Summary Epidemiological and clinical aspects of Brucella suis infection in 17 workers from a pork processing plant in Argentina occurring between January 2014 and July 2015 are presented. All patients reported working 9 h daily without adequate personal protection garment. Blood cultures were positive for Brucella spp. in 14 of the 17 patients (82.3%). All isolates were identified as B. suis biovar 1. Although fever, sweats, asthenia, myalgia and hepatic involvement were the most frequent clinical manifestations, an unusually high incidence of respiratory involvement was found. From 13 patients in which chest radiography was performed, four (30%) had radiological abnormalities, including lobar pneumonia in two cases (one with pleural effusion) and interstitial involvement in other two. The high frequency of respiratory involvement in our series makes necessary to consider brucellosis in the differential diagnosis of respiratory diseases in pork processing plant employees.

Summary Severe COVID‐19 is associated with a systemic inflammatory response and progressive CD4+ T‐cell lymphopenia and dysfunction. We evaluated whether platelets might contribute to CD4+ T‐cell dysfunction in COVID‐19. We observed a high frequency of CD4+ T cell–platelet aggregates in COVID‐19 inpatients that inversely correlated with lymphocyte counts. Platelets from COVID‐19 inpatients but not from healthy donors (HD) inhibited the upregulation of CD25 expression and tumour necrosis factor (TNF)‐α production by CD4+ T cells. In addition, interferon (IFN)‐γ production was increased by platelets from HD but not from COVID‐19 inpatients. A high expression of PD‐L1 was found in platelets from COVID‐19 patients to be inversely correlated with IFN‐γ production by activated CD4+ T cells cocultured with platelets. We also found that a PD‐L1‐blocking antibody significantly restored platelets’ ability to stimulate IFN‐γ production by CD4+ T cells. Our study suggests that platelets might contribute to disease progression in COVID‐19 not only by promoting thrombotic and inflammatory events, but also by affecting CD4+ T cells functionality.

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Background:The hyperinfestation by Strongyloides stercolaris is a general syndrome with high morbidity and mortality, which usually occurs in patients with immunological compromise or in corticosteroid treatments. In critical patients with paralytic intestinal ileus, the decrease in the bioavailability of oral ivermectin leads to therapeutic failure. The use of Ivermectin parenteral veterinary use is an extreme resource in patients with paralytic ileus secondary to hyperinflation by Strongyloides stercoralis. (SHSS)Methods & Materials: Retrospective and observational study. Clinical records of patients diagnosed with hyperinfestation by Strongyloides stercolaris, from January 2012 to August 2017, were evaluated in a sanatorium in the City of Buenos Aires. Inclusion criteria: positive culture (fecal matter, sputum, BAL) for Strongyloides stercoralis and diagnosis of intestinal ileus. The following variables were analyzed: sex, median age, nationality, residence, immunological commitment, corticotherapy, clinical and laboratory manifestations, days of hospitalization, stay in the ICU, treatment (enteral and parenteral), clinical resolution and mortality.Results: Of the 5 patients with inclusion criteria, the following were determined: Median age of 49.2 years; 2 foreigners (Peru and Bolivia); 4 residents of the Province of Buenos Aires and one of CABA. 2 with immunological compromise (HIV, DBT and kidney transplant); all 5 received corticotherapy. Clinical manifestations: all patients presented paralytic intestinal ileus with respiratory compromise, one presented rash and 4 had eosinophilia. The treatment started with oral Ivermectin but in the face of failure all received subcutaneous ivermectin as a last option. The 5 patients had a stay in the ICU, 4 with satisfactory clinical resolution and one death.Conclusion: Strongyloid hyperinflation syndrome is always a serious condition that can be manifested by respiratory distress, sepsis, meningitis or intestinal ileus. In this last presentation, the impossibility of digestive absorption of drugs makes it the only therapeutic option to use parenteral Ivermectin in the face of failure of the oral or rectal route. Our patients were immunosuppressed or had received corticosteroids, but they did not come from endemic areas. We emphasize the importance of the diagnosis prior to immunosuppression and the performance of the culture as a screening.