Enterocytozoon bieneusi Infection after Hematopoietic Stem Cell Transplant in Child, Argentina.

We report a case of Enterocytozoon bieneusi infection in a pediatric hematopoietic stem cell transplant recipient in Argentina. Spores were visualized in feces using Calcofluor White and modified trichrome stainings. PCR and sequencing identified E. bieneusi genotype D in fecal samples and liver samples, confirming extraintestinal dissemination of the parasite.

Microscopio and PCR-based detection of microsporidia spores in human stool samples

Abstract Microsporidia are obligate intracellular fungi with a remarkable ability to infect a wide range of invertebrate and vertebrate hosts. Namely, Enterocytozoon bieneusi is the most frequently microsporidia reported worldwide, and mainly associated with chronic diarrea and wasting syndrome in AIDS patients. Microscopy and PCR-based detection techniques are effective for diagnosis and identification of species and genotypes; however, these methods should be standardized in each laboratory. In this study, we performed microscopy and nested PCR techniques with PCR product sequencing to detect E. bieneusi in human stool samples. These techniques, if applied together, might prove useful for diagnosis and future epidemiological studies of intestinal microsporidiosis in Argentina.

Resumen Los microsporidios son hongos intracelulares obligados con una notable capacidad para infectar una amplia gama de hospedadores invertebrados y vertebrados. Enterocytozoon bieneusi es el microsporidio más frecuentemente reportado en todo el mundo, principalmente tricrómicaasociado con diarrea crónica y síndrome debilitante en pacientes con sida. Las técnicas dedetección basadas en microscopía y PCR son útiles para el diagnóstico y la identificación deespecies y genotipos, pero estos métodos deben estar estandarizados en cada laboratorio.En este estudio evaluamos técnicas de microscopía y PCR anidada, con secuenciación de losproductos, para detectar E. bieneusi en muestras de heces humanas. Estas técnicas, usadas con-juntamente, podrían ser útiles para su aplicación en el diagnóstico de microsporidiosis intestinaly para realizar estudios epidemiológicos de esta afección en Argentina.

Microscopic and PCR-based detection of microsporidia spores in human stool samples.

Microsporidia are obligate intracellular fungi with a remarkable ability to infect a wide range of invertebrate and vertebrate hosts. Namely, Enterocytozoon bieneusi is the most frequently microsporidia reported worldwide, and mainly associated with chronic diarrhea and wasting syndrome in AIDS patients. Microscopy and PCR-based detection techniques are effective for diagnosis and identification of species and genotypes; however, these methods should be standardized in each laboratory. In this study, we performed microscopy and nested PCR techniques with PCR product sequencing to detect E. bieneusi in human stool samples. These techniques, if applied together, might prove useful for diagnosis and future epidemiological studies of intestinal microsporidiosis in Argentina.

Evaluation of Scorpion Envenomation by Tityus trivittatus in Adults: An Analysis of Variables Related to Severity of Clinical Presentation.

INTRODUCTION: In Argentina, the scorpion species Tityus trivittatus has been the species most commonly associated with serious injury and death. METHODS: We performed a retrospective study of cases of T trivittatus envenomation that presented to the emergency department at an infectious disease hospital in Cordoba, Argentina, between December 2014 and February 2015. All cases were taxonomically confirmed using criteria established in the Argentine Ministry of Health national guidelines. The primary outcome was classification of clinical presentation (mild/moderate/severe). Classification of clinical presentation was performed in a post hoc fashion using the national guidelines and compared to the classification of clinical presentation given to patients at the time of diagnosis in the emergency department. RESULTS: We included 450 individuals with T trivittatus envenomation. The median age of was 36 y (interquartile range 25-52), and 57% were female. In the emergency department, only 5 patients (<1%) were diagnosed as moderate cases and received antivenom; all other cases were diagnosed as mild. Conversely, in our post hoc classification of clinical presentations, 280 patients had mild presentations, 170 had moderate presentations, and no patients had severe presentations. In our cohort, there were no deaths, no inpatient hospital admissions, and no requirements for continuous cardiac monitoring. We found that age >50 y, (odds ratio [OR] 2.5, P<0.001), time from sting to presentation >120 min (OR 2.6, P=0.02), and pre-existing hypertension (OR=3.9, P<0.001) were all independently associated with worse post hoc classification severity. CONCLUSIONS: Our study exposed factors associated with moderate presentations of scorpion envenomation and proposes the option of conservative treatment for affected adults.

Coinfección SIDA / Enfermedad de Chagas. Presentación de caso y revisión de la bibliografía / 9 CO-INFECTION AIDS / CHAGA'S DISEASE. REPORT OF A CASE AND LITERATURE REVISION

Chagas' disease caused by "Trypanosoma cruzi" (T. cruzi), is well recognized as an opportunistic infection in the setting of HIV / AIDS. More patients with Chagas' disease, live in countries of Central and South America, That's why, it is also called "American Trypanosomiasis ". T. cruzi is mainly transmitted by vectors ("Triatoma infestans" in Argentina) specially in the "endemic american area" and secondarily, by blood transfusion, not only in America, but also in the rest of the world. Many people have migrated from the endemic area of America to others countries around the world. Perhaps, some of them were asyntomatic "chagasic" patients and may have transmitted T. cruzi by blood transfusions in those non-endemic areas.. So that, Chagas' disease should be considered nowadays, as a "global pathology". In severely inmunocompromissed patients with AIDS, chronic Chagas' disease may have reactivated, affecting central nervous system (CNS) with brain mass lesions (called "chagomas"), similar to others necrotizing encephalitis like Toxoplasmosis.. We report a 32 year-old woman assisted in the Rawson Hospital of Córdoba City (Argentina), with AIDS and reactivation of Chagas' disease. Patient coming from Catamarca (north-western region of Argentina) with severe headache, unisocoria, desorientation in time and space, fine tremor, nistagmus, clonus, hiperreflexia and fascial-braquial-crural hemiparesia. Patient was afebrile and the rest of physical examination was normal. She had low count of CD4 cells and high HIV-viral load. Magnetic resonance imagin (MRI) showed: several enhanced rounded lesions surrounded by edema along the whole brain. Treatment with sulfadiacina + Pyrimethamine and Dexametasone, for a presuntive cerebral toxoplasmosis was implemented but, patient did not improve. So, cerebral biopsie was performed and it showed: intra and extracellular " AMASTIGOTES" of T. cruzi..Treatment with Benznidazol was prescribed, but in a few days, patient died.