[Comparison of 3 tests for the diagnosis of pulmonary pneumocystosis in AIDS patients]. / Comparacion de 3 técnicas para el diagnóstico de la neumocistosis pulmonar en pacientes con SIDA.

Since Pneumocystis jiroveci cannot be grown in vitro, laboratory diagnosis of pulmonary pneumocystosis (PCP) has been based mainly upon microscopy. The usefulness of 3 diagnostic methods of PCP was compared in 111 bronchoalveolar fluids belonging to an equal number of AIDS patients assisted in different wards of the Muñiz Hospital. Wet mount preparations, a rapid modification of Grocott technique and the direct immunofluorescence (DIF) with monoclonal antibodies were compared for the diagnosis of PCP on smears of clinical samples. Similar results (15 positive and 90 negative) were obtained with these three techniques in 105 (93.6%) of the studied samples; in 3 (2.7%) cases the DIF was positive while the other techniques were negative, and in other 3 (2.7%), the Grocott stain was negative when the other two techniques were positive. In the investigated samples, due to the abundance of P. jiroveci, the searching of "honeycombs" structures in wet mount preparations is perfectly adaptable as screening test. The Grocott stain showed to be useful for the diagnosis of other mycoses, and the DIF, due to its high cost, can be employed when the other techniques are negative.

Comparacion de 3 técnicas para el diagnóstico de la neumocistosis pulmonar en pacientes con SIDA / [Comparison of 3 tests for the diagnosis of pulmonary pneumocystosis in AIDS patients]

Since Pneumocystis jiroveci cannot be grown in vitro, laboratory diagnosis of pulmonary pneumocystosis (PCP) has been based mainly upon microscopy. The usefulness of 3 diagnostic methods of PCP was compared in 111 bronchoalveolar fluids belonging to an equal number of AIDS patients assisted in different wards of the Muñiz Hospital. Wet mount preparations, a rapid modification of Grocott technique and the direct immunofluorescence (DIF) with monoclonal antibodies were compared for the diagnosis of PCP on smears of clinical samples. Similar results (15 positive and 90 negative) were obtained with these three techniques in 105 (93.6

) of the studied samples; in 3 (2.7

) cases the DIF was positive while the other techniques were negative, and in other 3 (2.7

), the Grocott stain was negative when the other two techniques were positive. In the investigated samples, due to the abundance of P. jiroveci, the searching of [quot ]honeycombs[quot ] structures in wet mount preparations is perfectly adaptable as screening test. The Grocott stain showed to be useful for the diagnosis of other mycoses, and the DIF, due to its high cost, can be employed when the other techniques are negative.

Comparacion de 3 técnicas para el diagnóstico de la neumocistosis pulmonar en pacientes con SIDA. / [Comparison of 3 tests for the diagnosis of pulmonary pneumocystosis in AIDS patients]

Since Pneumocystis jiroveci cannot be grown in vitro, laboratory diagnosis of pulmonary pneumocystosis (PCP) has been based mainly upon microscopy. The usefulness of 3 diagnostic methods of PCP was compared in 111 bronchoalveolar fluids belonging to an equal number of AIDS patients assisted in different wards of the Muñiz Hospital. Wet mount preparations, a rapid modification of Grocott technique and the direct immunofluorescence (DIF) with monoclonal antibodies were compared for the diagnosis of PCP on smears of clinical samples. Similar results (15 positive and 90 negative) were obtained with these three techniques in 105 (93.6

) of the studied samples; in 3 (2.7

) cases the DIF was positive while the other techniques were negative, and in other 3 (2.7

), the Grocott stain was negative when the other two techniques were positive. In the investigated samples, due to the abundance of P. jiroveci, the searching of [quot ]honeycombs[quot ] structures in wet mount preparations is perfectly adaptable as screening test. The Grocott stain showed to be useful for the diagnosis of other mycoses, and the DIF, due to its high cost, can be employed when the other techniques are negative.

Immunodiagnosis of human fascioliasis by an enzyme-linked immunosorbent assay (ELISA) and a micro-ELISA.

Enzyme-linked immunosorbent assay (ELISA) and micro-ELISA were evaluated for their ability to detect anti-Fasciola hepatica antibodies in humans by using excretory-secretory antigen. The sensitivity of each method was 100%, but the specificity was 100% for ELISA and 97% for micro-ELISA. The micro-ELISA could be used as a screening assay and ELISA could be used as a confirmatory method for the serodiagnosis of human fascioliasis.

[Disseminated infection due to strongyloides stercoralis in AIDS patients. A report of 2 cases]. / Infección diseminada por strongyloides stercoralis en pacientes con SIDA. A propósito de 2 observaciones.

