Scielo RSS <![CDATA[Revista da Sociedade Brasileira de Medicina Tropical]]> http://www.scielo.br/rss.php?pid=0037-868220190001&lang=en vol. 52 num. lang. en <![CDATA[SciELO Logo]]> http://www.scielo.br/img/en/fbpelogp.gif http://www.scielo.br <![CDATA[Hepatitis Delta Prevalence in South America: A Systematic Review and Meta-Analysis]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100200&lng=en&nrm=iso&tlng=en Abstract Hepatitis delta virus (HDV) has been associated with acute or chronic hepatitis in Latin America, but there is no prevalence study covering South American countries. This meta-analysis aimed to estimate anti-HDV prevalence through a systematic review of published articles in English, Portuguese and Spanish until December 2017. Searches were conducted in Health Virtual Library, Capes, Lilacs, PubMed, and SciELO, according to defined criteria regarding participant selection and geographical setting. Study quality was assessed using the GRADE guidelines. Pooled anti-HDV prevalence was calculated using the DerSimonian-Laird random-effects model with Freeman-Tukey double arcsine transformation. Out of the 405 identified articles, only 31 met the eligibility criteria for inclusion in the meta-analysis. In South America, pooled anti-HDV prevalence among hepatitis B virus carriers was 22.37% (95% confidence interval: 13.72-32.26), though it appeared less frequently in some countries and populations, according to the data collection date. The findings indicated significant successive reductions in anti-HDV prevalence over thirty years. However, there was a scarcity of HDV epidemiological studies outside the Amazon Basin, notably in the Southwest continent and absence of target population standardization. There was a high HDV prevalence in South American countries, despite differences in methodological characteristics and outcomes, highlighting a drastic decline in the last decades. Future studies should identify HDV prevalence estimates in other regions of the continent and identify risk factors. <![CDATA[Characteristics of basic health units and detection of tuberculosis cases]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100300&lng=en&nrm=iso&tlng=en Abstract INTRODUCTION Tuberculosis (TB) is an infectious and contagious disease caused by Mycobacterium tuberculosis. TB emerged in the 21st century as an unsolved public health problem. This study aimed to analyze the relationship between the characteristics of basic health units (BHUs) and the number of TB cases detected in Maranhão, Brazil. METHODS An ecological, analytical study was conducted using the municipalities in the state of Maranhão as the unit of analysis. Data regarding the number of detected TB cases was obtained from the Sistema de Informação de Agravos de Notificação database, and the characteristics of the BHUs were obtained from the first cycle of data collection for the Program to Improve Access and Quality of Basic Care. The BHU structure was classified as adequate (80%-100%), partially adequate (60%-79%), poorly adequate (40%-59%), or inadequate (&lt;40%) according to the presence of specified items. The number of BHUs per municipality in each adequacy category was estimated. Inflated Poisson regression analysis was performed to estimate the incidence density ratios (IDRs) and the 95% confidence intervals (95% CIs). RESULTS Municipalities with a higher level of BHU adequacy had a higher number of detected TB cases (IDR = 1.61, 95% CI: 1.01-2.60). CONCLUSIONS Better structured health services in primary care may be associated with better detection and/or notification of TB cases. <![CDATA[Influence of exposure and vertical transmission of HIV-1 on the neuropsychomotor development in children]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100301&lng=en&nrm=iso&tlng=en Abstract INTRODUCTION: Exposure to human immunodeficiency virus (HIV)-1 during pregnancy is a major risk factor for neurodevelopmental delay and deleterious effects in children. However, limited information about these conditions exists in poor geographical areas in Brazil. Prevention of vertical transmission of HIV-1 is dealt differently in different regions of the country and in poorer areas it is more difficult to evaluate the impact of the prevention methods. The outcomes of the exposure to HIV-1 and the impact of vertical HIV-1 transmission on neuropsychomotor development was evaluated for the first time in children born to HIV-infected mothers in the North region of Brazil, where the majority of the population has poor access to health services. METHODS: Sixty children born to HIV-1-infected mothers (case group) and 58 born to non-infected mothers (control group) were followed for the first 12 months of life in a