[Acute non cholestatic hepatitis as the first manifestation of secondary syphilis]. / Hepatitis aguda no colestásica como primera manifestación de sífilis secundaria.

We present a 34 year old male who enter the Digestive Department of the University Hospital Severo Ochoa in Madrid, Spain with jaundice with a great elevation of transaminases in relationship with an infectious syndrome that was correctly diagnosed and treated with a very good outcome.

Hepatitis aguda no colestásica como primera manifestación de sífilis secundaria / Acute non cholestatic hepatitis as the first manifestation of secondary syphilis

Presentamos a continuación un paciente varón de 34 años ingresado en el Servicio Digestivo del Hospital Universitario Severo Ochoa en Madrid, por un cuadro de ictericia con gran elevación de transaminasas en relación con un cuadro infeccioso que se identificó y trató adecuadamente con la consecuente evolución favorable de dicha enfermedad...

We present a 34 year old male who enter the Digestive Department of the University Hospital Severo Ochoa in Madrid, Spain with jaundice with a great elevation of transaminases in relationship with an infectious syndrome that was correctly diagnosed and treated with a very good outcome...

Un caso de transmisión congénita de la enfermedad de Chagas en Cataluña / No disponible

La enfermedad de Chagas es una zoonosis endémica en América Central y del Sur con una elevada prevalencia de la enfermedad crónica asintomática entre la población gestante. En los últimos años España recibe una creciente inmigración femenina procedente de estas zonas endémicas. Documentamos un caso de transmisión vertical de Trypanosoma cruzi de una gestante boliviana con Chagas crónico residente en Cataluña, que nos informa por vez primera de su situación clínica en el momento del parto. Los estudios serológicos y la PCR-nested para T. cruzi fueron positivos en la madre. En placenta y cordón umbilical los estudios histopatológicos mostraron formas amastigotes. En la sangre del recién nacido se observaron formas tripomastigotes y se pudo aislar el parásito a partir del cultivo in vitro y detectar su DNA. El tratamiento con benznidazol iniciado al 8º día de vida y continuado durante 2 meses fue efectivo y bien tolerado. Controles posteriores mostraron el examen directo, cultivo y PCR-nested negativos a partir de los 20 días de iniciar el tratamiento y los estudios serológicos lo fueron a partir de los 4 meses. En conclusión, expresamos la necesidad de identificar el estado de portadora en las gestantes inmigrantes de las zona endémicas y confirmar si se ha producido transmisión vertical para el tratamiento precoz de sus recién nacidos (AU)

Chagas disease is an endemic zoonosis in Central and South America with a high prevalence of pregnant women with chronic asymptomatic disease. In the last years Spain is a receptor country for immigrant people coming from these endemic regions. We document a patient that is a male, new- born of Bolivian mother with chronic Chagas disease living in our country, who informed physicians of her condition at the moment of delivery. In the mother the serology and blood nested-PCR were positive. In histopathological study of placenta and umbilical cord amastigote forms were observed in both samples. In the neonate blood the parasite was directly observed in trypomastigote forms and isolated byblood culture and also T. cruzi DNA was detected. Baby began treatment with benznidazol at the age of eight days and continued for 2 months. Parasitological and serological tests were performed after the treatment: directexamination, blood culture and nested-PCR were negative to T. cruzi at the20th day and remained negative 4 and 7 months thereafter. Serological tests were negative at the 4th month. Protocols are required to monitor pregnant women with Chagas disease who migrate from endemic areas to settle in Spain. Vertical transmission must be cheeked to begin early treatment to their babies (AU)

Congenital transmission of Trypanosoma cruzi in Europe (Spain): a case report.

Here we report a documented case of congenital transmission of Trypanosoma cruzi from a Bolivian mother with chronic Chagas disease living in Spain. The serology and blood nested polymerase chain reaction (PCR) were positive for the mother, and amastigote forms were observed in histopathological study of the placenta and umbilical cord. Direct examination, culture, and nested PCR were positive in the blood of the neonate. At the age of 8 days, the neonate began treatment with 5-7.5 mg/kg/day of benznidazol, which was continued for 60 days. Direct examination, blood culture, and nested PCR were negative to T. cruzi 20 days after the start of treatment and remained negative 4 and 7 months thereafter. Serological tests were negative at 4 months. To detect congenital infection and initiate early treatment of infected newborns, protocols are required to detect Chagas disease in pregnant women who migrate from endemic to non-endemic areas.