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Introducción . La toxoplasmosis es una zoonosis parasitaria que compromete al ser humano y muchas otras especies de vertebrados, provocada por el agente etiológico Toxoplasma gondii. Objetivo . El objetivo del presente estudio es determinar la frecuencia de toxoplasmosis en muestras de pacientes atendidos en el Instituto SELADIS (*) durante el período de enero de 2021 a julio de 2022, además de su relación con el diagnóstico clínico que incluyen las solicitudes de pruebas. Materiales y métodos . Se consideraron 290 pruebas de pacientes con requerimiento de anticuerpos IgG e IgM anti-Toxoplasma gondii, utilizando la prueba de ELISA (comercial). Resultados . Se encontró que la frecuencia de anticuerpos IgM contra T. gondii fue del 7.24 % (21/290) y de anticuerpos IgG contra T. gondii, del 33.1 % (96/290). En relación con la edad, se observó que en pacientes adultos (mayores de 31 años) la frecuencia fue mayor (IgM: 4.14% % e IgG: 23.8%). El 6.9% de los pacientes tenían un diagnóstico relacionado con patología ocular, el 6.21% eran mujeres embarazadas y entre ellas la seropositividad para anticuerpos IgG fue del 24.64%; y para IgM fue del 8.70% (primer trimestre 2.90% y segundo 4.35%). La seropositividad para anticuerpos IgG, en pacientes trasplantados renales, fue del 1.4% y para IgM del 0%. En pacientes con adenomegalia, el 2.4% fueron positivos para IgG y el 0.69% para IgM. Conclusión . En conclusión, se encontró que la frecuencia de anticuerpos contra toxoplasmosis en la población de estudio fue de 33.1% para IgG y 7.24% para IgM. En relación con el diagnóstico clínico, se encontró que los tres principales escenarios de salud son (en orden descendente de importancia) para el Ac IgG contra toxoplasmosis: patología ocular, el embarazo y adenomegalias. En cambio, la relación con el diagnóstico de estos tres escenarios para el Ac IgM contra toxoplasmosis, son: el embarazo, patología ocular y adenomegalias.

Introduction . Toxoplasmosis is a parasitic zoonosis disease that affects humans and many other vertebrate species, and is caused by the etiological agent known as Toxoplasma gondii. Objective . The aim of this study is to determine the frequency of toxoplasmosis in samples from patients who were assisted in the SELADIS Institute (*) in the period between January 2021 and July 2022, in addition to its relation to the clinical diagnosis including requested tests. Materials and methods . 290 samples from patients were considered that also required IgG and IgM anti-Toxoplasma gondii antibodies, using an ELISA assay (commercial kit). Results. The frequency of IgM antibodies against T. gondii was 7.24% (21/290) and IgG antibodies against T. gondii were 33.1% (96/290). In relation to age, it was observed that in adult patients (over 31 years of age) the frequency was higher (IgM: 4.14%, IgG: 23.8%). 6.9% of the patients had a diagnosis related to ocular pathology, 6.21% were pregnant women and among them the seropositivity for IgG antibodies was 24.64%; and for IgM it was 8.70% (first trimester 2.90% and second 4.35%). The seropositivity for IgG antibodies in kidney transplant patients was 1.4% and 0% for IgM. In patients with adenomegaly, 2.4% were positive for IgG and 0.69% for IgM. Conclusion . In conclusion, it was found that the frequency of antibodies against Toxoplasmosis in the study population was 33.1% for IgG and 7.24% for IgM. In relation to clinical diagnosis, it was found that the three main health scenarios are (in descending order of importance), for IgG Ab against toxoplasmosis: ocular pathology, pregnancy and adenomegaly. Besides this, it was found that the relation of these three scenarios diagnoses to IgM Ab against toxoplasmosis are: pregnancy, ocular pathology and adenomegaly.

