Accessibility / Report Error
Revista da Sociedade Brasileira de Medicina Tropical, Volume: 51, Issue: 2, Published: 2018
  • A quick fix for Chagas disease therapy: a new trick using an old drug Editorial

    Siqueira-Neto, Jair Lage de
  • Preventing diseases in round-the-world travelers: a contemporary challenge for travel medicine advice Review Article

    Rodrigues, Karis Maria de Pinho; Moreira, Beatriz Meurer

    Abstract in English:

    Abstract Providing advice for travelers embarking on long-term trips poses a challenge in travel medicine. A long duration of risk exposure is associated with underuse of protective measures and poor adherence to chemoprophylaxis, increasing the chances of acquiring infections. Recently, in our clinic, we observed an increase in the number of travelers undertaking round-the-world trips. These individuals are typically aged around 32 years and quit their jobs to embark on one-to-two-year journeys. Their destinations include countries in two or more continents, invariably Southeast Asia and Indonesia, and mostly involve land travel and visiting rural areas. Such trips involve flexible plans, increasing the challenge, especially with regard to malaria prophylaxis. Advising round-the-world travelers is time-consuming because of the amount of information that must be provided to the traveler. Advisors must develop strategies to commit the traveler to his/her own health, and verify their learnings on disease-prevention measures. Contacting the advisor after the appointment or during the trip can be helpful to clarify unclear instructions or diagnosis made and prescriptions given abroad. Infectious diseases are among the most frequent problems affecting travelers, many of which are preventable by vaccines, medicines, and precautionary measures. The dissemination of counterfeit medicines, particularly antibiotics and antimalarial medicines, emphasizes the need for travelers to carry medicines that they may possibly need on their trip. Additional advice on altitude, scuba diving, and other possible risks may also be given. Considering the difficulties in advising this group, we present a review of the main recommendations on advising these travelers.
  • Response to different benznidazole doses in animal models of chronic phase Chagas disease: a critical review Mini Review

    Scarim, Cauê Benito; Ribeiro, Aline Rimoldi; Rosa, João Aristeu da; Chin, Chung Man

    Abstract in English:

    Abstract Chagas disease is a protozoan infection that was identified over a century ago. No drugs are available to treat the indeterminate and determinate chronic phases of the disease. Success of a drug design is dependent on correct biological evaluation. Concerning new drug designs for Chagas disease, it is essential to first identify the most effective, existing, experimental chronic protocols that can be used for comparison purposes. Here, we present a literature review regarding experimental models with chronic Chagas disease to evaluate the efficacy of benznidazole (BZN). We searched literature published in PubMed and Web of Science databases, using these keywords: animal model, BZN, Chagas disease, T. cruzi, and chronic phase, with no timeframe limitations. We excluded articles involving acute phase animal models and/or those without BZN treatment. The selected studies were conducted using different BZN concentrations (10mg-100mg) involving several different periods (5-70 days). Concentrations and durations of use are directly related to side effects, but do not prevent chronic tissue lesions. BZN use during the late/chronic phases of Chagas disease is unable to eliminate amastigote forms present in infected tissues. This study suggests the administration of a lower BZN concentration (<100mg/kg/day) during the chronic phase of the animal model, as this had been reported to result in fewer side effects.
  • HCMV UL97 phosphotransferase gene mutations may be associated with antiviral resistance in immunocompromised patients in Belém, PA, Northern Brazil Major Article

    Silva, Dorotéa de Fátima Lobato da; Cardoso, Jedson Ferreira; Silva, Sandro Patroca da; Arruda, Leda Mani França; Medeiros, Renato Lopes Fernandes de; Moraes, Marluce Matos; Sousa, Rita Catarina Medeiros

    Abstract in English:

    Abstract INTRODUCTION: Human cytomegalovirus is one of the causes of opportunist infections in immunocompromised patients, and is triggered by factors such as state of viral latency, weakened immune responses, and development of antiviral resistance to ganciclovir, the only drug offered by the public health system in Brazil to treat the infection. The goal of this study was to identify mutations that may be associated with antiviral resistance in immunocompromised patients. METHODS: Molecular analysis was performed in 82 blood samples and subjected to genomic DNA extraction by a silica-based method. Three sequences of the HCMV UL97 gene, which encodes a phosphotransferase protein required for activation of ganciclovir, were amplified by polymerase chain reaction. Pyrosequencing methods were applied to one external 2096-bp segment DNA and two internal sequences between nucleotides 1087 to 1828 to detect mutations in this gene. RESULTS: Approximately 10% of sequences contained mutations between nucleotides 377 and 594, in conserved regions of the UL97 gene, leading to amino acid changes. Eleven coding mutations were identified, including changes leading to amino acid substitutions, E596K and S604F, which were observed in 100% of samples and are described for the first time in Brazil. In addition, one mutation (A594V) that is associated with ganciclovir resistance was detected in a kidney transplant patient. CONCLUSIONS: Further studies to detect mutations associated with HCMV resistance to antiviral drugs are required to demonstrate the need to increase the variety and availability of drugs used to treat viral infections in the public health care system in Brazil.
  • First-wave protease inhibitors for hepatitis C genotype 1 treatment: a real-life experience in Brazilian patients Major Article

    Chachá, Silvana Gama Florencio; Rodrigues, João Paulo Vilela; Araújo, Roberta Chaves; Pereira, Leonardo Régis Leira; Villanova, Márcia Guimarães; Souza, Fernanda Fernandes; Santana, Rodrigo de Carvalho; Martinelli, Ana de Lourdes Candolo

    Abstract in English:

    Abstract INTRODUCTION: Licensed for chronic hepatitis C treatment in 2011, the protease inhibitors (PIs) telaprevir (TVR) and boceprevir (BOC), which have high sustained viral responses (SVR), ushered a new era characterized by the development of direct-action drugs against the hepatitis C virus (HCV). The aim of this study was to analyze the effectiveness and safety of BOC and TVR administered with pegylated interferon and ribavirin and to share the experience of a Brazilian reference center. METHODS: A retrospective descriptive study was conducted in patients with HCV genotype 1 infection who started treatment between July 2013 and December 2015. Data were collected using a computerized system. RESULTS: A total of 115 subjects were included, of which 58 (50.4 %) had liver cirrhosis and 103 (89.6 %) used TVR. The overall SVR rate was 61.7 % (62.1 % for TVR and 58.3 % for BOC). The presence of cirrhosis was associated with a lower SVR rate, whereas patients who relapsed after prior therapy had a greater chance of showing SVR than did non-responders. The incidence of adverse drug reactions (ADRs) was high. Almost all patients (~100 %) presented with hematologic events. Furthermore, treatment had to be discontinued in 15 subjects (13 %) due to severe ADRs. CONCLUSIONS: In conclusion, the SVR rates in our study were lower than those reported in pre-marketing studies but were comparable to real-life data. ADRs, particularly hematological ADRs, were more common compared to those in previous studies and resulted in a high rate of treatment discontinuity.
  • Clinical outcomes and risk factors for death from disseminated histoplasmosis in patients with AIDS who visited a high-complexity hospital in Campo Grande, MS, Brazil Major Article

    Boigues, Barbara Cristina Scarcelli; Paniago, Anamaria Mello Miranda; Lima, Gláucia Moreira Espíndola; Nunes, Maina de Oliveira; Uehara, Silvia Naomi de Oliveira

    Abstract in English:

    Abstract INTRODUCTION: Disseminated histoplasmosis (DH) is a systemic mycosis caused by Histoplasma capsulatum (H. capsulatum) and is characterized by progressive and fatal evolution in immunocompromised patients. Moreover, it is considered an AIDS-defining disease. METHODS: We performed an observational, analytical, retrospective study to identify the clinical outcomes and risk factors for death from DH in patients with AIDS at an infectious diseases service facility in Brazil between September 2011 and July 2016. Patients with a positive serology for HIV and DH were diagnosed via direct examination and/or positive cultures for H. capsulatum. RESULTS: Twenty-three patients were included in this study. Approximately, 82.6% were men, with a mean age of 41.0±11.5 years, and 52.2% had a concomitant diagnosis of AIDS and DH. The median CD4+ T cell count was 19 cells/mm3, and 56.5% of the patients died. The most frequently observed symptoms were fever, dyspnea, and skin lesions. On the basis of a comparative analysis of those who died and survived, the absence of splenomegaly and hepatomegaly and the presence of H. capsulatum in the peripheral blood were considered as risk factors for death. Those who died had a higher leukocyte count; CRP, urea, and lactate dehydrogenase levels; AST index; and international normalized ratio prothrombin time. The serum total protein and albumin levels of the patients were lower. CONCLUSIONS: The mortality rate for DH is high among severely immunocompromised patients with AIDS. The risk factors for death were those traditionally associated with blood dyscrasia, inflammatory activity, as well as increased renal and nutritional impairment.
  • Balance, functional mobility, and fall occurrence in patients with human T-cell lymphotropic virus type-1-associated myelopathy/tropical spastic paraparesis: a cross-sectional study Major Article

    Fonseca, Erika Pedreira da; Sá, Katia Nunes; Nunes, Rebeca Freitas Reis; Ribeiro Junior, Antônio Carlos; Lira, Síntia Freitas Bastos; Pinto, Elen Beatriz

    Abstract in English:

    Abstract INTRODUCTION: Human T-cell lymphotropic virus type-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) may lead to reduced functional mobility and balance. It is important to establish specific parameters that identify these changes and predict the risk of falls in these patients. The aim was to compare balance, functional mobility, and occurrence of falls among patients with and without HAM/TSP and to suggest values to predict the risk of falls in these patients. METHODS: A cross-sectional study in patients with and without HAM/TSP involved balance assessments based on the berg balance scale (BBS) and functional mobility evaluation based on the timed up and go (TUG) test. From reports of falls, the sensitivity, specificity, and best cutoff points for the risk of falls assessed by these instruments were established using the receiver-operating characteristic (ROC) curve; 5% alpha was considered. RESULTS: We selected 42 participants: 29 with HAM/TSP and 13 without HAM/TSP. There was a statistically significant difference in the occurrence of falls, balance, and functional mobility between the groups (p<0.05). Good accuracy was determined for the BBS (77%) and TUG test (70%) and the cutoff points for the risk of falls were defined as 50 points for the BBS and 12.28 seconds for the TUG test. CONCLUSIONS: Patients with HAM/TSP present reduced functional mobility and balance in relation to those without HAM/TSP. The risk of falls increased for these patients can be evaluated by the values ​​of 50 points using the BBS and 12.28 seconds using the TUG test.
  • Evaluating the use of fluorescence-based flow cytometry assay for dengue diagnosis using peripheral blood mononuclear cells Major Article

    Barreira, Luzia Aparecida Costa; Scheucher, Priscila Santos; Romeiro, Marilia Farignoli; Serra, Leonardo La; Badra, Soraya Jabur; Souza, William Marciel de; Figueiredo, Luiz Tadeu Moraes

    Abstract in English:

    Abstract INTRODUCTION: Dengue virus (DENV) is the most important arthropod-borne viral disease worldwide with an estimated 50 million infections occurring each year. METHODS: In this study, we present a flow cytometry assay (FACS) for diagnosing DENV, and compare its results with those of the non-structural protein 1 (NS1) immunochromatographic assay and reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS: All three assays identified 29.1% (39/134) of the patients as dengue-positive. The FACS approach and real-time RT-PCR detected the DENV in 39 and 44 samples, respectively. On the other hand, the immunochromatographic assay detected the NS1 protein in 40.1% (56/134) of the patients. The Cohen's kappa coefficient analysis revealed a substantial agreement among the three methods. CONCLUSIONS: The FACS approach may be a useful alternative for dengue diagnosis and can be implemented in public and private laboratories.
  • Insect vectors of Chagas disease (Trypanosoma cruzi) in Northeastern Brazil Major Article

    Fidalgo, Arduina Sofia Ortet de Barros Vasconcelos; Costa, Alanna Carla da; Silva Filho, José Damião da; Cândido, Darlan da Silva; Freitas, Erlane Chaves; Pereira, Laíse dos Santos; Andrade, Mônica Coelho de; Gomes, Kátia Cristina Morais Soares; Bezerra, Cláudia Mendonça; Oliveira, Maria de Fátima

