Absence of borrelia burgdorferi antibodies in the sera of Venezuelan patients with localized scleroderma (morphea)

En los últimos años se ha postulado una posible asociación entre Borrelia burgdorferi ( Bb ) y esclerodermia localizada (morfea). Sin embargo, los datos publicados no han proporcionado pruebas inequívocas de tal asociación. En Suramérica se han realizado estudios serológicos que han evidenciado resultados positivos. El objetivo de este estudio fue buscar evidencia de la infección por Bb en pacientes venezolanos con morfea, mediante la detección de anticuerpos antibacterianos, usando el protocolo de dos pasos recomendado por el Center for Disease Control and Prevention de Atlanta (Estados Unidos). Veintiún muestras de suero de pacientes con morfea y veintiún muestras de sujetos sanos (control) fueron analizadas. Cuatro muestras resultaron ELISA positivas: tres correspondieron a pacientes con morfea y una, a un sujeto control. Todas las muestras ELISA positivas fueron negativas en la prueba IgG Western Blot. Los resultados obtenidos no soportan una asociación entre la infección por Bb y las lesiones escleróticas de morfea, pero tampoco descartan la posibilidad de una relación entre morfea y una genoespecie desconocida del complejo Bb sensulato, entre morfea y una especie diferente de Borrelia o entre morfea y otra espiroqueta, como agente etiológico de la lesión en la localidad

Absence of Borrelia burgdorferi antibodies in the sera of Venezuelan patients with localized scleroderma (morphea).

A possible association of Borrelia burgdorferi (Bb) with localized scleroderma (LS) has been postulated. However, the published data do not provide unequivocal results. Previous serologic analysis in LS patients in South American countries yielded positive results. The present study in our laboratory looked for evidence of Bb in LS patients in Venezuela, by antibacterial antibodies detection using the two-tiered approach as recommended by the Center for Disease Control and Prevention of Atlanta (United States). Twenty one serum samples from LS patients and twenty one samples from healthy individuals were analyzed. Four serum samples were ELISA positive: three from patients with LS and one from a healthy control. All ELISA positive samples were negative by IgG Western Blot. Our data do not support an association of Bb infection and the sclerotic lesions of LS; but do not rule out the possibility of a relationship between LS and an unknown geno-specie of Bb sensu lato complex, a different Borrelia specie or a different spirochetal organism, as the etiological agents of the skin lesions in the area.

Manifestaciones neurológicas tardías de un emponzoñamiento por escorpión: reporte de un caso / Late neurological manifestation of scorpion poisoning: a case report

Se presneta el caso de un paciente masculino de 54 años de edad procedente del municipio Mara del Estado Zulia, Venezuela, quien luego de picada de insecto tiene manifestaciones clínicas de pancreatitis aguda. En la convalecencia de la pancreatitis presenta convulsiones tónico-clónicas generalizadas por lo que es hospitalizado. Durante la evolución intrahospitalaria desarrolla pérdida de la fuerza muscular y de la sensibilidad de miembros inferiores. Se discute la posible etiología ponzoñoza por escorpión del genero Tityus y los posibles mecanismos fisiopatológicos que explicarían estas manifestaciones neurológicas tardías del accidente escorpiónico

[Oropharyngeal bacteria in asthmatic patients in the city of Maracaibo, Venezuela]. / Flora bacteriana orofaríngea en pacientes asmáticos de la ciudad de Maracaibo, Venezuela.

Bronchial asthma is an intercurrent disease that affects a major portion of the population. Neither its etiopathogenesis nor its complications have been fully established. The purpose of this study was to determine the composition of oropharyngeal bacterial flora in asthmatic patients and compare it with oropharyngeal bacterial flora in a group of healthy patients in order to establish its relationship with the pathogenesis of asthma and its complications. A sample consisting of 116 pharyngeal swabs was analysed from march 1995 to december 1996. 58 of the total amount of pharyngeal swabs corresponded to asthmatic patients (during asthmatic crisis), while the other 58 corresponded to healthy subjects. Common bacteriological culture techniques were carried out in order to obtain the bacteriological diagnosis. The results showed that isolation of transitory flora bacteria in asthmatic patients was 75.8%, which was significantly higher (p < 0.05) than in the control group (27.5%). Streptococcus pyogenes was the most frequent isolated bacteria in the group of asthmatic patients (17.2%), while Escherichia coli was the most frequent bacteria in the control group. No significant difference was found regarding sex and the presence of transitory flora bacteria. It was also found that enterobacteria and non fermenting negative gram bacillus increased with age in both groups; a higher incidence was observed in the group of 40-year-old subjects. These finding confirm the existence of a relationship between the asthmatic condition and the percentage of transitory bacterial flora carriers. The explanation to this phenomenon might be the frequent use of antibiotics and the possible contamination of the micro-nebulization equipment used for the treating the asthma crisis. This data must be considered when applying empiric therapy in asthmatic patients complicated with pneumonia. The possibility that certain infectious agents, including bacteria, could play a role in asthma pathogenesis is one of the questions that should be answered in future studies on this topic.

