Benidipine impairs innate immunity converting sublethal to lethal infections in a murine model of spotted fever rickettsiosis.

Spotted fever group rickettsiae are tick-borne obligate intracellular bacteria that infect microvascular endothelial cells. Humans and mammalian infection results in endothelial cell barrier dysfunction and increased vascular permeability. We previously demonstrated that treatment of Rickettsia parkeri-infected cells with the calcium channel blocker benidipine significantly delayed vascular barrier permeability. Thus, we hypothesized that benidipine, known to be safe and effective for other clinical processes, could reduce rickettsia-induced vascular permeability in vivo in an animal model of spotted fever rickettsiosis. Based on liver, lung and brain vascular FITC-dextran extravasation studies, benidipine did not reliably impact vascular permeability. However, it precipitated a deleterious effect on responses to control sublethal R. parkeri infection. Animals treated with benidipine alone had no clinical signs or changes in histopathology and splenic immune cell distributions. Benidipine-treated infected animals had marked increases in tissue and blood bacterial loads, more extensive inflammatory histopathologic injury, and changes in splenic architecture and immune cell distributions potentially reflecting diminished Ca2+ signaling, reduced innate immune cell activation, and loss of rickettsial propagation control. Impaired T cell activation by R. parkeri antigen in the presence of benidipine was confirmed in vitro with the use of NKT cell hybridomas. The unexpected findings stand in stark contrast to recent discussions of the benefits of calcium channel blockers for viral infections and chronic infectious or inflammatory diseases. A role for calcium channel blockers in exacerbation of human rickettsiosis and acute inflammatory infections should be evaluated by a retrospective review of patient's outcomes and medications.

Facial nerve monitoring in parotid gland surgery: Design and feasibility assessment of a potential standardized technique.

Background: Even though the use of nerve monitoring during parotid gland surgery is not the gold standard to prevent damage to the nerve, it surely offers some advantages over the traditional approach. Different from thyroid surgery, where a series of steps in intraoperative nerve monitoring have been described to confirm not only the integrity but-most importantly-the function of the recurrent laryngeal nerve, in parotid gland surgery, a formal guideline to follow while dissecting the facial nerve has yet to be described. Methods: A five-year retrospective study was done reviewing the intraoperative records of patients who underwent parotid gland surgery under neural monitoring. The operative findings regarding the neuromonitoring process, particularly in regard to the amplitude of two main branches, were revised. A literature search was done to search for guidelines to follow when a facial nerve loss of signal is encountered. Results: Fifty-five patients were operated on using the Nim 3 Nerve Monitoring System (Medtronic); 31 were female patients, and 47 patients had benign lesions. Minimum changes were observed in the amplitude records after a comparison was made between the first and the last stimulation. There were only three articles discussing the term loss of signal during parotid gland surgery. Conclusion: Today, no sufficient attention has been given to the facial nerve monitoring process during parotidectomy. This study proposes a formal guideline to follow during this procedure as well as an instruction to consider when a loss of signal is observed to develop a uniform technique of facial nerve stimulation.

Innate immunity in rickettsial infections.

Rickettsial agents are a diverse group of alpha-proteobacteria within the order Rickettsiales, which possesses two families with human pathogens, Rickettsiaceae and Anaplasmataceae. These obligate intracellular bacteria are most frequently transmitted by arthropod vectors, a first step in the pathogens' avoidance of host cell defenses. Considerable study of the immune responses to infection and those that result in protective immunity have been conducted. Less study has focused on the initial events and mechanism by which these bacteria avoid the innate immune responses of the hosts to survive within and propagate from host cells. By evaluating the major mechanisms of evading innate immunity, a range of similarities among these bacteria become apparent, including mechanisms to escape initial destruction in phagolysosomes of professional phagocytes, those that dampen the responses of innate immune cells or subvert signaling and recognition pathways related to apoptosis, autophagy, proinflammatory responses, and mechanisms by which these microbes attach to and enter cells or those molecules that trigger the host responses. To illustrate these principles, this review will focus on two common rickettsial agents that occur globally, Rickettsia species and Anaplasma phagocytophilum.

Whole-Genome Sequence of Rickettsia parkeri Strain Atlantic Rainforest, Isolated from a Colombian Tick.

