ABSTRACT
Introducción: El síndrome cardiopulmonar por hantavirus (SCPH) es una enfermedad infecciosa aguda, caracterizada por insuficiencia cardio-respiratoria súbita y alta mortalidad, causada por un virus ARN del género Hantavirus, familia Bunyaviridae. Un 15 por ciento de los casos chilenos ha sido pesquisado en la Araucanía. Objetivo: Conocer en casos fatales de SCPH, sus características clínicas y morfológicas. Material y Método: Estudio descriptivo-retrospectivo de siete casos fatales con examen postmortem, de SCPH, atendidos entre 1997 y 2009 en el Hospital Regional de Temuco. Resultados: Los casos fueron principalmente pacientes jóvenes, rurales, con un cuadro de compromiso respiratorio progresivo, con leucocitosis, trombopenia e infiltrado pulmonar intersticial bilateral. Los principales hallazgos histopatológicos fueron un acentuado edema pulmonar intra-alveolar e intersticial, con escaso daño epitelial e infiltrado mono-nuclear y leve edema miocárdico con infiltrado mononu-clear. Conclusiones: Los antecedentes epidemiológicos, clínicos y laboratorio permiten sospechar SCPH. En los casos fatales la autopsia permite diferenciar el SCPH de otras patologías similares y aporta tejidos para confirmar el diagnóstico.
Introduction: Hantavirus cardiopulmonary syndrome (HCPS) is an acute infectious disease characterized by sudden cardiorespiratory failure and high mortality, caused by a RNA virus of the genus Hantavirus, family Bunyaviridae, 15 percent of Chilean cases have been detected in the Araucania Region. Objective: To determine in fatal cases of HCPS, clinical and morphological characteristics. Materials and Methods: Descriptive-retrospective analysis of seven fatal cases with postmortem study of HCPS, attended between 1997 and 2009 at the Hospital of Temuco, Chile. Results: Cases were young patients from rural areas, and presented as an illness of progressive respiratory failure, with leukocytosis, thrombocytopenia and bilateral interstitial pulmonary infiltrates. Main morphological findings were marked intersticial and intraalveolar pulmonary edema, with minimal epithelial injury and mononuclear cell intersticial infiltrate and mild edematous intersticial inflamatory process. Conclusions: Epidemiological, clinical and laboratory background allow to suspect HCPS. In fatal cases, the autopsy makes possible to discard other similar pathologies and provide tissue for confirmation of the disease.
Subject(s)
Adult , Child, Preschool , Female , Humans , Male , Middle Aged , Hantavirus Pulmonary Syndrome/pathology , Autopsy , Chile/epidemiology , Fatal Outcome , Hantavirus Pulmonary Syndrome/epidemiology , Orthohantavirus/immunology , Lung/ultrastructureABSTRACT
The aim of this study was to inventory the species of small mammals in Uberlândia, Minas Gerais, Brazil, based on regurgitated pellets of the barn owl and to compare the frequency of rodent species in the diet and in the environment. Since in the region there is a high incidence of hantavirus infection, we also evaluate the importance of the barn owl in the control of rodents that transmit the hantavirus. Data on richness and relative abundance of rodents in the municipality were provided by the Centro de Controle de Zoonoses, from three half-yearly samplings with live traps. In total, 736 food items were found from the analysis of 214 pellets and fragments. Mammals corresponded to 86.0 percent of food items and were represented by one species of marsupial (Gracilinanus agilis) and seven species of rodents, with Calomys tener (70.9 percent) and Necromys lasiurus (6.7 percent) being the most frequent. The proportion of rodent species in barn owl pellets differed from that observed in trap samplings, with Calomys expulsus, C. tener and Oligoryzomys nigripes being consumed more frequently than expected. Although restricted to a single place and based on few individuals, the present study allowed the inventory of eight species of small mammals in Uberlândia. The comparison of the relative frequencies of rodent species in the diet and in the environment indicated selectivity. The second most preyed upon species was N. lasiurus, the main hantavirus reservoir in the Cerrado biome. In this way, the barn owl might play an important role in the control of this rodent in the region, contributing to the avoidance of a higher number of cases of hantavirus infection.
O objetivo deste estudo foi inventariar as espécies de pequenos mamíferos em Uberlândia, Minas Gerais, Brasil, com base em pelotas regurgitadas de suindara e comparar a freqüência das espécies de roedores na dieta e no ambiente. Como na região ocorre grande incidência de casos de hantavirose, também se avaliou a importância da suindara no controle de roedores que transmitem o hantavírus. Os dados de riqueza e abundância relativa de roedores no município foram fornecidos pelo Centro de Controle de Zoonoses, a partir de três amostragens semestrais com armadilhas. No total, foram encontrados 736 itens alimentares a partir da análise de 214 pelotas e fragmentos de regurgitação. Os mamíferos corresponderam a 86,0 por cento dos itens alimentares e estiveram representados por uma espécie de marsupial (Gracilinanus agilis) e sete espécies de roedores, sendo os mais freqüentes Calomys tener (70,9 por cento) e Necromys lasiurus (6,7 por cento). A proporção das espécies de roedores nas pelotas da suindara diferiu daquela observada nas coletas com armadilhas, sendo que as espécies Calomys expulsus, C. tener e Oligoryzomys nigripes foram consumidas com maior freqüência do que o esperado. Apesar de restrito a um único local e baseado em poucos indivíduos, o presente estudo permitiu inventariar oito espécies de pequenos mamíferos em Uberlândia. A comparação da freqüência relativa das espécies de roedores na dieta e no ambiente indicou a existência de seletividade. A segunda espécie mais predada foi N. lasiurus, o principal reservatório de hantavírus no bioma Cerrado. Desta forma, a suindara parece desempenhar um importante papel no controle desse roedor na região, contribuindo para evitar um maior número de casos de hantavirose.