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1.
Medicina (B.Aires) ; 81(5): 780-785, oct. 2021. graf
Article in Spanish | LILACS | ID: biblio-1351051

ABSTRACT

Resumen Se realizó un estudio retrospectivo de las infecciones fúngicas atendidas en un centro de quemados de alta complejidad situado en Buenos Aires, entre 2011 y 2014, mediante el análisis de las histo rias clínicas (n = 36). Las edades de los pacientes estuvieron entre 18 y 87 años, y 23 (63.9%) fueron mujeres. La extensión de la superficie corporal afectada más prevalente varió entre 30 y 50% (p = 0.03), y entre 71% y 100% en pacientes de menor edad, relacionándose con intentos de femicidio. En el 69.4% la profundidad de la quemadura fue grado 4, y en el 50% de los casos se observaron lesiones por inhalación, con una alta mortali dad (p = 0.04). El Candida score resultó de 3 en el 77.7% de los casos. Se usaron vías centrales y ventilación mecánica. Todos los pacientes recibieron tratamiento antibiótico y en 33 (91.7%) antifúngicos. La escisión qui rúrgica de la quemadura se practicó en 33 (91.7%) y los autoinjertos de piel en 29 (80.6%). La infección fúngica se desarrolló en una media de 21.4 días del ingreso en UCI. Se estudiaron 52 muestras de levaduras que se aislaron de urocultivo (42.3%), hemocultivo (26.9%), biopsia cutánea (9.6%), punta de catéter (15.4%) y aspirado traqueal (5.8%). Por cultivo microbiológico y métodos moleculares se identificaron a Candida albicans (53.8%), C. tropicalis (23.1%), C. parapsilosis sensu stricto (13.5%), C. krusei (5.8%), C. glabrata (1.9%) y C. dubliniensis (1.9%). Las infecciones fúngicas representan severas complicaciones en quemados con factores de riesgo.


Abstract A retrospective analysis of fungal infections was carried out in a health-care burn center between 2011 and 2014 using the patients' medical records (n = 36). Patients ranged from 18 to 87 years of age, with 23 (63.9%) being women. The most prevalent widespread total body surface area affected (TBSA) was 30-50% (p = 0.03), and 71-100% in younger patients, mainly associated with femicide. Fourth degree burns were revealed in 69.4% of the patients while in 50%, inhalation injuries were observed to represent a higher mortality rate (p = 0.04). The Candida score was 3 in 77.7% of cases respectively. Central venous catheter and mechanical ventilation were used. All patients received antibiotic treatment and 91.7% antifungal treatment. Surgical excision of the burn was performed in 33 (91.7%) patients, and skin autografting in 29 (80.6%). The median of the fungal infection devel oped was 21.4 days after admission to the ICU. The specimens analyzed involved 52 yeast samples isolated from different cultures: urine (42.3%), blood (26.9%), skin biopsy (9.6%), catheter tip (15.4%) and tracheal aspirate (5.8%). The use of microbiological culture and molecular methods allowed for the identification of Candida albicans (53.8%), C. tropicalis (23.1%), C. parapsilosis sensu stricto (13.5%), C. krusei (5.8%), C. glabrata (1.9%) and C. dubliniensis (1.9%). Fungal infections observed in skin burns lead to severe complications in at-risk patients.


Subject(s)
Humans , Female , Candida , Mycoses/drug therapy , Retrospective Studies , Risk Factors , Antifungal Agents
2.
Infectio ; 25(3): 197-199, jul.-set. 2021. graf
Article in English | LILACS, COLNAL | ID: biblio-1250093

ABSTRACT

Abstract Mycetoma is a chronic and slow-developing granulomatous disease characterized by the triad of large painless tumour-like subcutaneous swellings, the formation of sinuses, and discharge that usually contains grains. Phellinus spp. are saprophytic wood-decaying filamentous basidiomycetes. They are an under-recognised cause of invasive fungal infections and are rarely reported worldwide. We report a 59-year-old male patient with mycetoma caused by Phellinus spp. The diagnosis was confirmed with clinical examination, magnetic resonance imaging (MRI) study, soft tissue and bone biopsy culture, and polymerase chain reaction. To the best of our knowledge, this is the first reported case of mycetoma due to Phellinus spp. without chronic granulomatous disease (CGD).


Resumen El micetoma es una enfermedad granulomatosa crónica y de lento desarrollo caracterizada por la tríada de grandes inflamaciones subcutáneas similares a tumores indoloras, la formación de los senos nasales y secreción que generalmente contiene granos. Phellinus spp. son basidiomicetos filamentosos saprofitos que descomponen la madera. Son un poco reconocido causa de infecciones fúngicas invasivas y rara vez se informan en todo el mundo. Presentamos un paciente masculino de 59 años con micetoma causado por Phellinus spp. El diagnostico se confirmó con examen clínico, estudio de resonancia magnética (RM), cultivo de biopsia de tejido blando y óseo y reacción en cadena de la polimerasa. A lo mejor que sepamos, este es el primer caso reportado de micetoma debido a Phellinus spp. sin enfermedad granulomatosa crónica (EGC).