Rickettsia parkeri is classified as a member of the alphaproteobacterial microorganisms, genus Rickettsia Here, we report the complete genome sequence of Rickettsia parkeri strain Atlantic Rainforest, which was isolated from an Amblyomma ovale tick collected in the municipality of Necoclí, Colombia.

Detection of Rickettsiae, Borreliae, and Ehrlichiae in Ticks Collected from Walker County, Texas, 2017-2018.

Cases of tick-borne diseases, including spotted fever rickettsioses, borreliosis, babesiosis, anaplasmosis and ehrlichiosis, in the United States and territories have more than doubled from 2004 to 2016 and account for 77% of all vector-borne disease reports. In an effort to inform control efforts, the presence of tick-borne pathogens and their vectors was assessed in a recreational park in Walker County, Texas. Here we report data from questing ticks collected on three dates from June 2017 to June 2018. The majority of ticks collected were Amblyomma americanum (96.69%) followed by three additional tick species: Dermacentor variabilis (2.59%), Ixodes scapularis (0.52%), and A. maculatum (0.21%). Ticks were pooled and tested for molecular evidence of bacterial and viral pathogens, respectively. All of the 68 pools of A. americanum had molecular evidence of the spotted fever group rickettsia, Rickettsia amblyommatis. Additionally, six (8.82%) of the A. americanum pools contained sequences matching Ehrlichia chaffeensis, the pathogen responsible for human monocytotropic ehrlichiosis, and 11 (16.18%) for E. ewingii. Three of the A. americanum pools demonstrated evidence of Borrelia lonestari. The presence of etiologic agents of known human disease in this study merits the continued surveillance efforts of ticks and their pathogens in areas where they could pose risks to public health.

Aislamiento e identificación de bacterias con potencial nosocomial procedentes de ambientes y superficies de una clínica veterinaria Universitaria del Área Metropolitana del Valle de Aburrá, Antioquia-Colombia / Isolation and identification of bacteria with nosocomial potential from environments and surfaces of a veterinary university clinic of Metropolitan area of Aburra Valley Antioquia-Colombia

Introducción: Las infecciones nosocomiales son aquellas adquiridas por los pacientes durante la hospitalización. Son de gran importancia en medicina humana pero aún se desconoce cuál es su papel en medicina veterinaria. Objetivo: Identificar la presencia de bacterias asociadas a infecciones hospitalarias en ambientes y superficies en una clínica veterinaria. Materiales y métodos: Se realizaron dos muestreos, se determinó a través de sedimentación y torunda la presencia de bacterias en el ambiente y las superficies de las 8 unidades de la clínica veterinaria. La presencia de nosocomiales se determinó por el crecimiento y purificación en medios diferenciales, la identificación se hizo por descripción macroscópica de las colonias y tinción de Gram y posteriormente se realizó una caracterización bioquímicamente por medio del API20E y API50 CH/E y un antibiograma en las cepas relacionadas con resistencia a antibióticos. Resultados: Se obtuvo 95 aislados y se logró determinar la presencia de 28 agentes potencialmente nosocomiales, donde se destaca la presencia de Pseudomonas aeruginosa, Proteus sp. y Staphylococcus sp. microorganismos relacionados con infecciones asociadas a hospitales veterinarios. Conclusiones: Se realiza la primera aproximación a este tipo de infecciones en hospitales veterinarios en Antioquia, y se evidencia la circulación en ambiente y superficies de potenciales bacterias nosocomiales en la clínica veterinaria.

Introduction: Care associated infections are of importance in human medicine but few is known in veterinary medicine. Aims: To identify pathogenic bacteria in surfaces of veterinary clinics. Materials and methods: Two samples with cotton hissops were obtained in inert surfaces from 8 veterinary clinics. The presence of pathogenic bacteria was established by growth in agar media, identification of species was performed through colonies morphology and Gram stain and biochemistry identification with API20E and API50 CH/E system and antibiogram. Results: 95 isolates were characterized and within them 28 were pathogenic. The most prevalent were Pseudomonas aeruginosa, Proteus sp. and Staphylococcus sp. Conclusions: This is the first description of pathogenic microorganisms present in veterinary clinics in Antioquia that have potential for clinical consequences for personnel working at this veterinary centers.

Infection by Rickettsia felis in Ctenocephalides felis felis Fleas from North of Colombia.

