RESUMO
BACKGROUND: Neurocysticercosis (NCC) is the most common parasitic neurological disease worldwide and a major cause of epilepsy. Spain is the country reporting the highest number of NCC imported cases in Europe. METHODOLOGY: Retrospective case series of NCC patients registered in the +REDIVI Network from October 1, 2009 to July 2018. A specific questionnaire, including clinical and diagnostic characteristics, was created and sent to the collaborator centers. RESULTS: 46 cases were included in the analysis. 55% were male, mean age of 40 years. 95.6% were migrants. The median duration since migration from an endemic area was 10 years. Predominant nationalities were Ecuadorians (50%) and Bolivians (30.4%). Frequent locations were parenchymal (87%), subarachnoid (26.1%) and intraventricular cysts (10.9%). Serological analysis was performed in 91.3%, being 54.8% positive. Most prevalent clinical manifestations were persistent headache (60.9%), epilepsy (43.5%) and visual changes (13%). Patients were mainly treated with albendazole (76.1%), corticosteroids (67.4%), and anticonvulsionants (52.2%). 82.5% had a favorable clinical outcome. CONCLUSIONS: Most NCC cases were long-standing migrants. Few clinical differences were observed depending on the cysticerci location. The treatment was often not according to current recommendations, and no uniform criteria were followed when it came to the therapeutic regimen. NCC case management in Spain (including clinician awareness and laboratory capacity improvements) needs to be strengthened.
Assuntos
Cisticercose , Neurocisticercose , Adulto , Europa (Continente) , Humanos , Masculino , Estudos Retrospectivos , EspanhaRESUMO
Fundamentos: El papel del género Aeromonas como enteropatógeno continúa en entredicho en numerosos trabajos. El objetivo es conocer en nuestra serie la distribución epidemiológica, sensibilidad antimicrobiana y el significado clínico de Aeromonas spp aisladas en el coprocultivo. Métodos: Se estudió retrospectivamente la evolución clínica de 152 casos de diarrea con aislamiento de Aeromonas spp. (1999-2004). Se utilizó el medio agar sangre ampicilina para aislar Aeromonas añadiendo el medio CIN en la segunda parte del estudio. Resultados: Se aisló Aeromonas spp. en 1,24% de 27.109 muestras, distribuidas entre A. caviae59,21%, A. hydrophila 17,76%, A. veronii var. sobria 21,05%, A. veronii var. veronii 1,31%, A. schubertii0,65%. En el área pediátrica se obtuvieron 124 aislamientos, 90 procedían de urgencias, de primaria17, de hepatología 9 de neonatología 6 y 2 de hematooncología. Los adultos la mayoría presentaban enfermedad de base. Conclusiones: A. caviae es la especie más prevalente. Son frecuentes las enfermedades de base asociadas a la diarrea. Para obtener óptimos resultados en el coprocultivo se requiere utilizar más de un medio. La mayoría de las cepas presentaron resistencia exclusivamente a amoxicilina. A falta de estudios de patogenicidad, el aislamiento de Aeromonas spp como único agente en el coprocultivo, adquiere significado clínico junto a la diarrea y una posible enfermedad de base (AU)
Fundaments: Aeromonas and their link to diarrheic disease have not been clearly established. Astudy has been performed to observe species distribution, drugs sensitivity and clinical signification of the Aeromonas species isolated from patients with diarrhea. Method: Retrospective study has been performed (1999-2004) to observe the clinical evolution from patients with diarrhea and Aeromonas species. To isolate Aeromonas two specific means were used, only blood agar with ampilicin in the first phase, and then adding CIN agar in the second phase of the study. Results: Aeromonas has been isolated in 1,24% of 27.109 samples, with A. caviae 59,21%, A. hydrophila17,76%, A. veronii var. sobria 21,05%, A. veronii var. veronii 1,31%, A. schubertii 0,65%.124 were children, 90 from emergencies, 17 from primary, 9 hepathology, 6 from neonathology and2 from hematooncology. Among the adult patients, most of them were frequently suffering from the basic disease. Conclusion: The A. caviae is the most prevalent species. Most of the stocks were only resistant tothe amoxicillin. Isolation of Aeromonas strains from stool specimens may require the use of more than one medium. Aeromonas are an important cause of diarrhea in patients infected with Aeromonas species and underlaying disease with clinical signification (AU)
