Investigação clínica e comparação do esfregaço sanguíneo e PCR para diagnóstico de hemoparasitas em equinos de esporte e tração (carroceiros) / Clinical investigation and comparison of blood smear and PCR to diagnose haemoparasites in Sports Horses and Traction Horses (Cart Horses)

Na clínica médica de equinos, explora-se o perfil hematológico do animal, geralmente, com a finalidade de encontrar alterações que não foram constatadas ao exame clínico. A pesquisa de hematozoários em equinos, muitas vezes, apresenta resultados conflitantes entre o quadro clínico apresentado pelo animal e o resultado laboratorial, levantando a hipótese de que a técnica de pesquisa de hematozoários seja a responsável por falhas diagnósticas. Este estudo visa comparar os valores obtidos em exames hematológicos de 15 equinos de esporte e 15 equinos de tração (carroceiros), levando-se em consideração diferenças como características nutricionais, estado de higidez e tipo de atividade realizada, e comparar as diferentes técnicas de pesquisa de hematozoários, como esfregaço sanguíneo e PCR. Verificou-se que apenas os equinos de tração apresentaram valores médios de hemácias, hematócrito e hemoglobina abaixo do considerado fisiológico para a espécie, embora 100% dos animais, de ambos os grupos experimentais, tenham sido considerados positivos para hemoparasitoses por PCR. Verifica-se a superioridade do método de pesquisa de hemoparasitas por PCR, em comparação com esfregaço sanguíneo, realizado por diferentes técnicas, visto que apenas 33,3% dos animais foram considerados positivos para Theileria equi por esta técnica, enquanto que o PCR revelou 100% de positividade, para Theileria equi, Babesia caballi e infecção mista. Nenhum dos animais estudados foi diagnosticado com Anaplasma phagocytophilum (Ehrlichia equi) e Ehrlichia risticcii (Neoricketsia risticii). Verifica-se, então, que muitos dos diagnósticos de ausência de hemoparasitose por exame hematológico e ou esfregaço sanguíneo são errôneos, devido à baixa sensibilidade da técnica e podem repercutir em falha no tratamento ou disseminação dos hemoparasitos e das hemoparasitoses. Ressalta-se, então, a importância de exames como o PCR na elaboração de diagnóstico definitivo.(AU)

The blood profile is usually explored in equine medicine to find changes not detected through clinical examination. The haematozoa search in horses, often presents conflicting results between the clinical picture presented by the animal and the laboratory result, raising the hypothesis that the hematozoa search technique is responsible for diagnostic failures. Thus, this study aims to compare the values obtained from blood tests in 15 sports horses and 15 traction horses (cart horses), taking into account differences such as nutritional characteristics, state of health and type of activity performed, and to compare the different techniques with hematozoa search, as blood smear and PCR. It was found that only the traction horses showed mean values of red blood cells, hematocrit and hemoglobin below the considered physiological for the species, although 100% of the animals of both experimental groups were considered positive for hemoparasitoses by PCR. It was verified the superiority of hemoparasites search method by PCR, compared with blood smear performed by different techniques, since only 33.3% of the horses were considered positive for Theileria equi by this technique, while the PCR showed 100% positive for Theileria equi, Babesia caballi and mixed infection. None of the animals studied was diagnosed with Anaplasma phagocytophilum (Ehrlichia equi) and Ehrlichia risticcii (Neoricketsia risticii). It is shown that many cases of hemoparasitosis absence of diagnostic by hematological exams and or blood smears are erroneous due to the low sensitivity of the technique and may impact on treatment failure or spread of blood parasites and hemoparasitoses. It is noteworthy to stres the importance of tests such as PCR for the definitive diagnosis.(AU)

Leishmanasis mucocutánea tratada con miltefosine / Mucocutaneous leishmaniasis treated with miltefosine