BACKGROUND: Rickettsia felis is an emergent Rickettsial agent whose main vector is Ctenocephalides felis, but ticks, mites and lice are also infected. We aimed to search for molecular evidence of Rickettsia spp. in fleas collected from dogs and wild rodents (Heteromys anomalous) from three villages of Córdoba and Antioquia provinces (Northern of Colombia), where outbreaks of rickettsioses have occurred, and discuss the possible role of fleas on endemic/enzootic regions for rickettsia. METHODS: During 2010 and 2012, 649 Ctenocephalides felis felis and 24 Pulex irritans fleas were removed from dogs and wild rodents (Heteromys anomalous), respectively, in 3 locations from Córdoba and Antioquia provinces (Colombia). These fleas were tested into pools for Rickettsial infection by PCR, targeting gltA, ompB, and ompA Rickettsial genes. RESULTS: Almost 20% (30/153) of C. felis felis pools contained Rickettsial DNA. The fragments of ompB gene showed high identity values between sequences from Necocli and Los Cordobas with R. felis strain from Senegal (100% and 99.7% respectively) and all were highly related by phylogenetic analyses. Rickettsial DNA in pools of P. irritans was not detected. CONCLUSION: Our findings highlighted the endemicity of the infection by R. felis in fleas from northern of Colombia and showed the likely importance of dogs as hosts of C. felis felis fleas and their potential role as reservoirs of R. felis.

A Cluster of Cases of Rocky Mountain Spotted Fever in an Area Of Colombia Not Known to be Endemic for This Disease.

Rocky Mountain spotted fever (RMSF) has been reported in Colombia since 1937. Most recent outbreaks were in 2006-2008, followed by the absence of recognized cases. This report describes new clinical cases of RMSF and epidemiologic investigations. Medical records were reviewed, and fieldwork, serological and molecular diagnostic testing, and bacterial isolation were performed. Fever, hypotension, abdominal discomfort, and rash accompanied by thrombocytopenia and leukopenia were the most characteristic manifestations. Two convalescent sera from the index case and sera from two dogs revealed high anti-spotted fever group Rickettsia antibody titers. Rickettsia rickettsii was isolated from case 4. Cases 2 and 3 were identified by epidemiological connection with the index case. Thus, a new cluster of cases of RMSF was identified in Antioquia, Colombia, with the occurrence of fatal cases, which indicates the active circulation of the bacteria and a potential risk for the population.

A biosafety level-2 dose-dependent lethal mouse model of spotted fever rickettsiosis: Rickettsia parkeri Atlantic Rainforest strain.

BACKGROUND: The species of the Rickettsia genus are separated into four groups: the ancestral group, typhus group, transitional group and spotted fever group. Rickettsia parkeri, a spotted fever group Rickettsia, has been reported across the American continents as infecting several tick species and is associated with a relatively mild human disease characterized by eschar formation at the tick feeding site, regional lymphadenopathy, fever, myalgia and rash. Currently, there are several mouse models that provide good approaches to study the acute lethal disease caused by Rickettsia, but these models can only be performed in an animal biosafety level 3 laboratory. We present an alternative mouse model for acute lethal rickettsial disease, using R. parkeri Atlantic Rainforest strain and C3H/HeN mice, with the advantage that this model can be studied in an animal biosafety level 2 laboratory. PRINCIPAL FINDINGS: In the C3H/HeN mouse model, we determined that infection with 1x106 and 1x107 viable R. parkeri Atlantic Rainforest strain organisms produced dose-dependent severity, whereas infection with 1x108 viable bacteria resulted in a lethal illness. The animals became moribund on day five or six post-infection. The lethal disease was characterized by ruffled fur, erythema, labored breathing, decreased activity, and hunched posture, which began on day three post-infection (p.i.) and coincided with the peak bacterial loads. Significant splenomegaly (on days three and five p.i.), neutrophilia (on days three and five p.i.), and thrombocytopenia (on days one, three and five p.i.) were observed. SIGNIFICANCE: Since R. parkeri is used at biosafety level 2, the greatest advantage of this inbred mouse model is the ability to investigate immunity and pathogenesis of rickettsiosis with all the tools available at biosafety level 2.

