<p>La piomiositis tuberculosa es una manifestación poco frecuente de tuberculosis extrapulmonar, siendo más común en pacientes inmunosuprimidos, con manifestaciones clínicas similares a la piomiositis de otra etiología, pero con una edad menor de presentación; como factores de riesgo se destacan la infección tuberculosa previa y la inmunosupresión farmacológica. El diagnóstico depende de una alta sospecha clínica en una población susceptible, ya que en muchas ocasiones el aislamiento microbiológico no es posible. La respuesta al tratamiento y el pronóstico son buenos. El caso que se presenta a continuación, es llamativo dada la rareza de esta manifestación de tuberculosis y la respuesta lenta al manejo antituberculoso de primera línea en un paciente con infección por VIH con recaída y un aislamiento microbiológico susceptible. </p>
The role of Streptococcus pneumoniae as a causative agent of skin and soft tissue infections (SSTI) is unusual and its clinical interpretation is difficult. We describe here three cases of SSTI due to S. pneumoniae in patients admitted to the Provincial Pediatric Hospital of Misiones, Argentina that were detected during 10 years of invasive disease (ID) surveillance documented in 2010, 2011 and 2015. These cases involved two girls aged 8 and 7 months old, and a two-year-old male child with diagnoses of gluteal abscess, preseptal cellulites and pyoderma respectively. All the patients were eutrophic and in good general condition on admission; one of them was seropositive for HIV. Antimicrobial susceptibility and serotypes were framed within the local epidemiology of invasive pneumococcal disease. Despite its low frequency, S. pneumoniae as an etiological agent of SSTI must be considered. Our findings revalue the role of the diagnostic laboratory and contribute to document the behavior of this pathogen.
Most vaccines are still delivered by injection. Mucosal vaccination would increase compliance and decrease the risk of spread of infectious diseases due to contaminated syringes. However, most antigens are unable to induce immune responses when administered mucosally and require the use of strong adjuvant or effective delivery systems. Vibrio cholerae toxin (CT) is a powerful mucosal adjuvants when co-administered with soluble antigens, but present important drawbacks such as residual toxicity. In the current report, a recombinant verotoxin, rVTX1 from Escherichia coli O157 has been tested to be used as oral adjuvant. A common antigen, BSA (bovine serum albumin), was orally co-administered with the toxoid rVTX1 in BALB/c mice. Commercial CT was used as a reference adjuvant. In this study, the specific antibody response was determined in sera (IgG1, IgG2a, IgA and IgE) and in fecal samples (IgA). In addition, the oral toxicity of the new adjuvant candidate was studied in mice. Results indicated that rVTX1 possesses a higher mucosal adjuvant activity than CT when administered orally without inducing any toxic symptoms. These preliminary results support further experiments to demonstrate the potential applications of this protein in oral vaccine development.
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