Subject(s)
Humans , Male , Middle Aged , Basidiomycota , Phellinus , Mycetoma , Brazil , Polymerase Chain Reaction , Invasive Fungal Infections , Mycoses
3.
Medicina (Ribeirão Preto) ; 54(1)jul, 2021. fig.
Article in Portuguese | LILACS | ID: biblio-1353671

ABSTRACT

RESUMO: Introdução: O gênero Candida possui alta taxa de incidência no ser humano, sendo a espécie Candida albicans a mais isolada em infecções invasivas e superficiais. Porém, tem sido relatado um aumento considerável de espécies de Candidanão-albicans em infecções fúngicas. Os óleos essenciais, por serem voláteis, podem agir como sinais de comunicação química e arma de defesa. Objetivo: Avaliar a eficácia, in vitro, dos óleos essenciais de Syzygium aromaticum e Eu-calyptus globulus na inibição do crescimento de espécies de Candida não-albicans. Métodos: Para avaliação da atividade antifúngica de S. aromaticum e de E. globulus e do efeito dos seus óleos essenciais sobre a micromorfologia das espécies Candida krusei, Candida parapsilosis e Candida glabrata, foram empregadas, nesta ordem, a técnica de difusão em ágar e de microcultivo para leveduras. Resultados: Na técnica de difusão, o óleo essencial de S. aromaticum apresentou for-mação de halo de inibição para Candida krusei, Candida parapsilosis e Candida glabrata. O óleo de E. globulus, por sua vez, não apresentou crescimento de halos de inibição em nenhuma das concentrações testadas frente às três espécies de Candida não-albicans. Todavia, com o microcultivo, ambos os óleos essenciais se provaram, in vitro, eficazes antimi-crobianos tendo apresentado estruturas indicativas de atividade antifúngica na maior concentração dos óleos e diferentes graus de destruição celular nas demais concentrações. Conclusão: Nas condições deste estudo, concluiu-se que os pro-dutos avaliados exerceram atividade antifúngica contra cepas de Candida não-albicans, destacando-se o óleo essencial de S. aromaticum que apresentou atividade antimicrobiana em ambas as metodologias. (AU)


ABSTRACT: Introduction: The genus Candida possesses a high incidence of infection in humans, with the Candida albicans species being the most isolated in invasive and superficial infections. However, a considerable increase in non-albicans Candidaspecies has been reported in fungal infections. Essential oils, for being volatile, can act as chemical communication sig-nals and defense mechanisms. Objective: Evaluate the effectiveness, in vitro, of the essential oils of Syzygium aromati-cum and Eucalyptus globulus in inhibiting the growth of non-albicans Candida species. Methods: To evaluate the antifun-gal activity of S. aromaticum and E. globulus and the effect of their essential oils on the micromorphology of the species Candida krusei, Candida parapsilosis and Candida glabrata, in this order, the agar diffusion technique and microculture for yeasts. Results: In the diffusion technique, the essential oil of S. aromaticum presented an inhibition halo for Candida krusei, Candida parapsilosis, and Candida glabrata. E. globulus oil, on the other hand, did not show inhibition halo growth in any of the concentrations tested against the three non-albicans Candida species. However, in the microculture, both essential oils have proven to be effective antimicrobials having shown structures indicative of antifungal activity in the highest concentration and different degrees of cell destruction in the other concentrations. Conclusion: In the conditions of this study, it was concluded that the products evaluated exerted antifungal activity against non-albicans Candidastrains, highlighting the essential oil of S. aromaticum that showed antimicrobial activity in both methodologies. (AU)


Subject(s)
Candida , Syzygium , Candida glabrata , Defense Mechanisms , Eucalyptus , Mycoses , Antifungal Agents
4.
Biomédica (Bogotá) ; 41(2): 240-246, abr.-jun. 2021. graf
Article in Spanish | LILACS | ID: biblio-1339263

ABSTRACT

Resumen | El síndrome verrugoso tropical comprende condiciones cutáneas infecciosas, crónicas y granulomatosas que cursan con placas, nódulos o úlceras verrugosas, de ahí su nombre. Este síndrome incluye la cromoblastomicosis, la esporotricosis, la paracoccidioidomicosis, la lobomicosis, la leishmaniasis y la tuberculosis cutánea verrugosa, todas ellas enfermedades de amplia distribución en áreas tropicales y subtropicales. Sus diagnósticos pueden ser difíciles y confundirse entre sí, lo cual es más frecuente entre la esporotricosis y la leishmaniasis. Para distinguirlas se recurre a criterios clínicos y epidemiológicos, y a métodos diagnósticos como intradermorreacción, examen directo, biopsia, cultivo, inmunofluorescencia y PCR, algunos de los cuales no son de uso común. El diagnóstico preciso conduce al tratamiento adecuado. Se presenta el caso de un hombre de 18 años con extensas placas verrugosas en una rodilla, inicialmente interpretadas como leishmaniasis verrugosa por la clínica, la epidemiología y la biopsia. Se le trató con Glucantime® durante 20 días, pero no presentó mejoría, por lo que se tomó una nueva biopsia que también se interpretó como leishmaniasis cutánea. La revisión de ambas biopsias evidenció inflamación con granulomas abscedados y presencia de cuerpos asteroides esporotricósicos, que condujeron al diagnóstico de esporotricosis, el cual se confirmó luego con el cultivo del hongo. Las lesiones remitieron con la administración de itraconazol. La clínica y la epidemiología de la leishmaniasis y las de la esporotricosis pueden ser semejantes, por lo que la biopsia y los estudios de laboratorio son esenciales para establecer el diagnóstico. El cuerpo asteroide esporotricósico es patognomónico de esta entidad. Se revisaron los conceptos esenciales de estas condiciones y los criterios para diferenciarlas.


Abstract | The tropical verrucous syndrome includes infectious, chronic, and granulomatous skin conditions appearing with plaques, nodules, or ulcers with a warty surface which gives name to the syndrome. It includes forms of chromoblastomycosis, sporotrichosis, paracoccidioidomycosis, lobomycosis, leishmaniasis, and tuberculosis verrucosa cutis with ample distribution in tropical and subtropical areas. The diagnoses may be difficult and confused among them, especially between sporotrichosis and leishmaniasis. Clinical, epidemiologic, intradermal reactions, direct smears, skin biopsies, cultures, immunofluorescence, and PCR are used to differentiate them, although several of these methods are not commonly used. We present an 18-year-old man with extensive verrucous plaques in one knee interpreted by clinic, epidemiology, and biopsy as verrucous cutaneous leishmaniasis. He was treated with Glucantime® for 20 days without improvement. A new biopsy was made that was also interpreted as cutaneous leishmaniasis. The revision of both biopsies showed inflammation with abscessed granulomas and asteroid sporotrichotic bodies at the center of the granulomas that led to the diagnosis of sporotrichosis later confirmed by the fungus culture. The patient responded to the treatment with itraconazole. As clinical and epidemiological findings of leishmaniasis and sporotrichosis can be similar, skin biopsy and other paraclinical studies are necessary to establish a proper diagnosis. The asteroid sporotrichotic body is pathognomonic of this mycosis. We review here the essential concepts of leishmaniasis and sporotrichosis and the criteria to differentiate them.