Modelos potenciales de distribución geográfica y climática del complejo Amblyomma cajennense (Acari: Ixodidae), potencial vector de Rickettsia rickettsii en Colombia / Potential models of the geographic and climatic distribution of the Amblyomma cajennense complex (Acari: Ixodidae), a potential vector of Rickettsia rickettsii in Colombia

Resumen Introducción. Las especies del complejo Amblyomma cajennense, potenciales vectores implicados en la transmisión de Rickettsia rickettsii en Centroamérica y Suramérica, presentan una amplia distribución geográfica en el neotrópico. En Colombia, todavía es incipiente el conocimiento sobre las especies de este complejo, su distribución y su ecología. Objetivo. Explorar la ecología del complejo A. cajennense en Colombia a partir del estudio de su selección de hábitat y la generación de modelos potenciales de distribución geográfica y climática. Materiales y métodos. Se utilizaron registros únicos de la presencia de estas garrapatas en el estudio de sus patrones de selección del hábitat, mediante el análisis factorial del nicho ecológico (Ecological Niche Factor Analysis, ENFA), y se construyeron modelos de distribución potencial con las metodologías MaxEnt y GARP. Resultados. El complejo A. cajennense se encontró en las cinco regiones naturales de Colombia, con 64,71 % de los registros procedentes de los departamentos de Antioquia, Cundinamarca y Huila. La selección del hábitat evidenció que estas garrapatas escogen preferentemente las áreas geográficas (ENFA: 96,03 %) según sus condiciones de índice de estabilidad térmica y de precipitación en el trimestre más seco del año. Los modelos de distribución potencial indicaron la idoneidad del hábitat en 31 a 51 % del área del país dependiendo del algoritmo empleado. Conclusiones. En Colombia, el complejo A. cajennense presenta una distribución muy influenciada por el comportamiento en la selección del hábitat climático, característica que facilitó la creación de modelos de distribución. En futuros estudios de campo, se podrían validar los modelos presentados; se requieren, además, otros estudios genéticos para la identificación de especies del complejo y el manejo de sus potenciales zonas de hibridación en el país.

Abstract Introduction: The species of the Amblyoma cajennense complex, potential vectors involved in the transmission of Rickettsia rickettsii in Central and South America, have a wide geographical distribution in the Neotropics. In Colombia, the knowledge about these species, their distribution, and many aspects of their ecology is still limited. Objective: To explore the ecology of A. cajennense complex in Colombia based on the study of its habitat selection, as well as the generation of potential geographic and climatic distribution models. Materials and methods: We used unique records of these ticks to study the selection patterns of the climatic habitat using the Ecological Niche Factor Analysis (ENFA), and we built distribution models using the MaxEnt and GARP algorithms. Results: The record of distributions showed that A. cajennense complex is present in all five natural regions of Colombia with 64.71% of the records found in the departments of Antioquia, Cundinamarca, and Huila. The analysis of their habitat selection showed that these ticks preferably select geographical areas (ENFA: 96.03%) according to the isothermality conditions and the precipitation of the driest quarter of the year. The potential distribution models indicated habitat suitability in 31 to 51% of the area of the country depending on the algorithm. Conclusions: The distribution of A. cajennense complex in Colombia is highly influenced by a climatebased habitat selection, a characteristic that favored the creation of distribution models. Field studies will allow the validation of the potential distribution models and further genetic studies will be required in the country to identify species within the complex and study their potential hybridization areas.

Epidemiological Surveillance of Rodent-Borne Viruses (Roboviruses).

This article will outline surveillance approaches for rodent-borne viruses (roboviruses). We present a synopsis of the main categories of trapping methods with some notes about their use in fieldwork. We also describe the types of laboratory analysis commonly used in Robovirus surveillance.

Potential models of the geographic and climatic distribution of the Amblyomma cajennense complex (Acari: Ixodidae), a potential vector of Rickettsia rickettsii in Colombia / Modelos potenciales de distribución geográfica y climática del complejo Amblyomma cajennense (Acari: Ixodidae), potencial vector de Rickettsia rickettsii en Colombia