    Abstract in English:

    Abstract INTRODUCTION: Chagas disease remains a public health problem in the rural and urban areas of 19 countries in the Americas. METHODS: The aim of the present study was to investigate the Trypanosoma cruzi infection rate of triatomines collected from both intra- and peridomiciliary areas in eleven municipalities of Southeastern Ceará, Brazil, from 2009 to 2015. RESULTS: A total of 32,364 triatomine specimens, including nymphs and adults, were collected, and 31,736 (98.06%) of these were examined. More nymphs were collected than adults, and the greatest number of triatomines (n = 8,548) was collected in 2010, for which the infection rate was 1.3%, with the highest rate of infections observed for specimens from Quixere. The species collected during the study were identified as Triatoma pseudomaculata, Triatoma brasiliensis, Panstrongylus megistus, Panstrongylus lutzi, and Rhodnius nasutus, with T. pseudomaculata being the most abundant (n = 19,962). CONCLUSIONS: These results verify the presence of triatomines in both intra- and peridomiciliary areas, thereby ensuring persistence of the pathogen and consequently, the disease, as the presence of infected vectors in households is an important risk factor. According to these findings, the Chagas Disease Control Program should intensify its efforts in order to prevent the spread of the disease.
  • Risk factors of Helicobacter pylori infection in an urban community in Northeast Brazil and the relationship between the infection and gastric diseases Major Article

    Basílio, Irigrácin Lima Diniz; Catão, Maria de Fátima Celino; Carvalho, Janilson Dantas de Sousa; Freire-Neto, Francisco Paulo; Ferreira, Leonardo Capristano; Jerônimo, Selma Maria Bezerra

    Abstract in English:

    Abstract INTRODUCTION: Helicobacter pylori, a water contaminant, is the primary pathogenic agent associated with gastric diseases in humans. Exposure to H. pylori is more likely higher in developing countries. This study aimed to evaluate the risk factors associated with H. pylori infection in patients undergoing endoscopy to validate the cause of dyspeptic symptoms in an urban population in northeast Brazil and to compare the urease test and polymerase chain reaction assay results with the histopathological findings. METHODS: We evaluated 200 of 759 individuals with dyspeptic complaints from Campina Grande, State of Paraiba, northeast Brazil. Patients underwent endoscopy, followed by gastric biopsies. Logistic regression analysis was performed to adjust for confounders and to determine significant risk factors of dyspeptic disorders. RESULTS: Women accounted for 72.5% (145/200) of the participants. Approximately 59.8% (120/200) of the samples tested positive for H. pylori based on histological examinations. The specificity of polymerase chain reaction assay was higher than that of the urease test (77% vs. 64%, p=0.034). City drinking water [odds ratio (OR): 2.6; 95% confidence interval (CI): 1.3-5.21; p=0.004] and smoking (OR: 4.0; 95% CI: 1.13-14.5; p=0.031) were the risk factors of H. pylori infection. Belching was the most common symptom associated with H. pylori infection (p=0.05). CONCLUSIONS: The increased risk of H. pylori infection associated with non-treated water consumption indicates the need for improvements in public water treatment and better sanitary conditions because these can be a source of not only H. pylori infections but also other water-borne pathogen infections.
  • Natural infection by Trypanosoma cruzi in triatomines and seropositivity for Chagas disease of dogs in rural areas of Rio Grande do Norte, Brazil Major Article

    Freitas, Yannara Barbosa Nogueira; Souza, Celeste da Silva Freitas de; Magalhães, Jamille Maia e; Sousa, Maressa Laíse Reginaldo de; d’Escoffier, Luiz Ney; Valle, Tânia Zaverucha do; Gonçalves, Teresa Cristina Monte; Gil-Santana, Hélcio Reinaldo; Kazimoto, Thais Aaparecida; Amora, Sthenia Santos Albano

    Abstract in English:

    Abstract INTRODUCTION: Chagas disease is caused by the protozoa Trypanosoma cruzi. Its main reservoir is the domestic dog, especially in rural areas with favorable characteristics for vector establishment and proliferation. The aims of this study were to collect data, survey and map the fauna, and identify T. cruzi infection in triatomines, as well as to assess the presence of anti-T. cruzi antibodies in dogs in rural areas of the municipality of Mossoró, Brazil. METHODS: An active entomologic research was conducted to identify adult specimens through an external morphology dichotomous key. The analysis of natural infection by T. cruzi in the insects was performed by isolation in culture and polymerase chain reaction. The antibody testing for T. cruzi in dogs was performed by enzyme-linked immunosorbent assay and indirect immunofluorescence assay. RESULTS: A total of 68 triatomines were captured, predominantly the Triatoma brasiliensis brasiliensis (Neiva 1911) species. The vector mapping displayed areas with greater risk for parasite transmission. Of the examined triatomines (51 specimens), 41.2% (21/51) were positive on polymerase chain reaction, and all were negative on culture. In the serum testing, 11% (25/218) of dogs were seropositive, but no association was found between the serologic results and the presence and infection by T. cruzi in triatomines. CONCLUSIONS: This study demonstrated the movement of T. cruzi in the studied area, by the presence of vectors and naturally infected domestic reservoirs. The mapping of the studied rural area demonstrates the risk of disease transmission.
  • High-risk behaviors for hepatitis B and C infections among female sex workers Short Communication

    Puga, Marco Antonio Moreira; Bandeira, Larissa Melo; Weis, Sabrina Moreira dos Santos; Fernandes, Fernanda Rodas Pires; Castro, Lisie Souza; Tanaka, Tayana Serpa Ortiz; Rezende, Grazielli Rocha de; Teles, Sheila Araújo; Castro, Vivianne de Oliveira Landgraf de; Murat, Paula Guerra; Capelin, Gina Jonasson Mousquer; Motta-Castro, Ana Rita Coimbra

    Abstract in English:

    Abstract INTRODUCTION: The prevalence of hepatitis B and hepatitis C and risk behaviors among 402 female sex workers in Central Brazil were investigated by respondent-driven sampling. METHODS: Blood samples were tested for hepatitis B and C markers by enzyme-linked immunosorbent assay. Two hepatitis B vaccination schedules were performed. RESULTS: The prevalence of hepatitis B and C infections were 9.3% and 0.5%, respectively. Susceptibility to hepatitis B infection was observed in 61.5% of subjects. There was no significant difference in adherence index (p=0.52) between vaccination schedules and all participants had protective antibody titers. CONCLUSIONS: This hard-to-reach population requires hepatitis B and C surveillance.
  • Prevalence of hypoalbuminemia in outpatients with HIV/AIDS Short Communication

    Leal, José Adalberto; Fausto, Maria Arlene; Carneiro, Mariângela; Tubinambás, Unaí

    Abstract in English:

    Abstract INTRODUCTION: Hypoalbuminemia may predict progression of disease and mortality in patients with human immunodeficiency virus (HIV) infection/acquired immune deficiency syndrome (AIDS). This study was conducted to investigate the risk factors associated with hypoalbuminemia in outpatients with HIV/AIDS. METHODS: A cross-sectional study was performed in 196 outpatients with HIV/AIDS. RESULTS: The prevalence of hypoalbuminemia was 11.7%. The only risk factor associated with hypoalbuminemia was current antiretroviral therapy (no exposure: odds ratio=3.46, 95% confidence interval=1.20-10.02). CONCLUSIONS: The monitoring of plasma albumin is key to determine when antiretroviral therapy should be initiated in individuals not exposed to antiretroviral medicines.
  • The relationship between atopy and neurological manifestations in HTLV-1 infection Short Communication

    Verde, Raquel Crisóstomo Lima; Carneiro Neto, José Abraão; Santos, Silvane Maria Braga; Carvalho, Edgar Marcelino; Lessa, Marcus Miranda

    Abstract in English:

    Abstract INTRODUCTION: Human T-cell lymphotropic virus type 1 (HTLV-1)induces exaggerated Th1 responses, whereas atopy is associated with exacerbated Th2 responses. METHODS: Here, a cross-sectional study compared the prevalence of atopy in HTLV-1 carriers and HAM/TSP patients. It also compared the spontaneous cytokine production in HTLV-1-infected individuals. A retrospective cohort study evaluated the development of neurological manifestations in atopic and non-atopic carriers. RESULTS: Atopic HAM/TSP patients with high IFN-γ production exhibited higher IL-5 levels than non-atopic patients. Allergic rhinitis accelerated the development of Babinski signals and overactive bladders. CONCLUSIONS: Abnormal Th1 and Th2 responses coexist in HTLV-1-infected individuals and allergic diseases may worsen the clinical course of HTLV-1 infections.
  • First report of Rhodnius neglectus (Hemiptera, Reduviidae, Triatominae) from the State of Acre, Brazil, and the Brazilian Western Amazon Region Short Communication

    Ramos, Leandro José; Castro, Gabriela Vieira de Souza; Souza, Janis Lunier de; Oliveira, Jader de; Rosa, João Aristeu da; Camargo, Luis Marcelo Aranha; Cunha, Renildo Moura da; Meneguetti, Dionatas Ulises de Oliveira

    Abstract in English:

    Abstract INTRODUCTION This communication reports the occurrence of Rhodnius neglectus in the State of Acre, Brazil. METHODS An adult male R. neglectus specimen was collected from the Catuaba Experimental Reserve, which is located in the municipality of Senador Guiomard. RESULTS This increases the number of triatomine species reported from the State of Acre to eight and is also the first report of R. neglectus from the Brazilian Western Amazon Region. CONCLUSIONS The occurrence of R. neglectus is alarming because even though the species is wild, it can invade and colonize human dwellings and peridomiciles, thereby increasing Chagas disease transmission.
  • Is it possible to perform bacterial identification and antimicrobial susceptibility testing with a positive blood culture bottle for quick diagnosis of bloodstream infections? Short Communication

    Lemos, Tamily Cristina; Cogo, Laura Lúcia; Maestri, Adriane Cheschin; Hadad, Milena; Nogueira, Keite da Silva

    Abstract in English:

    Abstract INTRODUCTION: Bloodstream infections can be fatal, and timely identification of the etiologic agent is important for treatment. METHODOLOGY: An alternative method, consisting of direct identification and susceptibility testing of blood culture bottles using the automated VITEK 2® system, was assessed. RESULTS: All 37 of the Gram-negative bacilli (GNB) identifications and 57.1% of the 28 Gram-positive cocci (GPC) identifications matched those obtained with standard methods. In susceptibility testing, the agreement was greater than 90%. CONCLUSIONS: This alternative methodology may assist in the early identification and susceptibility testing of GNB. Further research is necessary to develop appropriate methods for GPC.
  • Home care in the Federal District: factors associated with the first occurrence of acute lower respiratory infection and death Short Communication

    Barros, Leny Nunes de; Oliveira, Maria Regina Fernandes de

    Abstract in English:

    Abstract INTRODUCTION: We aimed to evaluate the frequency and associated factors of acute respiratory infection and death among home care patients in Sobradinho/DF, Brazil. METHODS: Data were obtained from patients’ medical records. Bivariate and multivariate analyses were performed. Odds ratio and 95% confidence interval were estimated. RESULTS: Factors associated with respiratory infection were ages <40 and >80 years and accommodation. Female sex was a protective factor. Age >30 years and dependency for daily activities were associated with death. CONCLUSIONS: These factors can improve clinical results in this specific home care and open new opportunities and questions for future research.
  • Epidemiological and clinical profile of patients with Chagas disease in the Central-North area of Paraná, Southern Brazil Short Communication

    Gasparim, Aretuza Zaupa; Fontes, Carlos Edmundo Rodrigues; Rossoni, Diogo Francisco; Toledo, Max Jean de Ornelas

    Abstract in English:

    Abstract INTRODUCTION Profiles of patients with Chagas disease in Paraná were studied. METHODS A descriptive, questionnaire-based study was performed. RESULTS Of 270 participants, 64% were female, 60% were aged ≥65 years, 91% were infected via vector transmission, and 44% were infected in Paraná. Indeterminate (30%), cardiac (36%), cardiodigestive (20%) and digestive (14%) forms were found. CONCLUSIONS: Patients who were older than 65 years of age, retired, female, living in the urban area of Maringá, and infected by vector transmission in childhood in Paraná presented cardiac and digestive signs and did not receive etiological treatment when first diagnosed.
  • Negative serology of Fasciola hepatica infection in patients with liver cancer in Peru: a preliminary report Short Communication