Subject(s)
Sporotrichosis , Leishmaniasis, Cutaneous , Dermatomycoses , Mycoses
5.
Medicentro (Villa Clara) ; 25(2): 315-323,
Article in Spanish | LILACS | ID: biblio-1279424

ABSTRACT

RESUMEN Se realizó un estudio descriptivo en el Hospital Universitario Clínico Quirúrgico Cmdte. «Manuel Fajardo Rivero¼, Santa Clara, Villa Clara, marzo - julio de 2020, con el objetivo de describir las infecciones bacterianas y fúngicas asociadas a la COVID-19. La población de estudio fue de 202 pacientes que permanecieron ingresados con diagnóstico confirmado de infección por SARS-CoV-2. Las variables de estudio fueron: edad, sexo, infección asociada, estado al egreso, microorganismos aislados y susceptibilidad antimicrobiana. El 7,9 % de los pacientes presentó una infección asociada; el 7,4 % falleció (la mayoría de las defunciones ocurrieron en los meses de marzo y abril, previo al establecimiento del protocolo definitivo de tratamiento de la COVID-19 en Cuba). El 60 % de los fallecidos presentaron una infección asociada. Escherichia coli fue el microorganismo más aislado. Es necesario establecer un protocolo de diagnóstico terapéutico para determinar las infecciones bacterianas y fúngicas asociadas al coronavirus.


ABSTRACT A descriptive study was carried out at "Cmdte. Manuel Fajardo Rivero" Clinical and Surgical University Hospital in Santa Clara, Villa Clara from March to July 2020, with the aim of describing bacterial and fungal infections associated with COVID-19. The study population consisted of 202 patients who remained hospitalized with a confirmed diagnosis of SARS-CoV-2 infection. Age, gender, associated infection, discharge status, isolated microorganisms, and antimicrobial susceptibility were the variables studied. The 7.9% of the patients had an associated infection; 7.4% died (most deaths occurred in March and April, prior to the establishment of the definitive protocol for the treatment of COVID-19 in Cuba). The 60% of the deceased patients had an associated infection. Escherichia coli was the most isolated microorganism. A diagnostic and therapeutic protocol is necessary to determine the bacterial and fungal infections associated with the coronavirus.


Subject(s)
Bacterial Infections , Coronavirus Infections , Coinfection , Mycoses
6.
Rev. bras. ortop ; 56(3): 390-393, May-June 2021. graf
Article in English | LILACS | ID: biblio-1288675

ABSTRACT

Abstract Spondylodiscitis is an uncommon but serious complication after spine surgeries, and its main etiologic agent is Staphylococcus aureus. Fungal infections are rare and mostly caused by Candida albicans. We report the clinical case of a 69-year-old male patient who underwent a L2-S1 arthrodesis for degenerative scoliosis correction. He presented an infection 2.5 months after the procedure, a spondylodiscitis at L5-S1 levels, caused by Candida parapsilosis. The treatment consisted of surgical material removal, tricortical iliac graft placement in an anterior approach (L5-S1), lumbopelvic fixation (from T10 to the pelvis) in a posterior approach, and drug treatment with anidulafungin and fluconazole. This last medication was administered for 12 months, with good clinical outcomes.


Resumo As espondilodiscites são complicações infrequentes, porém graves em pós-operatórios de cirurgias da coluna vertebral, tendo como principal agente etiológico o Staphylococcus aureus. As infecções fúngicas são raras, sendo a Candida albicans a principal representante desse grupo. Relatamos o caso clínico de um paciente do sexo masculino, 69 anos, operado com artrodese de L2 a S1 para correção de escoliose degenerativa. O paciente apresentou quadro clínico infeccioso 2 meses e meio após o procedimento, relacionado à espondilodiscite L5-S1, causada por Candida parapsilosis. O tratamento consistiu na remoção do material cirúrgico, colocação de enxerto tricortical de ilíaco pela via anterior (L5-S1) e fixação lombopélvica (de T10 à pelve) pela via posterior, além de iniciar o tratamento medicamentoso com anidulafungina e fluconazol, mantendo essa última medicação por 12 meses, com boa evolução clínica.


Subject(s)
Staphylococcus aureus , Discitis , Fluconazole , Candida parapsilosis , Anidulafungin , Mycoses
7.
Infectio ; 25(1): 11-15, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1154395

ABSTRACT

Resumen Objetivo: describir las características socio-demográficas, presentación clínica y condiciones extrínsecas que pueden favorecer el desarrollo de la pitiriasis versicolor. Material y métodos: estudio observacional descriptivo, de corte transversal y prospectivo, en el que se incluyeron pacientes con diagnóstico clínico y micológico de pitiriasis versicolor entre enero y diciembre de 2018, que asistieron al Hospital Universitario Centro Dermatológico Federico Lleras Acosta. Resultados: se incluyeron un total de 42 pacientes con diagnóstico de pitiriasis versicolor confirmado por examen directo, el 62% fueron hombres con una edad promedio de 33 años. La localización más común fue el tórax anterior (68%) y posterior (65%), en fototipos III y IV (78.5%), con una tonalidad hipocrómica. El 28% presentaron cuadros recurrentes, con síntomas hasta 7 años antes de la consulta. El signo de Besnier fue positivo en el 95% de los casos. El 64% refirió antecedente personal de hiperhidrosis y el 67% practicaba algún deporte como buceo, natación o gimnasia. Discusión: la identificación de las condiciones extrínsecas presentes esta población permite orientar medidas de prevención para evitar recurrencias de pitiriasis versicolor. Los viajes a lugares de clima cálido y la práctica de deportes son factores que favorecen el desarrollo de la micosis. En las formas clínicas atípicas se sugiere realizar siempre el examen micológico directo para confirmar el diagnóstico. El signo de Besnier es una maniobra útil para el diagnóstico clínico de la pitiriasis versicolor, particularmente cuando el acceso al examen directo es limitado.