Introduction: The species of the Amblyoma cajennense complex, potential vectors involved in the transmission of Rickettsia rickettsii in Central and South America, have a wide geographical distribution in the Neotropics. In Colombia, the knowledge about these species, their distribution, and many aspects of their ecology is still limited. Objective: To explore the ecology of A. cajennense complex in Colombia based on the study of its habitat selection, as well as the generation of potential geographic and climatic distribution models. Materials and methods: We used unique records of these ticks to study the selection patterns of the climatic habitat using the Ecological Niche Factor Analysis (ENFA), and we built distribution models using the MaxEnt and GARP algorithms. Results: The record of distributions showed that A. cajennense complex is present in all five natural regions of Colombia with 64.71% of the records found in the departments of Antioquia, Cundinamarca, and Huila. The analysis of their habitat selection showed that these ticks preferably select geographical areas (ENFA: 96.03%) according to the isothermality conditions and the precipitation of the driest quarter of the year. The potential distribution models indicated habitat suitability in 31 to 51% of the area of the country depending on the algorithm. Conclusions: The distribution of A. cajennense complex in Colombia is highly influenced by a climatebased habitat selection, a characteristic that favored the creation of distribution models. Field studies will allow the validation of the potential distribution models and further genetic studies will be required in the country to identify species within the complex and study their potential hybridization areas.

Introducción. Las especies del complejo Amblyomma cajennense, potenciales vectores implicados en la transmisión de Rickettsia rickettsii en Centroamérica y Suramérica, presentan una amplia distribución geográfica en el neotrópico. En Colombia, todavía es incipiente el conocimiento sobre las especies de este complejo, su distribución y su ecología.Objetivo. Explorar la ecología del complejo A. cajennense en Colombia a partir del estudio de su selección de hábitat y la generación de modelos potenciales de distribución geográfica y climática.Materiales y métodos. Se utilizaron registros únicos de la presencia de estas garrapatas en el estudio de sus patrones de selección del hábitat, mediante el análisis factorial del nicho ecológico (Ecological Niche Factor Analysis, ENFA), y se construyeron modelos de distribución potencial con las metodologías MaxEnt y GARP.Resultados. El complejo A. cajennense se encontró en las cinco regiones naturales de Colombia, con 64,71 % de los registros procedentes de los departamentos de Antioquia, Cundinamarca y Huila. La selección del hábitat evidenció que estas garrapatas escogen preferentemente las áreas geográficas (ENFA: 96,03 %) según sus condiciones de índice de estabilidad térmica y de precipitación en el trimestre más seco del año. Los modelos de distribución potencial indicaron la idoneidad del hábitat en 31 a 51 % del área del país dependiendo del algoritmo empleado.Conclusiones. En Colombia, el complejo A. cajennense presenta una distribución muy influenciada por el comportamiento en la selección del hábitat climático, característica que facilitó la creación de modelos de distribución. En futuros estudios de campo, se podrían validar los modelos presentados; se requieren, además, otros estudios genéticos para la identificación de especies del complejo y el manejo de sus potenciales zonas de hibridación en el país.

Wild and domestic animals likely involved in rickettsial endemic zones of Northwestern Colombia.

Between 2006 and 2008, three outbreaks of human rickettsiosis occurred in Northwestern Colombia (municipalities of Necoclí, Los Córdobas and Turbo), with case fatality rates between 27% and 54%. The aim of this study was to determine previous exposure of wild and domestic animals to spotted fever group (SFG) rickettsiae through serological tests, to detect rickettsial evidence in their ectoparasites, and to analyze their possible role in the epidemiology of rickettsial diseases in this zone of the country. A cross-sectional association study was performed from 2010 to 2011. Blood and ectoparasite samples were collected from domestic animals and small mammals. A statistically significant association (p<0.05) between seropositive animals and the study zones was observed. A total of 2937 ticks, 672 fleas and 74 lice were collected and tested in pools by PCR. The minimum infection rate (MIR) of the positive pools was 5% in ticks, 4% in fleas, and 0% in lice. Phylogenetic analyses showed circulation of three 4.Rickettsia species: R. felis in fleas, and R. bellii and Rickettsia sp. strain Atlantic rainforest, both in Amblyomma ovale ticks. In conclusion, this study demonstrated the occurrence of SFG rickettsiae in domestic, synanthropic and wild animals, and suggests the use of equines and canines as good sentinels of infection, in the study zone. We speculate that a transmission cycle exist involving rodents in the areas where these outbreaks have occurred. Tomes' spiny rats (Proechimys semispinosus) and common opossums (Didelphis marsupialis) could be good candidates as amplifier hosts for SFG rickettsiae in enzootic/endemic zones.

[First evidence of lymphocytic choriomeningitis virus (Arenavirus) infection in Mus musculus rodents captured in the urban area of the municipality of Sincelejo, Sucre, Colombia].

