The coronavirus disease 2019 (COVID-19) pandemic has particularly affected countries with weakened health services in Latin America, where proper patient management could be a critical step to address the epidemic. In this study, we aimed to characterize and identify which epidemiological, clinical, and paraclinical risk factors defined COVID-19 infection from the first confirmed cases through the first epidemic wave in Venezuela. A retrospective analysis of consecutive suspected cases of COVID-19 admitted to a sentinel hospital was carried out, including 576 patient cases subsequently confirmed for severe acute respiratory syndrome coronavirus 2 infection. Of these, 162 (28.1%) patients met the definition criteria for severe/critical disease, and 414 (71.2%) were classified as mild/moderate disease.The mean age was 47 (SD 16) years, the majority of which were men (59.5%), and the most frequent comorbidity was arterial hypertension (23.3%). The most common symptoms included fever (88.7%), headache (65.6%), and dry cough (63.9%). Severe/ critical disease affected mostly older males with low schooling (p < 0.001). Similarly, higher levels of glycemia, urea, aminotransferases, total bilirubin, lactate dehydrogenase, and erythrocyte sedimentation rate were observed in severe/critical disease patients compared to those with mild/moderate disease. Overall mortality was 7.6% (44/576), with 41.7% (28/68) dying in hospital. We identified risk factors related to COVID-19 infection, which could help healthcare providers take appropriate measures and prevent severe clinical outcomes. Our results suggest that the mortality registered by this disease in Venezuela during the first epidemic wave was underestimated. An increase in fatalities is expected to occur in the coming months

Melioidosis is an important disease in Asia and Australia. It is very rare in Venezuela. We describe the case of a 50-year-old diabetic patient with several episodes of right tibial osteomyelitis, left shoulder arthritis, sternal osteomyelitis, right parietal osteomyelitis, and subperiosteal abscess, followed by septic arthritis of the right knee. In all cases Gram stain smear showed Gram-negative bacilli. Culture yielded Burkholderia pseudomallei, susceptible to third- and fourth-generation cephalosporins, ciprofloxacin and aztreonam, and resistant to aminoglycosides. He developed sepsis syndrome. Blood cultures and culture of abscess and joint fluids also revealed B. pseudomallei. The patient was treated with ceftazidime and ciprofloxacin, then cefepime and trimethoprim-sulfamethoxazole. He was discharged with suppressive therapy consisting of oral doxycycline and trimethoprim-sulfamethoxazole, and follow-up has continued to date. At this time he remains asymptomatic. Melioidosis is an extremely rare disease in our country. To our knowledge, this is only the second case reported in Venezuela.

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

Introduction: Knowledge, attitudes, and practices (KAP) studies related to coronavirus disease 2019 (COVID-19) allow the identification of erroneous concepts and inadequate practices about this disease. This baseline information is essential to design effective strategies and improve adherence to prevention measures. Objective: Identify the KAP related to COVID-19 in Venezuelan patients screened at the Caracas University Hospital triage tent. Materials and methods: A cross-sectional study was conducted on 215 patients between April 25th and May 25th, 2020 with in-person interviews using a KAP survey. Results: Most surveyed patients (53.5%) were asymptomatic. Most of them had adequate knowledge about symptoms and transmission of the disease without distinction between the symptomatic and asymptomatic groups. Most of them indicated to be practicing quarantine, frequent handwashing, and face mask use in public areas; however, daily replacement of cloth face masks was more frequent in the asymptomatic group, whereas replacement every 3 days of cloth face masks was more frequent in the symptomatic group. Finally, more than half of the participants admitted having been in crowded places, being this practice more common among the symptomatic compared to the asymptomatic patients. Conclusions: This is the first KAP study in Venezuela about COVID-19. The knowledge and practices of Venezuelans could be improved through the strengthening of education and training programs. This information obtained from the early phase of the pandemic in Venezuela could contribute to the design of COVID-19 promotion and prevention strategies.

La histoplasmosis es una enfermedad granulomatosa, producida por Histoplasma capsulatum. Causa un amplio espectro de manifestaciones clínicas, la más frecuente es la pulmonar. En algunos casos se presentan formas diseminadas, con afectación de uno o múltiples órganos, de características atípicas, difíciles de reconocer. La patogenia de esta enfermedad es igual a la de tuberculosis y se ha descrito coinfección. Se reportan tres casos de histoplasmosis de presentación infrecuente: ancianos, coinfección con micobacterias y localizaciones atípicas y revisión de la literatura. El primero fue un paciente de 19 años de edad con absceso cerebral. El segundo y tercero, personas mayores de 60 años, con infección mixta por Histoplasma y micobacterias, uno de presentación articular y otra con enfermedad ginecológica. En Venezuela, zona endémica para esta micosis, el médico está obligado a tener un alto índice de sospecha acerca de la misma, teniendo en cuenta factores como la edad y la epidemiologia.