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1.
BMJ Case Rep ; 14(1)2021 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-33472801

RESUMEN

We report a case of a 42-year-old man who presented with acute epigastric and retrosternal chest pain and exertional dyspnoea, and was subsequently diagnosed with polyserositis secondary to post-Streptococcal mitis infection. A CT scan showed a large pericardial effusion requiring pericardiocentesis, small bilateral pleural effusions and small amount of ascites. Several serological tests were done, which were all found to be normal. Pericardial and pleural fluid aspirates revealed an exudate. Culture of the pleural fluid yielded growth of S.  mitis and this was deemed the cause of the polyserositis, which is rare. The patient made a spontaneous recovery. He was started on colchicine by the cardiologists to help prevent pericardial fluid recurrence and this was continued for 3 months. A dental review confirmed the presence of dental caries, the possible source of infection. On follow-up, the patient remained well with no further relapses.


Asunto(s)
Ascitis/diagnóstico por imagen , Derrame Pericárdico/diagnóstico por imagen , Derrame Pleural/diagnóstico por imagen , Serositis/diagnóstico por imagen , Infecciones Estreptocócicas/diagnóstico , Adulto , Antiinflamatorios/uso terapéutico , Ascitis/etiología , Colchicina/uso terapéutico , Humanos , Masculino , Derrame Pericárdico/etiología , Derrame Pericárdico/terapia , Pericardiocentesis , Derrame Pleural/etiología , Derrame Pleural/microbiología , Serositis/etiología , Infecciones Estreptocócicas/complicaciones , Streptococcus mitis , Tomografía Computarizada por Rayos X
2.
BMJ Case Rep ; 14(1)2021 Jan 25.
Artículo en Inglés | MEDLINE | ID: mdl-33495174

RESUMEN

Constrictive pericarditis is a relatively uncommon form of cardiac failure and presents due to scarring and consequent loss of the normal elasticity of the pericardial sac. This results in abnormal/limited ventricular filling and symptoms of heart failure. The aetiology is varied, from infective causes to idiopathic causes, or can manifest after cardiothoracic surgery. This case involves a 46-year-old man presenting with acute group A beta haemolytic streptococcus infection, and over the subsequent 6 months develops constrictive pericarditis due to what is believed to be a rheumatic aetiology. The patient subsequently underwent pericardiectomy and had restoration of normal filling dynamics confirmed on follow-up echocardiography. This case provides a subject matter for the review of the features of constrictive pericarditis and its investigation and management. This case is that it highlights the fact that pericarditis is not a benign condition. Emerging evidence suggests that pericarditis is due to a failure in inflammatory regulatory mechanisms, and patients suffering this condition have a preponderance to 'autoinflammation'. Pericarditis should be recognised early and treated fully with anti-inflammatory agents.


Asunto(s)
Bacteriemia/diagnóstico , Pericarditis Constrictiva/diagnóstico , Cardiopatía Reumática/diagnóstico , Infecciones Estreptocócicas/diagnóstico , Antibacterianos/uso terapéutico , Antiestreptolisina/inmunología , Bacteriemia/complicaciones , Bacteriemia/tratamiento farmacológico , Cultivo de Sangre , Proteína C-Reactiva/inmunología , Cateterismo Cardíaco , Ceftriaxona/uso terapéutico , Electrocardiografía , Hospitalización , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Pericardiectomía , Pericarditis Constrictiva/etiología , Pericarditis Constrictiva/fisiopatología , Pericarditis Constrictiva/cirugía , Combinación Piperacilina y Tazobactam/uso terapéutico , Cardiopatía Reumática/etiología , Cardiopatía Reumática/fisiopatología , Cardiopatía Reumática/cirugía , Infecciones Estreptocócicas/complicaciones , Infecciones Estreptocócicas/tratamiento farmacológico , Streptococcus pyogenes , Presión Ventricular
4.
BMJ Case Rep ; 13(12)2020 Dec 21.
Artículo en Inglés | MEDLINE | ID: mdl-33370943

RESUMEN

A previously independent 56-year-old immunocompetent woman presented with septic shock in the setting of periorbital swelling and diffuse infiltrates on chest imaging. Blood cultures were positive for growth of group A Streptococcus (GAS). Broad spectrum antimicrobials were initiated with the inclusion of the antitoxin agent clindamycin. Necrosis of periorbital tissue was noted and surgical consultation was obtained. Débridement of both eyelids with skin grafting was performed. GAS was isolated from wound cultures and also observed on periorbital tissue microscopy. The final diagnosis was bilateral periorbital necrotising fasciitis (PONF) associated with invasive GAS infection. The patient had a prolonged intensive care unit course with input from multiple specialist teams. This case demonstrates the importance of early recognition and treatment of PONF, the profound systemic morbidity caused by these infections, and illustrates successful multidisciplinary teamwork.