prospective case-control study. Neuropsychomotor development was assessed using the Denver II test. RESULTS: Suspected neuropsychomotor developmental delays were more frequent in the case group (33.3%), namely in language (38.9%) and gross motor skills (27.8%). These delays were reversed in most children after 12 months of life due to therapeutic intervention. The delays were not reversed in three children, all of whom belonged to the case group. Only one of these was infected with HIV-1, and this child had the poorest neuropsychomotor outcomes. CONCLUSIONS: Maternal HIV-1 infection negatively affected the neuropsychomotor development in children, although other factors may have played a role. <![CDATA[Oral microbiota and their antibiotic susceptibility in free-living monkeys in Goiás State, Brazil: Repercussions for injuries in humans]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100302&lng=en&nrm=iso&tlng=en Abstract INTRODUCTION: Goiás State, which is in the midwest region of Brazil, has several urban forests. This fact, along with the expansion of urban areas within the limits of Forest Conservation Units, increases the contact between humans and wildlife, such as capuchin monkeys. The impulsive behavior of these animals and the scarcity of food cause them to vigorously search for food, leading to direct encounters with Park visitors, which can result in scratches and bites and making them potential disseminators of pathogenic microorganisms. METHODS: Ten specimens of bearded capuchin monkey (Sapajus libidinosus) were captured at the Onofre Quinan Environmental Park in Anápolis, Goiás, Brazil. Samples were collected from the monkeys, and the bacteria and fungi present in the samples were isolated and identified. Then, the identified microorganisms were subjected to antibiotic susceptibility testing. RESULTS: A total of 111 bacteria and 12 fungi were isolated, including two strict anaerobic bacteria of the genus Peptostreptococcus, 109 facultative anaerobic bacteria, and 12 yeasts. Among the facultative bacteria, enterobacteria and Staphylococcus were common. Resistance to tetracycline and ampicillin antibiotics was detected in the enterobacteria, and resistance to tetracycline, erythromycin, and clindamycin was detected in the Staphylococci. The other strains were sensitive to all tested antimicrobials. Cefoxitin showed 100% efficacy in all isolated bacteria. CONCLUSIONS: For bites from capuchin monkeys, we recommend performing complete hygiene and antibiotic therapy, according to medical recommendations. Given the 100% effectiveness of cefoxitin, it should be considered for this type of injury, especially in the study region. <![CDATA[Emergence of chikungunya and Zika in a municipality endemic to dengue, Santa Luzia, MG, Brazil, 2015-2017]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100303&lng=en&nrm=iso&tlng=en Abstract INTRODUCTION: The recent circulation of arboviruses transmitted by vectors, such as dengue, chikungunya, and Zika, is concerning due to the high morbidity rates, clinical complications, and increased demand on health services. The objective of this study was to analyze the clinical and epidemiological aspects of an epidemic caused by arboviruses in the municipality of Santa Luzia, Minas Gerais, Brazil. METHODS: Longitudinal study of patients with acute febrile disease and suspected arbovirus infection reported to Brazilian Notifiable Disease Information System (Sistema de Informação de Agravos de Notificação) from the epidemiological week 44 of 2015 to epidemiological week 52 of 2016. Patients with confirmed chikungunya were followed-up for 18 months and those with Zika for 15 months. Additionally, we analyzed and described the temporal distribution of confirmed cases of these arboviruses in this municipality. RESULTS: Overall 3,531 arboviruses cases, including 3,481 (98.7%) cases of dengue, 38 (1.0%) cases of chikungunya, and 12 (0.3%) cases of Zika were confirmed. The highest incidence of arbovirus infection occurred in the first quarter of 2016 (epidemiological week 7 to 14). The most frequent symptoms were for dengue, which included fever, headache, retro-orbital pain, and exanthema. Chikungunya infection was associated with fever, myalgia, arthralgia, and rash while Zika infection with pruritus and rash. CONCLUSIONS: Given the similarities in the initial clinical profiles of these arboviruses, it is important to perform a detailed clinical analysis, laboratory diagnosis, and patient follow-up. <![CDATA[Factors associated with the presence of triatomines in rural areas of south Argentine Chaco]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100304&lng=en&nrm=iso&tlng=en Abstract INTRODUCTION: The domestic and peridomestic presence of