INTRODUCTION: The lymphocytic choriomeningitis virus is an Old World arenavirus that infects Mus musculus, and can cause congenital hydrocephalus, chorioretinitis and multisystemic failure in transplant human recipients. Although the disease has not been clinically diagnosed in Colombia yet, there have been reports of infection with the Pichindé virus in rodents from Cauca and Valle del Cauca departments, and with the Guanarito virus in rodents from Córdoba department. OBJECTIVE: To identify the lymphocytic choriomeningitis virus from Mus musculus captured in the municipality of Sincelejo. MATERIALS AND METHODS: We evaluated 80 samples of plasma by ELISA using antigen from lymphocytic choriomeningitis virus. Additionally, a nested RT-PCR was performed to seropositive and seronegative samples for the S-segment. RESULTS: We found a 10% seroprevalence (8/80) and the viral genome was detected in 16 brain samples; the alignment (BLAST) and the phylogenetic analysis (MrBayes, version 3.2.2) confirmed the presence of the lymphocytic choriomeningitis virus. CONCLUSION: The results indicated that human infection with the lymphocytic choriomeningitis virus in humans could occur in the urban area of Sincelejo, although no cases have been reported so far.

Primera evidencia de infección por el virus de la coriomeningitis linfocítica (arenavirus) en roedores Mus musculus capturados en la zona urbana del municipio de Sincelejo, Sucre, Colombia / First evidence of lymphocytic choriomeningitis virus (Arenavirus) infection in Mus musculus rodents captured in the urban area of the municipality of Sincelejo, Sucre, Colombia

Resumen Introducción. El virus de la coriomeningitis linfocítica es un arenavirus del Viejo Mundo que se hospeda en el ratón casero (Mus musculus), y puede causar infecciones congénitas, hidrocefalia, coriorretinitis y falla orgánica múltiple en pacientes receptores de trasplantes. En Colombia aún no se ha reportado la enfermedad mediante diagnóstico clínico, pero en estudios serológicos se ha detectado la infección por el virus Pichindé en roedores en los departamentos del Cauca y Valle del Cauca, y por el virus Guanarito, en roedores en Córdoba. Objetivo. Detectar el virus de la coriomeningitis linfocítica en M. musculus en el municipio de Sincelejo. Materiales y métodos. Se evaluaron 80 muestras de plasma mediante la prueba ELISA usando antígeno del virus de la coriomeningitis linfocítica. Además, se empleó la reacción en cadena de la polimerasa con transcriptasa inversa (RT-PCR) anidada en muestras de animales seropositivos y seronegativos para la detección del segmento S. Resultados. Se encontró una seroprevalencia de 10% (8/80) y se detectó el genoma viral en 16 muestras de cerebro; el alineamiento (en la Basic Local Alignment Search Tool, BLAST) y el análisis filogenético (mediante el programa MrBayes, versión 3.2.2) confirmaron que correspondía al virus de la coriomeningitis linfocítica. Conclusión. Los resultados indicaron que la infección por el virus de la coriomeningitis linfocítica en humanos podría ocurrir en el área urbana de Sincelejo, aunque hasta la fecha no se hayan reportado casos.

Abstract Introduction: The lymphocytic choriomeningitis virus is an Old World arenavirus that infects Mus musculus, and can cause congenital hydrocephalus, chorioretinitis and multisystemic failure in transplant human recipients. Although the disease has not been clinically diagnosed in Colombia yet, there have been reports of infection with the Pichindé virus in rodents from Cauca and Valle del Cauca departments, and with the Guanarito virus in rodents from Córdoba department. Objective: To identify the lymphocytic choriomeningitis virus from Mus musculus captured in the municipality of Sincelejo. Materials and methods: We evaluated 80 samples of plasma by ELISA using antigen from lymphocytic choriomeningitis virus. Additionally, a nested RT-PCR was performed to seropositive and seronegative samples for the S-segment. Results: We found a 10% seroprevalence (8/80) and the viral genome was detected in 16 brain samples; the alignment (BLAST) and the phylogenetic analysis (MrBayes, version 3.2.2) confirmed the presence of the lymphocytic choriomeningitis virus. Conclusion: The results indicated that human infection with the lymphocytic choriomeningitis virus in humans could occur in the urban area of Sincelejo, although no cases have been reported so far.

Human prevalence of the spotted fever group (SFG) rickettsiae in endemic zones of Northwestern Colombia.

