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1.
Arch Argent Pediatr ; 117(4): e399-e402, 2019 Aug 01.
Artigo em Espanhol | MEDLINE | ID: mdl-31339283

RESUMO

Syphilis shows marked increase in its prevalence in Argentina and the world. The World Health Organization estimates that annually there are 12 million people infected in the world, 270,000 corresponding to newborns with congenital syphilis. We describe an 8-year-old girl who was undergoing mononucleosis due to Epstein-Barr virus and presented syphilis as a diagnostic finding, confirmed by two different positive treponemal tests, assuming a compatible picture of late latent congenital asymptomatic syphilis.

2.
Travel Med Infect Dis ; 30: 19-24, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31238107

RESUMO

The next Pan American Games will be held in Peru in the period July-August 2019. Around 6680 participants from 41 countries are expected to take part in the event. There will be a total of 62 sport disciplines. This event poses specific challenges, given its size and the diversity of attendees. Such gatherings also have potential for the transmission of imported or endemic communicable diseases, including measles in view of the global outbreak situation, but also tropical endemic diseases. In anticipation of increased travel, a panel of experts from the Latin American Society for Travel Medicine (SLAMVI) developed the current recommendations taking into consideration the epidemiology and risks of the main communicable diseases at potential destinations in Peru, recommended immunizations and other preventives measures. These recommendations can be used as a basis for advice for travelers and travel medicine practitioners. Mosquito-borne infections also pose a challenge. Although Lima is malaria free, travelers visiting Peruvian high-risk areas for malaria should be assessed regarding the need for chemoprophylaxis. Advice on the correct timing and use of repellents and other personal protection measures is key to preventing vector-borne infections. Other important recommendations for travelers should focus on preventing water- and food-borne diseases including travelers' diarrhea. This paper addresses pre-travel, preventive strategies to reduce the risk of acquiring communicable diseases during the Pan American Games and also reviews the spectrum of endemic infections in Lima and Peru to facilitate the recognition and management of infectious diseases in travelers returning to their countries of origin.


Assuntos
Controle de Doenças Transmissíveis , Transmissão de Doença Infecciosa/prevenção & controle , Doenças Endêmicas , Medicina de Viagem , Doenças Endêmicas/prevenção & controle , Humanos , Peru/epidemiologia , Esportes
3.
Arch. argent. pediatr ; 117(1): 6-11, feb. 2019. tab
Artigo em Espanhol | LILACS-Express | ID: biblio-983770

RESUMO

Introducción. Las infecciones por bacilos Gram-negativos multirresistentes (BGN-MR) constituyen un problema creciente en las unidades de cuidado intensivo neonatal. El objetivo del estudio fue conocer las características epidemiológicas, clínicas, microbiológicas, evolutivas y los factores de riesgo de infección por BGN-MR resistentes a carbapenemes en el Servicio de Neonatología de un hospital de alta complejidad. Población y método. Se realizó un estudio de cohorte retrospectivo en dicho Servicio, donde se incluyeron los pacientes con infección documentada por BGN-MR del 24/4/2013 al 29/4/2015. Resultados. Se incluyeron 21 pacientes. La mediana de edad gestacional y peso de nacimiento fue 35 semanas y 2070 gramos, respectivamente. Dieciocho pacientes (86 %) tuvieron hemocultivos positivos y el aislamiento microbiológico más frecuente fue Acinetobacter baumannii (17 pacientes, 81 %), seguido por Klebsiella pneumoniae productora de carbapenemasa (3 pacientes, 14 %) y Enterobacter cloacae (1 paciente, 5 %). La mediana de edad al momento del diagnóstico fue de 28 días y todos tenían factores de riesgo para la infección, como cirugía, asistencia respiratoria mecánica, nutrición parenteral, catéter central y antibióticos. El tratamiento antibiótico definitivo fue colistina en todos los casos, combinado en el 84 %. Cinco pacientes (24 %) fallecieron por la infección. La prematurez y el peso < 2000 g fueron factores de riesgo estadísticamente significativos asociados a la mortalidad (p = 0,03 y 0,01, respectivamente). Conclusión. Las infecciones por BGN-MR se presentaron en pacientes con factores predisponentes. Acinetobacter baumannii fue el primer agente etiológico. La mortalidad fue elevada y relacionada con prematurez y bajo peso al nacer.