Triatoma infestans depends on several factors, such as human behavior, vector behavior, ecology, and the environment. METHODS: This work was conducted in 139 domiciliary units, where triatomines were captured and risk factors in domiciles and peridomicilies were recorded. Household dwellers were interviewed to obtain information about practices regarding this disease and entomological indicators were calculated. RESULTS: Infestation indices were 59.7% for house compounds, 4.3% for domestic areas and 58.3% for the peridomestic areas. Intradomicile infestation was significantly associated with housing characteristics. The presence of chicken coops in peridomicilies was associated with an increased risk of infestation. Of the respondents, 80% did not recognize the importance of the peridomiciliary structures for triatomine control and had infested peridomicilies. CONCLUSIONS: The results show the importance of peridomiciles as refuge sites for Triatominae bugs; however, household dwellers do not perceive peridomiciles as areas that favor the presence of vectors. Actions for raising awareness about factors that favor the presence of triatomines are needed to improve the conditions of peridomiciliary environments. <![CDATA[Hansen’s disease deformities in a high risk area in Mozambique: A case study]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100305&lng=en&nrm=iso&tlng=en Abstract INTRODUCTION: Hansen’s disease is no longer a public health problem in Mozambique, since 2008 (incidence under 1 / 10,000 inhabitants). The country is one of the most affected in the world and Nampula province’s Murrupula district (incidence 1.7 / 10,000) has a high deformity rate (22% in 2010). This study aimed to identify high deformity rate associated determinants and proposals for better health program results. METHODS: This study involved a descriptive quantitative survey, systematic observation of patients and health professionals, and a survey of community volunteers. Data were analyzed using Epi Info 7.2. Pearson's chi-square and Fisher’s exact test were used to assess statistical association with deformity, with a significance level of 5% and 95% confidence interval. Ethical procedures followed the Helsinki declaration (2013). RESULTS: Among 238 subjects, 175 were patients and 63 leprosy health staff. Most patients relied on subsistence agriculture facing social exclusion (43, 25%). The waiting time from first symptoms to diagnosis was over one year for 63%. Deformity affected 116 subjects (68%), particularly those who considered the disease as God’s desire (p = 0.01), and practiced traditional treatments (p = 0.001). Among leprosy health staff, 35 (52%) were not trained on diagnosis and management. CONCLUSIONS: High deformity rate is associated with low economic status, the belief that the disease is God’s desire, the use of traditional healers, late diagnosis, and poor disease management. A health education program targeting professionals and population, with infection screening and self-care groups can prevent deformities. <![CDATA[β-Glucan of <em>Candida albicans</em> Cell Wall Extract Inhibits <em>Salmonella</em> Typhimurium Colonization by Potentiating Cellular Immunity (CD8 <sup>+</sup> and CD4 <sup>+</sup> T Cells)]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100306&lng=en&nrm=iso&tlng=en Abstract INTRODUCTION: Antimicrobial resistance has been reported in the drugs used for the treatment of typhoid fever. The immunomodulatory substance β-glucan can be used as an alternative therapy as it potentiates host immunity. The aims of this study are to observe the effect of Candida albicans cell wall (CCW) extract towards host immunity (TCD8+ and TCD4+ cells in spleen, intestinal sIgA) and its capacity to kill Salmonella in the intestine and liver of typhoid fever mice models. METHODS: Typhoid fever mice models were created by infecting mice with S. Typhimurium orally. Mice were divided into four groups: the Non-Infected, Infected, CCW (infected mice treated with 300 µg CCW extract/mouse once a day), and Ciprofloxacin groups (infected mice treated with 15 mg/kg BW ciprofloxacin twice a day). RESULTS: Secretory IgA (sIgA) concentrations of mice in the CCW group remained unchanged. However, their TCD4+ and TCD8+ cells increased substantially compared to those in the Non-Infected group. In the Ciprofloxacin group, sIgA concentrations increased markedly compared to those in the Non-Infected and CCW groups; TCD4+ and TCD8+ cells also increased significantly compared to those in the Infected Group, but not significant compared to those in the CCW group. Colonization of S. Typhimurium in the intestine and liver decreased significantly in the CCW and Ciprofloxacin groups compared to that in the Infected group, with the lowest reduction being found in the Ciprofloxacin group. CONCLUSIONS The inhibition of S. Typhimurium colonization by CCW is associated with the increase in TCD4+ and TCD8+ cells. <![CDATA[The use of meta-analysis in infectious disease surveillance: Is it a relevant tool?]