During 2003 and during late September of 2004, more than 1230 cases of gastroenteritis were reported in the south of Sinaloa State, north-western Mexico. All cases were attributed to the consumption of raw or undercooked shrimp collected at the Huizache-Caimanero lagunary system. Vibrio parahaemolyticus was identified by standard biochemical methods, and many strains were positive for PCR amplifications of the tlh and tdh genes and negative for the trh gene. A representative strain belonged to the O3:K6 serogroup. This is the first outbreak of gastroenteritis caused by the pandemic strains of O3:K6 V. parahaemolyticus in México.

Objectives: Meningococcal meningitis is reported as a rare condition in Mexico. There are no internationally published studies on bacterial causes of meningitis in the country based on active surveillance. This study focuses on finding the etiology of bacterial meningitis in children from nine Mexican Hospitals. Methods: From January 2010 to February 2013, we conducted a three years of active surveillance for meningitis in nine hospitals throughout Mexico. Active surveillance started at the emergency department for every suspected case, and microbiological studies confirmed/ruled out all potentially bacterial pathogens. We diagnosed based on routine cultures from blood and cerebrospinal fluid (not polymerase chain reaction or other molecular diagnostic tests), and both pneumococcal serotyping and meningococcal serogrouping by using standard methods. Results: Neisseria meningitidis was the leading cause, although 75% of cases occurred in the northwest of the country in Tijuana on the US border. Serogroup C was predominant. Streptococcus pneumoniae followed Neisseria meningitides, but was uniformly distributed throughout the country. Serotype 19A was the most incident but before universal implementation of the 13-valent pneumococcal conjugate vaccine. Other bacteria were much less common, including Enterobacteriaceae and Streptococcus agalactiae (these two affecting mostly young infants). Conclusions: Meningococcal meningitis is endemic in Tijuana, Mexico, and vaccination should be seriously considered in that region. Continuous universal vaccination with the 13-valent pneumococcal conjugate vaccine should be nationally performed, and polymerase chain reaction should be included for bacterial detection in all cultures – negative but presumably bacterial meningitis cases.

The Strep A OIA (BioStar, Inc., Boulder, Colo.) rapid detection system is an intriguing technology that utilizes an immunoassay relying on changes in reflected light to directly detect group A streptococcal antigen from specimens. In this evaluation, 424 routine pediatric throat specimens and 20 simulated oropharyngeal

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Antecedentes: La pericarditis aguda es poco frecuente en los niños; puede evolucionar a derrame o taponamiento cardiaco. Los principales agentes infecciosos son virus y bacterias. El tratamiento farmacológico es con antiinflamatorios no esteroideos; pocos pacientes requieren pericardiocentesis.Caso clínico: Paciente escolar hospitalizada por dolor torácico en zona precordial, quien fue diagnosticada con pericarditis aguda y derrame pericárdico, sin otra sintomatologia clínica. El cuadro progresó a tos seca, dolor abdominal epigástrico opresivo, vómitos gastroalimentarios y fiebre. Por mala respuesta al tratamiento inicial se solicitaron estudios inmunológicos. Se encontró positividad a los autoanticuerpos antinucleares, anti-ADN de doble cadena, Coombs directo y anticardiolipinas; también se encontró hipocomplementemia con linfopenia, indicativos de lupus eritematoso sistémico.Conclusiones: La evolución tórpida o recurrencia de la pericarditis debe orientar a descartar entidades neoplásicas o autoinmunes. Las manifestaciones cardiovasculares se presentan de forma inicial en pocos pacientes con lupus eritematoso sistémico.

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Introducción: La candidiasis mucocutánea crónica asociada a autoinmunidad y displasia ectodérmica es un error innato de la inmunidad, caracterizado por una triada clásica (candidiasis mucocutánea crónica, hipoparatiroidismo e insuficiencia suprarrenal) debido a la presencia de autoanticuerpos contra diferentes órganos endocrinos y no endocrinos; predomina en judíos y finlandeses. Reporte de caso: Mujer de 7 años de edad de ascendencia europea y consanguinidad positiva, con historia personal de infecciones respiratorias de repetición, candidiasis crónica, colitis pseudomembranosa y pancitopenia. Los hallazgos clínicos hicieron sospechar de un error innato de la inmunidad y el diagnóstico preciso de APECED (autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy) se realizó al detectar una variante patogénica en el gen AIRE, a través de tecnologías de secuenciación de nueva generación. Conclusión: Hoy en día, se tiene acceso a nuevas herramientas genéticas para establecer el diagnóstico temprano de los diferentes errores innatos de la inmunidad, así se puede ofrecer un tratamiento oportuno y un mejor pronóstico.