Introduction. Multidrug resistant Gramnegative (MDRGN) infections are an increasing problem in neonatal intensive care units. The objective of this study was to establish the epidemiological, clinical, microbiological, and evolutionary characteristics of carbapenem-resistant MDRGN infections and the risk factors for them at the Division of Neonatology of a tertiary care hospital. Population and method. A retrospective cohort study was done in this Division in patients with a documented MDRGN infection between 4/24/2013 and 4/29/2015. Results. Twenty-one patients were included. Their median gestational age and birth weight were 35 weeks and 2070 g, respectively. Eighteen patients (86 %) had a positive blood culture; the most commonly isolated microorganism was Acinetobacter baumannii (17 patients, 81 %), followed by carbapenemase-producing Klebsiella pneumoniae (3 patients, 14 %) and Enterobacter cloacae (1 patient, 5 %). The median age at diagnosis was 28 days and all patients had risk factors for infection, including surgery, assisted mechanical ventilation, parenteral nutrition, central venous line, and antibiotics. The definite antibiotic therapy included colistin in all cases; in combination, in 84 %. Five patients (24 %) died due to the infection. Prematurity and a birth weight < 2000 g were statistically significant risk factors associated with mortality (p = 0.03 and 0.01, respectively). Conclusion. MDRGN infections were observed in patients with predisposing factors. Acinetobacter baumannii was the main etiologic agent. Mortality was high and related to prematurity and a low birth weight.

4.
Arch Argent Pediatr ; 117(1): 6-11, 2019 02 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30652440

RESUMO

INTRODUCTION: Multidrug resistant Gramnegative (MDRGN) infections are an increasing problem in neonatal intensive care units. The objective of this study was to establish the epidemiological, clinical, microbiological, and evolutionary characteristics of carbapenem-resistant MDRGN infections and the risk factors for them at the Division of Neonatology of a tertiary care hospital. POPULATION AND METHOD: A retrospective cohort study was done in this Division in patients with a documented MDRGN infection between 4/24/2013 and 4/29/2015. RESULTS: Twenty-one patients were included. Their median gestational age and birth weight were 35 weeks and 2070 g, respectively. Eighteen patients (86 %) had a positive blood culture; the most commonly isolated microorganism was Acinetobacter baumannii (17 patients, 81 %), followed by carbapenemase-producing Klebsiella pneumoniae (3 patients, 14 %) and Enterobacter cloacae (1 patient, 5 %).The median age at diagnosis was 28 days and all patients had risk factors for infection, including surgery, assisted mechanical ventilation, parenteral nutrition, central venous line, and antibiotics. The definite antibiotic therapy included colistin in all cases; in combination, in 84 %. Five patients (24 %) died due to the infection. Prematurity and a birth weight < 2000 g were statistically significant risk factors associated with mortality (p = 0.03 and 0.01, respectively). CONCLUSION: MDRGN infections were observed in patients with predisposing factors. Acinetobacter baumannii was the main etiologic agent. Mortality was high and related to prematurity and a low birth weight.

