Complete remission of loiasis-associated nephrotic syndrome with collapsing glomerulopathy after diethilcarbamazine treatment

Case report: A 42-year-old male from Equatorial Guinea with nephrotic syndrome (NS)and renal dysfunction. Loa loa microfilariae were detected on a peripheral blood smear and renal biopsy showed collapsing glomerulopathy. In absence of other causes of NS, the treatment with diethylcarbamazine brought a complete remission (AU)

Caso Clínico: Hombre de 42 años de Guinea Ecuatorial con un síndrome nefrótico e insuficiencia renal. Se encontraron microfilarias de Loa loa en sangre periférica y la biopsiarenal mostró una glomerulonefritis colapsante. No se objetivó otra causa de síndrome nefrótico y el tratamiento con el filaricida dietilcarbamacina consiguió una remisión completa de su patología (AU)

[Imported malaria in a general hospital in Madrid]. / Paludismo importado en un hospital general de Madrid.

INTRODUCTION: To study the clinical and epidemiological characteristics of malaria and the diagnosis of this condition in a general hospital that does not have a specialized tropical medicine unit. METHODS: Retrospective study of all malaria cases diagnosed by thick film and/or PCR-positive status for any Plasmodium spp. from 1999 to 2003 in Hospital Príncipe de Asturias in Alcalá de Henares (Madrid, Spain). RESULTS: Over the period studied, 89 cases of malaria were diagnosed. Most patients were African immigrants who had recently left their countries of origin (52%), or immigrants residing in Spain who had traveled to Africa for a short visit (35%) and did not take prophylaxis. The distribution of cases by species was Plasmodium falciparum 89%, P. ovale 7% and P. malariae 4%. Clinical data were non-specific and the percentage of severe complications was low (6.7%). A second-generation test for rapid detection of P. falciparum antigen (PfHRP2) was studied in a group of 46 patients with suspected malaria; the results obtained were similar to thick film as compared to PCR for diagnosing P. falciparum infection. CONCLUSIONS: Access to information on prevention and chemoprophylaxis should be available to all travelers, particularly immigrants visiting their countries of origin. Most semi-immune patients with uncomplicated malaria can be treated on an outpatient basis. PfHRP2 antigen detection, a fast, reliable method for diagnosing malaria due to P. falciparum, can be used in addition to the thick film method in our setting.

Paludismo importado en un hospital general de Madrid / Imported malaria in a general hospital in Madrid

Introducción. Estudiar las características epidemiológicas de la malaria y su diagnóstico en un hospital general sin unidad especializada de Medicina Tropical. Métodos. Se estudiaron retrospectivamente todos los casos de malaria diagnosticados con gota gruesa y/o reacción en cadena de la polimerasa (PCR) positivas para cualquier especie de Plasmodium desde 1999 a 2003 en el Hospital Príncipe de Asturias de Alcalá de Henares (Madrid). Resultados. En este período se diagnosticaron 89 casos de malaria. La mayoría eran inmigrantes africanos recién llegados (52%) o inmigrantes residentes en España que viajaron a África de visita durante poco tiempo (35%) y no tomaron ninguna profilaxis. La distribución por especies fue: Plasmodium falciparum, 89%; P. ovale, 7%; y P. malariae, 4%. La clínica fue inespecífica y el porcentaje de complicaciones graves fue bajo (6,7%). Con los test de detección rápida de antígenos palúdicos PfPRH2 de segunda generación realizados en un grupo de 46 pacientes con sospecha de malaria se obtuvieron resultados equiparables a la gota gruesa en comparación con la PCR en el diagnóstico de la infección por P. falciparum. Conclusiones. Se debe mejorar el acceso a la información preventiva y a la quimioprofilaxis para todos los viajeros, especialmente para los inmigrantes que vuelven de visita a sus países de origen. La mayoría de pacientes semiinmunes con malaria no complicada puede recibir un tratamiento ambulatorio. En nuestro medio, la detección rápida de antígenos puede ser una técnica complementaria de la gota gruesa, sencilla y fiable en el diagnóstico rápido de malaria por P. falciparum (AU)

Introduction. To study the clinical and epidemiological characteristics of malaria and the diagnosis of this condition in a general hospital that does not have a specialized tropical medicine unit. Methods. Retrospective study of all malaria cases diagnosed by thick film and/or PCR-positive status for any Plasmodium spp. from 1999 to 2003 in Hospital Príncipe de Asturias in Alcalá de Henares (Madrid, Spain). Results. Over the period studied, 89 cases of malaria were diagnosed. Most patients were African immigrants who had recently left their countries of origin (52%), or immigrants residing in Spain who had traveled to Africa for a short visit (35%) and did not take prophylaxis. The distribution of cases by species was Plasmodium falciparum 89%, P. ovale 7% and P. malariae 4%. Clinical data were non-specific and the percentage of severe complications was low (6.7%). A second-generation test for rapid detection of P. falciparum antigen (PfHRP2) was studied in a group of 46 patients with suspected malaria; the results obtained were similar to thick film as compared to PCR for diagnosing P. falciparum infection. Conclusions. Access to information on prevention and chemoprophylaxis should be available to all travelers, particularly immigrants visiting their countries of origin. Most semi-immune patients with uncomplicated malaria can be treated on an outpatient basis. PfHRP2 antigen detection, a fast, reliable method for diagnosing malaria due to P. falciparum, can be used in addition to the thick film method in our setting (AU)