Asunto(s)
Fascitis Necrotizante/complicaciones , Choque Séptico/microbiología , Infecciones Estreptocócicas/complicaciones , Streptococcus pyogenes/aislamiento & purificación , Antibacterianos/uso terapéutico , Desbridamiento , Quimioterapia Combinada , Párpados/microbiología , Párpados/cirugía , Fascitis Necrotizante/diagnóstico , Fascitis Necrotizante/microbiología , Fascitis Necrotizante/terapia , Femenino , Humanos , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Choque Séptico/diagnóstico , Choque Séptico/terapia , Trasplante de Piel , Infecciones Estreptocócicas/diagnóstico , Infecciones Estreptocócicas/microbiología , Infecciones Estreptocócicas/terapia , Resultado del Tratamiento
5.
BMJ Case Rep ; 13(12)2020 Dec 22.
Artículo en Inglés | MEDLINE | ID: mdl-33370987

RESUMEN

Cavernous sinus thrombosis (CST) is a rare and potentially fatal complication of acute sinusitis. Timely diagnosis and management is, therefore, essential in preventing death and neurological disability. Here, we describe the case of a paediatric patient with bilateral CST secondary to acute unilateral pansinusitis that presented with rapidly progressing bilateral periorbital oedema. Initial imaging was negative. This case serves to emphasise the importance of maintaining a high index of suspicion when managing paediatric patients with suspected CST with persistent symptoms. Expeditious investigation and management of our patient in this case resulted in a positive outcome, with resolution of symptoms and no residual neurological deficit.


Asunto(s)
Trombosis del Seno Cavernoso/diagnóstico , Seno Cavernoso/microbiología , Cefalea/etiología , Sinusitis/diagnóstico , Infecciones Estreptocócicas/diagnóstico , Administración Intravenosa , Adolescente , Antibacterianos/administración & dosificación , Anticoagulantes/administración & dosificación , Seno Cavernoso/diagnóstico por imagen , Seno Cavernoso/patología , Seno Cavernoso/cirugía , Trombosis del Seno Cavernoso/líquido cefalorraquídeo , Trombosis del Seno Cavernoso/tratamiento farmacológico , Trombosis del Seno Cavernoso/etiología , Diagnóstico Diferencial , Quimioterapia Combinada/métodos , Endoscopía , Cefalea/líquido cefalorraquídeo , Cefalea/terapia , Humanos , Angiografía por Resonancia Magnética , Masculino , Sinusitis/complicaciones , Sinusitis/microbiología , Sinusitis/terapia , Infecciones Estreptocócicas/complicaciones , Infecciones Estreptocócicas/microbiología , Infecciones Estreptocócicas/terapia , Streptococcus intermedius/aislamiento & purificación , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
6.
BMC Infect Dis ; 20(1): 817, 2020 Nov 10.
Artículo en Inglés | MEDLINE | ID: mdl-33167878

RESUMEN

BACKGROUND: Gastrointestinal (GI) mucormycosis is a rare and often deadly form of mucormycosis. Delayed diagnosis can lead to an increased risk of death. Here, we report a case of GI mucormycosis following streptococcal toxic shock syndrome in a virologically suppressed HIV-infected patient. CASE PRESENTATION: A 25-year-old Thai woman with a well-controlled HIV infection and Grave's disease was admitted to a private hospital with a high-grade fever, vomiting, abdominal pain, and multiple episodes of mucous diarrhea for 3 days. On day 3 of that admission, the patient developed multiorgan failure and multiple hemorrhagic blebs were observed on all extremities. A diagnosis of streptococcal toxic shock was made before referral to Siriraj Hospital - Thailand's largest national tertiary referral center. On day 10 of her admission at our center, she developed feeding intolerance and bloody diarrhea due to bowel ischemia and perforation. Bowel resection was performed, and histopathologic analysis of the resected bowel revealed acute suppurative transmural necrosis and vascular invasion with numerous broad irregular branching non-septate hyphae, both of which are consistent with GI mucormycosis. Peritoneal fluid fungal culture grew a grayish cottony colony of large non-septate hyphae and spherical sporangia containing ovoidal sporangiospores. A complete ITS1-5.8S-ITS2 region DNA sequence analysis revealed 100% homology with Rhizopus microsporus strains in GenBank (GenBank accession numbers KU729104 and AY803934). As a result, she was treated with liposomal amphotericin B. However and in spite of receiving appropriate treatment, our patient developed recurrent massive upper GI bleeding from Dieulafoy's lesion and succumbed to her disease on day 33 of her admission. CONCLUSION: Diagnosis of gastrointestinal mucormycosis can be delayed due to a lack of well-established predisposing factors and non-specific presenting symptoms. Further studies in risk factors for abdominal mucormycosis are needed.


