La fiebre de Mayaro es una enfermedad viral aguda autolimitada causada por el virus del género Alphavirus que pertenece a la familia Togaviridae. Este virus ha sido reportado en zonas tropicales de Suriname, Guayana Francesa, Colombia, Panamá, Brasil, Perú y Bolivia. La enfermedad cursa con un periodo de incubación de hasta 12 días, manifestándose comúnmente como fiebre, cefalea, mialgia, artralgia y rash maculopapular. De manera general la enfermedad suele autolimitarse, sin embargo, la enfermedad articular puede ser incapacitante y persistir por meses. Se reporta el caso de un paciente de 77 años sin antecedentes patológicos de importancia, quien viajó de vacaciones a Iquitos y a su regreso fue admitido en el Hospital III Daniel Alcides Carrión de Tacna, Perú. Ingresó con fiebre persistente evolutiva, y por el antecedente epidemiológico se tuvo la sospecha del virus Mayar...

Background: Tuberculosis (TB) is one of the leading causes of death worldwide. However, an accurate diagnosis contributes to timely treatment, reducing its adverse consequences. The aim of this research was to determine the diagnostic accuracy of the molecular test Xpert MTB/RIF and Xpert MTB/RIF Ultra (Xpert Ultra) for the diagnosis of pulmonary and extrapulmonary TB compared to Löwenstein-Jensen culture. Methods: We conducted a cross-sectional study of diagnostic accuracy. We included samples from patients who attended a Peruvian laboratory between 2011 and 2022. The index test was the Xpert MTB/RIF and Xpert Ultra and the reference standard was Löwenstein-Jensen solid culture for Mycobacterium tuberculosis. We calculated sensitivity, specificity, and positive and negative likelihood ratios. Results: We evaluated 1023 samples, of which 737 were pulmonary samples, 197 tested positive ...

Los medios de contraste iodados pueden presentar diferentes efectos adversos, siendo los más frecuentes daño renal y reacciones de hipersensibilidad. La ceguera cortical y amnesia global transitoria son complicaciones neurológicas raras descritas tras la administración de medios de contraste. Reportamos el caso de un paciente de 63 años, hipertenso que acude por cianosis, frialdad del segundo y tercer dedo de mano izquierda. Es sometido a arteriografía de miembro superior, usando 50 mL de iopamidol e inmediatamente desarrolla cefalea occipital asociada a visión borrosa bilateral que progresa rápidamente a ceguera; la tomografía cerebral reveló hiperdensidades subaracnoideas occipitales, sin efecto de masa. A las dieciocho horas del evento, el paciente presenta amnesia anterógrada con persistencia de amaurosis. Su tomografía cerebral de control no muestra trastornos focales. E...

Se realizó un estudio descriptivo en el que se evaluaron las características clínicas y laboratoriales en la evolución de pacientes con diagnóstico de síndrome de distrés respiratorio agudo (SDRA) secundario a infección por SARS-CoV-2 y que recibieron Tocilizumab. Veinticuatro pacientes recibieron Tocilizumab, la mayoría eran varones (95,8 %), la comorbilidad más frecuente fue obesidad (33,3 %), al momento de recibir Tocilizumab la mediana de PaO2/FiO2 fue 159,5 (RIC 114,5-255,3). Veintiún (87,5 %) pacientes presentaron mejoría clínica y 3 (12,5 %) fallecieron. Quince pacientes (62,5 %) desarrollaron hepatotoxicidad, la mayoría de grado 3 (33,3 %) y tres (12,5 %) pacientes presentaron injuria hepática grado 4. Once pacientes (45,8 %) presentaron sobreinfección bacteriana, siendo el germen más frecuente Acinetobacter baumannii. Luego de la administración de Tocilizumab m...

Una infección respiratoria aguda es aquella infección que compromete una o más partes del aparato respiratorio con duración menor de 15 días causada por un agente infeccioso la cual presenta algunos signos clínicos o síntomas como la tos, la disfonía, respiración ruidosa, fiebre, obstrucción nasal, entre otras

La ponencia presentará el caso de una paciente de sexo femenino, ama de casa procedente de Tacna que ingresa a emergencia el 15 de junio del 2021 y tiene como antecedentes enfermedad renal crónica que está en diálisis desde hace seis meses de manera regular tres veces por semana, también sufre de hipertensión arterial entre otras indicaciones.