    Machicado, Claudia; Bertani, Stéphane; Herrera-Velit, Patricia; Espinoza, Jose; Ruiz, Eloy; Marcos, Luis

    Abstract in English:

    Abstract INTRODUCTION: The etiology of several hepatocellular carcinoma (HCC) cases remains largely unknown. Although Fasciola hepatica has been associated with liver fibrosis in Latin America, it has not yet been associated with HCC. This study aimed to determine the existence of specific IgG antibodies against F. hepatica in the serum samples of HCC patients. METHODS In total, 13 serum samples from 13 HCC patients were screened using Fas2-ELISA. RESULTS Fas2-ELISA demonstrated negative results in all HCC patients included in this study. CONCLUSIONS The pre-existence of F. hepatica infection in HCC patients needs to be further investigated in epidemiological and experimental studies.
  • The role of the Xpert MTB/RIF assay among adolescents suspected of pulmonary tuberculosis in Rio de Janeiro, Brazil Short Communication

    Sieiro, Thania Luiza de Andrade; Aurílio, Rafaela Baroni; Soares, Elizabeth Cristina C.; Chiang, Silvia S.; Sant´Anna, Clemax Couto

    Abstract in English:

    Abstract INTRODUCTION The teste rápido molecular para tuberculose (TRM-TB) was introduced in 2014 in Brazil for tuberculosis screening. However, its role in adolescents in Brazil has not been studied. METHODS A descriptive study of adolescents with suspected tuberculosis using National Laboratory software. RESULTS Of 852 (15.4%) suspected cases, 131 were positive by TRM-TB and 2% were resistant to rifampicin. Among TRM-TB-positive cases, 105 (91.4%) were culture-positive. Sixty-four of 96 samples were sensitive to rifampicin by TRM-TB; 11 were resistant to other drugs by drug sensitivity test (DST). CONCLUSIONS Among suspected cases, 16% were diagnosed by TRM-TB, of which 17% were drug-resistant by DST.
  • Microscopic detection of Mycobacterium tuberculosis in direct or processed sputum smears Short Communication

    Magalhães, José Luiz de Oliveira; Lima, Juliana Figueiredo da Costa; Araújo, Ana Albertina de; Coutinho, Ilyana Oliveira; Leal, Nilma Cintra; Almeida, Alzira Maria Paiva de

    Abstract in English:

    Abstract INTRODUCTION: Microscopic identification of active pulmonary tuberculosis (PTB) from direct smears of sputum (DS) is widely used for detection, but has limited sensitivity. Here, we assessed the yield of acid-fast bacilli (AFB) detection in processed sputum smears (PSS). METHODS: Sputum samples were simultaneously analyzed by direct sputum smearing and after chemical treatment and spontaneous sedimentation. RESULTS: Of the 1,719 samples analyzed, 16.4% were positive for AFB in conventional DS and 21.4% in PSS, corresponding to a 30% increase in detection. CONCLUSIONS: Increased sensitivity from analyzing PSS and better safety protocols will contribute to improved detection and control of the disease.
  • Occurrence of Blastocystis spp. in domestic animals in Triângulo Mineiro area of Brazil Short Communication

    Moura, Renata Gregório Franco; Oliveira-Silva, Márcia Benedita de; Pedrosa, André Luiz; Nascentes, Gabriel Antônio Nogueira; Cabrine-Santos, Marlene

    Abstract in English:

    Abstract INTRODUCTION: Currently, there are few studies regarding Blastocystis epidemiology. This study aimed to evaluate the occurrence of Blastocystis in animals in Uberaba, Brazil. METHODS: Fecal samples were examined by parasitological methods and screened for Blastocystis by polymerase chain reaction. RESULTS: Blastocystis spp. were observed in pigs, sheep, cattle, and dogs. Blastocystis polymerase chain reaction was positive in 14/22 samples positive by parasitological methods. CONCLUSIONS: The occurrence of Blastocystis in animals is high, with a predominance of subtype 1 in the region. This is the first study conducted in Brazil showing the genetic profile of Blastocystis isolated from animals.
  • Meningitis caused by Salmonella enterica serotype Panama in Brazil: first case reported Case Report

