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INTRODUCTION: The genus Bartonella includes species and subspecies of fastidious, facultative intracellular Gram-negative bacilli that infect a wide variety of mammalian reservoirs including cats and humans. In 2022, the Ecuadorian Ministry of Health reported an outbreak of cat scratch disease caused by B. henselae in the city of Guayaquil. Therefore, we aimed to characterize the presence of Bartonella spp. in domestic and stray cats from the area of Guayaquil where the outbreak happened in 2022. METHODS: Whole blood samples of 100 domestic and stray cats were collected. Riboflavin synthase (ribC) and 16S rRNA genes detection was performed by PCR using Bartonella spp. specific primers, followed by Sanger sequencing and phylogenetic analysis. RESULTS: 14 cats were positive for Bartonella spp. carriage. Phylogenetic analysis confirmed the presence of 12 cats infected with B. henselae and 2 cats with B. clarridgeiae. CONCLUSIONS: There is a high prevalence of Bartonella spp. carriage in cats in the city of Guayaquil within the area where a recent cat scratch disease outbreak happened. Considering the high presence of cats and other domestic and stray animals in the city of Guayaquil, a One Health approach for surveillance and prevention of zoonotic diseases like cat scratch disease is needed.
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Infecções por Bartonella , Bartonella henselae , Bartonella , Doenças do Gato , Doença da Arranhadura de Gato , Surtos de Doenças , Filogenia , RNA Ribossômico 16S , Animais , Gatos , Equador/epidemiologia , Surtos de Doenças/veterinária , Bartonella/genética , Bartonella/isolamento & purificação , Bartonella/classificação , Doença da Arranhadura de Gato/epidemiologia , Doença da Arranhadura de Gato/microbiologia , Doenças do Gato/microbiologia , Doenças do Gato/epidemiologia , Bartonella henselae/genética , Bartonella henselae/isolamento & purificação , RNA Ribossômico 16S/genética , Infecções por Bartonella/epidemiologia , Infecções por Bartonella/veterinária , Infecções por Bartonella/microbiologia , Portador Sadio/microbiologia , Portador Sadio/epidemiologia , Portador Sadio/veterinária , Masculino , Feminino , PrevalênciaRESUMO
INTRODUCTION: After Hartmann-type colostomy, the adequate selection of some patients allows reversal and closure of the colostomy, however, this reversal is not free of complications. Among complications, anastomotic leaks and fistulae can have functional, economic, and oncological consequences. Complications have been treated with surgery; yet, this management has changed considerably in recent years, moving towards less invasive therapies. PRESENTATION OF CASE: This is the report of a 42-year-old man with a history of closed abdominal trauma with perforation of the sigmoid colon managed with a Hartmann-type colostomy. Six months later, he was admitted for a Hartmann reversal procedure without immediate complications. He was assessed again after 4 months observing a small area of erythema and periumbilical edema. EUS was performed without evidence of collections. Colonoscopy evidenced a 7-mm fistulous orifice in the colocolonic anastomosis. The Endo-VAC system was used, performing endoscopically exchanges twice a week following a low-residue diet. The procedure was performed on an outpatient basis and the closure of the leak hole in the colonic anastomosis was achieved in 30 days. DISCUSSION: Endoluminal vacuum therapy or EVAC, is an adaptation of the therapy used for negative pressure wound closure. This minimally invasive technique has been used for the treatment of gastrointestinal leaks and fistulae in selected patients and within a hospital setting. Our case presents the use of this technique in a late colocutaneous postoperative leak on an outpatient basis. CONCLUSION: To the best of our knowledge we report the first case of a late colocutaneous anastomotic leak managed with EVAC on an outpatient basis.
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Pacemakers are used in small children with increasing frequency for the treatment of life-threatening bradyarrhythmias. The epicardial approach is generally preferred in these patients, to avoid the risks of vessel thrombosis. We examined the feasibility and safety of transvenous pacemaker implantation in children weighing <10 kg, via subclavian puncture, using a 4 Fr sheath introduced after a venogram was performed to evaluate the vein diameter. Progressive dilation with 5, 6, and 7 Fr sheaths preceded the insertion and placement of the endocardial lead. A subaponeurotic pocket was created in the abdominal or pectoral regions, depending upon the patient's size. Between 2001 and 2007, we treated 12 patients (median age = 16 months; range 1-32; median weight = 7.9 kg; range 2.3-10.0; 7 males), of whom four weighed <5 kg. Indications for permanent pacing included postsurgical complete atrioventricular block (n = 8), sinus node dysfunction (n = 2), congenital atrioventricular block (n = 1), and long QT syndrome (n = 1). Single-chamber pacemakers were implanted in 10, and dual-chamber pacemakers in two patients. The patients were evaluated at 48 hours, 10 days, and at 3 and 6 months. The mean follow-up was 31.8 +/- 23.5 months. There were no procedural complications. Lead dislodgment occurred in one patient and required replacement of the ventricular lead. One patient died from septicemia. Endocardial pacemaker implantation was feasible and safe in children weighing <10 kg. This procedure is less invasive than the standard epicardial approach.
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Bradicardia/prevenção & controle , Estimulação Cardíaca Artificial/métodos , Peso Corporal , Veias Cerebrais , Pré-Escolar , Estudos de Viabilidade , Feminino , Humanos , Lactente , Recém-Nascido , MasculinoRESUMO
Se presenta un caso raro de sepsis por Shigella flexneri en una paciente de 45 años de edad quien estando hospitalizada para el estudio de un tumor cerebral, requirió el uso de manitol y dosis altas de corticoides; luego de ello presenta deposiciones líquidas con moco y sangre, desarrolla síndrome de respuesta inflamatoria sistémica, luego se aísla Shigella flexneri en el hemocultivo; recibió tratamiento antibiótico con ciprofloxacina. Se describen las características del caso y se comenta de acuerdo con la revisión de literatura.
An unusual case of sepsis caused by Shigella flexneri in a 45-year old female patient is presented. While being hospitalized for diagnostic management of a brain tumor, she required mannitol and high-dose steroids; she had liquidand dysenteric stools, and soon afterwards she developed a systemic inflammatory response syndrome. Shigella flexneri was isolated in the blood culture, and she was treated with ciprofloxacin. The case features are described and comments are presented, together with a review of the literature.
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Feminino , Humanos , Pessoa de Meia-Idade , Bacteriemia , Sepse , Shigella flexneriRESUMO
Se han estudiado 18 casos de carcimoma de piel en el Hospital Regional de Cajamarca-Perú. En la serie de nuestra casuística, el paciente más joven fue de 20 años de edad. De los casos, 14 corresponden al sexo masculino y 4 al sexo femenino. La mayoría trabaja como obrero en las carreteras a las minas, otros son agricultores y pastores. Todos proceden de las regiones mineras de Cajamarca (Michiquillay, Encañada, Celendín, Hualgayoc, etc.). Los extremos del tiempo de la enfermedad fueron 2 meses y 2 años. La historia del paciente con 2 meses de enfermedad, refiere que la lesión empezó como un "granito" que al pelliscarse comenzó a sangrar, posteriormente aumentó de tamaño poco a poco. La historia del paciente con 2 años de enfermedad, refiere que comenzó como una pequeña verruga, que a la fecha aumentó de tamaño. La distribución de la lesión, como de aprecia en la fig. No 1, fue en las extremidades distales y en la cara. Del total de nuestra casuística el 61.05 por ciento (11 casos) correspondieron a carcinoma epidermoide y el resto al carcinoma basocelular