccionaron trabajos nacionales y extranjeros publicados para responder varias preguntas acerca de B. hominis. Se consideraron variables como edad, sexo, diagnóstico y tratamiento. Estos trabajos apoyan el rol patógeno de B. hominis. Sus manifestaciones más frecuentes son diarrea, dolor abdominal y, con menor frecuencia, meteorismo, anorexia náuseas y vómitos. Como convención entre laboratorios, se considera positivo un examen con visualización de al menos cinco parásitos por campo (40x). Metronidazol es el fármaco más efectivo para erradicar B. hominis. En los estudios revisados se reportó altas prevalencias nacionales con cifras entre 21,3 y 63,2 por ciento. Clínicos y científicos sugieren mayores estudios y vigilancia epidemiológica

Application of the bivariate spectrophotometric method for the determination of metronidazole, furazolidone and di-iodohydroxyquinoline in pharmaceutical formulations.

The bivariate calibration algorithm was applied to the spectrophotometric determination of metronidazole, furazolidone and di-iodohydroxyquinoline in pharmaceutical dosage forms. The results obtained were compared with the results of derivative spectrophotometry. The statistical evaluation of method bias was carried out, and it was shown that the proposed procedure may be competitive with commonly used first-derivative spectrophotometry. The advantage of the bivariate calibration is its simplicity, and the fact that there is no need to use the derivatization procedures.

Severe vaginal infection with Entamoeba histolytica in a woman who recently returned from Mexico: case report and review.

Genital amebiasis is a rare complication of infection with Entamoeba histolytica, even in areas where the pathogen is endemic. We describe a patient who apparently contracted intestinal amebiasis on a trip to Mexico and who presented with ulcerative vulvovaginitis 2 months later. Her condition rapidly progressed to severe necrotizing vulvovaginitis that required a radical vulvectomy. Histopathologic examination of the surgical specimen revealed the presence of E. histolytica trophozoites. The patient recovered after surgery and antiamebic therapy. We review the epidemiology and pathogenesis of genital amebiasis as well as therapy for this rare infection.

Utilización empírica de diyodohidroxiquinoleína y dimeticona para el tratamiento de la colitis amebiana en escolares / Empirical use of diiodohydroxyquinolein and dimeticone in treating amoebic colitis in school children

Se estudió la evolución de 60 pacientes escolares con diagnóstico clínico de colitis amebiana, habitantes de una zona rural llamada Xico. La muestra se dividió en dos grupos, 30 del sexo femenino y 30 del masculino con edades entre seis y 12 años. Se administró una combinación de diyodohidroxiquinoleína y dimeticona a dosis de 30 mg por kg por día por vía oral en forma de suspensión. A los 4.5 días promedio hubo notable mejoría en 93.7 por ciento de los pacientes, por lo que concluye que esta combinación es una alternativa empírica eficaz para el tratamiento de la colitis amebiana.

Tratamiento simplificado de la amebiasis intestinal con diyodohidroxiquinoleína en niños / A simplified treatment of intestinal amebiasis in children with diiodohydroxyquinolein

Se trataron con diyodohidroxiquinoleina 53 niños de ambos sexos, en edad comprendida entre cinco y 17 años, atendidos en la consulta externa del servicio de parasitología del Instituto Nacional de Pediatía, en los cuales se diagnosticó amebiasis intestinal no invasiva en fase clínica y por exámenes de laboratorio (CPS) Faust). El fármaco se administró a razón de 30 mg/kg/dpia 10 días. Hubo curación en el 98.1% sólo dos pacientes refirieron efectos advrsos atribuidos al medicamento, uno presentó diarrea y otro náusea. Los resultados obtenidos permiten recomendar el uso de diyodohidroxiquinoleína en el tratamiento de la amebiasis intestinal no invasiva en niños con un esquema más corto que el convencional, que disminuye la presentación de efectos adversos y abatimiento del costo

[Reliability of the PEHPS culture medium for the in vitro evaluation of antiamebic drugs]. / Confiabilidad del medio de cultivo pehps para la evaluación in vitro de drogas antiamibianas.

Monophasic liquid media for axenical cultivation of Entamoeba histolytica, have permitted to define diverse aspects of this parasite's biology, without associated organisms interference. In addition, these media have allowed the in vitro evaluation of new drugs with potential antiamebic properties. PEHPS, a new medium recently developed in our laboratory, was used in order to determine its usefulness in the searching for new antiamebic compounds. The antiamebic potency of currently employed drugs in clinical therapy: emetine, metronidazole and diiodohydroxyquinoline on E. histolytica, strain HM-1, trophozoites grown in PEHPS was tested. The IC50 for each drug was 0.082 microgram/ml, 0.10 micrograms/ml and 5.84 micrograms/ml respectively. Results obtained with each drug are statistically reliable and reproducible, and agree with the species sensibility reported by several other authors. Accordingly, we propose PEHPS as a useful medium for new antiamebic drug research.

Balantidiasis humana en la isla de Chiloé, Chile / Human balantidiasis in the Chiloé Island, Southern Chile

Se comunica la experiencia lograda en balantidiasis humana con el hallazgo de 44 casos en el Hospital de Achao, Chiloé, durante el período de 1979-1986, mediante examen coproparasitológico seriado. Todas las personas infectadas provenían de localidades rurales, tenían contacto con cerdos y vivían en condiciones deplorables de saneamiento básico. 41 de los casos (93,2%) correspondieron a niños, siendo los preescolares el grupo más afectado (50%), al igual que el sexo masculino (61,4%). En el 97,7% de los casos había también otros parásitos en las deposiciones, principalmente Ascaris sp (86,4%), Trichuris sp (84,1%) y G. lamblia (22,3%). 14 casos fueron hospitalizados y en éllos se realizó estudio clínico. La gran mayoría de éstos casos (92,9%) correspondió a pacientes asintomáticos o con síntomas inespecíficos y hubo uno sólo con diarrea disentérica, incluyendo los 30 pacientes ambulatorios. Se obtuvo buena respuesta al tratamiento con diyodohidroxiquinoleína en niños y con tetraciclina en adultos. Dada la frecuencia con que se observa ésta infección en la zona, se propone adiestrar a los equipos de salud rural para educar a la población respecto a mejorar las condiciones de saneamiento básico y el adecuado manejo de la crianza de cerdos

[Radiographic identification of duodenal ulcer by ingestion of iodine tablets (radiological clinical case)]. / Identificación radiográfica de la úlcera duodenal después de la ingestión de comprimidos iodados (caso clínico radiológico).

Radiological diagnosis of peptic ulcer disease is currently made with a barium meal examination occassionaly is possible to demonstrate an ulcer by air contrast in a plain film of the abdomen or by the retention of a cholecistographic agent in the crater. In the present case, the ulcer was opacified by the ingestion of an antiamoebic yodinated drug. The value and possible mecanisms of its findings are discussed.