Epidemiology of coccidioidomycosis in Argentina, an update.

The National Reference Laboratory in Clinical Mycology of Argentina conducted a retrospective review of human coccidioidomycosis cases diagnosed by the National Mycology Laboratory Network of Argentina between 2010 and 2022 to determine the burden of the disease in the country. A total of 100 human coccidioidomycosis cases were documented, with a higher prevalence in male patients (male-to-female ratio of 1.9:1), with a median age of 41 years. Comparing the number of cases between two ten-year periods (2000-2009 and 2010-2019), the increase was 36.51% (from 63 to 86 cases). Among the 100 recorded cases, 79 tested positive using the double immunodiffusion test. Spherules were observed in 19 cases through histopathology or direct microscopic examination and the fungus was isolated in 39 cases. Thirty six isolates were identified as Coccidioides posadasii through partial sequencing of the Ag2/PRA gene. Catamarca Province had the highest number of cases, comprising 64% of the total, with an incidence rate above 1.0-2.5/100,000 inhabitants until 2018. However, there has been a recent downward trend in the region from 2018 to 2022. It is concerning that more than half of diagnosed cases were chronic pulmonary or disseminated forms, indicating a lack of early disease detection. To rectify this issue, it is imperative to conduct targeted training programs for healthcare personnel and enhance public awareness within the endemic area. This will contribute to a better understanding of the true burden of coccidioidomycosis and enable the implementation of appropriate sanitary control measures.

We conducted a retrospective review of human coccidioidomycosis cases in Argentina between 2010 and 2022. We recorded 100 cases, 64% of which came from Catamarca Province. A significant number of diagnosed cases were chronic pulmonary or disseminated forms, indicating a lack of early detection.

Circulación del parásito Echinococcus granulosus en Los Antiguos, Santa Cruz / Circulation of Echinococcus granulosus in Los Antiguos, Santa Cruz

Resumen La hidatidosis, causada por el parásito Echinococcus granulosus, es una zoonosis endémica en la provincia de Santa Cruz asociada a áreas de producción ganadera. El hombre puede permanecer asintomático durante un largo período luego de la infección. Una vez desarrollada, la enfermedad representa un importante problema de salud pública debido a la complejidad y el costo de su tratamiento. Los objetivos del trabajo fueron determinar la prevalencia de contaminación ambiental por E. granulosus en zona rural y periurbana de la localidad de Los Antiguos, mediante la detección de antígenos específicos en heces caninas, e identificar factores de riesgo de transmisión. Entre mayo-2016 y abril-2017, se visitaron 38 chacras periurbanas y estancias rurales, definidas como "unidades epidemiológicas". Se analizaron 144 muestras de heces de caninos con téc nica copro-ELISA. Se realizó una encuesta epidemiológica de los pobladores rurales sobre patrones culturales relacionados a la hidatidosis. Se encontró un índice de contaminación ambiental del 17.3% y el 44.7% de las unidades epidemiológicas fueron positivas. Se identificaron prácticas de riesgo como faena domiciliaria (34.2%), alimentación de caninos con vísceras crudas (52.6%), y ausencia de desparasitación de perros (86.8%). Alrededor de la mitad de la población encuestada desconocía las formas de contagio y las medidas de prevención de la enfermedad. Este trabajo muestra un índice alto de contaminación y establece una línea de base para realizar comparaciones a futuro. También refuerza la necesidad de implementar medidas de educación, prevención y control de hidatidosis a nivel local de acuerdo a los programas nacionales.

