Strongyloides stercoralis, nemátode intestinal de alta prevalencia en zonas tropicales y subtropicales, se presenta clínicamente de forma asintomática u oligosintomática en personas inmunocompetentes. No obstante, la diseminación o hiperinfección por este parásito, puede producir severas complicaciones, a veces fatales en pacientes inmunosuprimidos. Este reporte describe a un paciente masculino de 53 años, trasplantado renal, cuyas complicaciones coinciden con la detección de larvas en las heces. La terapia inmunosupresora usual no impidió el desarrollo de nefritis aguda en este paciente. Los métodos de Baermann y cultivo en agar resultaron positivos en tres muestras consecutivas. Adicionalmente, en el sedimento urinario, se encontraron larvas rabditoides. Posterior al tratamiento con ivermectina la función renal evidenció significativa mejoría. El caso presentado enfatiza la necesidad de investigar la infección por S. stercoralis en los protocolos pre-trasplante en donantes y receptores, y en las complicaciones post-trasplante asociadas con eosinofilia, especialmente cuando proceden del trópico.
The specific roles of ethanol and malnutrition in the pathogenesis of neurogical disorders of chronic alcoholism remain unclear. We measured plasmatic thiamine levels and erythrocyte transketolase activity in 30 alcoholics with peripheral neuropathy and in 4 with a Wernicke-Korsakoff (W-K) syndrome. Thiamine levels in the first group were comparable to those of normal subjects while a significantly lower concentration was found in W-K syndrome. Transketolase activity was lower for both groups in comparison with normal subjects. We suggest that a defect in thiamine utilization is involved in peripheral neuropathy of alcoholics, rather than a lack of thiamine itself.
Pathogenic strains of Acanthamoeba are causative agents of keratitis and encephalitis that often may end fatal in humans and other animals. In the present study, twenty-seven soil samples were collected in the Bolivar State in Venezuela and checked for the presence of Acanthamoeba. Samples were cultivated onto 2% non-nutrient agar plates seeded with a layer of heat killed E. coli. Amplification by PCR and sequencing of the DF3 region of the 18S rDNA of Acanthamoeba was carried out in order to confirm morphological identification of the amoebae. Furthermore, Acanthamoeba spp. was isolated from 51.8% of soil samples. Sequencing of the DF3 region of the 18S rDNA resulted in the identification of genotype T4 in all samples. To the best of our knowledge, this is the first report of genotype T4 in soil sources from Venezuela. Further studies should be carried out in this State and in the country in order to determine the current occurrence of Acanthamoeba in Venezuelan environments.
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