Flora bacteriana orofaríngea en pacientes asmáticos de la ciudad de Maracaibo, Venezuela / Oropharyngeal bacteria in asthmatic patients in the city of Maracaibo, Venezuela

Bronchial asthma is an intercurrent disease that affects a major portion of the population. Neither its etiopathogenesis nor its complications have been fully established. The purpose of this study was to determine the composition of oropharyngeal bacterial flora in asthmatic patients and compare it with oropharyngeal bacterial flora in a group of healthy patients in order to establish its relationship with the pathogenesis of asthma and its complications. A sample consisting of 116 pharyngeal swabs was analysed from march 1995 to december 1996. 58 of the total amount of pharyngeal swabs corresponded to asthmatic patients (during asthmatic crisis), while the other 58 corresponded to healthy subjects. Common bacteriological culture techniques were carried out in order to obtain the bacteriological diagnosis. The results showed that isolation of transitory flora bacteria in asthmatic patients was 75.8, which was significantly higher (p < 0.05) than in the control group (27.5). Streptococcus pyogenes was the most frequent isolated bacteria in the group of asthmatic patients (17.2), while Escherichia coli was the most frequent bacteria in the control group. No significant difference was found regarding sex and the presence of transitory flora bacteria. It was also found that enterobacteria and non fermenting negative gram bacillus increased with age in both groups; a higher incidence was observed in the group of 40-year-old subjects. These finding confirm the existence of a relationship between the asthmatic condition and the percentage of transitory bacterial flora carriers. The explanation to this phenomenon might be the frequent use of antibiotics and the possible contamination of the micro-nebulization equipment used for the treating the asthma crisis. This data must be considered when applying empiric therapy in asthmatic patients complicated with pneumonia. The possibility that certain infectious agents, including bacteria, could play a role in asthma pathogenesis is one of the questions that should be answered in future studies on this topic.

Detección de anticuerpos contra borrelia burgdorferi en una muestra poblacional del Estado Zulia / Detection of antibodies against borrelia burgdorferi in a sample population from Zulia State, Venezuela

Entre los meses de julio de 1992 y septiembre de 1993, se investigó la presencia de anticuerpos contra Borrelia burgdoferi en una población del Estado Zulia, Venezuela, con la finalidad de diagnosticar serológicamente la enfermedad de Lyme. Para ello se estudiaron 37 pacientes asintomáticos y 37 pacientes sintomáticos clínicamente sospechosos de la enfermedad (74 pacientes en total). Se practicó la prueba de ELISA para determinar anticuerpos contra Borrelia burgdoferi. A los casos positivos, confirmados por duplicado, se les practicó VDRL, Monotest, Factor Reumatoideo y Anticuerpos Antinucleares para detectar falsos positivos. Se obtuvo un porcentaje de positividad global del 18.9 por ciento( 14 de 74), siendo mayor (29.7 por ciento) en el grupo de pacientes sospechosos que el grupo de personas asintomáticas (8.9 por ciento). El diagnóstico clínico más frecuente fue morfea (54.52 por ciento), y la mayor positividad serológica (54.5 por ciento) se obtuvo en los pacientes crónicos (más de 1 año de evolución). Un 45.5 por ciento de los pacientes sintomáticos presentaron anticuerpos a pesar de haber recibido tratamiento antibiótico. La mayoría de los casos positivos sintomáticos o no, presentaron el antecedente de visita o permanencia en áreas boscosas o rurales. Los resultados de este trabajo permiten demostrar la existencia de anticuerpos contra Borrelia buradorferi en una muestra de la población del Estado Zulia, tanto pacientes sospechosos como en los asintomáticos. Tales resultados abren el camino para diagnosticar definitivamente, mediante pruebas más específicas como el inmunoblot, la enfermedad de Lyme en nuestro medio