RESUMO
We studied a 19-year-old woman, with a 4-month pregnancy who presented with four cutaneous leg ulcers of three months of evolution diagnosed by biopsy as cutaneous leishmaniasis. Direct smear and the leishmanin skin test were negative. Since all the usual medications for cutaneous leishmaniasis are contraindicated in pregnancy, she did not receive any treatment but cured spontaneously of her lesions during pregnancy. It is believed that cutaneous leishmaniasis does not carry danger for pregnant women and that there is no maternal-fetal transmission in humans, though it occurs in experimental animals. The patient gave birth without complications and both she and her son remained normal after two years of follow-up.
Assuntos
Leishmaniose Cutânea , Complicações Infecciosas na Gravidez , Antiprotozoários , Contraindicações de Medicamentos , Feminino , Humanos , Transmissão Vertical de Doenças Infecciosas , Úlcera da Perna/etiologia , Leishmaniose Cutânea/complicações , Leishmaniose Cutânea/diagnóstico , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Remissão Espontânea , Adulto JovemAssuntos
Leishmaniose Cutânea , Complicações Infecciosas na Gravidez , Antiprotozoários , Contraindicações de Medicamentos , Feminino , Humanos , Recém-Nascido , Úlcera da Perna/diagnóstico , Úlcera da Perna/parasitologia , Leishmaniose Cutânea/diagnóstico , Masculino , Troca Materno-Fetal , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Remissão Espontânea , Conduta Expectante , Adulto JovemRESUMO
Se estudió a una mujer de 19 años, con embarazo de cuatro meses, que presentaba cuatro úlceras cutáneas de tres meses de evolución, diagnosticadas por biopsia como leishmaniasis cutánea. El frotis directo y la leishmanina fueron negativos. Dado que todos los medicamentos usuales para la leishmaniasis cutánea están contraindicados en el embarazo, la paciente no recibió tratamiento, aunque curó espontáneamente durante el embarazo. Se cree que la leishmaniasis cutánea no tiene peligro para la mujer embarazada y que no hay transmisión de la madre al feto en el humano, aunque se ha detectado en animales en condiciones experimentales. La paciente tuvo un parto sin complicaciones y la condición de salud tanto de ella como de su hijo era normal a los dos años de seguimiento.
We studied a 19-year-old woman, with a 4-month pregnancy who presented with four cutaneous leg ulcers of three months of evolution diagnosed by biopsy as cutaneous leishmaniasis. Direct smear and the leishmanin skin test were negative. Since all the usual medications for cutaneous leishmaniasis are contraindicated in pregnancy, she did not receive any treatment but cured spontaneously of her lesions during pregnancy. It is believed that cutaneous leishmaniasis does not carry danger for pregnant women and that there is no maternal-fetal transmission in humans, though it occurs in experimental animals. The patient gave birth without complications and both she and her son remained normal after two years of follow-up.
Assuntos
Gravidez , Leishmaniose Cutânea/terapia , Transmissão Vertical de Doenças Infecciosas , Hipertermia InduzidaRESUMO
Disseminated histoplasmosis in South America is associated with AIDS in 70-90 % of cases. It is visceral and cutaneous, compromising the oral, pharynx, and laryngeal mucous membranes. The involvement of the nasal mucosa is unusual. Two patients with perforation of the nasal septum as the only sign of their disease were clinically and histopathologically diagnosed as leishmaniasis. The revision of the biopsies and the culture of nasal discharge secretions showed that the pathogens seen were not amastigotes but Histoplasma capsulatum. Other mycotic lesions were not detected, nor there was history of cutaneous leishmaniasis. The leishmanin skin test, available only for the male patient, was negative. The PCR and immunofluorescence antibody titers for Leishmania were negative in both patients. They were HIV positive; in the male, his CD4+ T cell count was 60/mm(3) and in the female 133/mm(3). The nasal ulcer was the only manifestation of histoplasmosis and the first of AIDS in both patients. The male patient recovered with amphotericin B and itraconazole treatment. The female has improved with itraconazole. Both patients received antiretroviral treatment. Nasal mucous membrane ulcers should include histoplasmosis among the differential diagnosis. In conclusion, two patients had perforation of their nasal septum as the only manifestation of histoplasmosis, a diagnosis confirmed by nasal mucosa biopsy and by culture of H. capsulatum, findings which demonstrated that both patients had AIDS.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Histoplasma/isolamento & purificação , Histoplasmose/diagnóstico , Histoplasmose/patologia , Perfuração do Septo Nasal/etiologia , Perfuração do Septo Nasal/patologia , Adulto , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Feminino , Histoplasmose/tratamento farmacológico , Humanos , Itraconazol/uso terapêutico , Masculino , América do SulRESUMO
El presente estudio es un escrutinio clínico, prospectivo, descriptivo y transversal, cuyo objetivo fue detectar picopatología en escolares con diagnóstico de diabetes mellitus insulinodependiente (DMID), así como la presencia de los padecimientos psicopatológicos más frecuentes. Se estudiaron 32 escolares, entre siete y 12 años de edad, con diagnóstico de DMID, con un mínimo de seis meses de evolución, tratados en el servicio de consulta externa de endocrinología del INP. El instrumento aplicado fue el BPRS-C (brief Psychiatric Rating Sacle for Children), escala de valoración psiquiátrica de 21 preguntas a los padres de los pacientes, a fin de detectar psicopatología. En 90.6 por ciento se encontró al menos un inciso sugestivo de enfermedad. En primer lugar están los problemas de conducta, seguidos por síntomas de hiperactividad y ansiedad, y en tercer lugar retraimiento y evitación social. No hubo elementos diagnósticos de procesos psicóticos, trastorno depresivo mayor, del pensamiento, o profundo del desarrollo