Iodinated contrast substances may cause different adverse events, most frequently renal involvement and hypersensitivity reactions. Transient cortical blindness and global amnesia are rarely described neurological complications after the administration of contrast substances. We report the case of a 63-year old patient with high blood pressure who presented with cyanosis and cold sensation affecting the second and third digits of his left hand. The patient underwent an arteriography of the left arm, where 50-mL of iopamidol was used as a contrast substance, and he immediately developed occipital headache associated to bilateral blurred vision that rapidly progressed to blindness. A cerebral computed tomography (CT) scan showed occipital subarachnoid hypodense areas, with no mass effect. Eighteen hours after the event, the patient showed retrograde amnesia with persistent amaurosis. His c...

A descriptive study was carried out, in which clinical and laboratory characteristics were evaluated in patients with a diagnosis of acute respiratory distress syndrome (ARDS) secondary to SARS-CoV-2 infection and who received Tocilizumab. Twenty four patients received Tocilizumab, the majority were male (95.8%), the most frequent comorbidity was obesity (33.3%). At the time of receiving Tocilizumab the median PAO2 / FiO2 was 159.5 (IQR 114.5-255, 3). Twenty-one (87.5%) patients presented clinical improvement and 3 (12.5%) died. Fifteen patients (62.5%) developed hepatotoxicity, the majority grade 3 (33.3%) and three (12.5%) patients presented grade 4 liver injury. Eleven patients (45.8%) presented bacterial superinfection, the more common organism being Acinetobacter baumannii. After the administration of Tocilizumab, more than half of the patients presented an adverse reaction; despite...

Se realizó un estudio descriptivo en el que se evaluaron las características clínicas y laboratoriales en la evolución de pacientes con diagnóstico de síndrome de distrés respiratorio agudo (SDRA) secundario a infección por SARS-CoV-2 y que recibieron Tocilizumab. Veinticuatro pacientes recibieron Tocilizumab, la mayoría eran varones (95,8 %), la comorbilidad más frecuente fue obesidad (33,3 %), al momento de recibir Tocilizumab la mediana de PaO2/FiO2 fue 159,5 (RIC 114,5-255,3). Veintiún (87,5 %) pacientes presentaron mejoría clínica y 3 (12,5 %) fallecieron. Quince pacientes (62,5 %) desarrollaron hepatotoxicidad, la mayoría de grado 3 (33,3 %) y tres (12,5 %) pacientes presentaron injuria hepática grado 4. Once pacientes (45,8 %) presentaron sobreinfección bacteriana, siendo el germen más frecuente Acinetobacter baumannii. Luego de la administración de Tocilizumab m...

A descriptive study was carried out, in which clinical and laboratory characteristics were evaluated in patients with a diagnosis of acute respiratory distress syndrome (ARDS) secondary to SARS-CoV-2 infection and who received Tocilizumab. Twenty four patients received Tocilizumab, the majority were male (95.8%), the most frequent comorbidity was obesity (33.3%). At the time of receiving Tocilizumab the median PAO2 / FiO2 was 159.5 (IQR 114.5-255, 3). Twenty-one (87.5%) patients presented clinical improvement and 3 (12.5%) died. Fifteen patients (62.5%) developed hepatotoxicity, the majority grade 3 (33.3%) and three (12.5%) patients presented grade 4 liver injury. Eleven patients (45.8%) presented bacterial superinfection, the more common organism being Acinetobacter baumannii. After the administration of Tocilizumab, more than half of the patients presented an adverse reaction; despite...

Iodinated contrast substances may cause different adverse events, most frequently renal involvement and hypersensitivity reactions. Transient cortical blindness and global amnesia are rarely described neurological complications after the administration of contrast substances. We report the case of a 63-year old patient with high blood pressure who presented with cyanosis and cold sensation affecting the second and third digits of his left hand. The patient underwent an arteriography of the left arm, where 50-mL of iopamidol was used as a contrast substance, and he immediately developed occipital headache associated to bilateral blurred vision that rapidly progressed to blindness. A cerebral computed tomography (CT) scan showed occipital subarachnoid hypodense areas, with no mass effect. Eighteen hours after the event, the patient showed retrograde amnesia with persistent amaurosis. His c...

