RESUMEN
Sporotrichosis occurs after fungal implantation of Sporothrix spp. in the skin, and is the main subcutaneous mycosis in Latin America. Here we describe three atypical cases of the disease. The first case report an extra-cutaneous occurrence of the disease with joint infection; the second one describes a patient with bilateral lymphocutaneous form of sporotrichosis; and the third shows a zoonotic cutaneous case with the development of an erythema nodosum as a hypersensitivity reaction. These cases show the disease importance on the region and the necessity of fungal culture to the diagnosis confirmation.
Asunto(s)
Esporotricosis/diagnóstico , Adulto , Antifúngicos/uso terapéutico , Femenino , Humanos , Itraconazol/uso terapéutico , Masculino , Persona de Mediana Edad , Esporotricosis/tratamiento farmacológicoRESUMEN
Sporotrichosis occurs after fungal implantation of Sporothrix spp. in the skin, and is the main subcutaneous mycosis in Latin America. Here we describe three atypical cases of the disease. The first case report an extra-cutaneous occurrence of the disease with joint infection; the second one describes a patient with bilateral lymphocutaneous form of sporotrichosis; and the third shows a zoonotic cutaneous case with the development of an erythema nodosum as a hypersensitivity reaction. These cases show the disease importance on the region and the necessity of fungal culture to the diagnosis confirmation.
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Esporotricosis/diagnóstico , Antifúngicos/uso terapéutico , Itraconazol/uso terapéutico , Esporotricosis/tratamiento farmacológicoRESUMEN
We conducted a molecular epidemiological study to investigate HIV-1 strains in Rio Grande, southern Brazil, searching for an association with transmission mode and risk behavior. Patients (185) identified at an AIDS treatment reference Hospital, from 1994 to 1997, were included; from which 107 blood samples were obtained. Nested PCR was realized once for each sample; for amplified samples (69) HIV subtypes were classified using the heteroduplex mobility assay. Subtypes identified were B (75 percent), C (22 percent) and F (3 percent). All infections with C were diagnosed after 1994. Comparing patients with B and C, no differences were detected regarding demographic, clinical and laboratory characteristics; survival analysis did not reveal differences in HIV to AIDS evolution. A higher proportion of injecting drug users, IDU (not significant, p<.07) was found among those with C. This suggests that C may have been introduced in this area through IDU, and is being spread, probably by their sexual partners, to persons with other risk practices
Asunto(s)
Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Síndrome de Inmunodeficiencia Adquirida/epidemiología , ADN Viral/genética , VIH-1 , Síndrome de Inmunodeficiencia Adquirida/transmisión , Brasil/epidemiología , Variación Genética , Análisis Heterodúplex , VIH-1 , Epidemiología Molecular , Reacción en Cadena de la Polimerasa , Factores de RiesgoRESUMEN
Com a finalidade de descrever a clínica e a conduta terapêutica, nos casos de intoxicaçäo por Paraquat, foi feita uma coletânea de três casos e uma revisäo bibliográfica atualizada. Säo descritos três casos de intoxicaçäo pelo Gramoxone (Paraquat), dois por via digestiva (fins suicidas) e um por via inalatória (acidental). Dois doentes evoluíram para óbito tardio (3 a 4 semanas), por insuficiência respiratória severa, devido à fibrose pulmonar, e um sobreviveu com seqüela radiológica-funcional respiratória moderada. Descreveu-se a toxicologia do herbicida, a fisiopatologia das lesöes viscerais (pulmonares, renais e hepáticas), e as possibilidades evolutivas e terapêuticas. Essas últimas dividem-se em, três classes de medidas destinadas a: a) Diminuir a absorçäo do tóxico; b) Aumentar a excreçäo do tóxico; c) Diminuir as lesöes teciduais. Conclui-se a importância de tomar medidas preventivas, mais eficazes, já que apesar da elevada toxicidade do Paraquat, ainda näo é bem conhecido seu mecanismo de açäo, e näo existem medidas terapêuticas específicas de comprovada eficácia