Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Sporotrichosis is the most common subcutaneous or implantation mycosis in Mexico. The case of a preauricular cutaneous-fixed sporotrichosis simulating atypical bacterial cellulitis is reported in an elderly patient with no history of trauma. The biopsy showed a suppurative granuloma with scarce yeast. Sporothrix schenckii was identified in the culture and confirmed by molecular biology. She was treated with itraconazole and a clinical and mycological cure was obtained. The case of atypical presentation is presented, coming from a semi-arid zone with extreme weather.

In this practical article, based on questions and answers, the main queries made to specialists are addressed, such as Why vaccinate against HPV? Composition of the vaccine? What are their effectiveness and safety? Should men be vaccinated? and several others.

Syphilis is produced by Treponema pallidum, which is acquired mainly through sexual contact and transplacental, but can also be acquired by transfusion of contaminated human blood and direct accidental inoculation. The natural history of the infection is characterized by three symptomatic clinical stages: primary, secondary and tertiary syphilis; these last two are preceded by asymptomatic or latent stages of the disease: early latent syphilis and late latent syphilis. This report presents the epidemiological situation of syphilis in Chile up to 2016, using as a method the descriptive analysis of cases that entered surveillance. In the last 5 years the syphilis rate remained relatively stable between 22 and 24 cases per one hundred thousand inhabitants (habs). In 2016, 4,147 cases were reported, showing a rate of 22.8 per one hundred thousand inhabitants. In relation to age, the greatest risk was found in the group of 20 to 34 years. The year 2016 increased the gap between the sexes, by increasing the rate in men. According to geographical distribution, in 2016 the highest notification rates are presented in the regions of the extreme north and center of the country, with the highest risk being the regions of Tarapacá, Antofagasta and Valparaíso. Congenital syphilis showed a progressive decrease in the number of cases since 2012 (n = 39) to 2016 (n = 24), whose rate was 0.1 per thousand live births.

Among the infectious diseases characterized by a febrile picture are: dengue, leptospirosis, rickettsiosis and salmonellosis, among others. The objective of this study was to identify IgM antibodies against dengue and Leptospira in febrile patientes. The seropositivity for IgM antibodies to dengue was 34%; 26.3% for women and 7.6% for men, without differences significant (p = 0.181). The seropositivity for IgM antibodies to Leptospira was 3.2%, being found only in women. Positive serology for both dengue and Leptospira was 1%. The serovars detected were Pomona and Canicola by the microagglutination technique. It was possible to identify the unsuspected presence of leptospirosis and dengue in atypical months for the latter, an important fact to consider the study of serology in the differential diagnosis of febrile diseases.

Sarocladium kiliense is a saprophyte fungus that can cause opportunistic infections associated to invasive procedures. We report a multi-hospital nosocomial outbreak of fungemias due to this agent. Patients with positive blood culture to this agent were studied after six bloodstream infections identified in three Chilean hospitals in July 2013 were reported to Ministry of Health National Infection and Prevention Control Program. In general, there were mild clinical manifestations, without deaths attributable to the infection. Epidemiological and microbiological study identified 65 cases in 8 hospitals, mostly pediatric patients in chemotherapy. Initial studies of 94 different drugs and medical devices had negative results, until a second analysis of specific blisters and their pharmaceutical matrix selected by epidemiological criteria identified an intrinsic contamination of ondansetron blisters from a specific producer used in all the patients. A recall of contaminated ondansetron blisters was performed in all the country, after which the outbreak was contained. Surveillance and response of local and national infection prevention and control programs and laboratory support were key to control of a national multi-hospital common source outbreak due to contamination of a drug by an unusual fungus.

Background: Factors associated with candidiasis and colonization in HIV-positive children and adolescents in developing countries are not well understood. Aim: To identify the factors associated with oral Candida colonization and candidiasis in institutionalized HIV-positive children and adolescents in Tijuana, México, as well as the response of the isolates to antifungals. Materials and Methods: Sample of the oral mucosa of 30 HIV positive children and adolescents were obtained to isolate and identify Candida species by culture and metabolic profile. Antifungal drugs susceptibility was determined according to CLSI. Indicators of immunological and virologic failure were classified in accordance to WHO criteria. Results: Six Candida species were identified from oral mucosa, 53% colonizers and 47% in candidiasis. Factors associated with candidiasis and oral colonization were viral load (p = 0,001), CD4+ counts (p = 0,002) and HAART regimen (p ≤ 0,014). The most prevalent species was C. glabrata (33%), but C. albicans (27%) was more resistant to fluconazole (p = 0,001). Itraconazol resistant species were identified in regimens that include an NNRTI (p = 0,041). Conclusion: HIV-positive children and adolescents living in an orphanage showed high prevalence of colonizing Candida spp. and resistance to antifungals, related to NNRTI.

Background: Primary and secondary antiretroviral (ARV) resistance rates of 15 and 40% respectively have been reported in worldwide. Its prevalence in Uruguay is unknown. Aim: To know the prevalence of ARV resistance in Uruguayan children under 15 years old infected with HIV that are controlled in the Centro Hospitalario Pereira Rossell between 2008 and 2016. Specific objectives: Quantify primary and secondary mutations, to identify variables associated with resistance; to describe if the result of the resistance test contributed to achieve undetectable viral load (VL). Methodos: Observational descriptive, longitudinal follow-up. Only children under 15 years with resistance test done between January first 2008 and December 31th 2016 were included in the study. Maternal and child variables. Results: Fifty six children were included. 36 children (64%) had resistance tests prior to the initiation of ART and the other 20 children (36%) due to therapeutic failure. Total resistance: 28.6% (16 children); 4 (11.1%) children with primary mutations and 12 (60%) secondary mutations. The test result changed the ARV plan in 15 (26.7%) of the 56 children. The change achieved undetectable CV in 8 children at month 6. The ART change was not associated with AIDS or death. Discussion: Prevalence studies are useful in making decisions about initial ARV treatment. The prevalence of primary mutations was similar to that published, while secondary prevalence was higher.