Abstract Objective: to describe the sociodemographic aspects, clinical presentation and extrinsic conditions that may increase the risk of developing pityriasis versicolor. Materials and methods: a descriptive, cross-sectional and prospective observational study was conducted. Patients with clinical and mycological diagnosis of ptyriasis versicolor were included from january to december 2018 who attended to the Hospital Universitario Centro Dermatológico Federico Lleras Acosta. Results: a total of 42 patients were included in the study, all of them had confirmed mycological diagnosis of pityriasis versicolor. The most common location of the lesions was the anterior thorax (68%) and posterior thorax (65%), in III and IV phototypes (78.5%) with a hypochromic color. 28% had recurrent infection, with symptoms mean of 7 years before the consultation. The Besnier sign was positive in 95% of cases, 64% reported personal history of hyperhidrosis and 67% practiced some sports: diving, swimming and gymnastics. Discussion: recognizing extrinsic conditions that may increase the risk of developing pitiraisis versicolor in this population allows identifying control measures to prevent a relapse. The main factors involved in the development of pitiraisis versicolor were traveling to places with high temperatures and sport practice. In atypical clinical presentation it is mandatory to perform the mycological direct test to confirm the diagnosis. The Besnier sign is a useful method for the clinical diagnosis of pityriasis versicolor, particularly when access to direct examination is limited.


Subject(s)
Humans , Male , Female , Adult , Tinea Versicolor , Signs and Symptoms , Epidemiology , Colombia , Reinfection , Hyperhidrosis , Malassezia , Mycoses
8.
Journal of Experimental Hematology ; (6): 1710-1713, 2021.
Article in Chinese | WPRIM | ID: wpr-922322

ABSTRACT

OBJECTIVE@#To explore the effect of posaconazole in the primary prevention of invasive fungal disease (IFD) in the induction therapy of childhood acute lymphoblastic leukemia (ALL).@*METHODS@#From August 2018 to November 2020, 144 pediatric patients with ALL treated in Department of Pediatrics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University were selected, 88 cases received fluconazole as IFD prophylaxis (fluconazole prophylaxis group), 56 cases received posaconazole as IFD prophylaxis (posaconazole prophylaxis group). The incidence of IFD and treatment-related adverse reactions between the two groups were compared, and the safety of posaconazole was evaluated.@*RESULTS@#The incidence of IFD in the fluconazole prophylaxis group was 20.4% (18/88), and in the posaconazole prophylaxis group was 7.1% (4/56). The incidence of IFD between the two groups was statistically significant different(P=0.030). There was no serious adverse reactions in the two groups. The incidence of mild adverse reactions in the posaconazole prophylaxis group (23.2%) was lower than that in the fluconazole prophylaxis group(39.8%), and the difference was statistically significant (P=0.039). There were 12 cases died in the fluconazole prophylaxis group and 4 in the posaconazole prophylaxis group, while no significant difference in the overall survival rate between the two groups (P=0.281).@*CONCLUSION@#The effect of posaconazole in the primary prophylaxis of IFD is better and incidence of adverse reactions is lower than fluconazole. Posaconazole can be tolerated, and expected to become the first-line primary prophylaxis drug for IFD during the induction remission therapy of childhood ALL.


Subject(s)
Antifungal Agents/therapeutic use , Child , Humans , Induction Chemotherapy , Mycoses/drug therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Primary Prevention , Triazoles
9.
Journal of Experimental Hematology ; (6): 1649-1653, 2021.
Article in Chinese | WPRIM | ID: wpr-922310

ABSTRACT

OBJECTIVE@#To investigate the clinical characteristics of infection in children with acute myeloid leukemia (AML) after high intensive chemotherapy, so as to provide reference for prevention and control of infection.@*METHODS@#56 children diagnosed as acute myeloid leukemia in our hospital from January 2016 to August 2019 were enrolled and retrospectively analyzed, the infection rate, pathogens of disease and common location of infection during the induction and consolidation period were analyzed.@*RESULTS@#The total infection rate of the patients was 93.4%-96.4%, the average of serious infection rate was 16.0%(11.3%-19.6%), and the infection related mortality was 10.7%. Fever of unknown cause was the main reason of infection, while blood flow infections were the most common in severe infection, which were mainly caused by Gramnegative bacteria. The rate of fungal infection was 35.7% during chemotherapy.@*CONCLUSION@#Children with AML shows a high incidence of infection in each stage of chemotherapy. The serious illness caused by blood flow infection and take antifungal drugs to reduce the occurrence of fungal infection in AML patients should be paid attention.


