Imported eosinophilic fever with myositis: A diagnostic challenge

A 39-year-old caucasian man presented to our hospital in Barcelona with fever, dry cough, headache and weight loss of 4 kg. Symptoms started 5 days after returning from a 21-day travel to Malaysia. His physical examination was unremarkable except for a splenomegaly. Laboratory tests showed mild elevation of transaminases, elevated levels of lactate dehydrogenase (468 UI/L) and a normal blood cell count. Blood cultures, thick and thin blood smear and serologic tests for dengue, chikungunya, HIV, cytomegalovirus, Epstein-Barr virus, herpes virus 6, parvovirus B19, Toxoplasma spp and Rickettsia conorii were negative

Relevance of screening for Chagas and viral hepatitis in Bolivian migrants

© 2020 Elsevier España, S.L.U. Objectives: Given the scarcity of data regarding prevalence of various infectious diseases in Latin-American countries, our study aims to assess the burden of T. cruzi, S. stercoralis, HIV and viral hepatitis in Latin-American migrants, with a focus on Bolivian migrants. Methods: We performed a retrospective observational study of 565 screening evaluations in adults (≥18 years) carried out at our International Healthcare referral service in Barcelona. We reviewed structured clinical records and microbiological results of patients attended between February 2012 and April 2015. Results: The median age was 35 years and 74% were women. Of the population screened, 87% were of Bolivian origin. We found a 48% prevalence of T. cruzi, 16% of S. stercoralis, 0.2% of HIV, 0.2% HBV and 0.2% HCV. Conclusions: These results support the relevance of screening for T. cruzi and S. stercoralis in Bolivian migrants but challenge the pertinence of systematic screening for HBV in this population

Two cases of subcutaneous dirofilariasis in Barcelona, Spain

In recent years, the number of reported cases of human dirofilariasis in Europe has increased and the circulation of Dirofilaria spp. in mosquitoes in several European countries has been proven. We report here two likely autochthonous cases of subcutaneous human dirofilariasis from Barcelona, Spain, caused by Dirofilaria repens. The potential for an increase in human infection is high given the number of cases published recently and the ability of vectors to spread through the Mediterranean basin

Blackwater fever in a non-immune patient with Plasmodium falciparum malaria after intravenous artesunate

Blackwater fever was typically reported after quinine administration, although it is poor recognized in patients receiving artesunate. This case describes a blackwater fever in a non-immune patient after artesunate for severe malaria. It highlights the importance of monitoring haemolytic parameters in severe malaria to avoid renal impairment or severe anaemia

Positive direct antiglobulin test in post-artesunate delayed haemolysis: more than a coincidence?

Background: Delayed haemolysis is a frequent adverse event after treatment with artesunate (AS). Removing onceinfected “pitted” erythrocytes by the spleen is the most accepted mechanism of haemolysis in these cases. However, an increasing number of cases with positive direct antiglobulin test (DAT) haemolysis after AS have been reported. Methods: All malaria cases seen at Hospital Clinic of Barcelona between 2015 and 2017 were retrospectively reviewed. Clinical, parasitological and laboratory data from patients treated with intravenous artesunate—specifcally looking for delayed haemolysis and DAT—was collected. Results: Among the 36 severe malaria patients treated with artesunate at the hospital, 10 (27.8%) developed postartesunate delayed haemolysis. Out of these, DAT was performed in six, being positive in four of them (at least 40%). DAT was positive only for complement—without IgG—suggesting drug-dependent immune-haemolytic anaemia of the immune-complex type. Three of the four patients were treated with corticosteroids and two also received blood transfusion, with a complete recovery. Conclusions: Drug-induced auto-immune phenomena in post-artesunate delayed haemolysis may be underre‑ ported and must be considered. The role of corticosteroids should be reassessed

Positive direct antiglobulin test in post-artesunate delayed haemolysis: more than a coincidence?