Asunto(s)
Tracto Gastrointestinal/microbiología , Enfermedad de Graves/complicaciones , Infecciones por VIH/complicaciones , Mucormicosis/complicaciones , Rhizopus/genética , Choque Séptico/complicaciones , Infecciones Estreptocócicas/complicaciones , Streptococcus pyogenes/aislamiento & purificación , Adulto , Anfotericina B/uso terapéutico , Antifúngicos/uso terapéutico , ADN de Hongos/genética , Resultado Fatal , Femenino , Infecciones por VIH/virología , Humanos , Mucormicosis/diagnóstico , Mucormicosis/tratamiento farmacológico , Mucormicosis/microbiología , Choque Séptico/diagnóstico , Choque Séptico/microbiología , Infecciones Estreptocócicas/diagnóstico , Infecciones Estreptocócicas/microbiología , Síndrome , Tailandia
7.
Obstet Gynecol ; 136(4): 756-764, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32925625

RESUMEN

OBJECTIVE: To compare maternal and cord blood penicillin concentrations in women with and without obesity who are receiving intrapartum group B streptococcus (GBS) prophylaxis. METHODS: We performed a prospective cohort study of term women receiving intrapartum penicillin prophylaxis for GBS colonization (determined by antenatal rectovaginal culture). The following outcomes were compared between obese (body mass index [BMI] 35 or higher at delivery) and nonobese (BMI less than 30 at delivery) groups: penicillin concentration in maternal blood (after two penicillin doses) and umbilical cord blood, GBS rectovaginal colonization status on admission and after two completed doses, and neonatal GBS colonization (using a postnatal ear swab). Fifty-five women were needed to detect a 0.75 SD difference in cord blood penicillin concentrations. RESULTS: Fifty-five women were enrolled and had all specimens collected; 49 had complete data for analysis (obese n=25, nonobese n=24). There was no difference in the median maternal penicillin concentration between groups (obese 4.2 micrograms/mL vs nonobese 4.0 micrograms/mL, P=.58). There was, however, a 60% lower median cord blood penicillin concentration in the obese compared with the nonobese group (2.7 micrograms/mL vs 6.7 micrograms/mL, respectively, P<.01), with no significant difference in time from last penicillin dose to delivery (obese 2.9 hours vs nonobese 1.7 hours, P=.07). The difference in cord blood concentrations remained significant after adjustment for nulliparity, hypertensive disorders, and time from last penicillin dose to delivery. Only 59.6% of women tested positive for GBS by rectovaginal culture on admission (obese 60.9% vs nonobese 58.3%, P=.86). CONCLUSION: The median cord blood penicillin concentration was 60% lower in neonates born to women with obesity compared with those born to women without obesity. However, all concentrations exceeded the minimum inhibitory concentration. Maternal penicillin levels were not significantly different between groups. More than 40% of women who previously tested positive for GBS by antenatal culture tested negative for GBS on admission for delivery.


