RESUMO
Nocardia asiatica causing pyogranulomatous pleuropneumonia is reported for the first time in a dog coinfected with canine morbillivirus (CM), diagnosed based on epidemiological, clinical, haematological, images, microbiological, histopathological, polymerase chain reaction and hsp65 gene sequencing findings. The immunosuppression of CM probably favoured the opportunistic behaviour of N. asiatica. Despite the therapeutic measures, the animal died, mainly due to respiratory distress. The association of methods to improve early diagnosis, therapy procedures and prognosis of canine nocardiosis is discussed, as well as the close relationship between pets and their owners, which may favour the transmission of pathogens such as Nocardia from pets-to-humans, which poses an emerging public health issue.
Assuntos
Coinfecção/veterinária , Vírus da Cinomose Canina/isolamento & purificação , Cinomose/complicações , Nocardiose/veterinária , Nocardia/isolamento & purificação , Pleuropneumonia/veterinária , Animais , Brasil , Coinfecção/diagnóstico por imagem , Cinomose/diagnóstico por imagem , Cães , Evolução Fatal , Feminino , Nocardiose/complicações , Nocardiose/diagnóstico , Pleuropneumonia/complicações , Pleuropneumonia/diagnóstico por imagemAssuntos
Febre de Chikungunya/epidemiologia , Coinfecção/virologia , Dengue/epidemiologia , Doença Aguda , Adulto , Anticorpos Antivirais/sangue , Encéfalo/diagnóstico por imagem , Brasil , Vírus Chikungunya , Coinfecção/diagnóstico por imagem , Vírus da Dengue/genética , Vírus da Dengue/imunologia , Feminino , Humanos , Imageamento por Ressonância MagnéticaRESUMO
OBJECTIVES: Progression of hepatic fibrosis is accelerated in patients co-infected with human immunodeficiency virus and hepatitis C virus compared to hepatitis C virus mono-infected patients. This study aimed to compare ultrasound features and selected clinical and biochemical variables between patients with human immunodeficiency virus/hepatitis C virus co-infection (n=16) versus hepatitis C virus mono-infection (n=16). METHODS: Each patient underwent abdominal ultrasound, and a specific evaluation was performed in order to detect findings consistent with chronic liver disease. Characterization of spleen size, liver structural pattern, diameter of the portal, spleen, and mesenteric veins was based on classical ultrasound parameters. Propensity score was used for control of selection bias and performed using binary logistic regression to generate a score for each patient. The Fisher and Mann-Whitney tests were used to evaluate categorical variables and continuous variables, respectively. RESULTS: On univariate analysis right hepatic lobe size was larger in human immunodeficiency virus/hepatitis C virus patients (157.06 ± 17.56 mm) compared to hepatitis C virus mono-infected patients (134.94 ± 16.95 mm) (p=0.0011). The left hepatic lobe was also significantly larger in human immunodeficiency virus/hepatitis C virus patients (115.88 ± 22.69 mm) versus hepatitis C virus mono-infected patients (95.06 ± 24.18 mm) (p=0.0177). Also, there was a strong correlation between hepatomegaly and co-infection (p=0.005). CONCLUSION: Human immunodeficiency virus infection was the primary variable influencing liver enlargement in this population. Hepatomegaly on ultrasound was more common among cirrhotic human immunodeficiency virus/hepatitis C virus co-infected patients than among cirrhotic hepatitis C virus mono-infected patients. This aspect is very important in the management of human immunodeficiency virus/hepatitis C virus co-infected patients, because screening for hepatocellular carcinoma is necessary in this population.
Assuntos
Coinfecção/diagnóstico por imagem , Infecções por HIV/diagnóstico por imagem , Hepatite C Crônica/diagnóstico por imagem , Hepatomegalia/diagnóstico por imagem , Cirrose Hepática/diagnóstico por imagem , Análise de Variância , Biópsia , Estudos de Casos e Controles , Coinfecção/patologia , Progressão da Doença , Feminino , Infecções por HIV/complicações , Hepatite C Crônica/complicações , Hepatite C Crônica/patologia , Hepatomegalia/patologia , Humanos , Cirrose Hepática/patologia , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Índice de Gravidade de Doença , UltrassonografiaRESUMO
OBJECTIVE: To compare clinical, radiological, and laboratory characteristics of individuals with pulmonary tuberculosis co-infected or not with HIV. METHODS: A cross-sectional study, in which signs and symptoms were assessed by anamnesis and physical examination in patients hospitalized with pulmonary tuberculosis. The results of sputum smear microscopy and culture for Mycobacterium tuberculosis, as well as hemoglobin levels and CD4+ T-cell counts, were obtained from medical records, and chest X-ray reports were consulted. RESULTS: We included 50 pulmonary tuberculosis patients, who were divided into two groups (HIV-positive and HIV-negative; n = 25 per group). The mean age of the participants was 38.4 ± 10.5 years; 46 (92%) were males; and 27 (54%) were White. Expectoration was presented by 21 (84%) and 13 (52%) of the patients in the HIV-negative and HIV-positive groups, respectively (p = 0.016). Radiological findings of cavitation were present in 10 (43%) and 2 (10%) of the patients in the HIV-negative and HIV-positive groups, respectively (p = 0.016), whereas an interstitial pattern was observed in 18 (78%) and 8 (40%), respectively (p = 0.012). The mean hemoglobin level was 11.1 ± 2.9 g/dL and 9.3 ± 2.2 g/dL in the HIV-negative and HIV-positive groups, respectively (p = 0.015). CONCLUSIONS: In our sample of tuberculosis patients, expectoration was less prevalent, hemoglobin levels were lower, and cavitation was less common, as was an interstitial pattern, among those co-infected with HIV than among those without HIV co-infection.