RESUMO
Cryptococcus neoformans is an encapsulated, yeast-like fungus that can cause a systemic mycosis, particularly in immunocompromised patients. Disseminated infections typically affect the central nervous system, and osseous lesions are infrequent. Only 5%-10% of disseminated cryptococcosis involves bones. A 69-year-old female presented pain, swelling, and a soft tissue mass in her right lateral hindfoot. Her medical history included a kidney transplant (10 years earlier) secondary to chronic disease due to IgA nephropathy. The patient underwent an excisional biopsy, surgical debridement, and secondarily negative pressure wound therapy to achieve skin closure. Biopsy revealed a rare Cryptococcus neoformans osteomyelitis of the calcaneus. The patient then received IV treatment with liposomal amphotericin B at 3 mg/kg/d for 25 days. In conclusion, we present a case of cryptococcal osteomyelitis which, although not a frequent disease, must be considered as one of the differential diagnoses of osteolytic osseous lesions in patients with chronic osteomyelitis. Cryptococcus neoformans may be a potential cause of below-knee infection, mainly in immunocompromised patients.
RESUMO
With the purpose of evaluating the health condition of children in public primary schools in the province of Cordoba in Argentina, cross sectional data were collected from the School Health Program of the Ministry of Health of Cordoba Province in 2001. To conduct an analysis, a total of 25,701 pupils of the first and the seventh grades from one hundred and fifty primary schools were studied. The data consisted of variables in three groups: i.e., nutrition, vaccination and disease groups. Descriptive statistics revealed a higher prevalence in scoliosis, lower weight, no scar from BCG vaccination and skin transmission diseases in urban and rural areas than in interurban areas, while male genital diseases showed a high prevalence in the three areas. Dental caries had a high prevalence in rural areas. Factor analysis was carried out and six factors were extracted out of 27 variables to cover 64 % of total variance. Regression analyses revealed that nutritional variables such as lower weight and the absence of BCG vaccination were significantly related to scoliosis, and that lower weight significantly affected skin transmission diseases. We considered the necessity of modifying conduct in the school health program from the viewpoints of health promotion and community participation.