Strongyloides stercoralis is an intestinal nematode that infects humans worldwide. Infected patients with severe involvement of cellular immunity may develop a syndrome characterized by the dissemination of larvae throughout the body. Extraintestinal strongyloidiasis has been infrequently reported and despite the prevalence of the helminth in tropical and developing countries there are few cases reported in AIDS patients. Most patients with disseminated strongyloidiasis present with fever, cough, diarrhea and shortness of breath. Chest radiographs usually show diffuse infiltrates. The diagnosis has been made by finding the helminth in respiratory secretions or stool. Enteric organisms like Escherichia coli can often be isolated in the blood or cerebrospinal fluid. We report two cases of disseminated strongyloidiasis in AIDS patients, in which stercoralis larvae were detected in sputum and stool samples.

Infección diseminada por strongyloides stercoralis en pacientes con SIDA. A próposito de 2 observaciones / Disseminated infection due to strongyloides stercoralis in AIDS patients. A report of 2 cases

El Strongyloides stercoralis es un nematelminto de distribución universal, que en pacientes con alteraciones de la respuesta inmune celular, puede provocar infecciones diseminadas graves. Las formas extraintestinales de la estrongiloidosis han sido publicadas con poca frecuencia, a pesar de la elevada prevalencia de infección por este parásito en áreas de clima tropical y en países en vías de desarrollo. Existen escasas publicaciones en pacientes con SIDA. La mayoría de los casos presentan compromiso gastrointestinal, respiratorio, cutáneo y del SNC. La radiografía de tóraz revela la existencia de infiltrados intersticiales difusos. El diagnóstico se confirma por el hallazgo de las larvas rhabditoides en las materias fecales o en el esputo e incluso en el LCR. Con frecuencia, las infecciones diseminadas por este helminto se asocian con septicemias o meningitis causadas por bacilos gram negativos, especialmente Escherichia coli. Presentamos 2 casos de estrongiloidosis diseminada en pacientes con SIDA con hallazgo de larvas en materias fecales y esputo.

Infección diseminada por strongyloides stercoralis en pacientes con SIDA. A propósito de 2 observaciones. / [Disseminated infection due to strongyloides stercoralis in AIDS patients. A report of 2 cases]

Strongyloides stercoralis is an intestinal nematode that infects humans worldwide. Infected patients with severe involvement of cellular immunity may develop a syndrome characterized by the dissemination of larvae throughout the body. Extraintestinal strongyloidiasis has been infrequently reported and despite the prevalence of the helminth in tropical and developing countries there are few cases reported in AIDS patients. Most patients with disseminated strongyloidiasis present with fever, cough, diarrhea and shortness of breath. Chest radiographs usually show diffuse infiltrates. The diagnosis has been made by finding the helminth in respiratory secretions or stool. Enteric organisms like Escherichia coli can often be isolated in the blood or cerebrospinal fluid. We report two cases of disseminated strongyloidiasis in AIDS patients, in which stercoralis larvae were detected in sputum and stool samples.

Infección diseminada por strongyloides stercoralis en pacientes con SIDA. A próposito de 2 observaciones / Disseminated infection due to strongyloides stercoralis in AIDS patients. A report of 2 cases

El Strongyloides stercoralis es un nematelminto de distribución universal, que en pacientes con alteraciones de la respuesta inmune celular, puede provocar infecciones diseminadas graves. Las formas extraintestinales de la estrongiloidosis han sido publicadas con poca frecuencia, a pesar de la elevada prevalencia de infección por este parásito en áreas de clima tropical y en países en vías de desarrollo. Existen escasas publicaciones en pacientes con SIDA. La mayoría de los casos presentan compromiso gastrointestinal, respiratorio, cutáneo y del SNC. La radiografía de tóraz revela la existencia de infiltrados intersticiales difusos. El diagnóstico se confirma por el hallazgo de las larvas rhabditoides en las materias fecales o en el esputo e incluso en el LCR. Con frecuencia, las infecciones diseminadas por este helminto se asocian con septicemias o meningitis causadas por bacilos gram negativos, especialmente Escherichia coli. Presentamos 2 casos de estrongiloidosis diseminada en pacientes con SIDA con hallazgo de larvas en materias fecales y esputo. (Au)

Diagnóstico ultrasonográfico, tratamiento y evolución en abscesos hepáticos: experiencia en nuestro medio / Hepatic abscess: US diagnosis, percutaneous drainage and clinical evolution

A fin de evaluar las características ecográficas y su correlación con la etiología, el rendimiento diagnóstico y terapéutico de la punción dirigida y otros hallazgos orientadores de la patogenia, se evaluaron 43 pacientes con abscesos hepáticos diagnosticados mediante US entre enero de 1990 y junio de 1998. Observamos que en nuestra población los abscesos múltiples se correlacionaron en el 69 por ciento de los casos con patogenia biliar o portal, siendo los criptogenéticos en su mayoría únicos (12/14). El rédito diagnóstico obtenido por punción percutánea (81 por ciento) fue significativamente mayor al obtenido por hemocultivo (31 por ciento). La terapéutica con drenaje percutáneo fue eficaz en el 78 por ciento de los casos aplicados. La mortalidad global (7 por ciento) es levemente inferior a la descripta en la literatura; destacamos que en nuestra población la asociación con pileflebitis se observó en 2 de los 3 casos