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100500&lng=en&nrm=iso&tlng=en Abstract INTRODUCTION: Antimicrobial resistance has been reported in the drugs used for the treatment of typhoid fever. The immunomodulatory substance β-glucan can be used as an alternative therapy as it potentiates host immunity. The aims of this study are to observe the effect of Candida albicans cell wall (CCW) extract towards host immunity (TCD8+ and TCD4+ cells in spleen, intestinal sIgA) and its capacity to kill Salmonella in the intestine and liver of typhoid fever mice models. METHODS: Typhoid fever mice models were created by infecting mice with S. Typhimurium orally. Mice were divided into four groups: the Non-Infected, Infected, CCW (infected mice treated with 300 µg CCW extract/mouse once a day), and Ciprofloxacin groups (infected mice treated with 15 mg/kg BW ciprofloxacin twice a day). RESULTS: Secretory IgA (sIgA) concentrations of mice in the CCW group remained unchanged. However, their TCD4+ and TCD8+ cells increased substantially compared to those in the Non-Infected group. In the Ciprofloxacin group, sIgA concentrations increased markedly compared to those in the Non-Infected and CCW groups; TCD4+ and TCD8+ cells also increased significantly compared to those in the Infected Group, but not significant compared to those in the CCW group. Colonization of S. Typhimurium in the intestine and liver decreased significantly in the CCW and Ciprofloxacin groups compared to that in the Infected group, with the lowest reduction being found in the Ciprofloxacin group. CONCLUSIONS The inhibition of S. Typhimurium colonization by CCW is associated with the increase in TCD4+ and TCD8+ cells. <![CDATA[Natural history of experimental arthritis induced by <em>Paracoccidioides brasiliensis</em> in wistar rats]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100600&lng=en&nrm=iso&tlng=en Abstract INTRODUCTION: Paracoccidioidomycosis (PCM) is the most prevalent systemic mycosis in Latin America. This study aimed to evaluate the natural history of Paracoccidioides brasiliensis-induced experimental arthritis of the knee joints in Wistar rats. METHODS: Rats were randomly allocated to either an absolute control group, or 15-day, 45-day, or 90-day experimental (fungus-inoculated) groups. RESULTS: Experimental groups developed classic signs of articular PCM. Titers of anti-gp43 were observed to increase during the interval from 15 to 45 days post-inoculation. CONCLUSIONS: Articular arthritic lesions were induced and progressed during the study period in all experimental groups. <![CDATA[Morphological differentiation between seven Brazilian populations of <em>Haemagogus capricornii</em> and <em>Hg. janthinomys</em> (Diptera: Culicidae) using geometric morphometry of the wings]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100601&lng=en&nrm=iso&tlng=en Abstract INTRODUCTION: Haemagogus capricornii and Hg. janthinomys females are considered morphologically indistinguishable. We analyzed morphometric variability between Brazilian populations of these species using wing geometric morphometry. METHODS: Size and shape at intra- and interspecific levels were analyzed in 108 Hg. capricornii and Hg. janthinomys females. RESULTS: Geometric morphometry indicated size and shape variables can differentiate these species at interspecific level. However, at intraspecific level, results show relative differentiation. Two populations of Hg. capricornii had a smaller centroid size with no significant differences between them, whereas all Hg. janthinomys populations showed significant differences. CONCLUSIONS: Both species were correctly identified by geometric morphometry. <![CDATA[Serological status of childbearing-aged women for <em>Toxoplasma gondii</em> and cytomegalovirus in northern Kosovo and Metohija]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100602&lng=en&nrm=iso&tlng=en Abstract INTRODUCTION: Toxoplasma gondii and cytomegalovirus (CMV) are pathogens associated with congenital anomalies. METHODS: Serum was collected from 79 reproductive-age women and tested for IgM and IgG antibodies to T. gondii and CMV. RESULTS: Seropositivity for T. gondii was detected in 24.1% of women and CMV in 96.2%. High seropositivity for CMV was found for all ages. The highest seropositivity for T. gondii was observed among older participants. CONCLUSIONS: T. gondii remains an important pathogen owing to low