ABSTRACT Neurotoxocariasis is uncommon. Its manifestations include events of meningitis, encephalitis and less frequently vasculitis, which manifest as headache, seizures, focalization, confusion, cognitive alterations and /or fever. Peripheral eosinophilia with clinical and neurological imaging elements, allow its early suspicion. We report a 48-year-old agricultural worker, admitted in our hospital for one week of gastrointestinal complaints, headache, progressive left hemiparesis and impaired consciousness. He had leukocytosis (13,530/μL) with peripheral eosinophilia (25%, absolute count 3,400 /μL). CSF analysis revealed no abnormalities and brain CT showed poorly defined hypodense lesions on subcortical areas and semioval centers. Magnetic resonance imaging showed multiple foci with increased signals predominantly in the white matter in both hemispheres, especially at frontal and occipital regions and at semioval centers. Lesions reinforced after paramagnetic contrast. Serological studies found specific IgG antibodies by ELISA against antigens of the genus Toxocara, which were confirmed by a positive IgG Western Blot. The patient was treated with albendazole (800 mg/d) for 14 days associated with parenteral and then oral corticosteroids with a favorable response and gradual complete recovery.

La neurotoxocariasis es infrecuente. Sus manifestaciones incluyen eventos de meningitis, encefalitis y con menor frecuencia vasculitis, que se manifiestan como cefalea, convulsiones, focalización, confusión, alteraciones cognitivas o fiebre. La eosinofilia periférica, junto a elementos clínicos e imágenes compatibles, permiten su sospecha. Informamos el caso de un trabajador agrícola de 48 años que ingresó por una semana de molestias gastrointestinales, cefalea, hemiparesia izquierda progresiva y deterioro de conciencia. Los exámenes revelaron leucocitosis (13.530/μL) con eosinofilia periférica (25%, recuento absoluto 3.400/μL). El análisis del LCR sin anomalías y la tomografía computada cerebral mostró lesiones hipodensas mal definidas en áreas subcorticales y centros semiovales. La resonancia magnética mostró múltiples focos con aumento de la señal predominantemente en la sustancia blanca en ambos hemisferios. Las lesiones presentaron refuerzo tras contraste paramagnético. Los estudios serológicos indicaron anticuerpos IgG específicos por ELISA contra antígenos del género Toxocara. El paciente fue tratado con albendazol (800 mg /día) durante 14 días asociado a corticoides con respuesta favorable y una recuperación gradual completa.

Leishmaniasis is an infection caused by protozoa of the genus Leishmania sp. and transmitted by sandfly vectors. Cutaneous leishmaniasis (CL) is the most frequent form of presentation. Clinically, chronic and painless ulcers are observed, which usually occur at the site of the sandfly bite. The diagnosis and treatment of this disease is specially challenging in non-endemic countries such as Chile, requiring the use of diverse laboratory techniques as well as the support of expert physicians. Herein we report an imported case of a healthy 42-year-old male with CL caused by L. braziliensis with successful response to liposomal amphotericin B.

Resumen La leishmaniasis es una infección producida por protozoos del género Leishmania, transmitida por insectos hematófagos. La forma de presentación más frecuente es la leishmaniasis cutánea (LC), en la cual se observan úlceras crónicas e indoloras, usualmente localizadas en el sitio de la picadura del insecto. El diagnóstico y tratamiento de esta enfermedad son especialmente desafiantes en zonas no endémicas como nuestro país, requiriendo el uso de diversas técnicas de laboratorio y el apoyo de expertos. Se reporta el caso clínico importado de un varón de 42 años con LC causada por L. braziliensis con respuesta exitosa al tratamiento con anfotericina B liposomal.

Although infrequent, Trypanosoma cruzi reactivation is possible among patients with HIV/AIDS infection that develop a tumor-like or granulomatous lesion in the CNS. We report the case of a 60 years old male patient with HIV/AIDS and low CD4 lymphocytes count with cerebellar symptoms and mild paresis, associated to supra and infratentorial hypodense lesions and positive serology tests both to T. gondii and Trypanosoma cruzi. Empirical therapy against toxoplasmosis was prescribed together with antiretroviral therapy but without a favorable response. Brain Chagas disease was confirmed by quantitative PCR in the CSF but he died despite nifurtimox treatment. Despite its rare occurrence, Chagas disease affecting the CNS is possible among patients with HIV/AIDS infection. Epidemiological exposure, a positive Chagas serological test and the image pattern of brain lesions support the suspicion. Diagnosis can be confirmed by molecular test in CSF samples, including new quantitative methods. Despite an adverse prognosis, specific therapy can be attempted besides antiretroviral treatment.

La reactivación de la infección por Trypanosoma cruzi es un diagnóstico infrecuente pero posible en pacientes con infección por VIH/SIDA y una lesión de tipo tumoral o granulomatosa en el sistema nervioso central. Presentamos el caso clínico de un paciente de 60 años con VIH/SIDA y recuentos bajos de linfocitos CD4, con síntomas cerebelosos y paresia leve, lesiones hipodensas supra e infratentoriales y serología positiva para Toxoplasma gondii y T. cruzi. Se trató empíricamente como una toxoplasmosis cerebral y con terapia antiretroviral, sin respuesta clínica. La enfermedad de Chagas cerebral se confirmó por RPC cuantitativa en el LCR. El paciente falleció a pesar de recibir terapia con nifurtimox. Apoyan la posibilidad de un Chagas cerebral en pacientes con VIH/SIDA, la exposición epidemiológica, la serología positiva y el patrón de distribución de las lesiones en las imágenes. El diagnóstico puede mejorarse con técnicas moleculares cuantitativas en LCR. A pesar de su mal pronóstico, se puede intentar una terapia específica junto al tratamiento antiretroviral.