La fiebre de Mayaro es una enfermedad viral aguda autolimitada causada por el virus del género Alphavirus que pertenece a la familia Togaviridae. Este virus ha sido reportado en zonas tropicales de Suriname, Guayana Francesa, Colombia, Panamá, Brasil, Perú y Bolivia. La enfermedad cursa con un periodo de incubación de hasta 12 días, manifestándose comúnmente como fiebre, cefalea, mialgia, artralgia y rash maculopapular. De manera general la enfermedad suele autolimitarse, sin embargo, la enfermedad articular puede ser incapacitante y persistir por meses. Se reporta el caso de un paciente de 77 años sin antecedentes patológicos de importancia, quien viajó de vacaciones a Iquitos y a su regreso fue admitido en el Hospital III Daniel Alcides Carrión de Tacna, Perú. Ingresó con fiebre persistente evolutiva, y por el antecedente epidemiológico se tuvo la sospecha del virus Mayar...

Objetivo: Describir las características demográficas, clínicas, laboratoriales y de tratamiento de pacientes hospitalizados por la COVID-19 y determinar los factores de riesgo de mortalidad hospitalaria. Materiales y métodos: Estudio de cohorte retrospectivo de pacientes adultos hospitalizados por la COVID-19. Se extrajeron datos demográficos, clínicos, laboratoriales y de tratamiento de las historias clínicas de pacientes que ingresaron al Hospital III Daniel Alcides Carrión de Tacna. Para el análisis de supervivencia se empleó el modelo de riesgos proporcionales de Cox y se calcularon los cocientes de riesgo instantáneos (HR) crudos y ajustados con sus respectivos intervalos de confianza al 95% (IC 95%). Resultados: Se evaluó a 351 pacientes, el 74,1% eran hombres; las comorbilidades más comunes fueron obesidad (31,6%), hipertensión (27,1%) y diabetes mellitus (24,5%). La...

Introduction: Late-onset Pompe disease is an extremely rare enzyme characterized by incapacitating and progressive neuromuscular damage. There is still no consensus on treatment, but clinical trials have shown that enzymatic replacement with recombinant alpha-glucosidase acid could slow the natural course of the disease and improve prognosis. Clinical case: A 67-year-old man diagnosed with Pompe disease for 4 years, in treatment with physical rehabilitation. He entered the service for right lower limb cellulite that decompensates his background leading to severe respiratory failure. It is admitted to mechanical ventilation, its evolution is torrid due to multiple bacterial infections associated with fan. After 7 months in mechanical ventilation despite multiple weaning attempts, the enzymatic replacement treatment with recombinant acid alpha glucosidase is proposed. Two weeks later, he b...

Rhombencephalitis is inflammation of the brainstem and cerebellum; one of the causes of this entity is Listeria monocytogenes, although it is an unusual presentation. The case is a 70-year-old woman with high blood pressure, obesity, bronchial asthma, and hypothyroidism. She began a 6-day clinical picture with nausea, vomiting, and headache, then dizziness and right lateropulsion were added, and a nuclear magnetic resonance was performed, diagnosing ischemic stroke in the medulla oblongata. She is hospitalized, she has a fever of 38.5 °C, compromised level of consciousness, and neck stiffness. Listeria monocytogenes infection was confirmed by CSF culture, she received meropenem, vancomycin, ampicillin, and dexamethasone, then the patient fully recovered on the fifth day of antibiotic treatment, without neurological sequela. The presence of posterior fossa symptoms on a CNS inflammatory ...

Cedecea lapagei is a gram-negative, non-encapsulated, facultative anaerobic bacterium that has been reported in only a few cases with varying clinical presentations, drug susceptibility, and treatment since its first isolation in 1981. This study aimed to describe a case report of C. lapagei in Peru and systematically review the documented case reports of individuals infected with C. lapagei. A 59-year-old man who had become bedridden with Parkinson’s disease and had epilepsy presented with a 1-week history of fever and sore throat and was admitted. Physical examination revealed an obtundation state and abolished vesicular murmur in the right hemithorax. During hospitalization, the patient was diagnosed with various infections, including tuberculosis, for which he received broad-spectrum antibiotics. In the absence of clinical improvement, a urine culture was performed showing C. lapag...