Subject(s)
Antifungal Agents/therapeutic use , Child , Fever/drug therapy , Humans , Leukemia, Myeloid, Acute/drug therapy , Mycoses/drug therapy , Retrospective Studies
11.
Rev. Méd. Paraná ; 79(1): 72-74, 2021.
Article in Portuguese | LILACS | ID: biblio-1282445

ABSTRACT

A sepse de origem fúngica representa um desafio tanto no seu diagnóstico precoce quanto ao tempo hábil para o seu tratamento. A apresentação dermatológica normalmente apresenta-se a nível cutâneo e a seguir evolui para compromentimento sistêmico. Apresentaremos um relato de caso cuja hipótese inicial foi de doença linfoproliferativa e não de sepse por fungo


Fungal sepsis represents a challenge for the early diagnosis and for a acceptable time for the diagnosis. The dermatological manifestation usually presents at the cutaneous level and then evolves to systemic impairment. We will present a case report that the first clinical suspicion was lymphoproliferative disease and not fungal sepsis


Subject(s)
Humans , Male , Middle Aged , Skin Manifestations , Sepsis , Mycoses , Critical Care
12.
Rev. epidemiol. controle infecç ; 10(4): 1-11, out.-dez. 2020. ilus
Article in English | LILACS | ID: biblio-1253087

ABSTRACT

Background and Objectives: Paracoccidioidomycosis (PCM) is a systemic disease caused by the dimorphic fungus Paracoccidioides brasiliensis found in the tropical and subtropical regions of Latin America. This study aimed to perform a retrospective analysis of PCM cases from the northern region of Rio Grande do Sul, Brazil. Methods: A total of 200 records of PCM cases diagnosed at the local reference pathology laboratory from 1995 to 2015 were analyzed Results: Of the patients, 185 were male and 15 female. Patients ranged in age from 31 to 80 years, the largest pro portion ( being aged between 51 and 60 years and living or working in the countryside. Clinical samples were mostly obtained from the oral cavity, followed by the oropharynx, lungs, brain, skin, and prostate. Conclusion: PCM is endemic in the south o f Brazil, as the local economy is largely based on agricultural activities, favoring the contact of the population with P. brasiliensis . Due to the great similarity between PCM symptoms and other respiratory diseases, the differential diagnosis is essentia l for the correct treatment of the disease and to avoid its progression.(AU)


Justificativa e Objetivos: A paracoccidioidomicose (PCM) é uma doença sistêmica causada pelo fungo dimórfico Paracoccidioides brasiliensis , o qual é encontrado nas regiões tropicais e subtropicais da América Latina. Este estudo objetivou realizar uma análise retrospectiva dos casos de PCM na região nor te do Rio Grande do Sul, Brasil . Métodos: Foram anal isados 200 prontuários relativos aos casos de PCM de 1995 até 2015 diagnosticados pelo laboratório de patologia referência na região . Resultados: Destes pacientes, 185 eram homens e 15 mulheres. Os pacientes tinham idade variando de 31 a 80 anos, sendo que a maior proporção (35,5%) tinha entre 51 e 60 anos e viviam ou trabalhavam na zona rural Os materiais clínicos eram provenientes em sua maioria da cavidade oral, seguido da região orofaríngea, pulmão, cérebro, provenientes em sua maioria da cavidade oral, seguido da região orofaríngea, pulmão, cérebro, pele e próstata. pele e próstata. Conclusão: O sul do Brasil O sul do Brasil é região endêmica de PCM, devido a sua é região endêmica de PCM, devido a sua economia estar centrada na agricultura, o que propicia o contato do homem com o fungo. economia estar centrada na agricultura, o que propicia o contato do homem com o fungo. Devido à grande semelhança dos sintomas da PCM com outras doenças respiratórias, o Devido à grande semelhança dos sintomas da PCM com outras doenças respiratórias, o diagnóstico diferencial é relevante para que se diagnóstico diferencial é relevante para que seja realizado o tratamento correto da doença e ja realizado o tratamento correto da doença e para que seu avanço seja evitado. para que seu avanço seja evitado.(AU)


Justificación y objetivos: L a paracoccidioidomicosis (PCM) es una enfermedad sistémica c ausada por el hongo dimorfo Paracoccidioides brasiliensis , que se encuentra en las regiones tropicales y subtropicales de América Latina. Este estudio tuvo como objetivo realizar un análisis retrospectivo de casos de PCM en la región nor te de Rio Grande do Sul, Brasil . Métodos: se analizaron 200 registros médicos relacionados con casos de PCM de 1995 a 2015 diagnosticado s por el laboratorio de patología de referencia en la región . Resultados: De estos pacientes, 185 eran hombres y 15 mujeres. Los pacientes tenían edades comprendidas entre 31 y 80 años, con la mayor proporción (35.5%) entre 51 y 60 años y viviendo o trabajando en el campo. Los materiales clínicos provenían principalmente de la cavidad oral, seguidos de la región orofaríngea, pulmón, cerebro, piel y próstata. Conclusión: El sur de Brasil es una región endémica de PCM, debido a que su economía se centra en la agricultura, que proporciona el contacto del hombre con el hongo. Debido a la gran similitud de los síntomas de PCM con otras enfermedade s respiratorias, el diagnóstico diferencial es relevante para el tratamiento correcto de la enferm edad y para evitar su progreso.(AU)


Subject(s)
Humans , Paracoccidioidomycosis/epidemiology , Mycoses
13.
Rev. cuba. med. trop ; 72(3): e562, sept.-dic. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1156548

ABSTRACT

Introducción: La histoplasmosis es una micosis profunda o sistémica causada por un hongo dimórfico que se puede diseminar principalmente en pacientes con inmunosupresión, como los que tienen diagnóstico de virus de la inmunodeficiencia humana. El síndrome de reconstitución inmune consiste en un empeoramiento paradójico de una condición conocida o de nueva aparición después del inicio de la terapia antirretroviral. Objetivo: Describir un caso de histoplasmosis diseminada asociada a síndrome de reconstitución inmune en un paciente con infección por virus de la inmunodeficiencia humana. Caso clínico: Paciente masculino de 32 años con diagnóstico de infección por virus de la inmunodeficiencia humana, con cuadro clínico de tres semanas de evolución. Este cuadro inició posterior al comienzo de la terapia antirretroviral, que consistió en pápulo-nódulos umbilicados diseminados, con compromiso pulmonar; además, tenía histopatología y cultivo positivos para Histoplasma capsulatum sl. y prueba de antigenuria para histoplasma también positiva. Se consideró un diagnóstico de histoplasmosis diseminada con presentación cutánea, fue la expresión de un síndrome de reconstitución inmune por desenmascaramiento. Se inició manejo con anfotericina B liposomal y se mantuvo la terapia antirretroviral; posteriormente se continuó el tratamiento con itraconazol durante 12 meses con mejoría de las lesiones. Conclusiones: El diagnóstico clínico, histopatológico y microbiológico fue oportuno; el paciente presentó una adecuada respuesta al tratamiento. Esta es una micosis curable e incluso prevenible, si se diagnostica a tiempo, se inicia tratamiento precoz y se mantiene la terapia retroviral(AU)