5.
Buenos Aires; Médica Panamericana; 2019. 160 p. ilus, tab.
Monografia em Espanhol | LILACS | ID: biblio-1026447

RESUMO

Las consultas pediátricas por temas infectológicos son frecuentes y relevantes durante toda la infancia, desde la etapa neonatal hasta la adolescencia. En este nuevo volumen de las Series Garrahan: El ñino y las infecciones, se han seleccionado temas específicos, sobre la base de la actualización del conocimiento, los cambios epidemiológicos y de las conductas clínicas ocurridos en los últimos años y la necesidad del manejo adecuado de estas afecciones, ya sea ambulatorio o durante la internación. Entre sus aspectos sobresalientes se incluyen: El estudio de temas destacados como el abordaje del niño febril; las infecciones de piel y partes blandas, incluidas las asociadas con mordeduras; las infecciones en el recién nacido; las infecciones respiratorias bajas, incluida la tuberculosis; y las infecciones osteoarticulares, del sistema nervioso central e intraabdominales. La inclusión de un capítulo especial sobre la prevención de infecciones para ayudar a reducir su incidencia. El enfoque práctico, con discusión de casos clínicos y definición de conductas, y ubicando al pediatra en un papel central como coordinador de la atención interdisciplinaria. Aspectos clave y lecturas recomendadas en el cierre de cada capítulo. Una obra actualizada que aporta información científica y la experiencia de los profesionales del Hospital Garrahan, dedicada a todos los miembros del equipo de salud que atienden y cuidan niños dondequiera que trabajen al servicio de la salud infantil


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Osteomielite , Peritonite , Pneumonia , Febre Recorrente , Dermatopatias Infecciosas , Tuberculose , Mordeduras e Picadas , Artrite Infecciosa , Coqueluche , Vacinação , Meningites Bacterianas , Antibioticoprofilaxia , Febre , Febre de Causa Desconhecida , Encefalite Infecciosa , Sepse Neonatal
6.
Rev Chilena Infectol ; 34(3): 270-275, 2017 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-28991326

RESUMO

Hydatid disease is a parasitic infection whose etiologic agent is Echinococcus granulosus. Human is an accidental intermediate host and the most common site is the liver. The brain involvement is unusual and up to 75% of cases are described in the pediatric population. We present six children with cerebral hydatid disease admitted to the Pediatric Hospital J.P. Garrahan. All had neurological involvement on admission. The images showed single cystic lesion in the brain. They did not present involvement in other organs. Serology was negative in all cases. Medical and surgical treatment in all cases. The clinical outcome was favorable without sequelae in five of them and one had a residual paresis right faciobrachiocrural. This infection should be considered in the differential diagnosis of cystic tumor lesions of the central nervous system.


Assuntos
Encefalopatias/diagnóstico , Helmintíase do Sistema Nervoso Central/diagnóstico , Equinococose/diagnóstico , Encefalopatias/cirurgia , Helmintíase do Sistema Nervoso Central/cirurgia , Criança , Pré-Escolar , Equinococose/cirurgia , Feminino , Humanos , Masculino
7.
Rev. chil. infectol ; 34(3): 270-275, jun. 2017. ilus, tab
Artigo em Espanhol | LILACS-Express | ID: biblio-899711

RESUMO

Hydatid disease is a parasitic infection whose etiologic agent is Echinococcus granulosus. Human is an accidental intermediate host and the most common site is the liver. The brain involvement is unusual and up to 75% of cases are described in the pediatric population. We present six children with cerebral hydatid disease admitted to the Pediatric Hospital J.P. Garrahan. All had neurological involvement on admission. The images showed single cystic lesion in the brain. They did not present involvement in other organs. Serology was negative in all cases. Medical and surgical treatment in all cases. The clinical outcome was favorable without sequelae in five of them and one had a residual paresis right faciobrachiocrural. This infection should be considered in the differential diagnosis of cystic tumor lesions of the central nervous system.


La hidatidosis es una infección parasitaria causada por Echinococcus granulosus. El ser humano es un hospedero intermediario accidental. La localización más frecuente es la hepática. El compromiso cerebral es inusual, se describe que hasta 75% ocurre en población pediátrica. Se presenta una serie de seis niños con hidatidosis cerebral internados en el Hospital de Pediatría J. P. Garrahan. Todos presentaron compromiso neurológico al ingreso. Las imágenes mostraron lesiones quísticas únicas en el cerebro. No tuvieron compromiso de otros órganos. La serología fue negativa en todos los casos. El tratamiento fue médico-quirúrgico. La evolución clínica fue favorable sin secuelas en cinco de ellos y uno presentó una hemiparesia faciobraquiocrural derecha como secuela. Esta infección debe considerarse entre los diagnósticos diferenciales de lesiones tumorales quísticas del sistema nervioso central.