In February 2006, an outbreak of human rickettsiosis occurred in the municipality of Necoclí Colombia, with 35% of lethality. This episode was, followed by two more, one in the municipality of Los Cordobas in 2007 with a 54% of lethality and the other one in the municipality of Turbo in 2008 with 27% of lethality. The aim of this study was to perform serological tests in healthy persons to determine the seroprevalence of antibodies against spotted fever group (SFG) rickettsiae and develop a survey to study some infection risk-related factors. A cross-sectional study was performed in 2011 and 2012. A blood sample and survey of associated factors was performed in healthy persons. A prevalence of 32%-41% was found in healthy people. From the multivariate analysis, we found that people living more than 16 years in these sites had a 79% higher risk of being seropositive and a 46% higher risk when they reported having birds in their houses if the variable of having a horse was included in the model. In conclusion, this study shows endemicity of at least one spotted fever group Rickettsia in the study zone.

Antibodies against spotted fever group Rickettsia sp, in horses of the colombian Orinoquia / Anticuerpos contra Rickettsia sp, del grupo de las fiebres manchadas en equinos de la Orinoquía colombiana

Objective. It was determined the presence of antibodies against Rickettsia sp. of the spotted fever group, in horses of 8 municipalities of the Colombian Orinoquia. Matherials and methods. A cross-sectional study was conducted on 246 sera from apparently healthy horses and processed by the indirect immunofluorescence test (IFI). Results. General seropositivity was (2.85%; 7/246), while by municipalities the results were, Arauca (9.1%; 2/22), Saravena (5.6%; 1/18), San José del Guaviare (4.9%; 2/41), San Martín (3.8%; 1/26), Yopal (1.9%; 1/52). It was not identified the presence of antibodies in Puerto López (0/52), Puerto Gaitán (0/15) and Villavicencio (0/20). Four of the positive samples presented titles of 1:64, while the remaining 3 1:128. Conclusions. It shows the circulation of Rickettsia sp. of the Spotted Fever Group in horses in the region of the Colombian Orinoquia, suggesting the need for further studies to understand the ecoepidemiology of municipalities with presence of seropositive.

Objetivo. Determinar la presencia de anticuerpos contra Rickettsia sp. del grupo de las fiebres manchadas, en equinos de 8 municipios de la Orinoquía Colombiana. Materiales y métodos. Se realizó un estudio transversal en 246 sueros equinos provenientes de animales aparentemente sanos y procesados por la técnica de inmunofluorescencia indirecta (IFI). Resultados. La seropositividad general fue (2.85%; 7/246), por municipios la seropositividad fue Arauca (9.1%; 2/22), Saravena (5.6%; 1/18), San José del Guaviare (4.9%; 2/41), San Martín (3.8%; 1/26) y Yopal (1.9%; 1/52). No se identificó la presencia de seropositivos en Puerto López (0/52), Puerto Gaitán (0/15) y Villavicencio (0/20).Cuatro de las muestras positivas presentaron títulos de 1:64, mientras las 3 restantes de 1:128. No se encontró asociación entre los títulos serológicos con la raza, el sexo, edad y actividad zootécnica. Conclusiones. Se demuestra la circulación de Rickettsia sp. del Grupo de las Fiebres Manchadas en equinos de la región de la Orinoquía Colombiana, sugiriendo la necesidad de nuevos estudios para entender la ecoepidemiología de los municipios con presencia de reactores serológicos.

Infection of Amblyomma ovale by Rickettsia sp. strain Atlantic rainforest, Colombia.

Our goal was to understand rickettsial spotted fevers' circulation in areas of previous outbreaks reported from 2006 to 2008 in Colombia. We herein present molecular identification and isolation of Rickettsia sp. Atlantic rainforest strain from Amblyomma ovale ticks, a strain shown to be pathogenic to humans. Infected ticks were found on dogs and a rodent in Antioquia and Córdoba Provinces. This is the first report of this rickettsia outside Brazil, which expands its known range considerably.

Hypoglossal nerve monitoring, a potential application of intraoperative nerve monitoring in head and neck surgery.