Introduction: Histoplasmosis is a deep or systemic mycosis caused by a dimorphic fungus which may disseminate mainly in immunocompromised patients, such as those diagnosed with human immunodeficiency virus. Immune reconstitution syndrome is a paradoxical worsening of a known condition or a condition appearing after the start of antiretroviral therapy. Objective: Describe a case of disseminated histoplasmosis associated to immune reconstitution syndrome in a patient with human immunodeficiency virus infection. Case report: A case is presented of a male 32-year-old patient diagnosed with human immunodeficiency virus with a clinical status of three weeks' evolution. The current status developed after the start of antiretroviral therapy. It consisted in disseminated umbilicated papular nodules with pulmonary involvement, as well as positive Histoplasma capsulatum sl. histopathology and culture, and a positive histoplasma antigen test. A diagnosis of disseminated histoplasmosis with a cutaneous presentation was considered. It was the expression of immune reconstitution syndrome by unmasking. Treatment was started with liposomal amphotericin B, maintaining the antiretroviral therapy. Management was then continued with itraconazole for 12 months with improvement of the lesions. Conclusions: Timely clinical, histopathological and microbiological diagnosis was performed. The patient displayed an adequate response to treatment. This mycosis is curable and even preventable when a diagnosis is made in time, treatment is started early and the retroviral therapy is maintained(AU)


Subject(s)
Humans , Skin Diseases , HIV , Immune Reconstitution Inflammatory Syndrome/complications , Mycoses , Histoplasmosis/etiology
14.
Rev. cuba. med. trop ; 72(3): e532, sept.-dic. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1156544

ABSTRACT

Introducción: En la actualidad las infecciones fúngicas representan un problema para la salud humana. Las infecciones causadas por especies patógenas de hongos registran un incremento constante y se ubican entre el cuarto y décimo lugar como causa de muerte, particularmente en las unidades de cuidado intensivo. Un diagnóstico adecuado y precoz impacta directamente en la morbilidad y mortalidad asociadas a estas. Objetivo: Describir las principales técnicas de diagnóstico no convencional de las enfermedades fúngicas más frecuentes, en especial las relacionadas con el diagnóstico serológico y molecular. Métodos: Se realizó una revisión de la literatura científica sobre el tema, publicada entre 2000 y 2019. Se revisaron un total de 63 trabajos. Como motores de búsqueda se emplearon Google y Google Scholar. Se revisaron las bases de datos Medline, PubMed, Science Direct, BUCea y SciELO. Análisis y síntesis de la información: Las técnicas serológicas se emplean en el diagnóstico de las micosis invasivas o sistémicas por ser fáciles, rápidas y confiables. La detección de anticuerpos tiene utilidad limitada en el diagnóstico de las micosis invasivas debido a que la respuesta puede estar retrasada, reducida o no existir en pacientes inmunocomprometidos. La detección de componentes no antigénicos liberados por los hongos durante la infección y la secuenciación de ácidos nucleicos fúngicos son otras opciones para el diagnóstico de las micosis. Conclusiones: El desarrollo biotecnológico aporta nuevas herramientas que incrementan las oportunidades de identificación de las micosis. En la actualidad se disponen de métodos basados tanto en la detección de marcadores inmunológicos como de elementos moleculares específicos. La eficacia de las herramientas no convencionales para el diagnóstico depende de la correcta combinación de estas(AU)


Introduction: Fungal infections are a current human health problem. Infections caused by pathogenic fungal species constantly increase in number, and are ranked between the fourth and tenth leading causes of death, particularly in intensive care units. Early accurate diagnosis has a direct impact on the morbidity and mortality of fungal infections. Objective: Describe the main non-conventional diagnostic techniques for the most common fungal diseases, especially those related to serological and molecular diagnosis. Methods: A review was conducted of the scientific literature about the topic published between the years 2000 and 2019. A total 63 publications were reviewed. The search engines used were Google and Google Scholar. The databases Medline, PubMed, Science Direct, BUCea and SciELO were reviewed. Data analysis and synthesis: Serological techniques are used for the diagnosis of invasive or systemic mycoses because they are easy, fast and reliable. The detection of antibodies has a limited usefulness in invasive mycosis diagnosis, for the response may be delayed, reduced or inexistent in immunocompromised patients. Detection of non-antigenic components released by fungi during infection and sequencing of fungal nucleic acids are other mycosis diagnosis options. Conclusions: Biotechnological development contributes new tools increasing mycosis identification opportunities. Methods are currently available which are based on detection of immunological markers and specific molecular elements. The efficacy of non-conventional diagnostic tools depends on their appropriate combination(AU)


Subject(s)
Humans , Molecular Diagnostic Techniques/methods , Mycoses/diagnosis , Mycoses/mortality , Clinical Laboratory Techniques/methods
15.
Rev. cuba. med. mil ; 49(3): e456, jul.-set. 2020. fig
Article in Spanish | LILACS, CUMED | ID: biblio-1144486