Asunto(s)
Sangre Fetal/química , Tamizaje Neonatal/métodos , Obesidad , Penicilinas , Complicaciones Infecciosas del Embarazo , Infecciones Estreptocócicas , Streptococcus agalactiae/aislamiento & purificación , Adulto , Antibacterianos/sangre , Antibacterianos/uso terapéutico , Profilaxis Antibiótica/métodos , Índice de Masa Corporal , Monitoreo de Drogas/métodos , Femenino , Humanos , Recién Nacido , Masculino , Obesidad/sangre , Obesidad/complicaciones , Obesidad/diagnóstico , Evaluación de Procesos y Resultados en Atención de Salud , Penicilinas/sangre , Penicilinas/uso terapéutico , Embarazo , Complicaciones Infecciosas del Embarazo/sangre , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Recto/microbiología , Infecciones Estreptocócicas/sangre , Infecciones Estreptocócicas/complicaciones , Infecciones Estreptocócicas/tratamiento farmacológico , Vagina/microbiología
9.
J Cardiothorac Surg ; 15(1): 135, 2020 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-32522279

RESUMEN

BACKGROUND: The aim of this study was to describe the clinical features and outcome of infective endocarditis at a general hospital in China and to identify the risk factors associated with in-hospital mortality. METHODS: A retrospective study was conducted and all patients diagnosed with definite or possible infective endocarditis between January 2013 and June 2018 according to the modified Duke criteria were included. RESULTS: A total of 381 patients were included. The mean age was 46 years old and 66.9% patients were male patients. Community acquired IE was the most common type of infective endocarditis and Viridans Group Streptococci (37.5%) was still the most common causative pathogen. The microbial etiology of infective endocarditis varied with location of acquisition. 97 (25.5%) patients had culture-negative infective endocarditis. Vegetations were detected in 85% patients and mitral valve was the most common involved valve. Operations were performed in 72.7% patients and in-hospital mortality rate was 8.4%. The risk factors of in-hospital mortality were age old than 70 years old, heart failure, stroke and medical therapy. CONCLUSIONS: Older age, heart failure, stroke and medical therapy were risk factors of in-hospital mortality. Infective endocarditis, were mainly caused by Viridans Group Streptococci, characterized by younger patients and lower mortality rate in China.


Asunto(s)
Endocarditis Bacteriana/microbiología , Mortalidad Hospitalaria , Infecciones Estreptocócicas/complicaciones , Estreptococos Viridans , Adulto , Factores de Edad , Anciano , China/epidemiología , Infecciones Comunitarias Adquiridas/complicaciones , Infecciones Comunitarias Adquiridas/microbiología , Endocarditis Bacteriana/complicaciones , Endocarditis Bacteriana/mortalidad , Endocarditis Bacteriana/terapia , Femenino , Insuficiencia Cardíaca/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Accidente Cerebrovascular/complicaciones , Centros de Atención Terciaria
10.
J Vet Diagn Invest ; 32(4): 565-571, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32532177

RESUMEN

Investigations of 2 cases of high mortality in cull sows and feeder pigs from a buying station in Ohio and cull sows at an abattoir in Tennessee were conducted at the Iowa State University Veterinary Diagnostic Laboratory. The animals were presented as weak, lethargic, and some with high fever. Rapidly escalating mortality was reported to be as high as 30-50% within groups at the buying station over 8-10 d, and 30-40% over 5-7 d at the abattoir. Splenomegaly and red lymph nodes were the most consistent macroscopic findings, with scant fibrinous polyserositis observed in one sow. The microscopic lesions of vasculitis, fibrin thrombi, fibrinosuppurative polyserositis, and intralesional bacteria were consistent with acute bacterial septicemia. Bacterial culture isolated Streptococcus equi subsp. zooepidemicus (S. zooepidemicus) from multiple organs, including spleen, lung, and kidney. PCR tests were negative for African swine fever virus, classical swine fever virus, Erysipelothrix rhusiopathiae, porcine reproductive and respiratory syndrome virus, porcine circovirus 2, and Salmonella spp. Porcine circovirus 3 was inconsistently detected at low levels by PCR, with a lack of associated lesions. Next-generation sequencing identified S. zooepidemicus and porcine partetravirus in the serum sample of the feeder pig from the buying station. Phylogenetic analysis of the szP gene indicated that the S. zooepidemicus isolates from Ohio and Tennessee are in genotype VI. We conclude that the cause of these high mortality events in swine was S. zooepidemicus septicemia.