seropositivity. <![CDATA[Performance of an immuno-rapid malaria <em>Pf</em>/<em>Pv</em> rapid diagnostic test for malaria diagnosis in the Western Brazilian Amazon]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100603&lng=en&nrm=iso&tlng=en Abstract INTRODUCTION: Rapid diagnostic tests (RDTs) for detecting Plasmodium antigens have become increasingly common worldwide. We aimed to evaluate the accuracy of the Immuno-Rapid Malaria Pf/Pv RDT in detecting Plasmodium vivax infection compared to standard thick blood smear (TBS) under microscopy. METHODS: Hundred and eighty-one febrile patients from the hospital’s regular admissions were assessed using TBS and RDT in a blinded experiment. RESULTS: RDT showed a sensitivity of 98.9%, specificity of 100%, and accuracy of 99.5% for P. vivax infection when compared to TBS. CONCLUSIONS: The RDT is highly accurate, making it a valuable diagnostic tool for P. vivax infection. <![CDATA[Prevalence of urodynamic changes with risk for upper urinary tract damage in neuroschistosomiasis patients]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100604&lng=en&nrm=iso&tlng=en Abstract INTRODUCTION: This study aimed to identify the prevalence of urodynamic changes with an associated risk of developing upper urinary tract damage in neuroschistosomiasis patients. METHODS: A prospective study was conducted, wherein68 patients were admitted for analysis of urodynamics, urea and creatinine levels, and uroculture. RESULTS: Blood test results did not indicate kidney failure. There were cases of asymptomatic bacteriuria. Common symptoms were frequent nocturia and detrusor overactivity. Results of low compliance and low cystometric capacity were both statistically significant (p = 0.001 and p = 0.002, respectively). CONCLUSIONS: A high prevalence of negative urodynamic changes were found in neuroschistosomiasis patients. <![CDATA[Popular names for bushmaster (<em>Lachesis muta</em>) and lancehead (<em>Bothrops atrox</em>) snakes in the Alto Juruá region: repercussions for clinical-epidemiological diagnosis and surveillance]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100605&lng=en&nrm=iso&tlng=en Abstract INTRODUCTION: The popular names “surucucu” and “jararaca” have been used in literature for Lachesis muta and Bothrops atrox snakes, respectively. We present the popular names reported by patients who suffered snakebites in the Alto Juruá region. METHODS: Fifty-seven (76%) patients saw the snakes that caused the envenomations and were asked about their popular names and sizes. RESULTS: The snakes Bothrops atrox, referred to as “jararaca,” were recognized as being mainly juveniles (80.7%) and “surucucu” as mainly adults (81.8%). CONCLUSIONS: The name “surucucu” is used in the Alto Juruá region for the snake B. atrox, mainly for adult specimens. <![CDATA[Anti-<em>Candida</em> and anti-quorum sensing activity of airborne microorganisms detected by a rapid method]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100606&lng=en&nrm=iso&tlng=en Abstract INTRODUCTION: Introducing new antibiotics to the clinic is critical. METHODS: We adapted a plate method described by Kawaguchi and coworkers in 20131 for detecting inhibitory airborne microorganisms. RESULTS: We obtained 51 microbial colonies antagonist to Chromobacterium violaceum, purified and retested them, and of these, 39 (76.5%) were confirmed. They comprised 24 bacteria, 13 fungi, and 2 yeasts. Among the fungi, eight (61.5%) produced active extracts. Among the bacterial, yeast, and fungal strains, 17 (44.7%) and 12 (31.6%) were active against Candida albicans and Candida parapsilosis, respectively. CONCLUSIONS: The proposed screening method is a rapid strategy for discovering potential antibiotic producers. <![CDATA[Biofilm formation by blood isolates of <em>Candida parapsilosis</em> sensu stricto in the presence of a hyperglycidic solution at comparable concentrations of total parenteral nutrition]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100607&lng=en&nrm=iso&tlng=en Abstract INTRODUCTION: Administration of total parenteral nutrition (TPN) via catheters increases the risk for candidemia from Candida parapsilosis. METHODS: C. parapsilosis sensu stricto blood isolates were evaluated for ability total biomass biofilm formation and morphogenesis in presence of glucose at TPN equivalent concentrations. RESULTS: Biofilms were increased at high glucose concentrations (25-30%) compared to the control medium. Significant increase in filamentous forms was observed in cultures with 30% glucose. CONCLUSIONS: Biofilm formation by C. parapsilosis sensu stricto in hyperglycidic medium may contribute to its pathogenic potential for fungemia related to TPN catheters. <![CDATA[Stress conditions in the host induce