Afectación oftalmológica en el contexto de un síndrome de Sweet: comunicación de un caso y revisión de la literatura / Ocular involvement in a patient with Sweet syndrome: report of a case and review of the literatura

Presentamos el caso clínico de una mujer de 66 años que acudió a urgencias por lesiones cutáneas en miembros tanto superiores como inferiores, edema facial y enrojecimiento ocular, acompañados de conjuntivitis hemorrágica. Tras pautar corticoides sistémicos el cuadro se resolvió en una semana. La biopsia cutánea confirmó que se trataba de un síndrome de Sweet. El síndrome de Sweet es una enfermedad infrecuente y desconocida para la mayor parte de los oftalmólogos a pesar de cursar con manifestaciones oftalmológicas. La afectación ocular está presente en un tercio de los pacientes, siendo los más usuales la epiescleritis y la conjuntivitis. El diagnóstico de confirmación es histopatológico y se caracteriza por una rápida respuesta a los corticoides sistémicos

The case presented is a 66-year-old woman who attended the emergency department due to skin lesions on the limbs, facial oedema, and eye redness accompanied by haemorrhagic conjunctivitis. The symptoms resolved after one week of systemic steroid treatment. Skin biopsy confirmed Sweet syndrome. Sweet syndrome is rare disorder and unknown by most ophthalmologists despite its frequent ophthalmological manifestations. Ocular involvement is present in one third of patients, with episcleritis and conjunctivitis being the most repeated. Pathology findings confirm the diagnosis which is also characterised by a rapid response to systemic corticosteroids

Molecular evolution of coxsackievirus A24v in Cuba over 23-years, 1986-2009.

Coxsackievirus A24 variant (CVA24v) is a major causative agent of acute hemorrhagic conjunctivitis outbreaks worldwide, yet the evolutionary and transmission dynamics of the virus remain unclear. To address this, we analyzed and compared the 3C and partial VP1 gene regions of CVA24v isolates obtained from five outbreaks in Cuba between 1986 and 2009 and strains isolated worldwide. Here we show that Cuban strains were homologous to those isolated in Africa, the Americas and Asia during the same time period. Two genotypes of CVA24v (GIII and GIV) were repeatedly introduced into Cuba and they arose about two years before the epidemic was detected. The two genotypes co-evolved with a population size that is stable over time. However, nucleotide substitution rates peaked during pandemics with 4.39 × 10-3 and 5.80 × 10-3 substitutions per site per year for the 3C and VP1 region, respectively. The phylogeographic analysis identified 25 and 19 viral transmission routes based on 3C and VP1 regions, respectively. Pandemic viruses usually originated in Asia, and both China and Brazil were the major hub for the global dispersal of the virus. Together, these data provide novel insight into the epidemiological dynamics of this virus and possibly other pandemic viruses.