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Dengue fever is a vector-transmitted viral infection. Non-vectorial forms of transmission can occur through organ transplantation. We reviewed medical records of donors and recipients with suspected dengue in the first post-transplant week. We used serologic and molecular analysis to confirm the infection. Herein, we describe four cases of dengue virus transmission through solid organ transplantation. The recipients had positive serology and RT-PCR. Infection in donors was detected through serology. All cases presented with fever within the first week after transplantation. There were no fatal cases. After these cases, we implemented dengue screening with NS1 antigen detection in donors during dengue outbreaks, and no new cases were detected. In the literature review, additional cases had been published through August 2017. Transmission of Dengue virus can occur through organ donation. In endemic regions, it is important to suspect and screen for dengue in febrile and thrombocytopenic recipients in the postoperative period.

Chikungunya virus is a recent emerging arbovirus in Latin America, and the clinical manifestations can vary from fever and rash to severe chronic inflammatory arthritis. Few reports have been published regarding this infection in immunocompromised patients, including solid organ transplant recipients. We report a case series of solid organ transplant recipients with confirmed Chikungunya infection by positive reverse transcription polymerase chain reaction (RT-PCR), identified between January 2014 and December 2016. In addition, we conducted a literature review searching PubMed, EMBASE, and LILACS databases on Chikungunya infection in solid organ transplant recipients. Ten solid organ transplant recipients were included, consisting of 5 kidney, 4 liver, and 1 liver/kidney transplant recipient. Mean age of the transplant recipients was 47 years, and the most frequent symptoms of Chikungunya infection were arthralgia and fever. None of the patients required treatment in the intensive care unit, no deaths or graft rejection occurred. None of our patients had recurrent arthritis during 3-month follow-up period after the infection. Twenty-one cases of Chikungunya virus were identified in the literature review. Most cases had a benign clinical course with no severe complications, death, or chronic inflammatory arthritis. In conclusion, Chikungunya infection in solid organ transplant recipients has a benign course and has no chronic recurrent arthritis. It is possible that the immunosuppression regimen could decrease the risk of severe or chronic inflammatory manifestations in solid organ transplant recipients infected with Chikungunya.

Background:The limited data available so far has shown a high mortality rate among COVID-19 patients admitted to the ICU. Possible risk factors for poor outcomes in this type of patients need to be analyzed so we can identify strategies to reduce mortality. Objective: Characterized the COVID-19 experience in Community hospital ICU. Methods: Single center retrospective cohort study involving all adult patients admitted to the ICU with severe COVID-19 infection. Results: 132 patients were admitted to ICU during the study period. There was a preponderance for males and the most common ethnicity was Hispanic. The overall mortality was 69%, and mortality after intubation was 76%. In the multivariable analysis older Age (OR = 15.7), Obesity (OR = 2.92) and Mechanical Ventilation (OR = 12.0) were found to be a significant independent risk factor for increased mortality. Conclusion:Our study confirms the high mortality rate in patients critically ill with COVID-19 requiring ICU care especially among older age group, mechanically ventilated and obese patients. Overall outcomes are comparable to larger tertiary care centers. Our findings highlight the need to plan for optimal resource allocation and tailoring therapies to target the disease so as to improve outcomes.

Dengue virus can infect humans through vectorial and non-vectorial transmission. Classically, non-vectorial transmission has been related to vertical transmission and health care–associated infections, but recently transmission to solid organ and bone marrow recipients has been reported. We performed a scoping review of the available literature searching for evidence on screening for dengue in potential organ donors and the use of these infected organs. From 372 unique records identified, 17 were eligible to be included in our scoping study. After applying inclusion and exclusion criteria, three studies were included. These studies described a total of six patients from India (two case reports; n=2) and Colombia (one case series; n=4). Three patients received a liver, two received a kidney and one had a heart transplant. The onset of symptoms occurred in the first week after transplant in all cases and all experienced fever as the primary symptom. All patients presented thrombocytopenia with a platelet count <50 000. None of the patients developed graft rejection. However, four patients presented graft complications. No recipient deaths occurred. There is not a strong recommendation for dengue screening of donors in transplantation guidelines, but in endemic areas, physicians should be aware of this type of transmission before transplantation.

Invasive aspergillosis usually affects immunocompromised hosts with variable manifestations depending on the site of infection. In this article, we present two cases of invasive Aspergillosis in two non-immunocompromised patients; both cases had a paranasal sinuses infection, with intraorbital and intracranial extension, requiring surgery and antifungal treatment with Voriconazole. These cases were initially diagnosed as paranasal sinus neoplasms. However, the pathology and microbiology studies revealed invasive fungal infection by Aspergillus flavus

Introducción. La leptospirosis es una infección bacteriana endémica en Colombia. Su curso clínico puede ser variable y, en ocasiones, fatal. Hay pocos estudios en el país sobre los casos graves de esta enfermedad.Objetivo. Describir las características demográficas y clínicas de los pacientes con diagnóstico de leptospirosis grave hospitalizados en salas generales o atendidos en la unidad de cuidados intensivos de un hospital de cuarto nivel. Materiales y métodos. Se llevó a cabo un estudio observacional descriptivo de los pacientes adultos y niños con diagnóstico serológico de leptospirosis entre el 2010 y el 2016.Resultados. Se analizaron las historias clínicas de 87 pacientes, 74 % de los cuales correspondía a hombres y, el 84 %, a mayores de 18 años. El 35 % tenía alguna comorbilidad y la hipertensión arterial sistémica (16 %) y la diabetes mellitus (9 %) fueron las más comunes. Los síntomas más frecuentes fueron: fiebre, náuseas, astenia, mialgias, artralgias y dolor abdominal. El 34 % requirió atención en la unidad de cuidados intensivos, con una mediana de estancia de 5 días. El 61 % requirió hospitalización en sala general, con una mediana de estancia de 6 días. Todos los casos recibieron tratamiento antibiótico con ceftriaxona o doxiciclina. La tasa de letalidad fue del 1,1 % (n=1).Conclusiones. La infección por Leptospira spp. tiene el riesgo de diagnosticarse de manera tardía por su presentación clínica inespecífica, lo que implica considerar un gran número de diagnósticos diferenciales. La atención temprana de los pacientes con cuadros graves de esta enfermedad en la unidad de cuidados intensivos, puede evitar una mayor incidencia de complicaciones y disminuir la mortalidad.

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