persister cells and influence biofilm formation by S<em>taphylococcus epidermidis</em> RP62A]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100608&lng=en&nrm=iso&tlng=en Abstract INTRODUCTION: Studies have demonstrated that pathogens react to the harsh conditions in human tissues by inducing mechanisms that promote survival. METHODS: Persistence and biofilm-forming ability were evaluated during stress conditions that mimic those in the host. RESULTS: Carbon-source availability had a positive effect on Staphylococcus epidermidis RP62A adhesion during hypoxia, accompanied by a decrease in pH. In contrast, iron limitation led to decreased surface-adherent biomass, accompanied by an increase medium acidification and lactate levels. Interestingly, iron starvation and hypoxia induced persister cells in planktonic culture. CONCLUSIONS: These findings highlight the role of host stress in the virulence of S. epidermidis. <![CDATA[Temporal and spatial distribution of American tegumentary leishmaniasis in north Paraná: 2010-2015]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100609&lng=en&nrm=iso&tlng=en Abstract INTRODUCTION: Describing the general aspects of American tegumentary leishmaniasis enables the identification of the epidemiological scenario of the disease and the development of preventive actions. METHODS: We analyzed the records of patients with American tegumentary leishmaniasis in north Paraná between 2010 and 2015. RESULTS: We identified 108 cases (mostly in 2014) with the following characteristics: male individuals, rural workers, and ages averaging 56.8 years. Isolated ulcerated lesions were predominant, and Glucantime® was the most frequently used drug. CONCLUSIONS: American tegumentary leishmaniasis remains endemic and affects mostly men found in areas surrounded by woods; its treatment is partially efficient considering its side effects and incidence of recurrences. <![CDATA[Good response to pentamidine isethionate in a case of Mucosal Leishmaniasis caused by <em>Leishmania (Viannia) braziliensis</em> that was difficult to treat: Case Report]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100700&lng=en&nrm=iso&tlng=en Abstract In Brazil, meglumine antimoniate is the first drug of choice for mucosal leishmaniasis treatment followed by amphotericin B and pentamidine isethionate. We report the case of a patient with severe mucosal lesions caused by Leishmania (Viannia) braziliensis that were difficult to treat. Over a 14-year period, the patient showed low adherence and three treatment attempts with meglumine antimoniate failed. Additionally, there was an unsatisfactory response to liposomal amphotericin B and nephrotoxicity when using amphotericin B deoxycholate that persisted after new treatment attempt with liposomal amphotericin B. Finally, healing was achieved with pentamidine isethionate and maintained during nine months of monitoring. <![CDATA[Septic arthritis caused by <em>Salmonella enterica</em> serotype Rubislaw: A case report]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100701&lng=en&nrm=iso&tlng=en Abstract An eleven-year-old boy presented with fever and hip pain, with limited mobility of the right side of the hip. Computed tomography scan revealed an increased volume of the right coxo-femoral joint, requiring surgical drainage of purulent secretion, from which Salmonella enterica was isolated. After four weeks of treatment with third-generation cephalosporin, he was discharged with a favorable evolution. Invasive disease caused by Salmonella spp represents a small proportion of salmonellosis cases, although it is responsible for greater rates of hospitalization, morbidity and mortality. Children under 5 years, elders over 60 years and immunodeficient patients have greater risk for invasive salmonellosis. <![CDATA[De novo histoid leprosy in a Colombian patient with multiple skin nodules on the ears and extremities]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100702&lng=en&nrm=iso&tlng=en Abstract Histoid leprosy is an uncommon form of lepromatous leprosy with distinct clinical, histopathological, immunological, and bacteriological features. This variant usually occurs in multibacillary patients who have irregular or inadequate treatment. Herein, we report a case of de novo histoid leprosy diagnosed in a patient from Cali, Colombia. In endemic areas, histoid leprosy should be in the differential diagnosis of any patient presenting with skin nodules. Early diagnosis and appropriate treatment are recommended for mitigating the impact of histoid leprosy cases, which are important reservoirs of Mycobacterium leprae. <![CDATA[Venom concentrations in blisters and hemorrhagic bullae in a patient bitten by a Taiwan habu (<em>Protobothrops