Posts filed under ‘FIEBRE y RASH’

Measles in 2019 — Going Backward

N Engl J of Medic April 18, 2019

C.I. Paules, H.D. Marston, and A.S. Fauci

In 2000, the United States achieved a historic public health goal: the elimination of measles, defined by the absence of sustained transmission of the virus for more than 12 months. This achievement resulted from a concerted effort by health care practitioners and families alike, working to protect the population through widespread immunization…..





April 21, 2019 at 11:39 am

Disseminated Gonococcal Infection

N Engl J of Medic April 18, 2019 V.380 P.1565


Florez-Pollack and M.M. Mauskar

A 20-year-old woman presented to the emergency department with a rash involving the arms, legs, trunk, and scalp, which had erupted that morning. She also reported generalized muscle aches, fever, and pain in both ankles. Two weeks earlier …



April 21, 2019 at 11:37 am

Review – Epidemiology, Diagnosis, and Antimicrobial Treatment of Acute Bacterial Meningitis.

Clinical Microbiology Review July 2010 V.23 N.3 P.467-492

Matthijs C. Brouwer, Allan R. Tunkel, Diederik van de Beek

The epidemiology of bacterial meningitis has changed as a result of the widespread use of conjugate vaccines and preventive antimicrobial treatment of pregnant women.

Given the significant morbidity and mortality associated with bacterial meningitis, accurate information is necessary regarding the important etiological agents and populations at risk to ascertain public health measures and ensure appropriate management.

In this review, we describe the changing epidemiology of bacterial meningitis in the United States and throughout the world by reviewing the global changes in etiological agents followed by specific microorganism data on the impact of the development and widespread use of conjugate vaccines.

We provide recommendations for empirical antimicrobial and adjunctive treatments for clinical subgroups and review available laboratory methods in making the etiological diagnosis of bacterial meningitis.

Finally, we summarize risk factors, clinical features, and microbiological diagnostics for the specific bacteria causing this disease.




March 17, 2019 at 10:17 am

Increased Risk for Invasive Group A Streptococcus Disease for Household Contacts of Scarlet Fever Cases, England, 2011–2016

Emerg Infect Dis March 2019 V.25 N.3

Watts et al.

The incidence of scarlet fever in England and Wales is at its highest in 50 years. We estimated secondary household risk for invasive group A Streptococcus (iGAS) disease within 60 days after onset of scarlet fever. Reports of scarlet fever in England during 2011–2016 were matched by residential address to persons with laboratory-confirmed iGAS infections. We identified 11 iGAS cases in ≈189,684 household contacts and a 60-day incidence rate of 35.3 cases/100,000 person-years, which was 12.2-fold higher than the background rate (2.89). Infants and contacts >75 years of age were at highest risk. Three cases were fatal; sepsis and cellulitis were the most common manifestations. Typing for 6 iGAS cases identified emm 1.0 (n = 4), emm 4.0 (n = 1), and emm 12.0 (n = 1). Although absolute risk in household contacts was low, clinicians assessing household contacts should be aware of the risk to expedite diagnosis and initiate life-saving treatment…



February 24, 2019 at 7:35 pm

Duration of the Presence of Infectious Zika Virus in Semen and Serum

Journal of Infectious Diseases, 1 January 2019 V.219 N.1  P.31–40

Freddy A Medina; Giselle Torres; Jenny Acevedo; Sharon Fonseca; Leslie Casiano …

Zika virus (ZIKV) has recently caused a large epidemic in the Americas that is associated with birth defects.

Although ZIKV is primarily transmitted by Aedes mosquitoes, ZIKV RNA is detectable in blood and semen of infected individuals for weeks or months, during which sexual and other modes of transmission are possible.

However, viral RNA is usually detectable longer than infectious virus is present.

We determined the frequency of isolation of infectious virus from semen and serum samples prospectively obtained from a cohort of patients in Puerto Rico.

We confirmed isolation of infectious virus on the basis of a tissue culture cytopathic effect, an increase in virus genome copy equivalents (GCE), and positive results of immunofluorescence analysis; virus in infected cells was quantitated by flow cytometry.

These criteria confirmed the presence of infectious virus in semen specimens from 8 of 97 patients for up to 38 days after initial detection when virus loads are >1.4 × 106 genome copy equivalents/mL. Two serum isolates were obtained from 296 patients.

These findings can help guide important prevention guidelines for persons that may potentially be infectious and transmit ZIKV sexually.



January 5, 2019 at 11:55 am

Multistate infestation with the exotic disease–vector tick Haemaphysalis longicornis — United States, August 2017–September 2018.

MMWR Morb Mortal Wkly Rep November 30, 2018 V.67 N.47 P.1310-1313.

Beard CB et al

Haemaphysalis longicornis is a tick indigenous to eastern Asia and an important vector of human and animal disease agents, resulting in such outcomes as human hemorrhagic fever and reduction of production in dairy cattle by 25%.

H. longicornis was discovered on a sheep in New Jersey in August 2017 (1).

This was the first detection in the United States outside of quarantine.

In the spring of 2018, the tick was again detected at the index site, and later, in other counties in New Jersey, in seven other states in the eastern United States, and in Arkansas.

The hosts included six species of domestic animals, six species of wildlife, and humans.

To forestall adverse consequences in humans, pets, livestock, and wildlife, several critical actions are indicated, including expanded surveillance to determine the evolving distribution of H. longicornis, detection of pathogens that H. longicornis currently harbors, determination of the capacity of H. longicornis to serve as a vector for a range of potential pathogens, and evaluation of effective agents and methods for the control of H. longicornis ….


December 6, 2018 at 8:00 am

Cluster of Fatal Group A Streptococcal emm87 Infections in a Single Family: Molecular Basis for Invasion and Transmission.

J Infect Dis. June 1, 2017 V.215 N.11 P.1648-1652.      

La enfermedad hipervirulenta debida a Strep pyogenes puede ser el resultado de cepas con mutaciones que mejoran la expresión del gen de virulencia pero reducen la transmisión posterior.

Los autores utilizan la secuenciación del genoma completo para investigar la diseminación intra-familiar entre 4 hermanos, de una infección debido a una cepa de Strep pyoegenes hipervirulenta que resultó en la muerte de uno de ellos.

Todos los aislamientos de Strep pyoegenes invasivos y faríngeos tenían una mutación idéntica en un gen que codifica una proteína reguladora clave que producía un fenotipo hiperinvasivo.

Estos datos desafían la teoría prevaleciente de la transmisión reducida inducida por mutaciones que conducen a un Strep pyoegenes hipervirulento con alta diseminación grupal.



September 25, 2018 at 8:13 am

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