8.
Arch. argent. pediatr ; 115(3): 282-286, jun. 2017. ilus, tab
Artigo em Espanhol | LILACS-Express | ID: biblio-1038372

RESUMO

La hidatidosis es una zoonosis con una amplia distribución en Argentina y en el mundo. Se adquiere en la infancia, pero se presenta, más frecuentemente, en la edad adulta. La población pediátrica representa el 10%-20% del total de los casos. Se presentan 47 niños con diagnóstico de hidatidosis durante un período de 20 años. La mediana de edad fue de 8 años (rango: 3-17) y, en su mayoría, tenían algún antecedente epidemiológico orientador, como la procedencia de un área endémica, rural y/o la tenencia de perros alimentados con visceras. El 85% fueron quistes únicos localizados en un solo parénquima. Las localizaciones quísticas pulmonares y hepáticas fueron las más frecuentemente encontradas. El tratamiento fue médico-quirúrgico en 45 pacientes (96%). Trece (28%) presentaron alguna complicación posterior, que fue más frecuente en aquellos con localización pulmonar. Tres (6%) recayeron entre el mes y los 24 meses, y requirieron una nueva cirugía. Ninguno falleció a causa de la enfermedad parasitaria.


Echinococcosis is a zoonotic disease that is widely spread across Argentina and worldwide. It is acquired during childhood but it is more common during adulthood. The pediatric population accounts for 10-20% of all cases. This study included 47 children diagnosed with echinococcosis over a 20-year period. Their median age was 8 years old (range: 3-17); most patients had some epidemiological history, such as having lived or living in an endemic or rural area and/or having dogs that are fed with viscera. Findings included 85% of single cysts in only one parenchyma. Cysts were most commonly located in the liver and lungs. Medical/surgical treatment was carried out in 45 patients (96%). Subsequent complications were observed in 13 patients (28%), which were more common in those with lung cysts. Three patients (6%) relapsed 1-24 months later and required a new surgery. No patient died as a result of the parasitic disease.

9.
Arch Argent Pediatr ; 115(3): 282-286, 2017 06 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28504496

RESUMO

Echinococcosis is a zoonotic disease that is widely spread across Argentina and worldwide. It is acquired during childhood but it is more common during adulthood. The pediatric population accounts for 10-20% of all cases. This study included 47 children diagnosed with echinococcosis over a 20-year period. Their median age was 8 years old (range: 3-17); most patients had some epidemiological history, such as having lived or living in an endemic or rural area and/ or having dogs that are fed with viscera. Findings included 85% of single cysts in only one parenchyma. Cysts were most commonly located in the liver and lungs. Medical/surgical treatment was carried out in 45 patients (96%). Subsequent complications were observed in 13 patients (28%), which were more common in those with lung cysts. Three patients (6%) relapsed 1-24 months later and required a new surgery. No patient died as a result of the parasitic disease.


Assuntos
Equinococose , Adolescente , Argentina/epidemiologia , Criança , Pré-Escolar , Equinococose/diagnóstico , Equinococose/epidemiologia , Equinococose/terapia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Centros de Atenção Terciária
10.
Arch. argent. pediatr ; 113(6): e345-e348, dic. 2015. ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-838149

RESUMO

La actinomicosis es una enfermedad producida por bacterias del género Actinomyces. La forma torácica representa el 30% de los casos. La evolución es habitualmente crónica, con clínica variable. Se presenta una nina de 11 años de edad con tumefacción subescapular derecha de un mes de evolución, asociada a fiebre, hiporexia y pérdida de peso. Se diagnosticó actinomicosis torácica producida por Actinomyces meyeri. Recibió tratamiento antibiótico durante un año, con resolución completa. Aunque es poco frecuente, debe ser tenida en cuenta como diagnóstico diferencial en cuadros de tumoración torácica de larga evolución con compromiso del estado general. Debe informarse al microbiólogo la sospecha diagnóstica por lo difícil de su desarrollo en los medios de cultivo habitual.