mucrosquamatus</em>)]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100800&lng=en&nrm=iso&tlng=en Abstract Histoid leprosy is an uncommon form of lepromatous leprosy with distinct clinical, histopathological, immunological, and bacteriological features. This variant usually occurs in multibacillary patients who have irregular or inadequate treatment. Herein, we report a case of de novo histoid leprosy diagnosed in a patient from Cali, Colombia. In endemic areas, histoid leprosy should be in the differential diagnosis of any patient presenting with skin nodules. Early diagnosis and appropriate treatment are recommended for mitigating the impact of histoid leprosy cases, which are important reservoirs of Mycobacterium leprae. <![CDATA[Herpes simplex virus transmission following brown howler monkey (<em>Alouatta guariba</em>) bite]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100801&lng=en&nrm=iso&tlng=en Abstract Histoid leprosy is an uncommon form of lepromatous leprosy with distinct clinical, histopathological, immunological, and bacteriological features. This variant usually occurs in multibacillary patients who have irregular or inadequate treatment. Herein, we report a case of de novo histoid leprosy diagnosed in a patient from Cali, Colombia. In endemic areas, histoid leprosy should be in the differential diagnosis of any patient presenting with skin nodules. Early diagnosis and appropriate treatment are recommended for mitigating the impact of histoid leprosy cases, which are important reservoirs of Mycobacterium leprae. <![CDATA[Prevention of zoonotic diseases in immunocompromised patients: a neglected question]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100900&lng=en&nrm=iso&tlng=en Abstract Histoid leprosy is an uncommon form of lepromatous leprosy with distinct clinical, histopathological, immunological, and bacteriological features. This variant usually occurs in multibacillary patients who have irregular or inadequate treatment. Herein, we report a case of de novo histoid leprosy diagnosed in a patient from Cali, Colombia. In endemic areas, histoid leprosy should be in the differential diagnosis of any patient presenting with skin nodules. Early diagnosis and appropriate treatment are recommended for mitigating the impact of histoid leprosy cases, which are important reservoirs of Mycobacterium leprae. <![CDATA[The dentist’s role in syphilis prevention and control]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000100901&lng=en&nrm=iso&tlng=en Abstract Histoid leprosy is an uncommon form of lepromatous leprosy with distinct clinical, histopathological, immunological, and bacteriological features. This variant usually occurs in multibacillary patients who have irregular or inadequate treatment. Herein, we report a case of de novo histoid leprosy diagnosed in a patient from Cali, Colombia. In endemic areas, histoid leprosy should be in the differential diagnosis of any patient presenting with skin nodules. Early diagnosis and appropriate treatment are recommended for mitigating the impact of histoid leprosy cases, which are important reservoirs of Mycobacterium leprae. <![CDATA[Luiz Fernando Ferreira (★1936 †2018)]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000101100&lng=en&nrm=iso&tlng=en Abstract Histoid leprosy is an uncommon form of lepromatous leprosy with distinct clinical, histopathological, immunological, and bacteriological features. This variant usually occurs in multibacillary patients who have irregular or inadequate treatment. Herein, we report a case of de novo histoid leprosy diagnosed in a patient from Cali, Colombia. In endemic areas, histoid leprosy should be in the differential diagnosis of any patient presenting with skin nodules. Early diagnosis and appropriate treatment are recommended for mitigating the impact of histoid leprosy cases, which are important reservoirs of Mycobacterium leprae. <![CDATA[Erratum: Prevalence and risk factors of toxoplasmosis among adults in a small Brazilian city]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822019000101500&lng=en&nrm=iso&tlng=en Abstract Histoid leprosy is an uncommon form of lepromatous leprosy with distinct clinical, histopathological, immunological, and bacteriological features. This variant usually occurs in multibacillary patients who have irregular or inadequate treatment. Herein, we report a case of de novo histoid leprosy diagnosed in a patient from Cali, Colombia. In endemic areas, histoid leprosy should be in the differential diagnosis of any patient presenting with skin nodules. Early diagnosis and appropriate treatment are recommended for mitigating the impact of histoid leprosy cases, which are important reservoirs of Mycobacterium leprae.