Asunto(s)
Sepsis/veterinaria , Infecciones Estreptocócicas/veterinaria , Streptococcus equi/aislamiento & purificación , Enfermedades de los Porcinos/mortalidad , Animales , Femenino , Genotipo , Ohio/epidemiología , Filogenia , Sepsis/microbiología , Sepsis/mortalidad , Infecciones Estreptocócicas/complicaciones , Infecciones Estreptocócicas/microbiología , Infecciones Estreptocócicas/mortalidad , Streptococcus equi/clasificación , Sus scrofa , Porcinos , Enfermedades de los Porcinos/microbiología , Tennessee/epidemiología
11.
Am J Trop Med Hyg ; 103(2): 672-674, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32431277

RESUMEN

We report a patient with risk factors for both microbial keratitis and endophthalmitis, which were initially challenging to distinguish. Cultures of corneal scrapings yielded several organisms, including an uncultivable Gram-negative rod, eventually identified as Kingella negevensis. Kingella negevensis is so named because most strains have been isolated in the Negev, a desert region of southern Israel. The epidemiology of K. negevensis remains incompletely understood. We found no other reports in the literature of this organism causing microbial keratitis.


Asunto(s)
Trastornos Relacionados con Cocaína/complicaciones , Cocaína/administración & dosificación , Inhibidores de Captación de Dopamina/administración & dosificación , Endoftalmitis/complicaciones , Queratitis/complicaciones , Infecciones por Neisseriaceae/complicaciones , Infecciones Estreptocócicas/complicaciones , Abuso de Sustancias por Vía Intravenosa/complicaciones , Administración Oftálmica , Adulto , Antiinflamatorios/uso terapéutico , Antioxidantes/uso terapéutico , Ácido Ascórbico/uso terapéutico , Ceftazidima/uso terapéutico , Coinfección/complicaciones , Coinfección/diagnóstico , Coinfección/tratamiento farmacológico , Doxiciclina/uso terapéutico , Endoftalmitis/diagnóstico , Endoftalmitis/tratamiento farmacológico , Endoftalmitis/microbiología , Femenino , Infecciones por Bacterias Grampositivas/complicaciones , Infecciones por Bacterias Grampositivas/diagnóstico , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Infecciones por Bacterias Grampositivas/microbiología , Humanos , Queratitis/diagnóstico , Queratitis/tratamiento farmacológico , Queratitis/microbiología , Kingella/genética , Kingella/aislamiento & purificación , Linezolid/uso terapéutico , Moxifloxacino/uso terapéutico , Infecciones por Neisseriaceae/diagnóstico , Infecciones por Neisseriaceae/tratamiento farmacológico , Infecciones por Neisseriaceae/microbiología , Soluciones Oftálmicas , Prednisona/uso terapéutico , Propionibacterium acnes/aislamiento & purificación , Infecciones Estreptocócicas/diagnóstico , Infecciones Estreptocócicas/tratamiento farmacológico , Infecciones Estreptocócicas/microbiología , Streptococcus/aislamiento & purificación , Tobramicina/uso terapéutico , Vancomicina/uso terapéutico , Voriconazol/uso terapéutico
14.
Int J Mol Sci ; 21(7)2020 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-32276523

RESUMEN

It is widely known that glomerulonephritis (GN) often develops after the curing of an infection, a typical example of which is GN in children following streptococcal infections (poststreptococcal acute glomerulonephritis; PSAGN). On the other hand, the term "infection-related glomerulonephritis (IRGN)" has recently been proposed, because infections are usually ongoing at the time of GN onset in adult patients, particularly in older patients with comorbidities. However, there has been no specific diagnostic biomarker for IRGN, and diagnosis is based on the collection of several clinical and pathological findings and the exclusion of differential diagnoses. Nephritis-associated plasmin receptor (NAPlr) was originally isolated from the cytoplasmic fraction of group A streptococcus as a candidate nephritogenic protein for PSAGN and was found to be the same molecule as streptococcal glyceraldehyde-3-phosphate dehydrogenase and plasmin receptor. NAPlr deposition and related plasmin activity were observed with a similar distribution pattern in the glomeruli of patients with PSAGN. However, glomerular NAPlr deposition and plasmin activity could be observed not only in patients with PSAGN but also in patients with other glomerular diseases, in whom a preceding streptococcal infection was suggested. Furthermore, such glomerular staining patterns have been demonstrated in patients with IRGN induced by bacteria other than streptococci. This review discusses the recent advances in our understanding of the pathogenesis of bacterial IRGN, which is characterized by NAPlr and plasmin as key biomarkers.


