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Introducción. Las miasis hospitalarias son entidades con una importancia manifiesta en salud pública. La documentación de este tipo de casos es escasa en la literatura biomédica regional y mundial. Objetivo. Informar un caso de miasis hospitalaria en Costa Rica, donde el agente etiológico implicado fue Lucilia cuprina (Diptera: Calliphoridae). Este caso de miasis hospitalaria figura como el primer informe para Latinoamérica asociado con este agente etiológico. Presentación del caso. Una paciente de 91 años de edad, con signos de inmunosupresión, afectación grave de la función pulmonar y asistencia respiratoria mecánica, presentó larvas en ambas fosas nasales al séptimo día después del ingreso hospitalario. Varios ejemplares fueron recolectados y procesados para su identificación. La identificación taxonómica de los ejemplares recolectados estableció que la especie de los muscomorfos correspondía a L. cuprina. Conclusión. El presente constituye el primer caso de miasis hospitalaria por L. cuprina en la literatura biomédica de Costa Rica y el primero registrado en Latinoamérica.

Introduction. Nosocomial myiases can be an important condition from a public health perspective. However, cases of this condition reported in regional and worldwide biomedical literature are scarce. Objective. A case of nosocomial myiasis is reported from Costa Rica, where the species involved was Lucilia cuprina (Diptera: Calliphoridae). Materials and methods. A 91-year-old patient with signs of immunosuppression, severe impairment of lung function, and mechanical ventilation presented larvae in both nostrils on the seventh day after admission. Five specimens were collected and processed for identification. Results. The taxonomic identification of the specimens established that the muscoid fly species was L. cuprina. Conclusion. This is the first case of nosocomial myiasis reported from Costa Rica and in Latin America for which the etiological agent is L. cuprina.

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Las parasitosis intestinal afectan sobre todo a los países en vías de desarrollo y constituyen un problema de salud pública, relacionado muchas veces con la falta de sistemas de salud eficientes, o fuentes de agua potable, que también se acentúan con enfermedades de fondo como Sida, que se presentan también en los países desarrollados. La bibliografía describe que Cryptosporidium spp, Isospora belli y Cyclospora cayetanensis son los parásitos con más frecuencia asociados con diarrea persistente en casos avanzados de pacientes con VIH/Sida. Este grupo de protozoarios requiere exámenes específicos para su diagnóstico, siendo la coloración de Ziehl-Neelsen, uno de los exámenes no rutinarios que permiten su identificación y que, en la mayoría de las ocaciones, no se realiza en el laboratorio si no es solicitado por el médico de manera explícita...

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INTRODUCTION: Nosocomial myiases can be an important condition from a public health perspective. However, cases of this condition reported in regional and worldwide biomedical literature are scarce. OBJECTIVE: A case of nosocomial myiasis is reported from Costa Rica, where the species involved was Lucilia cuprina (Diptera: Calliphoridae). MATERIALS AND METHODS: A 91-year-old patient with signs of immunosuppression, severe impairment of lung function, and mechanical ventilation presented larvae in both nostrils on the seventh day after admission. Five specimens were collected and processed for identification. RESULTS: The taxonomic identification of the specimens established that the muscoid fly species was L. cuprina. CONCLUSION: This is the first case of nosocomial myiasis reported from Costa Rica and in Latin America for which the etiological agent is L. cuprina.

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BACKGROUND: During evolution, innate immunity has been tuned to recognize pathogen-associated molecular patterns. However, some alpha-Proteobacteria are stealthy intracellular pathogens not readily detected by this system. Brucella members follow this strategy and are highly virulent, but other Brucellaceae like Ochrobactrum are rhizosphere inhabitants and only opportunistic pathogens. To gain insight into the emergence of the stealthy strategy, we compared these two phylogenetically close but biologically divergent bacteria. METHODOLOGY/PRINCIPAL FINDINGS: In contrast to Brucella abortus, Ochrobactrum anthropi did not replicate within professional and non-professional phagocytes and, whereas neutrophils had a limited action on B. abortus, they were essential to control O. anthropi infections. O. anthropi triggered proinflammatory responses markedly lower than Salmonella enterica but higher than B. abortus. In macrophages and dendritic cells, the corresponding lipopolysaccharides reproduced these grades of activation, and binding of O. anthropi lipopolysaccharide to the TLR4 co-receptor MD-2 and NF-kappaB induction laid between those of B. abortus and enteric bacteria lipopolysaccharides. These differences correlate with reported variations in lipopolysaccharide core sugars, sensitivity to bactericidal peptides and outer membrane permeability. CONCLUSIONS/SIGNIFICANCE: The results suggest that Brucellaceae ancestors carried molecules not readily recognized by innate immunity, so that non-drastic variations led to the emergence of stealthy intracellular parasites. They also suggest that some critical envelope properties, like selective permeability, are profoundly altered upon modification of pathogen-associated molecular patterns, and that this represents a further adaptation to the host. It is proposed that this adaptive trend is relevant in other intracellular alpha-Proteobacteria like Bartonella, Rickettsia, Anaplasma, Ehrlichia and Wolbachia.

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