Abstract Hydatidosis − caused by the parasite Echinococcus granulosus − is a zoonosis endemic to the province of Santa Cruz, associated with areas of livestock production. Once infected, man may remain asymptomatic for a prolonged pe riod but the disease has an important impact on public health owing to the complexity and costs of its treatment. This study aimed at assessing the prevalence of environmental E. granulosus infection in rural and peri-urban areas of the town of Los Antiguos, through the detection of antigens in scattered canine feces, and to identify risk factors for transmission. From May-2016 to April-2017, 38 peri-urban and rural farms, defined as "epidemio logical units", were visited; 144 samples of canine feces were analyzed with the copro-ELISA technique. Rural settlers were enrolled in an epidemiological survey on cultural patterns related to hydatidosis. An environmental contamination index of 17.3% was found and 44.7% of the epidemiological units were positive. Risk practices were found, such as domiciliary slaughter (34.2%), canine feeding with raw viscera (52.6%), and lack of dog de worming (86.8%). In turn, about half of the surveyed population ignored the modes of transmission of the infection and the measures to prevent it. This work shows a high infection index in the area and establishes a baseline for future comparisons. It also reinforces the need to implement education, prevention, and control activities at the local level − according to national program guidelines − in order to reduce the prevalence of environmental contamination of the disease.

[Circulation of Echinococcus granulosus in Los Antiguos, Santa Cruz]. / Circulación del parásito Echinococcus granulosus en Los Antiguos, Santa Cruz.

Hydatidosis - caused by the parasite Echinococcus granulosus - is a zoonosis endemic to the province of Santa Cruz, associated with areas of livestock production. Once infected, man may remain asymptomatic for a prolonged period but the disease has an important impact on public health owing to the complexity and costs of its treatment. This study aimed at assessing the prevalence of environmental E. granulosus infection in rural and peri-urban areas of the town of Los Antiguos, through the detection of antigens in scattered canine feces, and to identify risk factors for transmission. From May-2016 to April-2017, 38 peri-urban and rural farms, defined as "epidemiological units", were visited; 144 samples of canine feces were analyzed with the copro-ELISA technique. Rural settlers were enrolled in an epidemiological survey on cultural patterns related to hydatidosis. An environmental contamination index of 17.3% was found and 44.7% of the epidemiological units were positive. Risk practices were found, such as domiciliary slaughter (34.2%), canine feeding with raw viscera (52.6%), and lack of dog deworming (86.8%). In turn, about half of the surveyed population ignored the modes of transmission of the infection and the measures to prevent it. This work shows a high infection index in the area and establishes a baseline for future comparisons. It also reinforces the need to implement education, prevention, and control activities at the local level - according to national program guidelines - in order to reduce the prevalence of environmental contamination of the disease.

La hidatidosis, causada por el parásito Echinococcus granulosus, es una zoonosis endémica en la provincia de Santa Cruz asociada a áreas de producción ganadera. El hombre puede permanecer asintomático durante un largo período luego de la infección. Una vez desarrollada, la enfermedad representa un importante problema de salud pública debido a la complejidad y el costo de su tratamiento. Los objetivos del trabajo fueron determinar la prevalencia de contaminación ambiental por E. granulosus en zona rural y periurbana de la localidad de Los Antiguos, mediante la detección de antígenos específicos en heces caninas, e identificar factores de riesgo de transmisión. Entre mayo-2016 y abril-2017, se visitaron 38 chacras periurbanas y estancias rurales, definidas como "unidades epidemiológicas". Se analizaron 144 muestras de heces de caninos con técnica copro-ELISA. Se realizó una encuesta epidemiológica de los pobladores rurales sobre patrones culturales relacionados a la hidatidosis. Se encontró un índice de contaminación ambiental del 17.3% y el 44.7% de las unidades epidemiológicas fueron positivas. Se identificaron prácticas de riesgo como faena domiciliaria (34.2%), alimentación de caninos con vísceras crudas (52.6%), y ausencia de desparasitación de perros (86.8%). Alrededor de la mitad de la población encuestada desconocía las formas de contagio y las medidas de prevención de la enfermedad. Este trabajo muestra un índice alto de contaminación y establece una línea de base para realizar comparaciones a futuro. También refuerza la necesidad de implementar medidas de educación, prevención y control de hidatidosis a nivel local de acuerdo a los programas nacionales.

Comparison of feeding and defecation patterns between fifth-instar nymphs of Triatoma patagonica (Del Ponte, 1929) and Triatoma infestans (Klug, 1934) under laboratory conditions.

