Armando Cortés

Catastrophic antiphospholipid syndrome triggered by fulminant Chikungunya infection in a patient with systemic lupus erythematosus

The patient, a 21-year-old woman, was admitted to the intensive care unit with a 4-day history of fever, arthritis of the hands and feet, oli- guria with anasarca, diarrhea, and widespread skin rash. Systemic lupus erythematosus had been diagnosed 5 years previously. She was positive for lupus anticoagulant and anticardiolipin antibody but had no history of thrombotic or obstetric manifestations. Laboratory tests for infection and immunologic or biochemical abnormalities were performed and, based on multiple abnormal findings, treatment with broad-spectrum antibiotics was instituted.

Antimicrobial susceptibility of Helicobacter pylori with chronic gastritis

INTRODUCTION Infection by Helicobacter pylori is prevalent in approximately half the world´s population.However, the susceptibility of H. pylori to antimicrobial agents must be evaluated by in vitro methods in order to determine the susceptibility levels and to guide treatment regimes. OBJECTIVE The prevalence of infection and antibiotic susceptibility was evaluated in gastric biopsies containing H. pylori. MATERIALS AND METHODS The prevalence of infection and antibiotic susceptibility was investigated in 203 patients with chronic gastritis from Tumaco, Colombia. Diagnosis was confirmed by histopathological evidence (Dixon scale) and microbiological (culture on blood agar supplemented with antibiotics).The antibiotic resistance of H. pylori was measured by its response toantimicrobial amoxicillin and clarithromycin using the agar dilution method. RESULTS The prevalence of infection for H. pylori with histopathological and microbiological tests was88.7% and 84.7% respectively. The prevalence of resistance of H. pylori to antimicrobial amoxicillin was 20.5%, to clarithromycin 19.8%, and to both antibiotics concurrently, 10.9%. CONCLUSIONS A high incidence of clarithromycin-resistant and amoxicillin-resistant H. pylori was discovered in patients from Tumaco with chronic gastritis. Dual drug-resistant strains of H. pylori to clarithromycin and amoxicillin were also present.

A case report of transfusion-transmitted Plasmodium vivax malaria from an asymptomatic donor to a premature newborn

Most of the Colombian territory is endemic for malaria. Autochthonous cases with low parasitemia occur in the Pacific coast and in large zones of Antioquia and Córdoba. According to the Colombian legislation no malaria screening test is mandatory for blood donors from non-endemic areas. However, if they have traveled to malaria transmission regions they are deferred for six months before they can donate. This report describes a transfusion- transmitted malaria case in Cali (Valle del Cauca, Colombia), where a preterm newborn received infected blood from a donor that lived in the same city, but he had traveled to the rural area of the municipality of Dagua (Valle del Cauca, Colombia) 9 months before the donation. Thick blood smears confirmed Plasmodium vivax infection in the newborn and the donor sample was analyzed by PCR, which confirmed P. vivax infection. This case suggests the need for reviewing donor selection criteria and deferral strategies to prevent possible cases of transfusion-transmitted malaria.

Mucormicosis rino-órbito-cerebral de origen dental

Rhino-orbito-cerebral mucormycosis from dental origin is an acute infection caused by opportunistic fungi belonging to the order of Mucorales, which affects mainly diabetic and immunocompromised patients.We report the case of a 63-year old diabetic man who performed a dental extraction on himself by his own means and subsequently developed a rhino-orbito-cerebral mucormycosis with cutaneous and palatal affection. The species isolated in the mycological culture was Rhizopus sp.

Mucormicosis rinocerebral de origen dental: reporte de caso

Rhino-orbito-cerebral mucormycosis from dental origin is an acute infection caused by opportunistic fungi belonging to the order of Mucorales, which affects mainly diabetic and immunocompromised patients.We report the case of a 63-year old diabetic man who performed a dental extraction on himself by his own means and subsequently developed a rhino-orbito-cerebral mucormycosis with cutaneous and palatal affection. The species isolated in the mycological culture was Rhizopus sp.

Absence of occult hepatitis B in Colombian blood donors

INTRODUCTION In Colombian blood banks, screening for the surface antigen of hepatitis B is mandatory in all units collected. Testing of antibody against core antigens is not administered, although this method may be useful to detect donors infected with the hepatitis B virus. OBJECTIVE The prevalence of occult hepatitis B was determined by applying a full-serological profile of hepatitis B virus to blood samples of blood donors. MATERIALS AND METHODS Between April 2008 and October 2009, a prospective cross sectional study was conducted using 628 samples from donors to blood banks located in four Colombian cities. Prevalence for hepatitis B had been previously recorded for these cities. Serological screening was performed for the complete virus; then nucleic acid amplification was tested in sera that were anti-HBc reactive and with a titer of anti-HBs ≤30 mUI/ml. RESULTS Of the 628 samples tested, 129 met the serological criteria established to be tested nucleic acid amplification. None of them demonstrated evidence of nucleic acid amplification of hepatitis B virus. CONCLUSIONS This is the first study in Colombia to detect the presence of blood donors that may be occult hepatitis B carriers. None was detected.

Reliable information for cancer control in Cali, Colombia

Abstract Background: The Cali Population Cancer Registry (RPCC) has been in continuous operation since 1962 with the objective of producing valid statistics on the incidence of cancer, its patterns, trends and survival rates. Methods: During the period 2008-2012, 23,046 new cases were registered and during 2011-2015 there were 12,761 cancer deaths. The trend of the rates was described with the APC average annual change rate and with the Joinpoint analysis. We analyzed the individual data of 38,671 adults (15-99 years) diagnosed with cancer between 1995-2009, and we calculated the standardized net survival by age for the 14 most common cancer body sites, using the Pohar-Perme method. Results: Prostate and breast cancer were the first cause of cancer morbidity. The incidence rates in these were susceptible to early detection, tumors stabilized after decades of growth, while an increase in the incidence of colon cancer and papillary thyroid carcinoma was observed. The incidence rates of cervical and stomach cancer and conditions related to infectious agents decreased, although the number of absolute cases increased, due to the growth and aging of the population. Gastric cancer was responsible for the highest number of cancer related deaths. The types of cancer related to tobacco consumption (lung, oral cavity, esophagus, pancreas, urinary bladder) showed low numbers and a tendency to decrease. During the period 2000-2004, the 5-year net survival improved for cancers of the breast, cervix, prostate, melanoma and thyroid, although in the period 2005-2009 a stagnation was observed. In stomach, liver and lung cancer, the 5-year net survival was less than 15%. The 5-year overall survival in children was 51.0% (95% CI: 47.5, 54.3) and in adolescents 44.6% (95% CI: 36.0, 52.8). Comment: RPCC has been an advisor to the Colombian government in the evaluation of CPRs in the country and its data has contributed significantly to different aspects of cancer control in Colombia.

Toxoplasmosis aguda diseminada fatal en una paciente adulta inmunocompetente proveniente del Pacífico colombiano

We present the case of a 72-year-old immunocompetent patient from Chocó, Colombia, with a 12-day course of fever, headache, progressive neurological deterioration, and rapid evolution to multiorgan failure and death. In the histopathological study of tissues obtained at necropsy, tissue cysts morphologically suggestive of being bradyzoites of Toxoplasma gondii were identified and confirmed by immunohistochemistry in heart, brain, and striated muscle.