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Castleman disease is an uncommon and heterogenous lymphoproliferative disorder which is classified as unicentric or multicentric depending on the number of lymph nodes involved. Each type has a different clinical presentation, aetiology, treatment and prognosis. We report the case of a young woman who presented with cervical lymphadenopathy and a retroperitoneal mass, and was diagnosed with unicentric Castleman disease and pheochromocytoma. We describe the diagnostic steps, the complications that developed, and the importance of the differential diagnosis in the evaluation of these patients. LEARNING POINTS: Castleman disease in an uncommon disease and should be considered in all patients with adenomegalies and systemic symptoms.Pheochromocytoma should not be overlooked in the differential diagnosis of a retroperitoneal mass.It is important that doctors consider these two diagnoses in patients with adenomegalies and a retroperitoneal mass due to the potential harmful impact of a missed diagnosis.

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Lymphadenopathy is a common clinical concern in dogs. Causes of lymphadenopathy include neoplasia, infection, and immune-mediated diseases. Seasonal infectious diseases should be considered as a potential cause of lymphadenopathy in endemic regions, such as the Mediterranean region. Therefore, the purpose of this study was to evaluate the causes of peripheral lymph node enlargement in dogs in a Mediterranean region (north­eastern Spain). In addition, we aimed to assess the relationship between peripheral lymphadenopathy and other clinical data. Medical records of dogs admitted to 2 referral hospitals in Barcelona (Spain) with peripheral lymphadenopathy and cytological evaluation of lymph nodes, during a 4-year period (2015-2019) were included. One hundred and thirty dogs met the inclusion criteria. The most common final clinical diagnoses were lymphoproliferative neoplasia (36%) and dermatological disease (18.4%), followed by vector borne infectious disease (VBID; 16.5%). In the VBID group, 19 dogs were positive for Leishmania infantum and 2 dogs were positive for heartworm antigen. The presence of lymphadenopathy as the only clinical sign, generalized peripheral lymphadenopathy and internal lymphadenopathy was more frequent in dogs with lymphoma. The patients with metastatic neoplasms had significantly more localized lymphadenopathy compared to the other diagnosis groups. Twenty percent of the dogs had fever and this was more frequent in the immunemediated disease group. Our findings suggest that lymphoma is the most likely cause of lymphadenopathy in dogs. Clinicians should consider lymphoproliferative neoplasia in dogs with general peripheral lymphadenopathy concurrent with internal (abdominal or thoracic) lymphadenopathy and without other clinical signs. A higher incidence of immune-mediated disease was found in the population of febrile dogs included in this study.

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Las adenopatías cervicales benignas en lactantes son relativamente frecuentes, se definen como el aumento de volumen ganglionar de más de 1 cm, sin síntomas sistémicos y cuando están presentes, el término correcto es adenitis. Para su estudio, las adenitis se dividen en: locales, sistémicas, unilaterales, bilaterales, agudas, crónicas, y por edad, con diferentes etiologías. Se presenta el caso clínico de un lactante de 11 meses de edad con diagnóstico de adenitis cervical abscedada unilateral aguda, con cuadro de 72 h de evolución, con crecimiento constante a nivel cervical derecho, compromiso del estado general, fiebre y anorexia, por lo que se inician antibióticos de primera línea para los agentes bacterianos más frecuentes (Staphylococcus aureus y Streptococcus pyogenes), con evolución tórpida a las 48 h, por lo que se solicita ultrasonido cervical, ya que la familia no contaba con recursos para solicitar cultivo o tomografía, reportando el ultrasonido ganglio cervical de 3,5 cm de diámetro abscedado, por lo que se agrega cobertura para anaerobios, con respuesta muy favorable a las 24 h. Queda la duda del origen de los anaerobios en la paciente, sin antecedentes de importancia y en grupo etario diferente al afectado por esos gérmenes. Consideramos este caso interesante por su comportamiento atípico, para el enriquecimiento del ejercicio de la otorrinolaringología, recalcando el invaluable apoyo de la clínica y solo con un ultrasonido, ya que no siempre se tendrán todos los recursos disponibles, pero siguiendo las pautas de lo reportado en la literatura, se tuvo una resolución exitosa.