Among the vectors of Chagas disease, Triatoma patagonica is a species in the process of adaptation to the human environment. However, its vector competence is not well known. This study had the aim of evaluating and comparing feeding and defecation patterns among fifth-instar nymphs of Triatoma patagonica and Triatoma infestans that were fed ad libitum. The results showed that nymphs of Triatoma patagonica had a feeding pattern similar to that of Triatoma infestans. Sixty nine percent and 58% of nymphs of Triatoma patagonica and Triatoma infestans, respectively, produced their first defecation within five minutes after being fed. Triatoma patagonica defecated during feeding, with an average time until first defecation that was shorter than that of Triatoma infestans (3.4 and 6.2 min, respectively). The nymphs of Triatoma patagonica were capable of defecating during or immediately after feeding.

Comparison of feeding and defecation patterns between fifth-instar nymphs of Triatoma patagonica (Del Ponte, 1929) and Triatoma infestans (Klug, 1934) under laboratory conditions / Comparação dos padrões alimentar e de defecação em ninfas de quinto estádio de Triatoma patagonica (Del Ponte, 1929) e Triatoma infestans (Klug, 1934), em condições de laboratório

Among the vectors of Chagas disease, Triatoma patagonica is a species in the process of adaptation to the human environment. However, its vector competence is not well known. This study had the aim of evaluating and comparing feeding and defecation patterns among fifth-instar nymphs of Triatoma patagonica and Triatoma infestans that were fed ad libitum. The results showed that nymphs of Triatoma patagonica had a feeding pattern similar to that of Triatoma infestans. Sixty nine percent and 58 percent of nymphs of Triatoma patagonica and Triatoma infestans, respectively, produced their first defecation within five minutes after being fed. Triatoma patagonica defecated during feeding, with an average time until first defecation that was shorter than that of Triatoma infestans (3.4 and 6.2 min, respectively). The nymphs of Triatoma patagonica were capable of defecating during or immediately after feeding.

Entre os vetores da doença de Chagas, Triatoma patagonica é uma espécie que se encontra em processo de adaptação ao ambiente humano; embora sua competência vetorial não seja bem conhecida. O estudo teve como objetivo avaliar e comparar padrões de alimentação e defecação em ninfas de quinto estádio de Triatoma patagonica e Triatoma infestans ad libitum. Os resultados mostraram que as ninfas de Triatoma patagonica apresentou padrõe de alimentação semelhante a Triatoma infestans. Sessenta e nove por cento e 58 por cento das ninfas de Triatoma patagonica e Triatoma infestans respectivamente, realizaram a primeira defecação cinco minutos após de serem alimentadas; sendo que a primeira defecou durante a alimentação, com um tempo médio de dejeção menor do que para Triatoma infestans (3,4 vs 6,2 respectivamente). As ninfas de Triatoma patagonica foram capazes de defecar durante ou imediatamente após de se alimentarem.

[Pulmonary mucormycosis in a patient with diabetes mellitus: favorable evolution under medical treatment]. / Mucormicosis pulmonar y diabetes mellitus: buena respuesta al tratamiento medico. Reporte de un caso y revisión de la bibliografía.

Pulmonary mucormycosis is a relatively uncommon but an important opportunistic fungal infection in immunocompromised patients. It may be acquired by inhalation of spores into the lungs. The pathogenic hallmark of mucormycosis is vascular invasion resulting in thrombosis and tissue infarction/necrosis. The diagnosis can be difficult since presentation does not differ from other forms of pneumonia. Risk factors include neutropenia, haematologic malignancies, uncontrolled diabetes mellitus, skin burns and deferoxamine therapy in dialysis patients. Early recognition, control of underlying diseases and medical-surgical aggressive management are warranted to better outcomes. Pulmonary mucormycosis has a high mortality and medical treatment strategy alone has been associated in several studies to greater mortality. We describe a case of pulmonary mucormicosis with favorable evolution only under medical treatment. We reviewed the bibliography.