Falsas enfermedades tropicales: un estudio retrospectivo

Background. When we evaluate a patient with a suspected imported disease we cannot forget to include any autochthonous causes that may mimic imported pathologies to avoid misdiagnosis and therapeutic delay. Methods. A descriptive longitudinal retrospective study was designed with patients in whom an imported disease was suspected but who were finally diagnosed with autochthonous processes. The patients were selected from two internal medicine practices specializing in tropical diseases between 2008-2017 in Spain. Results. We report 16 patients, 11 (68.7%) were males, and the mean age was 43.4 ± 13.7 years old. Thirteen patients (81.2%) were travellers. Half of the patients were from Latin America, 7 (43.5%) were from Africa, and 1 (6.2%) was from Asia. The time from trip to evaluation ranged between 1 week and 20 years (me-dian, 4 weeks), and the mean time from evaluation to diagnosis was 58.4 ± 100.9 days. There were 5 (31.2%) cases of autochthonous infection, 5 (31.2%) cases of cancer, 2 (12.5%) cases of inflammatory disease, and 2 (12.5%) cases of vascular disease. Conclusions. Travel or migration by a patient can sometimes be a confusing factor if an imported disease is suspected and may cause delays in the diagnosis and treatment of an autochthonous disease. We highlight that 1/3 of the patients with autochthonous diseases in this study had cancer. The evaluation of imported diseases requires a comprehensive approach by the internist, especially if he specializes in infectious and/or tropical diseases and is, therefore, the best qualified to make an accurate diagnosis.Introducción. La evaluación de un enfermo con sospecha de patología importada debe incluir las causas autóctonas que puedan simular enfermedades importadas, para evitar un diagnóstico erróneo y un retraso terapéutico. Métodos. Estudio retrospectivo longitudinal descriptivo de pacientes con sospecha de patología importada con diagnóstico final de proceso autóctono. Los pacientes fueron seleccionados en dos consultas especializadas en enfermedades tropicales de dos hospitales españoles entre 2008-2017. Resultados. Se obtuvieron 16 pacientes, 11 (68,7%) hombres. La edad media fue de 43,4 ± 13,7 años. Trece pacientes (81,2%) eran viajeros. Ocho (50%) pacientes eran latinoamericanos, 7 (43,5%) africanos y un paciente asiático (6,2%). El tiempo desde el viaje hasta la evaluación osciló entre 1 semana y 20 años. El tiempo medio desde la evaluación hasta el diagnóstico fue de 58,4 ± 100,9 días. Hubo 5 (31,2%) casos de infección autóctona, 5 (31,2%) casos de cáncer, 2 (12,5%) casos de enfermedad inflamatoria y 2 (12,5%) casos de patología vascular. Conclusiones. El origen del paciente o el antecedente de un viaje pueden ser factores de confusión durante el proceso clínico y causar un retraso diagnóstico y terapéutico. Por lo tanto, es aconsejable una visión amplia al evaluar estas enfermedades. Destacamos que un tercio de los pacientes presentó un diagnóstico final de neoplasia

Skin and Soft Tissue Infections (Patera Foot) in Immigrants, Spain

An unusual skin and soft tissue infection of the lower limbs has been observed in immigrants from sub-Saharan Africa who cross the Atlantic Ocean crowded on small fishing boats (pateras). Response to conventional treatment is usually poor. Extreme extrinsic factors (including new pathogens) may contribute to the etiology of the infection and its pathogenesis

Monkeypox and HIV in the Canary Islands: A Different Pattern in a Mobile Population

Background. The clinical and epidemiological data of the recent outbreak of monkeypox (MPX) differ from previous reports. One difference is the epidemiological profile; the disease mainly affects a subgroup of MSM (men who have sex with men) with high-risk sexual behaviors, frequently persons living with human immunodeficiency virus (PLHIV). Methods. In this observational analysis, all patients with PCR (polymerase chain reaction)-confirmed MPX attending an Infectious Diseases and Tropical Medicine Unit in Gran Canaria (Spain) between May and July 2022 were considered. Results. In total, 42 men were included; 88% were identified as MSM, with a median age of 40 years. Only 43% were born in Spain. All the patients had systemic symptoms and skin lesions. The distribution of lesions was more frequent in the genital/anal region, and the involvement of hands and feet was less common. Fever and lymphadenopathies were less frequent than in other series. Other unusual manifestations were proctitis, pharyngitis and penile–scrotal edema. Half of the patients had other associated infections (mainly STIs, sexually transmitted infections), and 60% of the monkeypox patients had PLHIV (People Living with HIV). When comparing the clinical characteristics between HIV-positive and -negative patients, we found three main differences: (i) a higher frequency of perioral lesions, (ii) a higher frequency of pharyngitis and (iii) a higher number of sexually transmitted infections in HIV-positive patients. Conclusions. The clinical findings in this outbreak of MPX had great variability in presentation. Several clinical differences were found in PLHIV-coinfected patients

Quantitative Echocardiographic Findings (Mean and Standard Deviation).

<p>Quantitative Echocardiographic Findings (Mean and Standard Deviation).</p

Qualitative Echocardiographic Findings.

<p>Qualitative Echocardiographic Findings.</p

Demographic Data and General Characteristics.

<p>Demographic Data and General Characteristics.</p

Types of Eosinophilia and Final Diagnoses.

<p>Types of Eosinophilia and Final Diagnoses.</p