RESUMO
A syphilis outbreak began in Martinique, French Antilles, in 2004, initially among men who had sex with men (MSM) and who were living with human immunodeficiency virus (HIV). The outbreak subsequently affected all groups at risk, leading to a first epidemic peak in 2008. After an initial decrease, the outbreak started growing again in 2014 among patients living with HIV with unprecedented incidence among MSM. Herein, we describe the change in medical and social parameters of the outbreak since 2005.
Assuntos
Surtos de Doenças , Infecções por HIV/complicações , Sífilis/complicações , Adulto , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Martinica/epidemiologia , Comportamento Sexual , Sífilis/epidemiologiaRESUMO
Among the opportunistic mycoses that are emerging in patients with immunosuppression or severe underlying illness, many isolates lack of characteristic sporulation and until recently could not be identified. Clinical signs are mostly nonspecific and therefore such infections have often been disregarded. In the present paper we describe a novel, nonsporulating fungal species causing subcutaneous phaeohyphomycosis in two patients of different origin. One is a 73-year-old female from Martinique who suffered from rheumatoid arthritis, while the other case concerns a 72-year-old male from Mexico who had a history of type 2 diabetes mellitus. Sequencing of the partial ribosomal operon revealed that in both cases a member of the order Pleosporales was concerned which could not be affiliated to any family within this order. Multilocus analysis revealed that the fungus was related to another, unaffiliated agent of human mycetoma, Pseudochaetosphaeronema larense, and therefore the name Pseudochaetosphaeronema martinelli was introduced.
Assuntos
Ascomicetos/classificação , Ascomicetos/isolamento & purificação , Feoifomicose/diagnóstico , Feoifomicose/patologia , Infecções dos Tecidos Moles/diagnóstico , Infecções dos Tecidos Moles/patologia , Idoso , Artrite Reumatoide/complicações , Ascomicetos/genética , Análise por Conglomerados , DNA Fúngico/química , DNA Fúngico/genética , Complicações do Diabetes , Feminino , Humanos , Masculino , Martinica , México , Microscopia , Dados de Sequência Molecular , Feoifomicose/microbiologia , Filogenia , Análise de Sequência de DNA , Infecções dos Tecidos Moles/microbiologia , Tela Subcutânea/microbiologia , Supuração/microbiologiaRESUMO
We report the first case of visceral leishmaniasis (VL) caused by Leishmania martiniquensis in the Caribbean, which until now, was known only to cause cutaneous leishmaniasis. The disease presented with fatigue, anemia, and hepatosplenomegaly in a 61-year-old man with human immunodeficiency virus (HIV) infection who was receiving antiretroviral therapy. Diagnosis was made by bone marrow biopsy. VL is life-threatening, and its emergence in the Caribbean is of concern.
Assuntos
Leishmania , Leishmaniose Visceral/parasitologia , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/parasitologia , Anfotericina B/uso terapêutico , Humanos , Leishmaniose Visceral/epidemiologia , Masculino , Martinica/epidemiologia , Pessoa de Meia-Idade , Tripanossomicidas/uso terapêuticoRESUMO
The parasite responsible for autochthonous cutaneous leishmaniasis in Martinique island (French West Indies) was first isolated in 1995; its taxonomical position was established only in 2002, but it remained unnamed. In the present paper, the authors name this parasite Leishmania (Leishmania) martiniquensis Desbois, Pratlong & Dedet n. sp. and describe the type strain of this taxon, including its biological characteristics, biochemical and molecular identification, and pathogenicity. This parasite, clearly distinct from all other Euleishmania, and placed at the base of the Leishmania phylogenetic tree, is included in the subgenus Leishmania.
Assuntos
Doenças Endêmicas , Leishmania/classificação , Leishmaniose Cutânea/parasitologia , DNA Polimerase I/genética , Humanos , Isoenzimas/genética , Leishmania/enzimologia , Leishmania/genética , Leishmania/isolamento & purificação , Leishmania/fisiologia , Leishmaniose Cutânea/epidemiologia , Martinica/epidemiologia , Proteínas de Protozoários/genética , RNA Polimerase II/genética , RNA de Protozoário/genética , RNA Ribossômico 18S/genética , Ribotipagem , Terminologia como AssuntoRESUMO
Leishmania infantum is the only species occurring in metropolitan France; located in the Mediterranean part of the country, it is responsible for a highly enzootic canine disease, while the human endemicity is low, with about 23 cases yearly reported to the National Reference Centre of Leishmaniases, mainly visceral forms. In French Guyana, five Leishmania species occur in the Amazonian forest, of which L. guyanensis is the predominant species, and L. braziliensis is responsible for the most critical forms. The most frequent clinical feature is cutaneous leishmaniasis, with a mean annual incidence reaching 2 p. 1000, with some inter-annual fluctuations. In Martinique Island, recent studies have confirmed the presence of an ancestral Leishmania species, responsible for small cutaneous lesions, of mild evolution; the life cycle of this species remains unknown. In Guadeloupe Island, a few autochthonous visceral leishmaniasis cases have been reported, needing a prospective study.