Benign cervical lymphadenopathies in infants are relatively frequent, they are defined as an increase in lymph node volume of more than 1 cm, without systemic symptoms, and when they are present, the correct term is adenitis. For its study, adenitis is divided into: local, systemic, unilateral, bilateral, acute, chronic, and by age, with different etiologies. An 11-month-old infant with a diagnosis of acute unilateral abscessed cervical adenitis, with a 72 h evolution, with constant growth at the right cervical level, fever and anorexia, for which first-line antibiotics were started to the most frequent bacterial agents (Staphylococcus aureus and Streptococcus pyogenes), with torpid evolution at 48 h, for which only cervical ultrasound is requested, since the family did not have the resources to request culture or tomography, reporting the cervical ganglion ultrasound of 3.5 cm of abscessed diameter, so coverage for anaerobes is added, with a very favorable response at 24 hrs. There remains the doubt of the origin of the anaerobes in the patient, without important antecedents and in an age group different from that affected by these germs. We consider this case interesting due to its atypical behavior, for the enrichment of the otolaryngology exercise, emphasizing the invaluable support of the clinic, and only with an ultrasound, since other clinical tools were not available, but following the guidelines of what is reported in literature, there was a successful resolution.

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INTRODUCTION: Lymphogranuloma venereum (LG) is a sexually transmitted infection (STI) caused by Chlamydia trachomatis L serovar. METHODS: These five consecutive cases aim to highlight the risk of LG misdiagnosis, in case of initial presentation with isolated inguinal adenitis. RESULTS: Five men (mean age: 30±7 years) were seen in an internal medicine department, for inguinal adenopathy. One patient had clinical signs of urethritis. None presented an associated rectitis. Three patients had a history of STI, and two had a discovery of related HIV disease. Urinary polymerase chain reaction (PCR) was positive for the symptomatic patient and negative for the others. Lymph node PCR was positive in all patients within a L2b serotype (searched in 4 out of 5 cases). CONCLUSION: LG should be evoked in any patient with inguinal adenomegaly, particularly in case of STI history or risk factors. Negativity of urinary PCR should lead to further investigations, essentially a lymph node cytopuncture to evidence C. trachomatis.

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INTRODUCTION: We report a case of pneumonia associated with necrotic mediastinal lymph nodes in an immunocompetent patient. The case report illustrates the difficulties in making a diagnosis in necrotic mediastinal lymph nodes and discusses strategies to optimize sampling. OBSERVATION: A 21-year-old immunocompetent woman was admitted to hospital with dyspnea and fever occurring ten days after delivery. Physical examination, biological results and chest X-ray led to the diagnosis of right upper lobe pneumonia. Treatment with three broad-spectrum antibiotics was ineffective. Thoracic CT-scan showed compressive mediastinal and hilar necrotic adenopathies and consolidation of the right upper lobe. Bronchoscopy with bronchoalveolar lavage and transbronchial needle aspiration was non-diagnostic. A second bronchoscopy with bronchoalveolar lavage and transbronchial needle aspiration performed in close collaboration with the mycology laboratory led to the diagnosis of cryptococcosis. Antifungal therapy with fluconazole resulted in a complete resolution of clinical and radiological signs. CONCLUSION: Although it is extremely rare, pulmonary cryptococcosis should be considered in immunocompetent patients presenting with necrotic pneumonia. Effectiveness of lymph node sampling can be improved by collaboration between clinicians and microbiologists.

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Um grande número de viajantes visita anualmente, por estudo, turismo ou trabalho o continente africano. Um caso de adenomegalia cervical e hepatoesplenomegalia associado à febre de duas semanas de duração com teste sorológico positivo para Bartonella sp em uma paciente de 22 anos do sexo feminino que retornou da África do Sul após realização de trabalho de campo com primatas em área silvestre é apresentado.

A large number of travelers visit the African continent annually for studying, tourism or business reasons. The authors report a case of cervical adenomegaly, hepatomegaly and splenomegaly associated with a two-week history of fever and seropositivity for Bartonella sp in a 22-year-old female patient who returned from South Africa after field work with primates in a wild area.

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