    Carneiro, Maria Regina Pires; Patrício, Maria Iracema de Aguiar; Jain, Sona; Rodrigues, Dalia dos Prazeres; Fracalanzza, Sergio Eduardo Longo

    Abstract in English:

    Abstract Salmonella infections usually occur as gastroenteritis that is generally self-limited. However, some serotypes of Salmonella can cause severe extra-intestinal infections, such as bacteremia and meningitis. Here, we report the first Salmonella Panama case of meningitis in 4-month-old male newborn in Brazil. The invasive strain isolated was susceptible to all antimicrobial agents tested. The genes agfA, fimA, invA, sfbA, phoP, and slyA were detected using polymerase chain reactions. These findings are relevant and physicians should be alert to the possibility of meningitis in newborns due to S. Panama, which can present a high rate of mortality or recurrence of infection.
  • Cat scratch disease presenting as axillary lymphadenopathy and a palpable benign mammary nodule mimicking a carcinoma Case Report

    Marques, Larissa Cabral; Pincerato, Kátia; Yoshimura, Adriana Akemi; Andrade, Felipe Eduardo Martins; Barros, Alfredo Carlos Simões Dornellas de

    Abstract in English:

    Abstract We present a case involving a 74-year-old woman with cat scratch disease characterized by an enlarged and hard axillary lymph node as well as a palpable breast nodule mimicking a carcinoma. The lymph node and the breast nodule were excised. The pathologic examinations revealed granulomatous lymphadenitis with gram-negative bacilli and an intraductal papilloma. Antibiotic therapy (azithromycin) was prescribed and the patient’s clinical evolution was excellent.
  • Pulmonary paracoccidioidomycosis: a case report of reactivation in a patient receiving biological therapy Case Report

    Covre, Lúcia Carla Polaco; Hombre, Pâmela Mazzini; Falqueto, Aloísio; Peçanha, Paulo Mendes; Valim, Valéria

    Abstract in English:

    Abstract Paracoccidioidomycosis is an endemic disease in Latin America that is rarely associated with immunosuppression and biological therapy. Herein, we report for the first time a case of pulmonary paracoccidioidomycosis reactivation after infliximab treatment. A 47-year-old man from Brazil received infliximab to treat psoriatic spondyloarthropathy and presented with cough, dyspnea, weight loss, and fever. Chest computed tomography revealed a pulmonary nodule and biopsy confirmed paracoccidioidomycosis. Treatment with sulfamethoxazole and trimethoprim was initiated for fungal infection and infliximab was reintroduced two months later. Considering his clinical improvement and favorable radiologic evolution, antifungal therapy was discontinued after 29 months.
  • Central nervous system tuberculosis mimicking tentorium meningioma: a rare case Images In Infectious Diseases

    Muniz, Bernardo Carvalho; Niemeyer, Bruno; Makita, Lana Sayuri
  • Oral cavity syphilides Images In Infectious Diseases

    Eyer-Silva, Walter de Araujo; Azevedo, Marcelo Costa Velho Mendes de; Silva, Guilherme Almeida Rosa da
  • Efficacy of the main repellents available in the Brazilian market against Aedes aegypti bites under concentrations applied to pediatric populations Letter

    Silva, Bruna Oliveira da; Olivatti, Thainá Oliveira Felicio; Kanda, Rafael Guimarães; Marco, Gustavo Noé de; Santaella, Felipe José; Madeira, Newton Goulart; Haddad Junior, Vidal; Miot, Hélio Amante
Sociedade Brasileira de Medicina Tropical - SBMT Caixa Postal 118, 38001-970 Uberaba MG Brazil, Tel.: +55 34 3318-5255 / +55 34 3318-5636/ +55 34 3318-5287, http://rsbmt.org.br/ - Uberaba - MG - Brazil
E-mail: rsbmt@uftm.edu.br