Assuntos
Leishmaniose/epidemiologia , Animais , Doenças do Gato/epidemiologia , Doenças do Gato/parasitologia , Gatos , Reservatórios de Doenças/parasitologia , Vetores de Doenças , Doenças do Cão/epidemiologia , Doenças do Cão/parasitologia , Cães , França/epidemiologia , Guiana Francesa/epidemiologia , Geografia Médica , Guadalupe/epidemiologia , Humanos , Leishmania braziliensis , Leishmania guyanensis , Leishmania infantum , Leishmaniose/veterinária , Leishmaniose Cutânea/epidemiologia , Leishmaniose Mucocutânea/epidemiologia , Leishmaniose Visceral/epidemiologia , Martinica/epidemiologia , Vigilância em Saúde PúblicaRESUMO
Syphilis reemerged in Martinique in 2004 and initially affected 3 HIV-infected patients. By March 2008, syphilis was diagnosed for 37 men and 18 women. As of October 31, 2009, this outbreak had not yet been brought under control. It initially affected mainly men who had sex with men before it spread to heterosexual persons, minority group members, and crack cocaine users.
Assuntos
Surtos de Doenças , Sífilis/epidemiologia , Adulto , Surtos de Doenças/prevenção & controle , Feminino , Infecções por HIV/complicações , Humanos , Masculino , Martinica/epidemiologia , Comportamento Sexual , Sífilis/complicações , Sífilis/prevenção & controleRESUMO
In Martinique, among 9 HIV carriers recently diagnosed with early syphilis, 7 had biologic cholestasis. Less than half of the patients had been diagnosed on clinical grounds for syphilis (cutaneous eruption or syphilis in partner), whereas most of them were diagnosed on a systematic screening of HIV infected patients.
Assuntos
Colestase/microbiologia , Colestase/virologia , Infecções por HIV/microbiologia , Sífilis/virologia , Adulto , Fosfatase Alcalina/metabolismo , Colestase/epidemiologia , Doenças Endêmicas , Feminino , Infecções por HIV/epidemiologia , Humanos , Fígado/metabolismo , Masculino , Martinica/epidemiologia , Prevalência , Sífilis/epidemiologia , gama-Glutamiltransferase/metabolismoRESUMO
PURPOSE: We report an unusual increase in the number of cases of keratomycosis attributable to Fusarium solani in contact lens wearers. DESIGN: Observational case series. METHODS: Between November 2005 and May 2006, 14 corneal abscesses were reported at the University Hospital Center of Fort-de-France. Twelve patients were contact lens wearers, and 10 used Bausch & Lomb (Rochester, New York, USA) ReNu with MoistureLoc. Corneal scrapings were collected for microbiological analyses. RESULTS: In six months, five abscesses attributable to Fusarium solani in contact lens wearers, using Bausch & Lomb ReNu with MoistureLoc as contact lens solution, were reported. CONCLUSIONS: This study reports an epidemic of keratomycosis attributable to Fusarium solani among contact lens wearers in the Caribbean, during the same timeframe as a similar epidemic in Asia and North America. We are unaware of previous report of this phenomenon and could find no reference to it in a computerized search utilizing MEDLINE.
Assuntos
Úlcera da Córnea/epidemiologia , Surtos de Doenças , Infecções Oculares Fúngicas/epidemiologia , Fusarium/isolamento & purificação , Micoses/epidemiologia , Adolescente , Adulto , Idoso , Soluções para Lentes de Contato , Lentes de Contato Hidrofílicas/microbiologia , Úlcera da Córnea/microbiologia , Contaminação de Equipamentos , Infecções Oculares Fúngicas/microbiologia , Feminino , Humanos , Masculino , Martinica/epidemiologia , Pessoa de Meia-Idade , Micoses/microbiologia , Fatores de RiscoRESUMO
OBJECTIVE: Determine the prevalence of intestinal parasitosis between January 1, 1997 and December 31, 1999 in the microbiology laboratory of the Fort de France University Hospital. METHOD: Retrospective study of the results of 4684 parasitological examinations of stools performed in 2704 patients between January 1, 1997 and December 31, 1999 in this laboratory. RESULTS: This survey showed the high prevalence of anguillulosis, found in 51.69% of infested patients and in 4.56% of the population studied, the ever high prevalence of non or scarcely pathogenic amoebas (Endolimax nanus, Dientamoeba fragilis, Entamoeba coli) found in 27.19% of infested patients and 1.88% of the population studied, together with that of hookworms (12.80% of infested patients and 1.13% of the population), and the persistence of lambliasis. This study also revealed the presence of cryptosporidies (7 cases) and microsporidies (4 cases) in the patients infected by the human immunodeficiency virus. DISCUSSION: These results confirm the trend of the past twenty Years and the results of surveys initiated by the national statistics board (INSERM) in 1978, 1988 and 1995-1995, with the regression of bilharziosis and the persistence of anguillulosis and hookworms. CONCLUSION: The improvement in living conditions and hygiene, the combined efforts of the health care workers and Authorities in Martinique over the past 30 Years in the fight against parasites have led to a great reduction in the prevalence of classical intestinal parasitosis. However, new parasites associated with HIV infection have appeared.