An increase in morbidity associated with visceral leishmaniasis (VL) in human immunodeficiency virus (HIV)/AIDS patients has been described in Africa and the Mediterranean. Despite the high endemicity of VL and HIV-1/AIDS in Brazil, this association has not been thoroughly investigated. Our aim was to evaluate the epidemiologic and clinical characteristics of VL-HIV-1/AIDS cases from Central-west [Mato Grosso do Sul (MS)] Brazil. Medical records of 23 VL-HIV-1/AIDS patients were reviewed. Patients were predominantly adult males (87%) and 34.8% of the patients were intravenous drug users (IVDU). Leishmaniasis was the first opportunistic infection in 60% of the HIV-1 patients. Fever occurred in all patients, although splenomegaly and hepatomegaly were absent in 21.7% of the cases. CD4+ T-cell counts were below 200 cells/mm³ in 80% of the cases and the counts did not increase after clinical remission despite antiretroviral therapy. The first drug chosen to treat the cases was antimonial, but the therapeutic regimen was altered to amphotericin B in 12 of 17 cases due to side effects. Relapses were reported in 56.5% of the patients. IVDU may constitute an important risk factor for the transmission of both diseases in MS. VL-HIV-1/AIDS patients in MS share similar clinical characteristics as those from other endemic regions worldwide. Thus, these findings are critical for improving the surveillance of VL-HIV/AIDS patients.

São descritas as características clínicas e epidemiológicas de 422 casos de paracoccidioidomicose atendidos no Hospital Universitário da Universidade Federal do Mato Grosso do Sul (Campo Grande, Mato Grosso do Sul, Brasil) no período de Janeiro de 1980 a Agosto de 1999. A média de idade foi de 43,4 anos e a proporção homem: mulher foi de 10:1. Quase metade (45,5%) dos doentes era trabalhadora rural no momento do diagnóstico. A forma aguda/subaguda (tipo juvenil)(15,4% dos casos) revelou-se com importante comprometimento do sistema fagocítico-monocitário, manifestado principalmente por adenomegalia (95,4%); hepatomegalia (40%); esplenomegalia (23,1%). A forma crônica (tipo adulto)(84,6% dos casos) apresentou-se com maiores proporções de lesões em orofaringe (66,4%); rouquidão (31,4%) e tosse (50,7%). Para o diagnóstico, foram utilizados o exame micológico direto em 365 pacientes e o histopatológico em 302, com positividade de 50,7% e 97,3%, respectivamente. O tratamento antifúngico preferencial foi a associação de sulfametoxazol e trimetoprim (co-trimoxazol), utilizado em 90,3% dos doentes. Seqüelas foram observadas em 30,3% e óbito em 7,6% dos casos.

Clinical and epidemiological features of 422 cases of paracoccidioidomycosis attended at University Hospital of Universidade Federal de Mato Grosso do Sul (Campo Grande, Mato Grosso do Sul, Brazil) from January 1980 to August 1999, were analysed. The mean age was 43.4 years old and the male: female ratio was 10:1. Nearly half (45.5%) of the patients were agricultural workers at the moment of diagnosis. In the acute/subacute form (juvenile type) the phagocytic-monocytic system was very much impaired and mainly marked by lymphadenopathy (95.4%), hepatomegaly (40%), splenomegaly (23.1%). The chronic form (adult type) presents more lesions in oropharynx (66.4%), dysphonia (31.4%) and cough (50.7%). Mycological diagnosis was obtained by direct microscopy of wet mounts in 185/365 (50.7%) patients and by histopathological examination of biopsies in 294/302 (97.3%) patients. The treatment of choice was Sulfamethoxazole/ trimethoprim (Co-trimoxazole), used in 90.3% patients. Sequelae occurred in 30.3% and death in 7.6% of the cases.

Com o objetivo de avaliar alguns aspectos da doença de Chagas na população urbana dos 12 municípios do distrito sanitário de Rio Verde, Mato Grosso do Sul, em 1998 realizamos a pesquisa de IgG anti-T. cruzi pela imunofluorescência indireta em amostras de sangue obtidas em papel de filtro de 14.709 moradores, com posterior confirmação pelos testes de hemaglutinação indireta e ELISA em soros. A parasitemia foi avaliada por xenodiagnóstico indireto em 134 chagásicos crônicos e a cardiopatia por anamnese, exame físico e eletrocardiograma (ECG) em 191 pares de chagásicos/não-chagásicos. No total os resultados mostraram: soropositividade de 1,83% (0,93% em autóctones e 5,01% em alóctones), positividade do xenodiagnóstico de 17,2% (12,3% em autóctones e 20,8% em alóctones) e proporção de cardiopatia chagásica crônica de 24,6% (19,1% em autóctones e 27,8% em alóctones). A análise dos dados indicou a população de alóctones como a principal responsável pelas características da infecção e morbidade da doença de Chagas na área estudada.

In order to evaluate some aspects of the Chagas' disease on urban population of the 12 municipalities of the sanitarian district of Rio Verde, Mato Grosso do Sul state, on 1998 we carried out a serological survey investigating anti-T. cruzi IgG by indirect immunofluorescence on blood samples collected on filter paper of 14,709 resident persons, confirmed by indirect hemagglutination and ELISA in serum. The parasitaemia was evaluated by indirect xenodiagnosis on 134 chagasic patients and the morbidity evaluated by anamnesis, physical exam and electrocardiogram in 191 pairs of chagasic/non-chagasic patients. The seropositivity was 1.83% (0.93% in autochtonous, 5.01% in alochtonous), xenodiagnosis was positive in 17.2% of the individuals (12.3% in autochtonous, 20.8% in alochtonous) and 24.6% of the seropositive patients presented chronic chagasic cardiopathy (19.1% in autochtonous, 27.8 in alochtonous). The analysis of the dates showed that alochtonous population is the main responsible for presence of the infection and morbidity of Chagas disease in the studied area.