14th ICID - Poster Abstracts - International Society for Infectious ...

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When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 76.022 Session: Emerging Infectious Diseases Date: Friday, March 12, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation New lessons from a case series review of Lassa fever in pregnancy S. A. Okogbenin 1 , D. Asogun 2 , G. Akpede 2 , P. Okokhere 1 , S. Gunther 3 , C. Happi 4 1 Irrua Specialist Teaching Hospital, Irrua, Nigeria, Irrua, Edo, Nigeria, 2 Irrua Specialist Teaching Hospital, Irrua, Edo, Nigeria, 3 Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany, 4 UCH Ibadan, Ibadan, Nigeria Background: In endemic communities, 25% of maternal mortality is due to Lassa fever (LF) with CFRs of 30-75% for the mother and 95% for the fetus. The extra challenges in Management are to differentiate the features of LF from those of pregnancy and its complications as well as address the presence and the effect of the fetus. The erstwhile recommendation that uterine evacuation is required to improve maternal outcome raises ethical issues when the fetus is alive. The management in such circumstances therefore needs further review particularly as some reports indicate that outcome may be independent of the modality adopted. This review was done to provide further guidance in management. Methods: This was a descriptive case-series study of the presentation and outcome of 7 cases of RT-PCR confirmed LF in pregnancy managed at the Irrua Specialist Teaching Hospital, Irrua, Nigeria between February 2008 and August 2009. Results: The patients were aged 23-28 years with a parity of 0-4 and fetuses of gestational ages 7-34 weeks. Abdominal pain and bleeding from multiple sites were present in 5 patients and retrosternal pain, sore throat, difficulty in swallowing and seizures in 4. Other symptoms were oliguria in 3, breast pain in 2and preterm contractions in 2 while one had bilateral deafness. There were 4 maternal deaths, all with IUFDs as well. The average duration of symptoms before presentation was 4 days in survivors and 8 days in those who died. All 4 mothers with seizures died. All the three survivors had live fetuses at discharge; two subsequently had normal term deliveries after 8 and 12 weeks respectively, while the third who did not receive treatment with ribavirin while on admission had an IUFD 8 weeks later. Conclusion: The occurrence of breast pain and tenderness, preterm contractions and bleeding may be distinctive features of LF in pregnancy. The clinical finding of a viable fetus may be predictive of improved maternal and fetal outcome. Evacuation of the uterus in such circumstances should not be a first option in management. Rather conservative management with ribavirin treatment may be worthwhile. These observations need to be confirmed prospectively.
When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 76.023 Session: Emerging Infectious Diseases Date: Friday, March 12, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Neuroimmunological findings from the first report of Angiostrongylus cantonensis outbreak in Ecuador A. J. Dorta-Contreras 1 , B. Padilla-Docal 1 , J. M. Moreira 2 , L. Martini Robles 3 , J. Muzzio Aroca 3 , F. Alarcon 4 , R. Bu Coifiu Fanego 1 1 Universidad de Ciencias Medicas de la Habana.Facultad Miguel Enriquez, Ciudad de la Habana, Cuba, 2 Ministerio de Salud Pública, Quito, Ecuador., Quito, Ecuador, 3 Instituto Nacional de Higiene. “Dr.Leopoldo Izquieta Perez”, Guayaquil, Ecuador, 4 Hospital “Eugenio Espejo, Quito, Ecuador Background: Angiostrongylus cantonensis meningoencephalitis was recently reported in South America. The aim of this paper is to present a neuroinmmunological study of the first report of two outbreaks in subtropical regions from Ecuador. Methods: Eight young adults from two different outbreaks were studied. Simultaneous blood and cerebrospinal fluid simples were taken. IgA, IgM, IgG and albumin were quantified by radial immunodiffusion. Corresponding reibergrams were employed. The diagnosis of A. cantonensis meningoencephalitis was based on a previous antecedent of raw snail consumption, its symptoms and the cerebrospinal fluid characteristics. Results: A moderate elevation of protein content in cerebrospinal fluid with 7, 7 and 26% of mean eosinophilia in serum and cerebrospinal fluid were respectively observed. Three immunoglobulins synthesis pattern was the most frequent one and IgM was presented in all the different patterns. Conclusion: The reported patterns may be useful epidemiologically. The neuroimmunological findings contribute to improve and confirm the diagnosis of this disease now spreading over South America
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