SUMMARY The frequency of anti-Toxocara spp. antibodies in individuals attended by the Centro de Salud Familiar in the coastal Niebla town, Chile, was related to the host and to environmental factors. IgG anti- Toxocara antibodies were detected with a commercial ELISA kit (SCIMEDX Corporation, USA). Samples with undetermined absorbance values were subjected to an additional ELISA standardized by the Instituto de Salud Pública, Chilean Health Ministry, a commercial ELISA (NOVATEC, Germany), and a commercial Western blot kit (LDBio Diagnostics, France). Hematological exams were performed using an automated blood counter and blood smears. Dog feces were collected from the ground along the main road in Niebla, including rural and urban locations. Ninety (25.4%) of the 355 examined individuals were positive by the ELISA test. The frequency of anti-Toxocara antibodies and the infection risk were significantly higher (p < 0.05) among those individuals ≥ 40 years old with respect to the 20-39 years old group, in individuals from rural locations, those who did not have a safe drinking water supply in the house or who presented blood eosinophilia. The proportion of positive samples of dog feces and the mean number of Toxocara canis eggs/g of feces in urban and rural areas were similar (p > 0.05).

The microspore is protozoa, forced intracellular parasite, of different animal species. They belong to the Phylum Microspore, which produce very small spores and lack mitochondria. One of the microspores, there exists the Encephalitozoon cuniculi, which is an emergent opportunistic parasite, In the prevalence ofE. cuniculi in rabbits, ranks from 15 to 76 % at world-wide level are reported With the purpose of detecting the presence of this parasite in our country, the search of this one was made, in the parasitology laboratory of the Institute of Public Health of Chile (ISP). The sample was constituted by 100 normal rabbits without distinction of sex, pertaining to: Bioterio of ISP, familiar deposits from Pirque, "Mundo Granja " of the University of Chile and a commercial deposit. All the rabbits were previously evaluated by means of a clinical examination. After processing the sample of deposition and tinkles, they were dyed with trichromic colorants: Cromotropo 2R and Gram Cromotropo. A positive result was obtained in 55% of the individuals, where the greater percentage appears in inmunosuppressed rabbits and conventional raising rabbits. The objective of this study is to contribute to the health, in special the human being health, as well as the animals, determining the presence ofE. cuniculi in rabbits of different origins

Se realizó un estudio para determinar la presencia y el grado de infección por Encephalitozoon cuniculi en conejos de Santiago, Chile. Se obtuvieron muestras de deposiciones y orina de 100 conejos clínicamente sanos, sin distinción de sexo, procedentes del: Bioterio de ISP, Criaderos familiares de la localidad de Pirque, "Mundo Granja" perteneciente a la Universidad de Chile y a un Criadero comercial. Luego de procesar la muestra se procedió a teñirlas con colorantes tricrómicos: Cromotropo 2R y Gram Cromotropo. Se obtuvo una positividad en un 55% de los individuos, donde el mayor porcentaje se presenta en conejos inmuno-suprimidos

In may 2003 an epidemiologic-parasitological survey was carried out in 206 pre-school and school-children from San Vicente de Lo Arcaya School in Colina, a semi-rural county of the Santiago Province in the Metropolitan Region of Chile.The most frequent parasitic elements were: Blastocystis hominis - in men and women respectively - 38.8% and 44.4%, Giardia intestinalis with 9.5% and 16.2% and Enterobius vermicularis with 12.9% and 10.0%. It is notewortly that the infected children were asymptomatic Cryptosporidium parvum was not observed and an ELISA test for Strongyloides stercoralis infections was positive in one children.This study confirms that intestinal parasitic infections in children remain with a high prevalence in Chile.

En mayo de 2003 se efectuó una encuesta epidemio-parasitológica en pre-escolares y escolares de la Escuela San Vicente de Lo Arcaya de Colina, comuna semirural de la Provincia de Santiago ubicada en la Región Metropolitana de Chile. Hay que destacar que los niños estudiados eran asintomáticos. Los elementos parasitarios más frecuentemente encontrados fueron: Blastocystis hominis - en hombre y mujeres respectivamente - 38,8% y 44,4%, Giardia intestinalis con 9,5% y 16,2% y Enterobius vermicularis con 12,9% y 10,0%. Cryptosporidium parvum no fue encontrado y ELISA para Strongyloides stercoralis resultó positiva en un niño.

A limited epidemiological information on Strongyloides stercoralis infection excists in Chile. In 1983 a mentally retarded 53-year-old man died by disseminated strongyloidiosis associated with malabsortion syndrome, this case constitutes the first histopathological confirmation of the parasitose in Chile. Later on, cases have been described in hospitalized patients in mental institutions from the central part of the country, where the frequency of infection registered in studies carried out in the Psyquiatric Hospital of Putaendo in 1985 and 1987-1989 were 11.6% and 7.0%. In 1992 an outbreak of strongyloidiasis that affected 13 out of 55 children in a nutritional recuperation center in the north extreme of Chile was reported. In 2000 four cases were detected in a group of 20 hospitalized mental affected patients with elevated eosinophilia. Sensitive methods for detecting larvae in stool samples and seroepidemiological surveys would permit determine the importance of this human heminthic infection in Chile.