RESUMO
La salmonelosis se relaciona habitualmente con intoxicaciones alimentarias; sin embargo, existen otras fuentes de contagio que pueden pasar inadvertidas, como puede suceder al tener contacto con reptiles. En este estudio se investiga el contagio de salmonelosis a partir de una tortuga. A raíz de la notificación sobre un lactante de 11 meses de edad con diagnóstico de salmonelosis, se inició la investigación epidemiológica. Se entrevistó a todos los familiares sobre signos y síntomas, antecedentes epidemiológicos y fuentes de exposición domiciliaria y comunitaria. Se observó que en el domicilio había una tortuga; la madre era la encargada de su cuidado. Se analizó una muestra de agua del acuario y se aisló Salmonella parathyphi B variedad Java, que coincidía con la especie aislada en el niño. La tortuga como portadora de Salmonella está poco descrita en Europa, por ello la realización de este estudio. La falta de una correcta higiene después de haber estado en contacto con la tortuga o con su medio puede ocasionar casos de salmonelosis, tal como sucedió en este estudio, en el que la madre fue el vehículo de transmisión, dado que el lactante no tenía acceso a la tortuga. Frente a un diagnóstico de salmonelosis, se debe sospechar también una posible exposición a reptiles. Por lo tanto, las familias que tienen o piensan tener una tortuga u otro reptil deberían ser informadas acerca de los riesgos que conlleva. También cabe destacar el importante rol de enfermería en el desarrollo de estudios epidemiológicos (AU)
This is a continuation of the article published in this journal (Enfermeria Clinica), entitled 'Integral approach by the case manager and the community nurse to a complex case of diabetes mellitus in the home'. We present the case of a 76 year- old patient with long-term and clinically complex Diabetes Mellitus. The patient was taking part in the Primary Care home care program. This article describes the follow-up of the case in which new complications appeared in the right limb, which led to the amputation of the second limb. A new evaluation following Virginia's Henderson model was performed six months after the initial care plan. Nursing diagnoses were made following the North American Nursing Diagnosis Association (NANDA). These diagnoses led to changes in objectives and performance criteria using, nursing outcomes classification (NOC) and nursing interventions classification (NIC). One of the results obtained was the improvement of her well-being by enabling the patient to interact and integrate socially within her environment after mobilising the corresponding social and family resources. Involvement in clinical practice is important in the prevention of diabetes mellitus and diabetic foot complications. Difficult and complex situations are sometimes beyond the ability of the community nurse. It can be beneficial to take advantage of the clinical support offered by the case management model and the integrated approach of a multidisciplinary team (AU)
Assuntos
Humanos , Salmonella/patogenicidade , Infecções por Salmonella/transmissão , Tartarugas , Zoonoses/transmissão , Fatores de RiscoRESUMO
Salmonellosis is usually related to food poisoning however other possible causes such as reptile exposure are often unrecognised. The aim of this study is to describe a case of salmonella infection related to pet exposure. After a salmonella infection in an eleven month old baby was reported to our public health agency, an epidemiological investigation took place. Despite all family members had had clinical symptoms suggesting salmonella infection none of the microbiological analysis was positive. At the infant's home they had an exotic pet: a turtle. We found out that Salmonella was present in a sample of water of its aquarium. Both profiles of S. parathyphi B (from the infant and from the aquaria samples) were identical. Exotic pets are not often recognized as Salmonella infection carriers and vehicles in Europe. As described in this study, an inaccurate hygiene after touching turtles or its habitat can lead to spread salmonella infection in humans. When investigating Salmonella infection exposure to exotic pets has to be addressed. People that have or wish to have a turtle or any other reptile should be informed about its risks. Nursing role is most important in the surveillance and study of such cases.