BACKGROUND: Intraoperative nerve monitoring (IONM) has many applications in different surgical fields. In head and neck surgery, IONM has been used to perform surgery of the parotid, thyroid and parathyroid glands, preserving the facial and recurrent nerves. However, hypoglossal nerve neuromonitoring has not been addressed with such relevance. MATERIAL AND METHODS: A retrospective review of surgeries performed on patients with special tongue and floor of mouth conditions was undertaken to examine the indications that prompted its use. Particular attention was given to the pathology, intraoperative findings and the final outcome of each patient. RESULTS: Four patients, aged between 6 years and 68 years, with complex oral tongue and floor of mouth lesions were reviewed. Three patients were male, aged 22 years and younger, and two of these patients had oral tongue cancers with previous surgery. Oral tongue and neck conditions are challenging since the functions of the hypoglossal nerve are put at risk. The use of IONM technology allowed us to preserve nerve functions, speech and swallowing. CONCLUSIONS: Although IONM of the hypoglossal nerve is not a common indication in tongue and floor of mouth lesions, under special conditions its application can be extrapolated to challenging surgical cases, like the ones described.

Rattus norvegicus como indicador de la circulación de Capillaria hepatica y Taenia taeniaeformis en la Plaza Minorista de Medellín, Colombia / Rattus norvegicus as an indicator of circulation of Capillaria hepatica and Taenia taeniaeformis on a groceries trade center of Medellín, Colombia

Introducción. Rattus norvegicus cumple un papel epidemiológico en el mantenimiento y dispersión de agentes zoonóticos bacterianos, virales y parasitarios de interés en salud pública. La presencia de infección por helmintos en especies Rattus cercanas a poblaciones expuestas en condiciones ambientales propicias, puede convertirse en un factor de riesgo de transmisión. Objetivo. Reportar la frecuencia de infección con Capillaria hepatica y formas larvarias de Taenia taeniaeformis en ratas silvestres (R. norvegicus) capturadas en una zona urbana de Medellín. Materiales y métodos. Se capturaron 254 ejemplares de R. norvegicus. Los hígados de 54 ejemplares que presentaron lesión hepática macroscópica durante la necropsia, fueron examinados por histopatología convencional. Resultados. La frecuencia de infección por C. hepatica fue de 20,1 % (51/254). Seis hígados fueron también positivos para larvas de T. taeniaeformis con una frecuencia de 2,4 % (6/254). Los hígados infestados con C. hepatica exhibían parásitos en el estadio adulto o juvenil y huevos ovalados con opérculos bipolares, asociados con hepatitis granulomatosa leve a moderada multifocal y acompañada por infiltrado leucocitario. Se observaron lesiones granulomatosas en resolución y fibrosis residual o calcificada que contenía huevos. Donde se encontraron cisticercos de T. taeniaeformis, el hallazgo más frecuente fueron quistes hepáticos que contenían larvas, y lesiones inflamatorias y fibróticas. Conclusión. Estos resultados indican que helmintos de potencial zoonótico circulan en R. norvegicus de ambientes urbanos. Debe investigarse la verdadera distribución de estos parásitos, para determinar el riesgo potencial que corren las poblaciones animales y humanas expuestas a adquirir este tipo de infecciones.

Introduction. Rattus norvegicus, the Norway rat, plays a pivotal role in the maintenance and spread of several zoonotic bacterial, viral and parasitic pathogens of public health interest. The presence of helminthic infections near susceptible human populations can, under appropriate environmental conditions, become a risk factor for their transmission. Objective. Frequencies of infection were reported for Capillaria hepatica and larval forms of Taenia taeniaeformis in wild rats (R. norvegicus) captured in an urban area. Materials and methods. Two hundred and fifty-four adult specimens of R. norvegicus were collected in an urban zone of Medellín, Colombia. The livers of 54 specimens that showed macroscopic hepatic lesions during necropsy were examined by conventional histopathology. Results. The frequency of infestation with C. hepatica was 20.1% (51/254). Six livers (2.4%) were also positive for larvae of T. taeniaeformis. Livers infested with C. hepatica exhibited adult or juvenile parasites and oval eggs with bipolar opercula, and were associated with mild to moderate multifocal granulomatous hepatitis with leucocyte infiltrate. Granulomatous lesions and calcified residual fibroses were found with eggs but without adult parasites. Those animals with cysticerci of T. taeniaeformis showed a high frequency of hepatic cysts containing larvae as well as inflammed and fibrotic lesions. Conclusion. Zoonotic helminths circulate at high frequency in R. norvegicus that occur in urban environments. Further research about the distribution of these parasites will determine the level of health threat they present for susceptible human and domestic animal populations.