ABSTRACT

Introducción: La aspergilosis es una infección micótica oportunista que se presenta fundamentalmente en pacientes inmunodeprimidos y su principal fuente de transmisión lo constituyen las esporas presentes en el aire de salones de operaciones y unidades de cuidados intensivos. Objetivo: Presentar un caso de una micosis pulmonar masiva por una variante angioinvasiva de Aspergillus. Caso clínico: Se presenta un paciente con aspergilosis pulmonar grave, diagnosticada después de la resección de un tumor mediastinal. Se describen las características de la primera intervención, la evolución postoperatoria que condujo a la segunda, se muestran las imágenes tomográficas, quirúrgicas, microbiológicas y anátomo-patológicas que permitieron definir el diagnóstico. Conclusiones: La posibilidad de una micosis pulmonar debe tenerse en cuenta, aun cuando sea una afección rara y de manejo difícil, en pacientes inmunodeprimidos, con condensación pulmonar rebelde al tratamiento(AU)


Introduction: Aspergillosis is an opportunistic fungal infection that occurs mainly in immunosuppressed patients and its main source of transmission is the spores present in the air of operating rooms and intensive care units. Objective: To present a case of a massive pulmonary mycosis due to an angioinvasive variant of Aspergillus. Clinical case: A patient with severe pulmonary aspergillosis, diagnosed after resection of a mediastinal tumor, is presented. The characteristics of the first intervention are described, the postoperative evolution that led to the second one, the tomographic, surgical, microbiological and anatomo-pathological images that allowed to define the diagnosis are shown. Conclusions: The possibility of a pulmonary mycosis should be taken into account, even when it is a rare and difficult-to-handle condition, in immunocompromised patients, with pulmonary condensation that is rebellious to treatment. Aspergillosis is an opportunistic fungal infection that occurs mainly in immunosuppressed patients and its main source of transmission is the spores present in the air of operating rooms and intensive care units(AU)


Subject(s)
Humans , Male , Adult , Pulmonary Aspergillosis/drug therapy , Mycoses , Necrosis/diagnostic imaging , Teratocarcinoma/surgery , Teratocarcinoma/therapy , Invasive Pulmonary Aspergillosis/complications , Lung/pathology
17.
São Paulo; SMS; 22/06/2020. 37 p. ilus, mapa, tab.
Monography in Portuguese | ColecionaSUS, LILACS, ColecionaSUS, SMS-SP, COVISA-Producao, SMS-SP | ID: biblio-1102196

ABSTRACT

A Esporotricose é uma infecção fúngica de implantação, subaguda ou crônica, causada por fungo do complexo Sporothrix schenkii. No Brasil, a espécie mais frequente é S.brasiliensis. No município de São Paulo, em 2011, foram identificados os primeiros casos de esporotricose em felinos e em humanos, na região de Itaquera, na Coordenadoria Regional de Saúde Leste. A partir de 2018, houve um aumento significativo do número de casos em felinos, acompanhado do aumento de casos humanos. Esta Nota técnica, elaborada pela Coordenadoria de Vigilância em Saúde de São Paulo, tem como objetivo orientar a vigilância e o manejo clínico da esporotricose humana no município de São Paulo. O documento aborda a situação epidemiológica da esporotricose no município de São Paulo, o agente etiológico, as formas de transmissão, as manifestações clínicas, os diagnósticos diferenciais, o diagnóstico laboratorial, o tratamento, o prognóstico e as definições de casos suspeito e confirmado, além dos fluxos de atendimento e vigilância epidemiológica de esporotricose humana na cidade e da orientação para coleta e armazenamento de amostras para envio ao laboratório.


Subject(s)
Humans , Sporotrichosis , Public Health/methods , Epidemiology/standards , Sporotrichosis/diagnosis , Sporotrichosis/prevention & control , Clinical Laboratory Techniques , Delivery of Health Care , Mycoses
18.
Rev. bras. med. trab ; 18(1): 103-108, jan-mar.2020.
Article in Portuguese | LILACS | ID: biblio-1116154

ABSTRACT

Introdução: Fatores de risco associados ao trabalho podem causar, entre outros, câncer de colo uterino. Objetivo: Identificar na literatura especializada a associação entre câncer de colo de útero e a exposição aos fatores ocupacionais de risco. Métodos: Realizou-se um levantamento bibliográfico em bases de dados eletrônicos com os seguintes descritores: câncer de colo uterino e riscos ocupacionais. Resultados: Trabalhadores expostos ao tabaco nas fábricas de cigarro, fluidos de motores, exposição ocupacional a fungos e bactérias e ao tetracloroetileno, presente em produtos de limpeza usados em lavanderias e para desengraxar metais, estariam mais susceptíveis ao desenvolvimento de câncer de colo uterino. Conclusão: Há poucos estudos que identificam a relação entre o câncer de colo de útero e os fatores de risco ocupacional, dificultando a associação entre o carcinogênese e o fator de risco.


Background: Occupational risk factors are associated with many types of neoplasms including cervical cancer. Objective: To review the specialized literature for evidence on the relationship between cervical cancer and exposure to occupational hazards. Methods: Literature search in electronic databases using keywords cervical cancer and occupational risk. Results: Workers occupationally exposed to tobacco, fungi or bacteria, metalworking fluids and tetrachloroethylene used in dry cleaning and for metal degreasing exhibited higher susceptibility to cervical cancer. Conclusion: Few studies sought to investigate relationships between cervical cancer and occupational hazards, which hinders the attempts at establishing a causal link.