Asunto(s)
Fibrinolisina/análisis , Glomerulonefritis/diagnóstico , Receptores de Péptidos/análisis , Infecciones Estreptocócicas/complicaciones , Infecciones Bacterianas/complicaciones , Biomarcadores/análisis , Glomerulonefritis/etiología , Humanos , Glomérulos Renales/metabolismo
15.
BMJ Case Rep ; 13(3)2020 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-32161079

RESUMEN

Brain abscesses represent areas of localised infection of the brain parenchyma. Those confined to the brainstem are rare and usually fatal if untreated. Streptococcus intermedius is a common causative organism of brain abscesses and is associated with significant morbidity. We describe a case report of medullary abscess secondary to dental infection in a 68-year-old patient. The patient presented with headaches and flu-like symptoms progressing to left hemiparesis and reduced consciousness/bulbar function. The patient underwent emergency posterior fossa craniectomy and drainage with subsequent medical management with antibiotics. Prompt diagnosis, early surgical intervention and maximal therapy with antibiotics alongside extensive rehabilitation are all vital to ensure good neurological outcome. It is imperative for medical practitioners to consider the diagnosis of brain abscess in patients presenting with rapid onset neurological deterioration. Such cases require early neurological imaging with involvement of tertiary neurosurgery services.


Asunto(s)
Absceso Encefálico/diagnóstico , Infecciones Estreptocócicas/complicaciones , Anciano , Antibacterianos/uso terapéutico , Absceso Encefálico/etiología , Absceso Encefálico/patología , Absceso Encefálico/terapia , Craneotomía/métodos , Drenaje , Humanos , Imagen por Resonancia Magnética , Masculino , Bulbo Raquídeo/patología , Streptococcus intermedius/aislamiento & purificación , Tomografía Computarizada por Rayos X
16.
Proc Natl Acad Sci U S A ; 117(12): 6708-6716, 2020 03 24.
Artículo en Inglés | MEDLINE | ID: mdl-32161123

RESUMEN

Antibodies against neuronal receptors and synaptic proteins are associated with a group of ill-defined central nervous system (CNS) autoimmune diseases termed autoimmune encephalitides (AE), which are characterized by abrupt onset of seizures and/or movement and psychiatric symptoms. Basal ganglia encephalitis (BGE), representing a subset of AE syndromes, is triggered in children by repeated group A Streptococcus (GAS) infections that lead to neuropsychiatric symptoms. We have previously shown that multiple GAS infections of mice induce migration of Th17 lymphocytes from the nose into the brain, causing blood-brain barrier (BBB) breakdown, extravasation of autoantibodies into the CNS, and loss of excitatory synapses within the olfactory bulb (OB). Whether these pathologies induce functional olfactory deficits, and the mechanistic role of Th17 lymphocytes, is unknown. Here, we demonstrate that, whereas loss of excitatory synapses in the OB is transient after multiple GAS infections, functional deficits in odor processing persist. Moreover, mice lacking Th17 lymphocytes have reduced BBB leakage, microglial activation, and antibody infiltration into the CNS, and have their olfactory function partially restored. Th17 lymphocytes are therefore critical for selective CNS entry of autoantibodies, microglial activation, and neural circuit impairment during postinfectious BGE.


Asunto(s)
Encéfalo/patología , Modelos Animales de Enfermedad , Encefalitis/etiología , Encefalomielitis Autoinmune Experimental/etiología , Enfermedad de Hashimoto/etiología , Trastornos del Olfato/etiología , Infecciones Estreptocócicas/complicaciones , Células Th17/inmunología , Animales , Autoanticuerpos/inmunología , Ganglios Basales/inmunología , Ganglios Basales/patología , Barrera Hematoencefálica , Encéfalo/inmunología , Encefalitis/metabolismo , Encefalitis/patología , Encefalomielitis Autoinmune Experimental/metabolismo , Encefalomielitis Autoinmune Experimental/patología , Femenino , Enfermedad de Hashimoto/metabolismo , Enfermedad de Hashimoto/patología , Ratones , Microglía/inmunología , Microglía/patología , Neuronas/inmunología , Neuronas/patología , Trastornos del Olfato/metabolismo , Trastornos del Olfato/patología , Percepción Olfatoria , Streptococcus pyogenes/fisiología , Linfocitos T Reguladores/inmunología , Linfocitos T Reguladores/patología , Células Th17/patología
18.
Pediatr. aten. prim ; 22(85): 59-62, ene.-mar. 2020. ilus
Artículo en Español | IBECS | ID: ibc-193446