Diagnóstico ultrasonográfico, tratamiento y evolución en abscesos hepáticos: experiencia en nuestro medio / Hepatic abscess: US diagnosis, percutaneous drainage and clinical evolution

A fin de evaluar las características ecográficas y su correlación con la etiología, el rendimiento diagnóstico y terapéutico de la punción dirigida y otros hallazgos orientadores de la patogenia, se evaluaron 43 pacientes con abscesos hepáticos diagnosticados mediante US entre enero de 1990 y junio de 1998. Observamos que en nuestra población los abscesos múltiples se correlacionaron en el 69 por ciento de los casos con patogenia biliar o portal, siendo los criptogenéticos en su mayoría únicos (12/14). El rédito diagnóstico obtenido por punción percutánea (81 por ciento) fue significativamente mayor al obtenido por hemocultivo (31 por ciento). La terapéutica con drenaje percutáneo fue eficaz en el 78 por ciento de los casos aplicados. La mortalidad global (7 por ciento) es levemente inferior a la descripta en la literatura; destacamos que en nuestra población la asociación con pileflebitis se observó en 2 de los 3 casos (AU)

Acid fast filaments in stool samples from an AIDS patient.

The presence of filamentous bacteria morphologically similar to Nocardia in a fresh stool sample from an AIDS patient with pulmonary nocardiosis is here reported. The material was submitted to our laboratory for a parasitologic examination and was stained by the Kinyoun method, revealing numerous delicate, irregularly stained, branching acid-fast filaments. Nocardia asteroides had been isolated from sputum samples of this patient. The patient was a 32 year-old HIV+ female admitted to our center on June 1997 because of productive cough, right-sided thoracic pain and weight loss. Chest X rays showed the presence of right superior lobe excavated pneumonia. This was the first time we had observed filamentous bacteria similar to Nocardia in a stool sample submitted to parasitologic examination. For similar cases, and when its presence was not detected in other specimens collected from the same patient, intestinal endoscopy and biopsy should be performed for eventual lesions and smear examination repeated with Kinyoun stain and cultures for Nocardia.

Un caso de esparganosis humana en Argentina / A case of human sparganosis in Argentina

A male patient from Peru presented a nodule localized in the left costal region. All other clinical and laboratory data were normal. Upon biopsy, an helminth parasite emerged from the subcutaneous tissue, which presented a marked eosinophil infiltrate. The helminth was classified as a plerocercoid larva of Spirometra; the species was not determined. Since Spirometra are not common in Argentina, it is presumed that the patient was infested during his two year sojourn in the peruvian forest. Some epidemiological aspects are discussed. As far as we know, this is the first case of subcutaneous sparganosis and the second of sparganosis reported in Argentina.

Un caso de esparganosis humana en Argentina / A case of human sparganosis in Argentina

A male patient from Peru presented a nodule localized in the left costal region. All other clinical and laboratory data were normal. Upon biopsy, an helminth parasite emerged from the subcutaneous tissue, which presented a marked eosinophil infiltrate. The helminth was classified as a plerocercoid larva of Spirometra; the species was not determined. Since Spirometra are not common in Argentina, it is presumed that the patient was infested during his two year sojourn in the peruvian forest. Some epidemiological aspects are discussed. As far as we know, this is the first case of subcutaneous sparganosis and the second of sparganosis reported in Argentina.(Au)

[A case of human sparganosis in Argentina]. / Un caso de esparganosis humana en Argentina.

A male patient from Peru presented a nodule localized in the left costal region. All other clinical and laboratory data were normal. Upon biopsy, an helminth parasite emerged from the subcutaneous tissue, which presented a marked eosinophil infiltrate. The helminth was classified as a plerocercoid larva of Spirometra; the species was not determined. Since Spirometra are not common in Argentina, it is presumed that the patient was infested during his two year sojourn in the peruvian forest. Some epidemiological aspects are discussed. As far as we know, this is the first case of subcutaneous sparganosis and the second of sparganosis reported in Argentina.

Un caso de esparganosis humana en Argentina. / [A case of human sparganosis in Argentina]

A male patient from Peru presented a nodule localized in the left costal region. All other clinical and laboratory data were normal. Upon biopsy, an helminth parasite emerged from the subcutaneous tissue, which presented a marked eosinophil infiltrate. The helminth was classified as a plerocercoid larva of Spirometra; the species was not determined. Since Spirometra are not common in Argentina, it is presumed that the patient was infested during his two year sojourn in the peruvian forest. Some epidemiological aspects are discussed. As far as we know, this is the first case of subcutaneous sparganosis and the second of sparganosis reported in Argentina.