Actinomycosis is a disease produced by bacteria of the genus Actinomyces. The thoracic form represents 30% of the cases. Signs and symptoms are generally unspecific. A previously healthy 11 year old girl was admitted with a chest mass of a month of evolution associated with fever, hyporexia and weight loss. Thoracic actinomycosis was diagnosed with the isolation of Actinomyces meyeri in the mass drainage. She received antibiotic treatment for a year with complete resolution. Although rare, it should be taken into account as a differential diagnosis in long evolution thoracic tumor affecting the general condition. The microbiologist must be warned about the suspected diagnosis because it is difficult to find it in routinely used culture media.


Assuntos
Humanos , Feminino , Criança , Actinomyces/isolamento & purificação , Actinomicose/diagnóstico , Pneumopatias/diagnóstico
11.
Arch Argent Pediatr ; 113(6): e345-8, 2015 Dec 01.
Artigo em Espanhol | MEDLINE | ID: mdl-26593814

RESUMO

Actinomycosis is a disease produced by bacteria of the genus Actinomyces. The thoracic form represents 30% of the cases. Signs and symptoms are generally unspecific. A previously healthy 11 year old girl was admitted with a chest mass of a month of evolution associated with fever, hyporexia and weight loss. Thoracic actinomycosis was diagnosed with the isolation of Actinomyces meyeri in the mass drainage. She received antibiotic treatment for a year with complete resolution. Although rare, it should be taken into account as a differential diagnosis in long evolution thoracic tumor affecting the general condition. The microbiologist must be warned about the suspected diagnosis because it is difficult to find it in routinely used culture media.


Assuntos
Actinomicose/diagnóstico , Pneumopatias/diagnóstico , Actinomyces/isolamento & purificação , Criança , Feminino , Humanos
12.
Arch Argent Pediatr ; 113(1): 58-62, 2015 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-25622162

RESUMO

The number of children who travel outside their home countries has increased dramatically.Whatever the reason for it, it involves exposure to an environment with characteristics that must be taken into account. Similarly, the transfer itself can generate anxiety in the family and presents the risk of vehicle-related injuries (which is the leading cause of death in children who travel). Parents will often seek for pre-travel advice. The aim of this paper is to review the recommendations to assess a family who is planning to travel with children. Initially,general recommendations will be addressed in the preparation of the trip and afterwards insect-borne diseases prevention.


Assuntos
Saúde da Criança , Viagem , Criança , Pré-Escolar , Humanos , Lactente , Mordeduras e Picadas de Insetos/prevenção & controle
13.
Arch. argent. pediatr ; 113(1): 58-62, 2015 Jan.
Artigo em Espanhol | BINACIS | ID: bin-133783

RESUMO

The number of children who travel outside their home countries has increased dramatically.Whatever the reason for it, it involves exposure to an environment with characteristics that must be taken into account. Similarly, the transfer itself can generate anxiety in the family and presents the risk of vehicle-related injuries (which is the leading cause of death in children who travel). Parents will often seek for pre-travel advice. The aim of this paper is to review the recommendations to assess a family who is planning to travel with children. Initially,general recommendations will be addressed in the preparation of the trip and afterwards insect-borne diseases prevention.

14.
Arch Argent Pediatr ; 112(5)2014 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-25192533

RESUMO

The development and spread of drug resistant malaria parasites, population and travelers movements to malaria zones have led to the resurgence of malaria as a global health problem. Estimates suggest that 660,000 deaths occur annually, mainly in infants, children and pregnant woman. Disease knowledge and protection against mosquito bites are the first line of defense against malaria. Malaria chemoprophylaxis adds to these measures, it must be evaluated based on the individual risk.


