Endoftalmitis y septicemia por Klebsiella pneumoniae

La endoftalmitis endógena puede ser la primera manifestación de sepsis, secundaria a infección en el hígado, pulmón, tracto urinario o próstata. Los síntomas más comunes son la disminución de la agudeza visual y dolor ocular y el signo característico es el hipopion. La endoftalmitis endógena secundaria a absceso hepático por Klebsiella pneumoniae es una presentación poco común en el mundo occidental. La mayoría de casos son descritos en el este asiático, especialmente en Taiwán. Es probable que exista una reacción inmunológica y cierto mimetismo antigénico con dicho microorganismo, pero se necesitan más estudios para aclarar esta relación. Nuestro caso se trata de un paciente de 57 años, sin ningún antecedente de importancia, con absceso hepático, endoftalmitis bilateral e infección de vías urinarias, secundario a infección por Klebsiella pneumoniae. El pronóstico de estos pacientes depende de la rapidez con que se sospeche la endoftalmitis y de un tratamiento antibiótico adecuado.Presentación de casos256-258The endophtalmitis may be the first manifestation of sepsis, secondary to an infection in the liver, lung, urinary tract or postata. The most common symptoms are visual sharpness diminishment, ocular pain and the characteristic hipopion. The endongenous endophtalmitis secondary to a liver abscess by Klebsiella pneumoniae is rare in the western (R) countries. It is mostly reported in eastern Asia, specially in Taiwan. Probably an immunological reaction exists as well (RN) as certain antigenic mimetism with that microorganism, for which demonstration more studies are needed. This case reports a 57 years old patient, with no antecedents, with an hepatic abscess, bilateral endophtalmitis and urinary infection by Klebsiella pneumoniae. The prognosis of these patients depends on the quick suspicion of endophtalmitis and the adequate antibiotic treatment

Síndrome febril asociado a sífilis y bacteriemia por Clostridium limosum

Se informa el caso de un paciente masculino de 41 años con fiebre de origen desconocido (FOD) e insuficiencia aórtica, quien recibió dos ciclos independientes de antibiótico con persistencia de su cuadro febril, y a quien luego de múltiples estudios intrahospitalarios, se le diagnosticó bacteriemia por Clostridium limosum y sífilis latente versus tardía. Los estudios realizados no evidenciaron la presencia de enfermedad del tejido conectivo ni procesos tumorales. Las bacteriemias por gérmenes del género Clostridium no son comunes y cuando se presentan, se asocian con procesos neoplásicos, especialmente de colon. Las infecciones por C. limosum son aún más raras; en la literatura sólo se ha informado en cuatro casos (tres humanos y un animal), y en ninguno se ha relacionado con FOD. Por otra parte, aunque la sífilis era una causa frecuente de FOD, actualmente es poco común por la facilidad en su diagnóstico. En este caso no fue posible determinar cuál de los dos diagnósticos fue el origen de la FOD, ya que se inició tratamiento simultáneamente para ambos con resolución clínica. En conclusión, en este caso se presenta una posible nueva causa de FOD: bacteriemia por C. limosum, y se recuerda a la sífilis como uno de los posibles diagnósticos diferenciales de FOD.Presentación de casos429-43

Human papillomavirus detection in women with and without human immunodeficiency virus infection in Colombia

Background: HIV infection leads to a decreasing immune response, thereby facilitating the appearance of other infections, one of the most important ones being HPV. However, studies are needed for determining associations between immunodeficiency caused by HIV and/or the presence of HPV during the course of cervical lesions and their degree of malignancy. This study describes the cytological findings revealed by the Papanicolaou test, laboratory characteristics and HPV molecular profile in women with and without HIV infection. Methods: A total of 216 HIV-positive and 1,159 HIV-negative women were invited to participate in the study; PCR was used for the molecular detection of HPV in cervical samples. Statistical analysis (such as percentages, Chi-square test and Fisher's exact test when applicable) determined human papillomavirus (HPV) infection frequency (single and multiple) and the distribution of six types of high-risk-HPV in women with and without HIV infection. Likewise, a logistic regression model was run to evaluate the relationship between HIV-HPV infection and different risk factors. Results: An association was found between the frequency of HPV infection and infection involving 2 or more HPV types (also known as multiple HPV infection) in HIV-positive women (69.0% and 54.2%, respectively); such frequency was greater than that found in HIV-negative women (44.3% and 22.7%, respectively). Statistically significant differences were observed between both groups (p = 0.001) regarding HPV presence (both in infection and multiple HPV infection). HPV-16 was the most prevalent type in the population being studied (p = 0.001); other viral types had variable distribution in both groups (HIV-positive and HIV-negative). HPV detection was associated with <500 cell/mm(3) CD4-count (p = 0.004) and higher HIV-viral-load (p = 0.001). HPV-DNA detection, <200 cell/mm(3) CD4-count (p = 0.001), and higher HIV-viral-load (p = 0.001) were associated with abnormal cytological findings. Conclusions: The HIV-1 positive population in this study had high multiple HPV infection prevalence. The results for this population group also suggested a greater association between HPV-DNA presence and cytological findings. HPV detection, together with low CD4 count, could represent useful tools for identifying HIV-positive women at risk of developing cervical lesions.This project was supported by the Basque Cooperation Agency Development and by the Spanish Agency for International Development Cooperation (AECID) (Project 10-CAP1-0197)