BACKGROUND: Delayed haemolysis is a frequent adverse event after treatment with artesunate (AS). Removing once-infected 'pitted' erythrocytes by the spleen is the most accepted mechanism of haemolysis in these cases. However, an increasing number of cases with positive direct antiglobulin test (DAT) haemolysis after AS have been reported. METHODS: All malaria cases seen at Hospital Clinic of Barcelona between 2015 and 2017 were retrospectively reviewed. Clinical, parasitological and laboratory data from patients treated with intravenous artesunate-specifically looking for delayed haemolysis and DAT-was collected. RESULTS: Among the 36 severe malaria patients treated with artesunate at the hospital, 10 (27.8%) developed post-artesunate delayed haemolysis. Out of these, DAT was performed in six, being positive in four of them (at least 40%). DAT was positive only for complement-without IgG-suggesting drug-dependent immune-haemolytic anaemia of the immune-complex type. Three of the four patients were treated with corticosteroids and two also received blood transfusion, with a complete recovery. CONCLUSIONS: Drug-induced auto-immune phenomena in post-artesunate delayed haemolysis may be underreported and must be considered. The role of corticosteroids should be reassessed

High prevalence of S. Stercoralis infection among patients with Chagas disease: A retrospective case-control study

Background: We evaluate the association between Trypanosoma cruzi infection and strongyloidiasis in a cohort of Latin American (LA) migrants screened for both infections in a non-endemic setting. Methodology: Case-control study including LA individuals who were systematically screened for T. cruzi infection and strongyloidiasis between January 2013 and April 2015. Individuals were included as cases if they had a positive serological result for Strongyloides stercoralis. Controls were randomly selected from the cohort of individuals screened for T. cruzi infection that tested negative for S. stercoralis serology. The association between T. cruzi infection and strongyloidiasis was evaluated by logistic regression models. Principal findings: During the study period, 361 individuals were screened for both infections. 52 (14.4%) individuals had a positive serological result for strongyloidiasis (cases) and 104 participants with negative results were randomly selected as controls. 76 (48.7%) indiviuals had a positive serological result for T. cruzi. Factors associated with a positive T. cruzi serology were Bolivian origin (94.7% vs 78.7%; p = 0.003), coming from a rural area (90.8% vs 68.7%; p = 0.001), having lived in an adobe house (88.2% vs 70%; p = 0.006) and a referred contact with triatomine bugs (86.7% vs 63.3%; p = 0.001). There were more patients with a positive S. stercoralis serology among those who were infected with T. cruzi (42.1% vs 25%; p = 0.023). Epidemiological variables were not associated with a positive strongyloidiasis serology. T. cruzi infection was more frequent among those with strongyloidiasis (61.5% vs 42.3%; p = 0.023). In multivariate analysis, T. cruzi infection was associated with a two-fold increase in the odds of strongyloidiasis (OR 2.23; 95% CI 1.07-4.64; p = 0.030). Conclusions: T. cruzi infection was associated with strongyloidiasis in LA migrants attending a tropical diseases unit even after adjusting for epidemiological variables. These findings should encourage physicians in non-endemic settings to implement a systematic screening for both infections in LA individuals

Post-splenectomy acute glomerulonephritis due to a chronic infection with Plasmodium falciparum and malariae

A 38-year-old Senegalese man with no previous medical history and living in Spain since 2004 was admitted due to fever, hypotension and edemas. The patient had not traveled to malaria endemic areas for the last 2 years, and 43 days before this episode he underwent an elective splenectomy in order to rule out a hematologic neoplasm due to a 27-cm splenomegaly and pancytopenia

Sporotrichoid dissemination of cutaneous leishmaniasis possibly triggered by a diagnostic puncture

Case report: A 31 year old Spanish woman attended Hospital Clinic in Barcelona in August 2018, after working in La Paz (Bolivia) for six months. She remembered an insect bite on her right thigh, during a trip to Beni (Brazilian border) with progression to a papule with a central crater within one month. Treatment with oral moxicillin/clavulanic acid yielded no improvement. Thereupon, a diagnostic puncture of the ulcer was performed, with a positive result of polymerase chain eaction (PCR) for Leishmania spp. without bacterial isolates in the culture. She then decided to return to Spain for management

ATCG, el futuro de la agricultura

La Sociedad Europea de Ingeniería Agronómica (EurAgEng) concedió, en su congreso de 2004, el Premio UNACOMA de prospección científica a nueve investigadores de la Universidad Politécnica de Madrid. Este premio, patrocinado por la asociación de fabricantes de maquinaria agrícola italiana, promueve la búsqueda de respuestas a dos cuestiones fundamentales: qué puede hacer la ingeniería agronómica por la sociedad y cómo será la agricultura del futuro