El miltefosine (Impávido(r)) es un medicamento de componente antineoplásico que ha encontrado efectividad muy alta contra la leishmaniasis mucocutánea y visceral en el mundo, y se ha convertido en una opción muy atractiva para pacientes con enfermedades de fondo y tratamientos de base que contraindican el uso de amoniato de meglumina (Glucantime(r)) o stibogluconato de sodio (Pentostam(r)). Seguidamente se presenta el caso de un paciente de 78 años con antecedentes de diabetes mellitustipo 2, hipertenso, anticoagulado con warfarina por una fibrilación auricular crónica, que inició una dermatosis ulcerosa de bordes violáceos elevados, única en el hélix del oído derecho, de evolución crónica asociada a múltiples ulceraciones en la mucosa nasal. La biopsia cutánea se reportó como inespecífica, pero como la sospecha clínica era alta de leishmaniasis, se realizó una reacción de cadena polimerasa de tejido de mucosa nasal que fue reportada positiva por Leishmania panamensis. Por las comorbilidades y el tratamiento del paciente se decidió tratarlo con miltefosine (Impávido(r)).

Miltefosine (Impavido(r)) is an anticancer medicine that has been found highly effective against mucocutaneous and visceral leishmaniasis worldwide, making it a very attractive option for patients with underlying diseases and treatments that contraindicate the use of glucamine antimoniate (Glucantime(r)) or sodium stibogluconate (Pentostam(r)). Here we present the case of a 78 years old male, with a history of type 2 diabetes mellitus, high blood preasure, anticoagulated with warfarin for chronic atrial fibrillation, who started with a solitary cutaneous ulcer of purplish edges on the right ear helix of chronic evolution associated with multiple ulcerations on the nasal mucosa. Skin biopsy was reported as nonspecific, but as clinical suspicion of leishmaniasis was high, a polymerase chain reaction of nasal mucosa tissue was performed for Leishmania with positive results for Leishmania panamensis. Due to comorbidities and the treatment of our patient we decided to use miltefosine (Impavido(r)) for 2 months with very good results.

A Case of Primary Lid Tuberculosis after Upper Lid Blepharoplasty

Primary lid tuberculosis after lid surgery is a very rare condition and is likely caused by the introduction of bacilli through epithelial injury. Secondary infection, due to direct hematogenous spread or contiguous spread from adjacent structures are more common presentations of lid tuberculosis. The authors experienced a case of primary lid tuberculosis occurring in a 19 year old female after blepharoplasty for making a eyelid crease. Her upper lid skin showed a reddish and non-tender mass lesion measured 3x1 cm, which was diagnosed as the tuberculosis through typical histopathological findings (caseous necrosis), acid-fast bacilli stain and PCR, and treated with anti-tuberculosis medications.

Polymerase Chain Reaction in the Diagnosis of Infectious Endophthalmitis

PURPOSE: We evaluated the efficacy of the PCR which is known as more sensitive method than culture in the diagnosis of causal microorganisms of the infective endophthalmitis. METHODS: We used 0.3 ml of aqueous humor and 0.5 ml of vitreous sample in 3 cases of postoperative and 1 case of endogenous endophthalmitis for detecting causal microorganisms. To detect the bacteria we used universal, Gram positive and negative primers, and to detect the fungus we used fungal primer. RESULTS: Three cases of endophthalmitis, there was no bacteria in the bacterial culture for 10 days but PCR results identified causal microorganisms in all cases. CONCLUSIONS: PCR is effective in the fast and accurate diagnosis of infective endophthalmitis and especially in the culture-negative endophthalmitis.

DRB PCR-Single-Strand Coaformation Polymorphism Analysis of HLA-DR / 中国输血杂志

DRB alleles of 10 different HLA-DR individuals tested by serology typing were studied with polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) analysis, single-strand DNA of different sequence exhibited specific band patterns and mobilities by this technique. Our results suggested that PCR-SSCP is expected to be a useful tool for donor-recipient DRB allele HLA-matching in organ transplantation, as well as identification of criminal in forensic medicine.