RESUMO
A total of 11 patients with listeriosis wereadmited to the Hospital Emilio Ribas - Säo Paulo, Brasil. The etiology Listeria monocytogenes in 2 Aids and Listeria spp in underlying conditions was established in the other patients. The age ranged from 20 to 60 years old and white: black; male:famele ratio was 3:1 for all them. Acute meningoencephalitis in 11; renal failure in 2; acute respiratory failure, septicemia and AIDS with drug multiform exantema, respectively in 1 were observed. Leukocytosis > 500 cells/mm elevado ao cubo; glucose < 45 mg/dl; protein > 90 mg/dl and Gram-positive rod strains with positive culture to Listeria spp were revealed in the cerebrospinal fluid study. These strains were resistant to betalactamin; colistin; streptomycin and amikacin and sensitive to kanamicin; gentamicin; tetracicline; erytromicin and chloramphenicol. Monotherapy (ampicillin) or associate (ampicillin/chloramphenicol) had not influence on death or improvement during the follow-up of patients. Listeral meningoencephalitis is similar to tuberculosis or other bacterial meningitis include in cerebrospinal fluid chemistries data
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Síndrome da Imunodeficiência Adquirida , Listeriose , Meningoencefalite/tratamento farmacológico , Injúria Renal Aguda , Hiperpotassemia , LeucocitoseRESUMO
Samples of 1815 cerebrospinal fluid (CSF) were studied in a meningitis outbreak during 1989 in São Paulo, Brazil. Neisseria meningitis 56% with 44% type B, Haemophilus influenzae 17%, from which 72% in children (days to 3-year-old) and Streptococcus pneumoniae 14% from which 60% in children (day to 1-year-old) of 443 (24%) of all strains. Cytochemistry study showed: purulent or turbidity aspects in 70 to 79% positive bacterioscopy or culture of CSF; white cells count > 500/mm3; glucose < 45 mg/dl; protein > 90 mg/dl in 90% of all patients. We concluded that: CSF prognostic factors: (aspect and cytochemistry) were correlated with bacterial meningitis. Bacterioscopy and positive cultures were correlated to NM, SP and HI isolation from these patients (Goodman Test).
Assuntos
Meningite por Haemophilus/líquido cefalorraquidiano , Meningite Meningocócica/líquido cefalorraquidiano , Meningite Pneumocócica/líquido cefalorraquidiano , Adolescente , Adulto , Líquido Cefalorraquidiano/metabolismo , Líquido Cefalorraquidiano/microbiologia , Criança , Pré-Escolar , Feminino , Haemophilus influenzae/isolamento & purificação , Histocitoquímica , Humanos , Lactente , Recém-Nascido , Masculino , Meningite por Haemophilus/microbiologia , Meningite Meningocócica/microbiologia , Meningite Pneumocócica/microbiologia , Neisseria meningitidis/isolamento & purificação , Streptococcus pneumoniae/isolamento & purificaçãoRESUMO
UNLABELLED: A total of 112 AIDS and no AIDS cryptococcosis patients admitted at Emílio Ribas Hospital--São Paulo, Brazil, were treated with amphotericin B (AMB) or amphotericin B and 5 fluorocytosine (5FC). Age, race, predisposing and epidemiological factors, respiratory symptoms were evaluated. Goodman tests applied in three patients groups (I, II and III) with associate or unique therapy revealed: 1. prognostic factors: leukocytes ang glucose showed similar response in groups I, II and III and protein spinal fluid after 1.5g/AMB; 2. India ink tests and Cryptococcus culture were often positive until 1.0g/AMB; 3. significant hypokalemia during monotherapy. Hypo and hyperkalemia had similar data in associate therapy; 4. significant difference in adverse reactions often appeared above 0.7g AMB/250g 5FC; 5. early and late death were common in group III (unique) and group I (no AIDS) and III (2.5 to 4.0g) respectively; 6. similar remission and deaths were verified in AIDS/cryptococcosis. CONCLUSIONS: adverse reactions were observed above 0.75g/AMB plus 250g 5FC. Association was important in initial therapy and AMB maintenance permitted late relapses.