Assuntos
Malária/prevenção & controle , Viagem , Quimioprevenção , Criança , Humanos
15.
Arch Argent Pediatr ; 112(4): 332-6, 2014 Aug.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-24955903

RESUMO

INTRODUCTION: Pneumococcal meningitis is causedby Streptococcuspneumoniae and hashigh morbidity and mortality rates. The objective of this study was to identify the epidemiological and clinical characteristics, antibiotic sensitivity and evolution of pneumococcal meningitis in children prior to the introduction of the vaccine in Argentina. METHODS: Patients younger than 18 years old hospitalizedat Hospital J. P. Garrahanbetween1999 and 2010 were included. Children's microbiology lab records and case records were reviewed. RESULTS: One hundred and eleven children with S. pneumoniae meningitis were identified. Forty cases were found in the 1999-2002 period, 35 in the 2003-2006 period, and 36 in the 20072010 period. The mean age was 7 months old (range: 1-191). One hundred and four patients were immunocompetent (94%). Only 20 patients (18%) had an underlying disease. The most commonly observed clinical presentation was neurological involvement in 80 patients (75%), and sepsis in59 (53%). Forty-nine patients (44%) had to be admitted to the ICU. A second clinical source of infection was identified in 24 patients (22%); half of these cases corresponded to pneumonia. Positive findings were observed in the cerebrospinal fluid culture of 103 patients (93%) and in the blood culture of 88 (79%). Resistance to penicillin was identified in 15% of cases, while 5% showed resistance to cefotaxime. Antibiotic resistance was reduced over the years. Complications occurred in 56 patients (50%), and 11 (10%) died because of the infection. CONCLUSION: Antimicrobial resistance by S. pneumoniae was reduced over time. It is important to maintain epidemiological surveillance to assess the impact of immunization in Argentina.


Assuntos
Meningite Pneumocócica/prevenção & controle , Vacinas Pneumocócicas , Vacinas Conjugadas , Adolescente , Argentina , Criança , Pré-Escolar , Hospitais Pediátricos , Humanos , Programas de Imunização , Lactente , Meningite Pneumocócica/tratamento farmacológico , Meningite Pneumocócica/epidemiologia , Testes de Sensibilidade Microbiana , Estudos Retrospectivos , Fatores de Tempo
16.
Rev. iberoam. micol ; 31(2): 141-144, abr.-jun. 2014.
Artigo em Espanhol | IBECS | ID: ibc-121256

RESUMO

Antecedentes. La paracoccidioidomicosis es la micosis sistémica más frecuente en las zonas tropicales y subtropicales de Latinoamérica; el agente etiológico es Paracoccidioides. La enfermedad se presenta preferentemente en la población adulta, por lo que existen pocos reportes en la edad pediátrica. El objetivo del presente trabajo es describir las características clínicas, epidemiológicas y diagnósticas, y la evolución de los casos de paracoccidioidomicosis diagnosticados en el Hospital de Pediatría Prof. Dr. Juan P. Garrahan entre los años 2000 y 2010. Casos clínicos. Se presentan los casos de 4 pacientes previamente sanos procedentes del norte argentino con paracoccidioidomicosis diseminada juvenil y diagnóstico confirmatorio anatomopatológico o microbiológico. Conclusiones. La paracoccidioidomicosis debe ser considerada dentro de los diagnósticos diferenciales en niños con síndrome febril y compromiso linfoganglionar, acompañado por anemia, hipereosinofilia e hipergammaglobulinemia, procedentes de áreas endémicas del país (AU)


Background. Paracoccidioidomycosis is the most frequent systemic mycosis in Latin America, caused by the dimorphic fungus Paracoccidioides. Paracoccidioidomycosis in children is uncommon. Our aim is to describe clinical features of patients who had a confirmed diagnosis of paracoccidioidomycosis in our hospital in the last 10 years. Case reports. We describe 4 cases of paracoccidioidomycosis in previously healthy children from the north of our country. Diagnoses were made by biopsy or culture. Conclusions. The diagnosis of paracoccidioidomycosis should be considered in a patient coming from regions where Paracoccidioides is endemic, and presenting with a lymphoproliferative syndrome, anemia, eosinophilia and hypergammaglobulinemia (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Paracoccidioidomicose/complicações , Paracoccidioidomicose/microbiologia , Micoses/epidemiologia , Micoses/prevenção & controle , Diagnóstico Diferencial , Hipergamaglobulinemia/complicações , Hipergamaglobulinemia/diagnóstico , Paracoccidioidomicose/epidemiologia , Infecções Fúngicas do Sistema Nervoso Central/complicações , Infecções Fúngicas do Sistema Nervoso Central/epidemiologia , Eosinofilia/microbiologia
17.
Travel Med Infect Dis ; 12(3): 208-18, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24821081

