Candidemia in a brazilian tertiary hospital: microbiological and clinical features over a six-year period

Yeasts are becoming a common cause of nosocomial fungal infections in immunocompromised patients. Such infections often develop into sepsis with high mortality rates. The aim of this study was to evaluate some of the numerous factors associated with the development of candidemia. Medical records were retrospectively analyzed of 98 Candida spp. patients. Results showed that the most prevalent risk factors for developing candidemia were: antibiotics and antifungal agents (93.9% and 79.6%, respectively); the use of central venous catheter (93.9%); mechanical ventilation (73.5%); and parenteral nutrition (60.2%). The main species of Candida found were: C. parapsilosis (37.76%), C. albicans (33.67%); and others (28.57%). C. glabrata showed the highest mortality rate (75%), followed by C. tropicalis (57.1%) and C. albicans (54.5%). The elevated mortality rate found in this study indicates that preventive measures against candidemia must be emphasized in hospitals.(AU)

Candida spp: manual identification (reference method) and automated identification (Vitek system platform)

Yeasts are becoming a common cause of nosocomial fungal infections that affect immunocompromised patients. Such infections can evolve into sepsis, whose mortality rate is high. This study aimed to evaluate the viability of Candida species identification by the automated system Vitek-Biomerieux (Durham, USA). Ninety-eight medical charts referencing the Candida spp. samples available for the study were retrospectively analyzed. The system Vitek-Biomerieux with Candida identification card is recommended for laboratory routine use and presents 80.6% agreement with the reference method. By separate analysis of species, 13.5% of C. parapsilosis samples differed from the reference method, while the Vitek system wrongly identified them as C. tropicalis, C. lusitaneae or as Candida albicans. C. glabrata presented a discrepancy of only one sample (25%), and was identified by Vitek as C. parapsilosis. C. guilliermondii also differed in only one sample (33.3%), being identified as Candida spp. All C. albicans, C. tropicalis and C. lusitaneae samples were identified correctly.

Síndrome de Garcin relacionada a linfoma näo-Hodgkin / Garcin's syndrome related to non-Hodgkin's lymphoma

A síndrome de Garcin é rara. O objetivo deste trabalho é descrever um caso relacionado a linfoma näo-Hodgkin. Um paciente de 41 anos desenvolveu comprometimento sucessivo de múltiplos nervos cranianos. Do lado direito havia alteraçöes de todos os nervos cranianos, caracterizando a síndrome de Garcin. Exérese de linfonodo revelou linfoma näo-Hodgkin de grandes células, e observou-se infiltraçäo difusa da medula óssea. O líquido cefalorraquiano mostrou pleocitose com 100 por cento de imunoblastos. A tomografia computadorizada de crânio näo revelou massas. Esta é a primeira descriçäo clínica da síndrome de Garcin completa causada por infiltraçäo linfomatosa difusa dos nervos cranianos

Cytomorphological and immunocytochemical evaluation of fine needle aspirates from high grade non-Hodgkin's lymphomas

Fine needle aspirates from ten patients with high-grade malignant non-Hodgkin's lynmphomas were analyzed by cytomorphology and immunocytochemistry. The following morphologic diagnoses were made: lymphoblastic lymphoma (3 cases), Burkitt's lymphoma (3 cases), mixed small and large cell lymphomas with predominance of large cells (2 cases), and centroblastic lymphoma (2 cases). Immunocytochemistry showed a B-cell phenotype in five cases and a T-cell phenotype in four. One case of lymphoblastic lymphoma was negative for the T and B cell markers used.The results of histological and immunohistochemical analyses performed on surgical biopsies from 8 patients confirmed the morphological diagnosis in all cases. Two cases of Burkitt's lymphoma were submitted only to cytological and immunological diagnosis. The high diagnostic accuracy of combined cytomorphology and immunocytochemical assessmentof fine needle aspirate samples validates the use of the technique in the diagnostic work-up of high-grade non Hodgkin's lymphomas