Subject(s)
Humans , Female , Occupational Risks , Uterine Cervical Neoplasms/etiology , Occupational Diseases/etiology , Solvents/adverse effects , Tetrachloroethylene/adverse effects , Bacterial Infections/complications , Risk Factors , Tobacco Products/adverse effects , Mycoses/complications
19.
Rev. bras. med. fam. comunidade ; 15(42): 1939-1939, 20200210. ilus
Article in Portuguese | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1097398

ABSTRACT

Introdução: Cidades litorâneas possuem atividades econômicas como a pesca e o turismo que promovem o contato com a água do mar e, consequentemente, a exposição a microrganismos raramente encontrados em outros contextos e muitas vezes de diagnóstico tardio, podendo resultar em morbidade ou morte significativa. Objetivo: Essa revisão da literatura objetiva mostrar a importância da suspeição da infecção marinha na Atenção Primária, sua etiologia, manifestações clínicas, tratamento, complicações e prevenção. Métodos: Foi realizada pesquisa em bases de dados eletrônicos (SciELO, Google Acadêmico, MEDLINE e PubMed). Resultados: Foram encontrados 135 artigos e vinte foram selecionados, referentes aos anos de 2003 a 2018. Observou-se escassez de estudos que avaliam a efetividade de esquemas de antibioticoterapia e sua duração necessária. Além disso, verificou-se a ausência de classificação no Código Internacional de Doenças (CID-10) e Descritores em Ciências da Saúde (DeCS), fato que prejudica a notificação e estudos epidemiológicos sobre o assunto. Conclusão: É preciso incluir a infecção marinha no diagnóstico diferencial de casos de ferimentos crônicos de difícil diagnóstico, principalmente se houver histórico de exposição a ambiente marinho. Novos estudos se fazem necessários para avaliação da terapêutica adequada. Outrossim, é fundamental conscientizar a população quanto ao risco de infecção marinha e seus métodos de prevenção.


Introduction: Coastal cities have economic activities such as fishing and tourism that promote contact with sea water and consequent exposure to microorganisms rarely found in other contexts. Too often, late diagnosis can result in significant morbidity or death. Objective: This review of the literature aims to show the importance of the differential diagnosis of marine infection in primary care, its etiology, clinical manifestations, treatment, complications and prevention. Methods: Electronic databases (SciELO, Google Scholar, MEDLINE and PubMed) were searched. Results: 135 articles were found and twenty were selected, referring to the years 2003 to 2018. A shortage of studies evaluating the effectiveness of antibiotic therapy regimens and their necessary duration was observed. In addition, the absence of the International Code of Diseases (ICD-10) and Descriptors in Health Sciences (DeCS) was observed, which is detrimental to the epidemiological notification and study on the subject. Conclusion: It is necessary to include marine infection in the differential diagnosis of cases of chronic injuries difficult to diagnose, especially if there is a history of exposure to the marine environment. Further studies are needed to evaluate the appropriate therapy. It is also essential to educate the population about the risk of marine infection and methods of prevention.


Introducción: Las ciudades costeras tienen actividades económicas como la pesca y el turismo que promueven el contacto com la agua del mar y consecuentemente la exposición a microorganismos raramente encontrados em otros contextos y muchas veces de diagnóstico tardío, pudiendo resultar em morbilidad o muerte significativa. Objetivo: Esta revisión de la literatura objetiva mostrar la importancia de la sospecha de la infección marina en la atención primaria, su etiología, manifestaciones clínicas, tratamiento, complicaciones y prevención. Método: Se realizo investigación en bases de datos electrónicos (SciELO, Google Académico, MEDLINE y PubMed). Resultados: Se encontraron 135 artículos y veinte fueron seleccionados, referentes a los años de 2003 a 2018. Se observo escasez de estudios que evalúan la efectividad de esquemas de antibioticoterapia y suduración necesaria. Además, se verifico la ausencia de clasificación en el Código Internacional de Enfermedades (CID-10) y Descriptores em Ciencias de La Salud (DeCS), hecho que perjudica la notificación y estudio epidemiológicos sobre el tema. Conclusión: Es necesario incluir la infección marina em el diagnóstico diferencial de casos de lesiones crónicas de difícil diagnóstico, principalmente si hayun historial de exposición al ambiente marino. Los nuevos estudios se hacen necesarios para evaluar la terapéutica adecuada. También es fundamental concientizar a la población encuanto al riesgo de infección marina y sus métodos de prevención.


Subject(s)
Humans , Bacterial Infections , Marine Environment , Infections , Mycoses , Occupational Health
20.
Rev. chil. infectol ; 37(1): 77-81, feb. 2020. graf
Article in Spanish | LILACS | ID: biblio-1092725

ABSTRACT

Resumen Los episodios de neutropenia febril son cuadros graves, que requieren un estudio etiológico exhaustivo y un inicio rápido de antimicrobianos. Dentro de los posibles microorganismos causales se encuentran los de origen fúngico, los que, dependiendo de su grado de invasión tisular, pueden llegar a presentar una alta mortalidad. Presentamos el caso de un niño con una leucemia mieloide aguda, que tras su quimioterapia de inducción, presentó un episodio de neutropenia febril, con una infección rino-sinusal por Exserohilum rostratum, hongo filamentoso que raramente se asocia a cuadros patológicos. Se inició rápidamente terapia antifúngica, lo cual, asociado a un aseo quirúrgico precoz, lograron una respuesta clínica favorable, sin complicaciones. Luego del seguimiento, y tras recibir profilaxis secundaria durante los episodios de neutropenia, no ha vuelto a presentar nuevas lesiones ni compromiso rino-sinusal.


Abstract The episodes of febrile neutropenia are severe cases that require an exhaustive etiological study and a quick start of antimicrobial agents. Within the possible microorganisms, fungal origins are also found, and depending on its tissue invasion, they can reach a high mortality rate. A case of a pediatric patient who suffered from acute myeloid leukemia is reported, and after his induction chemotherapy, the patient showed an episode of febrile neutropenia, which matches a rhinosinusal infection caused by Exserohilum rostratum, a filamentous fungi that is uncommonly associated with pathological cases. An antifungal therapy and an early surgical treatment were started, which lead to a positive response, without complications to the patient. After the monitoring and receiving secondary prophylaxis during the episodes of neutropenia, the patient hasn't presented new injuries nor rhinosinusal damage.


Subject(s)
Humans , Child , Ascomycota/isolation & purification , Sinusitis/complications , Sinusitis/microbiology , Sinusitis/drug therapy , Leukemia, Myeloid, Acute/complications , Mycoses/complications , Mycoses/drug therapy , Antifungal Agents/therapeutic use , Treatment Outcome , Neutropenia/etiology
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