RESUMENEl dengue es la arbovirosis humana que más morbimortalidad ocasiona mundialmente. Durante 2016, se registró, en la Ciudad de Buenos Aires, Argentina, la mayor epidemia de esta enfermedad. Objetivo: describir las características clínicas y hematológicas en una población pediátrica. Métodos: estudio de corte transversal que incluyó a pacientes atendidos del 18-1-16 al 15-4-16 en el Hospital de Niños "Dr. Ricardo Gutiérrez". Resultados: se registraron 156 casos, 82 confirmados por virología; 130 (83 %), autóctonos. Las manifestaciones clínicas más frecuentes fueron fiebre, cefalea y dolor retroocular. Las alteraciones del laboratorio significativas fueron leucopenia, plaquetopenia y aumento de transaminasas. Se internaron 35 pacientes (23 %), 25 (16 %) con signos de alarma. No se presentó ningún caso de dengue grave. Conclusiones: el reconocimiento oportuno de los signos de alarma y el control hematológico resultan fundamentales para detectar a los niños en riesgo y ofrecerles tratamiento de soporte en forma precoz. Palabras clave: virus del dengue, niño, pediatría. ABSTRACTDengue is the human arbovirus with the highest morbidity and mortality in the world. The largest outbreak of dengue in Buenos Aires, Argentina, occurred during 2016. Dengue outbreak in Buenos Aires, Argentina, 2016: Clinical and hematological features in children Objective: To describe clinical and hematological features in children with confirmed dengue infection. Methods: Cross sectional study that included children attended since January 18 th to April 15 th 2016 at Hospital de Niños "Dr. Ricardo Gutiérrez". Results: among 156 registered cases, 82 confirmed cases by virology test; 130 (83 %) autochthonous cases. The most frequent clinical manifestations were fever, headache and retro-ocular pain. Laboratory abnormalities were leukopenia, thrombocytopenia and increased liver enzymes. Thirty-five children were hospitalized (23 %), 25 (16 %) with warning signs. In our study, no cases of severe dengue occurred. Conclusions: early recognition of warning signs and hematological monitoring is essential in order to detect patients at risk and offer them adequate early treatment. Brote epidémico de dengue en la Ciudad de Buenos Aires, 2016: características clínicas y hematológicas de la infección en una población pediátrica
Background Cat scratch disease (CSD) is a zoonosis caused primarily by Bartonella henselae. The aim of our study was to determine the incidence CSD before the preventive and obligatory social isolation/distancing that was indicated in Argentina as a consequence of the SARS-CoV-2 pandemic on March 19, 2020 ("first period") and to compare it with the incidence since then to present ("second period"). Methods Retrospective analysis of patients with CSD admitted to the Infectious Diseases outpatient office at Ricardo Gutiérrez Children’s Hospital (a tertiary care center) from March 2012 to March 2022. Charts were reviewed for demographic and epidemiological data, duration of symptoms, clinical manifestations and systemic compromise. Results Two hundred twenty-nine patients were observed during the study period. The median delay between symptoms onset and medical consultation was 15 days (IQR 9-30d), without statistically significant differences between periods The median age at presentation was 101.67 months (range 11.3 to 211.87 months) Age and gender were similar between periods. The average number of cases per month was 1.63 (158 in 97 months) versus 3.23 (71 cases in 22 months) in the first and second periods, respectively, with an increasing incidence of 98%. The frequency of systemic compromise was higher in the second period: 47.89% versus 32.28% (p= 0.01). The months with the highest incidence were February to July. Conclusion A significant increase of CSD were observed during the COVID pandemic probably related to a closer children´s contact with pets due to the strict quarantine that health authorities implemented. Moreover, an unexpected finding was a higher proportion of patients with systemic CSD during the pandemic period. Disclosures All Authors: No reported disclosures.
La encefalitis por el virus de Saint Louis es una enfermedad que se transmite a través de mosquitos de la especie Culex. En Argentina, se registran casos esporádicos, habitualmente asintomáticos en niños. Se presenta el caso de una paciente con manifestaciones clínicas inusuales en edad pediátrica y lesiones en el sistema nervioso central no descritas hasta el momento en la literatura. Se trata de una niña de 8 años, que consultó por síndrome febril, cambios conductuales, ataxia, clonus y rigidez de nuca. En el líquido cefalorraquídeo, se detectó pleocitosis predominantemente mononuclear. Se realizó una resonancia magnética, que evidenció imágenes de isquemia bitalámica. La infección por virus de Saint Louis se diagnosticó por IgM en el suero y el líquido cefalorraquídeo. La paciente evolucionó de manera favorable. Al momento del egreso hospitalario, persistía con bradipsiquia y alteraciones conductuales y se recuperó definitivamente 45 días después del alta. Palabras clave: encefalitis de St Louis, virus de la encefalitis de St Louis.ABSTRACT Saint Louis encephalitis is transmitted by Culex mosquitoes. In Argentina sporadic cases are registered. Symptomatic illness is unusual in children. We present a case of meningoencephalitis caused by an uncommon viral infection. The clinical signs and symptoms are unusual for pediatric patients and the bilateral thalamic compromise showed on magnetic resonance has not been described previously. An 8-year-old girl consulted due to fever, behavior disorders and ataxia. Clonus and neck stiffness were detected at physical exam. Cerebrospinal fluid revealed mononuclear leukocytosis; bilateral ischemic compromise was observed in thalamus by magnetic resonance. Saint Louis virus was confirmed by serology: serum and cerebrospinal fluid IgM were positive during the acute phase of the disease and serum IgG was positive four weeks later. Most of the signs and symptoms of the disease were resolved, however mild behavior disorders were observed as acute sequelae up to 45 days after hospital discharge.
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