RESUMEN

El síndrome de shock tóxico estreptocócico (SSTS) es un cuadro grave e infrecuente en Pediatría. Sin embargo, en las últimas décadas está aumentando la incidencia de infecciones invasivas por Streptococcus pyogenes o estreptococo del grupo A. Aparece más frecuentemente en niños preescolares, ya que el diagnóstico de enfermedad estreptocócica es más complicado a esta edad. Es fundamental el diagnóstico y tratamiento precoz debido a su potencial gravedad, precisando en algunas ocasiones medidas intensivas de soporte vital y prevención del fallo multiorgánico


Streptococcal toxic shock syndrome (STSS) is a serious and uncommon disease in Pediatrics. However, in the last decades the incidence of invasive infections by Streptococcus pyogenes of group A streptococcus has increased. It appears more frequently in preschool children since the diagnosis of streptococcal disease is more complicated at this age. Early diagnosis and treatment are essential due to its potential severity, sometimes requiring intensive life support measures and prevention of multiorgan failure


Asunto(s)
Humanos , Masculino , Preescolar , Choque Séptico/diagnóstico , Infecciones Estreptocócicas/diagnóstico , Streptococcus pyogenes/aislamiento & purificación , Infecciones Estreptocócicas/complicaciones , Tratamiento de Urgencia/métodos , Fiebre/etiología , Fluidoterapia/métodos , Proteínas de Fase Aguda/análisis , Antiestreptolisina/sangre
19.
BMJ Case Rep ; 13(2)2020 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-32071125

RESUMEN

A 9-year-old girl presented to hospital with a 6-week history of non-specific constitutional symptoms and weight loss. She initially underwent extensive medical investigation without diagnosis being achieved. Although raised inflammatory markers and impaired renal function were noted during her initial admission to hospital, it was her subsequent presentation 2 weeks later with sudden-onset bilateral anterior uveitis that prompted a renal biopsy that indicated acute tubulointerstitial nephritis. A diagnosis of tubulointerstitial nephritis and uveitis (TINU) syndrome was made and systemic glucocorticoid treatment initiated to prevent visual loss and preserve renal function. She has subsequently been reviewed in multidisciplinary outpatient clinics and treated with a tapering regimen of immunosuppressive therapy. Her treatment has been complicated by the side effects of glucocorticoids and by persistent relapses in ocular disease and abnormalities on urinalysis. Recent clinical investigations indicate that her uveitis is controlled and that renal function remains well preserved.


Asunto(s)
Metilprednisolona/uso terapéutico , Nefritis Intersticial/tratamiento farmacológico , Nefritis Intersticial/microbiología , Infecciones Estreptocócicas/complicaciones , Uveítis/tratamiento farmacológico , Uveítis/microbiología , Niño , Femenino , Glucocorticoides/uso terapéutico , Humanos
20.
Diagn Microbiol Infect Dis ; 97(1): 115005, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32081521

RESUMEN

Streptococcus agalactiae is an important pathogen that causes infections in neonates and adults; infections especially in nonpregnant adults are increasing worldwide. Of 1736 S. agalactiae isolates from individuals throughout Thailand, serotypes III (46.4%) and V (21%) were demonstrated to be the most common serotypes. Human cases (56.5% female and 43.5% male) could be found all year round, with the peak occurring more frequently during the rainy season (May-October). The mortality rate of S. agalactiae infections was 11.6%, and serotype III was the most common serotype involved. Serotype III was strongly significantly (P value <0.001) correlated with meningitis (odds ratio [OR] = 26.72), sepsis (OR = 5.56), and septic arthritis (OR = 22.79). Serotype V was more associated with urinary tract infection than other serotypes. (P value = 0.005; OR = 2.32).


Asunto(s)
Serogrupo , Infecciones Estreptocócicas/complicaciones , Infecciones Estreptocócicas/epidemiología , Adolescente , Adulto , Anciano , Artritis Infecciosa/epidemiología , Artritis Infecciosa/microbiología , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Meningitis/epidemiología , Meningitis/microbiología , Persona de Mediana Edad , Estudios Prospectivos , Estaciones del Año , Sepsis/epidemiología , Sepsis/microbiología , Infecciones Estreptocócicas/mortalidad , Streptococcus agalactiae , Centros de Atención Terciaria/estadística & datos numéricos , Tailandia/epidemiología , Infecciones Urinarias/epidemiología , Infecciones Urinarias/microbiología , Adulto Joven
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