RESUMO
Four serotypes of dengue viruses produce dengue fever, dengue hemorrhagic fever, and dengue shock syndrome. They are the most important arbovirus infections of humans, in terms of both morbidity and mortality, constituting one of the most rapidly expanding and re-emerging infectious disease problems in Latin America. In less than 20 years, the region has transformed itself from hypoendemic to hyperendemic, while serotype circulation in most countries has gone from none or single to multiple. Changes in endemicity have coincided with the emergence and increasing incidence of the severer forms of dengue infection. This article reviews the clinical presentations of these diseases. Health care providers who see patients in or returning from areas of Latin America, the Caribbean, and other tropical areas must consider dengue in the differential diagnosis of patients presenting with compatible symptoms, and must be knowledgeable in the current management of this important disease.
Assuntos
Vírus da Dengue/fisiologia , Dengue , Dengue Grave , Aedes/virologia , Animais , Região do Caribe/epidemiologia , Dengue/diagnóstico , Dengue/epidemiologia , Dengue/terapia , Dengue/virologia , Vírus da Dengue/imunologia , Humanos , Insetos Vetores , América Latina/epidemiologia , Controle de Mosquitos , Dengue Grave/diagnóstico , Dengue Grave/epidemiologia , Dengue Grave/terapia , Dengue Grave/virologia , Vacinas ViraisRESUMO
HTLV-1 infection is endemic in several Latin American countries. HTLV-1-associated myelophathy/tropical spastic paraparesis (HAM/TSP) and adult T-cell leukemia lymphoma (ATLL) are emerging diseases in the region. Documented risk factors for acquiring the virus include breast-feeding, contaminated blood transfusion, and sexual intercourse, all of which are amenable to prevention efforts. Strongyloides stercoralis hyperinfection syndrome and therapeutic failure in apparently healthy patients with nondisseminated strongyloidiasis may be markers of HTLV-1 infection. HTLV-1 co-infection may adversely effect the clinical course of scabies and HIV disease. The new enzyme-linked immunosorbent assays (ELISA) are sensitive and specific, and Western blot technology is reliable for differentiating HTLV-1 from less common HTLV-2. HTLV-1 screening of blood donors and individuals with any disorder that suggests infection has become a necessity in Latin America to prevent the spread of this important emerging pathogen.
Assuntos
Infecções por HTLV-I/epidemiologia , Vírus Linfotrópico T Tipo 1 Humano , Etnicidade , Feminino , Infecções por HIV/complicações , Infecções por HTLV-I/complicações , Infecções por HTLV-I/diagnóstico , Infecções por HTLV-I/virologia , Vírus Linfotrópico T Tipo 1 Humano/genética , Humanos , América Latina/epidemiologia , Leucemia-Linfoma de Células T do Adulto/complicações , Leucemia-Linfoma de Células T do Adulto/diagnóstico , Leucemia-Linfoma de Células T do Adulto/epidemiologia , Masculino , Paraparesia Espástica Tropical/complicações , Paraparesia Espástica Tropical/diagnóstico , Paraparesia Espástica Tropical/epidemiologia , Escabiose/complicações , Estrongiloidíase/complicaçõesRESUMO
Fungal infections remain a frequent health problem in Latin American countries. Although these diseases exhibit an extraordinary heterogeneity, they have certain features in common. Most patients belong to low socioeconomic groups and live in rural areas. This article presents a general view of the most prevalent subcutaneous mycoses, with emphasis on epidemiology, clinical manifestations, laboratory diagnosis, and treatment options in the developing countries of Latin America.