Human papillomavirus detection from human immunodeficiency virus-infected colombian women's paired urine and cervical samples

Infection, coinfection and type-specific human papillomavirus (HPV) distribution was evaluated in human immunodeficiency virus (HIV)-positive women from paired cervical and urine samples. Paired cervical and urine samples (n = 204) were taken from HIV-positive women for identifying HPV-DNA presence by using polymerase chain reaction (PCR) with three generic primer sets (GP5+/6+, MY09/11 and pU1M/2R). HPV-positive samples were typed for six high-risk HPV (HR-HPV) (HPV-16, -18, -31, -33, -45 and -58) and two low-risk (LR-HPV) (HPV-6/11) types. Agreement between paired sample results and diagnostic performance was evaluated. HPV infection prevalence was 70.6% in cervical and 63.2% in urine samples. HPV-16 was the most prevalent HPV type in both types of sample (66.7% in cervical samples and 62.0% in urine) followed by HPV-31(47.2%) in cervical samples and HPV-58 (35.7%) in urine samples. There was 55.4% coinfection (infection by more than one type of HPV) in cervical samples and 40.2% in urine samples. Abnormal Papanicolau smears were observed in 25.3% of the women, presenting significant association with HPV-DNA being identified in urine samples. There was poor agreement of cervical and urine sample results in generic and type-specific detection of HPV. Urine samples provided the best diagnosis when taking cytological findings as reference. In conclusion including urine samples could be a good strategy for ensuring adherence to screening programs aimed at reducing the impact of cervical cancer, since this sample is easy to obtain and showed good diagnostic performance

Ensemble-based satellite-derived carbon dioxide and methane column-averaged dry-air mole fraction data sets (2003-2018) for carbon and climate applications

Satellite retrievals of column-averaged dry-air mole fractions of carbon dioxide (CO₂) and methane (CH₄), denoted XCO₂ and XCH₄, respectively, have been used in recent years to obtain information on natural and anthropogenic sources and sinks and for other applications such as comparisons with climate models. Here we present new data sets based on merging several individual satellite data products in order to generate consistent long-term climate data records (CDRs) of these two Essential Climate Variables (ECVs). These ECV CDRs, which cover the time period 2003–2018, have been generated using an ensemble of data products from the satellite sensors SCIAMACHY/ENVISAT and TANSO-FTS/GOSAT and (for XCO₂) for the first time also including data from the Orbiting Carbon Observatory 2 (OCO-2) satellite. Two types of products have been generated: (i) Level 2 (L2) products generated with the latest version of the ensemble median algorithm (EMMA) and (ii) Level 3 (L3) products obtained by gridding the corresponding L2 EMMA products to obtain a monthly 5∘×5∘ data product in Obs4MIPs (Observations for Model Intercomparisons Project) format. The L2 products consist of daily NetCDF (Network Common Data Form) files, which contain in addition to the main parameters, i.e., XCO₂ or XCH₄, corresponding uncertainty estimates for random and potential systematic uncertainties and the averaging kernel for each single (quality-filtered) satellite observation. We describe the algorithms used to generate these data products and present quality assessment results based on comparisons with Total Carbon Column Observing Network (TCCON) ground-based retrievals. We found that the XCO₂ Level 2 data set at the TCCON validation sites can be characterized by the following figures of merit (the corresponding values for the Level 3 product are listed in brackets) – single-observation random error (1σ): 1.29 ppm (monthly: 1.18 ppm); global bias: 0.20 ppm (0.18 ppm); and spatiotemporal bias or relative accuracy (1σ): 0.66 ppm (0.70 ppm). The corresponding values for the XCH₄ products are single-observation random error (1σ): 17.4 ppb (monthly: 8.7 ppb); global bias: −2.0 ppb (−2.9 ppb); and spatiotemporal bias (1σ): 5.0 ppb (4.9 ppb). It has also been found that the data products exhibit very good long-term stability as no significant long-term bias trend has been identified. The new data sets have also been used to derive annual XCO₂ and XCH₄ growth rates, which are in reasonable to good agreement with growth rates from the National Oceanic and Atmospheric Administration (NOAA) based on marine surface observations. The presented ECV data sets are available (from early 2020 onwards) via the Climate Data Store (CDS, https://cds.climate.copernicus.eu/, last access: 10 January 2020) of the Copernicus Climate Change Service (C3S, https://climate.copernicus.eu/, last access: 10 January 2020)