RESUMO

The next FIFA World Cup will be held in Brazil in June-July 2014. Around 600,000 international visitors and participants (as well over 3 million domestic travelers) are expected. This event will take place in twelve cities. This event poses specific challenges, given its size and the diversity of attendees, including the potential for the transmission of imported or endemic communicable diseases, especially those that have an increased transmission rate as a result of close human proximity, eg, seasonal influenza, measles but also tropical endemic diseases. In anticipation of increased travel, a panel of experts from the Latin American Society for Travel Medicine (SLAMVI) developed the current recommendations regarding the epidemiology and risks of the main communicable diseases in the major potential destinations, recommended immunizations and other preventives measures to be used as a basis for advice for travelers and travel medicine practitioners. Mosquito-borne infections also pose a challenge. Dengue poses a significant risk in all states, including the host cities. Vaccination against yellow fever is recommended except for travelers who will only visit coastal areas. Travelers visiting high-risk areas for malaria (Amazon) should be assessed regarding the need for chemoprophylaxis. Chikunguya fever may be a threat for Brazil, given the presence of Aedes aegypti, vector of dengue, and the possibility of travelers bringing the virus with them when attending the event. Advice on the correct timing and use of repellents and other personal protection measures is key to preventing these vector-borne infections. Other important recommendations for travelers should focus on preventing water and food-borne diseases such as hepatitis A, typhoid fever, giardiasis and traveler's diarrhea. Sexually transmitted diseases (STD) should be also mentioned and the use of condoms advocated. This review addresses pre-travel, preventive strategies to reduce the risk of acquiring communicable diseases during a mass gathering such as the World Cup and also reviews the spectrum of endemic infections in Brazil to facilitate the recognition and management of infectious diseases in travelers returning to their countries of origin.


Assuntos
Controle de Doenças Transmissíveis , Doenças Transmissíveis/epidemiologia , Saúde Pública , Viagem , Brasil/epidemiologia , Aglomeração , Geografia , Humanos , Risco , Sociedades Médicas , Esportes , Medicina de Viagem
20.
Rev Iberoam Micol ; 31(2): 141-4, 2014.
Artigo em Espanhol | MEDLINE | ID: mdl-23792123

RESUMO

BACKGROUND: Paracoccidioidomycosis is the most frequent systemic mycosis in Latin America, caused by the dimorphic fungus Paracoccidioides. Paracoccidioidomycosis in children is uncommon. Our aim is to describe clinical features of patients who had a confirmed diagnosis of paracoccidioidomycosis in our hospital in the last 10 years. CASE REPORTS: We describe 4 cases of paracoccidioidomycosis in previously healthy children from the north of our country. Diagnoses were made by biopsy or culture. CONCLUSIONS: The diagnosis of paracoccidioidomycosis should be considered in a patient coming from regions where Paracoccidioides is endemic, and presenting with a lymphoproliferative syndrome, anemia, eosinophilia and hypergammaglobulinemia.


Assuntos
Paracoccidioidomicose/diagnóstico , Anfotericina B/uso terapêutico , Anemia/etiologia , Antifúngicos/uso terapêutico , Argentina , Criança , Pré-Escolar , Ácido Desoxicólico/uso terapêutico , Diagnóstico Diferencial , Combinação de Medicamentos , Doenças Endêmicas , Feminino , Febre/etiologia , Fungemia/diagnóstico , Hepatomegalia/etiologia , Humanos , Íleus/etiologia , Itraconazol/uso terapêutico , Doenças Linfáticas/etiologia , Transtornos Linfoproliferativos/diagnóstico , Masculino , Neoplasias/diagnóstico , Osteólise/etiologia , Paracoccidioidomicose/complicações , Paracoccidioidomicose/tratamento farmacológico , Paracoccidioidomicose/epidemiologia , Esplenomegalia/etiologia
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