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RESUMENSe present a un enfoqu e panorâmic o d e estúdios epidemiológicos , clínico s y experimentales referente s a Loxoscele s laet a y loxoscelism o efectuado s e n 1955-198 8 en Santiago , Chile .Se estudiaro n 21 6 caso s d e loxoscelismo . Los hechos más relevante s fueron : 52,8 % correspondió a mujeres; eda d entre 7 meses y 7 8 anos; 84,3 % fu é loxoscelismo cutâne o (LC) y 15,7 % loxoscelism o cutáneo-viscera l (LCV) ; 73,6 % sucedi ó e n époc a calurosa ; en 86,6 % e l accidente ocurri ó e n l a vivienda, especialment e e n dormitórios , mientra s la person a dormia o s e vestia. La arah a fu é vist a e n 60,2 % d e lo s caso s e identificad a en laboratório com o L . laeta e n 17,7 % (10,6 % d e lo s 21 6 casos) . Lo s sitios más frecue n temente afectado s fuero n Ia s extremidades co n 67,6% , lancetazo urent e fu é e l sintoma inicia l má s frecuente . Dolor , edem a y plac a livedoide , l a cua l posteriorment e se transformari a e n escar a necrótica , fuero n la s manifestacione s locale s predominantes. E n LCV hematuri a y hemoglobinuri a fuero n constantes , ictericia , fiebr e y compromiso d e concienci a s e presentaron e n l a mayorí a d e lo s casos .Tratamiento: L C co n antihistamínico s o corticoide s inyectables , LCV con corticoides inyectables .La condició n d e lo s paciente s e n e l últim o contro l fué : curació n complet a e n 75,5%, curació n co n secuel a cicatriza i e n 8,3% , muert e e n 3,7 % (todo s co n LCV ) y abandon o e n 12,5 % . El loxoscelism o e n Chil e e s causado po r Loxosceles laeta 12 2 1 4 2 44 , espéci e habitualment e doméstica, d e colo r pardo-caf é má s oscur o e n el abdomen , cuy o cuerp o mid e 8-1 5 mm , mie n tras qu e su s patas mide n 8-3 0 mm (Fig . 1) .

Patients suffering from Chagas' disease, as determined by positive serological results, were tested for further evidence of Trypanosoma cruzi infection by xenodiagnosis and PCR. The patients included 67 children aged from 0 to 10 years and 75 adults. All children were positive by PCR on their pre-therapy sample, while only 69% of the seropositive adults and none of the 78 seronegative control adults were PCR positive. Xenodiagnosis was positive in 79% of the children, but only in 21% of the adults. A group of 66 children was treated with nifurtimox, and followed up every 3 months during the first year and every 6 months during the second and third year post-therapy, by PCR, xenodiagnosis and serology. We concluded that PCR was the most effective test to monitor children for 3 years post-chemotherapy, when all the cases converted from positive to negative. Conventional serology, however, remained positive after that period in most cases. In contrast, conversion to negative xenodiagnosis occurred very early after treatment.

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A series of already published and unpublished seroepidemiological surveys for toxoplasmosis, carried out in Chile in 1982-1994, is reviewed, expanded and analyzed. The surveys included 76,317 apparently healthy individuals of different ages (0.57% of the country's total population), from 309 urban and rural-periurban localities. Urban groups were integrated by blood donors, delivering mothers and middle grade schoolchildren, while rural-periurban individuals corresponded to unselected family groups. Blood samples were collected in filter paper. The presence of antibodies to Toxoplasma gondii was determined by the indirect hemagglutination test (IHAT), titers > or = 16 were considered positive. The test resulted positive in 28,124 (36.9%) of the surveyed people. Two hundred and six (0.3%) individuals presented IHAT titers > or = 1000, probably corresponding to acute or reactivated infections. A progressive increase of positive IHAT from northern to southern regions of the country was noted, phenomenon probably related to geographical conditions and to a higher production and consumption of different types of meat in the latter regions. It is postulated that ingestion of T gondii cysts by humans is epidemiologically as important as ingestion of oocysts. The result presented stress the epidemiological importance of toxoplasmosis in humans, and warn about eventual implications in immunocompromised patients and in transplacental transmission, organ transplants and transfusions.

Between November 2001 and December 2002, 600 dog fecal samples were collected in main squares and public parks of 13 cities in Chile, from the extreme north to the extreme south of the country. The samples were processed in the laboratory by centrifugal sedimentation and the Harada-Mori methods. T. canis eggs were found in 12 cities. Detection rates ranged from 1.9 to 12.5% with an average of 5.2%. Seven percent of the samples had eggs and 9.5% had rhabditoid and/or filariform larvae of Ancylostomatidae. Strongyloides stercoralis were not found. Squares and public parks in Chile pose a potential risk of exposure to visceral, ocular, and/or cutaneous larva migrans syndromes. Resumo