RESUMO
Surveillance was conducted during February and March 1991 in the pediatric emergency department of Cayetano Heredia Hospital, Lima, Peru, to contrast the characteristics of children with epidemic cholera with those of children with noncholera-associated diarrhea. Among 626 patients 14 years of age or younger, Vibrio cholerae O1 was isolated from stool specimens of 310 patients (49%), more commonly from children older than 24 months of age (66%; p < 0.0001) than from younger children. Cholera was clinically characterized by a more sudden onset; watery diarrhea; and associated abdominal pain, muscle cramps, and vomiting, which led to more severe dehydration and hospitalization more often than in noncholera cases. Only one patient with cholera died, for a case-fatality rate of 3.2 deaths per 1000 persons. Nonpotable water and uncooked foods were identified as probable vehicles for V. cholerae. The frequency of diarrhea among relatives of patients with cholera suggested intrafamily transmission. This study of epidemic cholera describes the clinical features and the risk factors for acquisition of the infection, and points out the low case-fatality rate with prompt and appropriate treatment.
Assuntos
Cólera/etiologia , Cólera/fisiopatologia , Dor Abdominal , Adolescente , Fatores Etários , Criança , Pré-Escolar , Cólera/transmissão , Desidratação/fisiopatologia , Diarreia/fisiopatologia , Família , Humanos , Lactente , Fatores de Risco , VômitoRESUMO
Rectal swabs from 391 infants less than 18 months of age who were hospitalized with acute diarrhea and from 138 similarly aged healthy infants were examined for the etiologic agents of diarrhea. Aeromonas spp. were recovered from 205 of 391 (52.4%) diarrheic patients, whereas they were recovered from 12 of 138 (8.7%) controls (P less than 10(-11). Among the 205 Aeromonas-positive diarrheic patients, 118 (57.6%) were found to be coinfected with other common enteropathogens. Of the 164 Aeromonas-positive initial diarrheic specimens, 82 (50.0%) had one or more other enteropathogens present; 30 patients were coinfected with rotavirus, 20 with enterotoxigenic Escherichia coli, 16 with Campylobacter spp., 14 with Shigella spp., 13 with enteropathogenic E. coli, 4 with Vibrio spp., 1 with Salmonella spp., and 1 with Plesiomonas spp. of Aeromonas strains from cases compared with that from controls supports an etiologic role for this organism. However, frequent concomitant infections with other well-recognized enteropathogens and a lack of disease correlation with common Aeromonas phenotypes suggest that only a subset of Aeromonas strains may be diarrhea causing and that such strains may be common to several of the existing species.
Assuntos
Aeromonas , Infecções Bacterianas/microbiologia , Diarreia/microbiologia , Aeromonas/isolamento & purificação , Aeromonas/metabolismo , Aeromonas/patogenicidade , Infecções Bacterianas/epidemiologia , Diarreia/epidemiologia , Feminino , Humanos , Lactente , Masculino , Peru/epidemiologia , Fenótipo , Estações do Ano , VirulênciaRESUMO
Se revisan las historias clinicas de 225 ninos con fiebre tifoidea, observados en un periodo de 10 anos, encontrandose que 75 de ellos (33.3%) presentaron por lo menos una complicacion o proceso asociado a dicha enfermedad, siendo las mas frecuentes las siguientes: hepatitis, neumonia, sangrado digestivo y perforacion intestinal