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1.
Braz. j. infect. dis ; 4(2): 100-2, apr. 2000. ilus
Artículo en Inglés | LILACS | ID: lil-278696

RESUMEN

When present for a first time blood donation, a 28-year-old Brazilian white female reported a pruritic eczema of the scalp and retroauricular areas since childhood that had been frequently infected. Her mother had been diagnosed as having HTLV-I-associated myelopathy (HAM), and the patient was found to be a human T-lymphotropic virus type-I (HTLV-I) carrier. The patient had been breast-fed for 6 months. The patient had a complete examination, and a biopsy was taken from eczema in the retroauricular area. The byopsy indicated chronic lymphohistiocytic dermatitis with no abnormal lymphocystes. Eleven months later, the patient had an infliltration in the skin of the retroauricular area and a new biopsy revealed atypical lymphocytes. Nested polymerase chain reaction (PCR) was positive for HTLV-I and immunohistochemistry of the tissue at this time confirmed adult T-cell leukemia/lymphoma (ATLL). Retrospective immunohistochemistry showed that the first fragment submitted from the biopsy 11 months before was also compatible with the diagnosis of ATLL. This case fulfilled all major criteria for diagnosis of HTLV-I-associated infective dermatitis (HTLV-I-ID). We postulate that the patient has indolent ATLL associated with HTLV-I infective dermatitis since childhood. We recommended that tissue immunohistochemistry analysis be done in any patient with HTLV-associated infective dermatitis.


Asunto(s)
Humanos , Femenino , Adulto , Antivirales/uso terapéutico , Dermatitis/diagnóstico , Dermatitis/tratamiento farmacológico , Virus Linfotrópico T Tipo 1 Humano/efectos de los fármacos , Infecciones por HTLV-I/diagnóstico , Infecciones por HTLV-I/tratamiento farmacológico , Leucemia-Linfoma de Células T del Adulto/diagnóstico , Eccema/diagnóstico , Reacción en Cadena de la Polimerasa
2.
Rev. Inst. Med. Trop. Säo Paulo ; 41(1): 27-32, Jan.-Feb. 1999. tab
Artículo en Inglés | LILACS | ID: lil-236722

RESUMEN

The medical records of patients with AIDS admitted to a general hospital in Brazil from 1989 to 1997 were reviewed retrospectively with the aim at defining the frequency and etiology of fever of undetermined origin (FUO) in HIV-infected patients of a tropical country and to evaluate the usefulness of the main diagnostic procedures. 188 (58.4 percent) out of 322 patients reported fever at admission to hospital and 55 (17.1 percent) had FUO. Those with FUO had a mean CD4+ cell count of 98/ml. A cause of fever was identified for 45 patients (81.8 percent). Tuberculosis (32.7 percent), Pneumocystis carinii pneumonia (10.9 percent), and Mycobacterium avium complex (9.1 percent) were the most frequent diagnoses. Other infectious diseases are also of note, such as cryptococcal meningitis (5.5 percent), sinusitis (3.6 percent), Salmonella-S. mansoni association (3.6 percent), disseminated histoplasmosis (3.6 percent), neurosyphilis (1.8 percent), and isosporiasis (1.8 percent). Four patients had non-Hodgkin's lymphoma (7.3 percent). We conclude that an initial aggressive diagnostic approach should be always considered because biopsies (lymph node, liver and bone marrow) produced the highest yield in the diagnosis of FUO and the majority of the diagnosed diseases are treatable. The association of diseases is common and have contributed to delay the final diagnosis of FUO in most cases. In our study area the routine request of hemocultures for Salmonella infection and the investigation of cryptococcal antigen in the serum should be considered.


Asunto(s)
Humanos , Fiebre de Origen Desconocido/etiología , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Síndrome de Inmunodeficiencia Adquirida/patología , Fiebre de Origen Desconocido/diagnóstico , Infecciones Oportunistas Relacionadas con el SIDA/sangre , Estudios Retrospectivos , Síndrome de Inmunodeficiencia Adquirida/sangre , Técnicas y Procedimientos Diagnósticos
3.
Rev. Inst. Med. Trop. Säo Paulo ; 40(6): 383-5, Nov.-Dec. 1998.
Artículo en Inglés | LILACS | ID: lil-228040

RESUMEN

Os autores relatam o caso de um jovem com piomiosite tropical grave, eosinofilia e hiperimunoglobulinemia E. O paciente relatou historia de contato com um cao e o teste de ELISA para Toxocara canis revelou-se positivo. O Staphylococcus aureus foi a unica bacteria isolada da secrecao purulenta obtida dos abscessos musculares. Sugere-se que a piomiosite tropical possa ser iniciada pela presenca das larvas desse ou de outros parasitos com tropismo para os musculos. As alteracoes imunologicas e estruturais nos musculos acometidos pelas larvas e a presenca de bacteriemia podem favorecer a instalacao da bacteria e o desenvolvimento da piomiosite


Asunto(s)
Humanos , Animales , Adolescente , Perros , Enfermedades Transmisibles/parasitología , Larva Migrans Visceral/diagnóstico , Piodermia/parasitología , Absceso/etiología , Edema/etiología , Ensayo de Inmunoadsorción Enzimática , Eritema/etiología , Fiebre/etiología , Estudios de Seguimiento , Larva Migrans Visceral/sangre , Larva Migrans Visceral/parasitología , Músculos/parasitología , Miositis/parasitología , Dolor/etiología
4.
Rev. Inst. Med. Trop. Säo Paulo ; 40(4): 233-5, July-Aug. 1998.
Artículo en Inglés | LILACS | ID: lil-225881

RESUMEN

Apresentam-se os casos de dois jovens com bacteriemia por Salmonella associada a esquistossomose mansoni ativa em pacientes com a sindrome da imunodeficiencia adquirida. A apresentacao clinica incluiu sintomas e sinais inespecificos como fadiga, perda de peso, diarreia, febre prolongada e hepatoesplenomegalia. A biopsia hepatica em um paciente revelou granulomas mal formados em torno de ovos de S. mansoni e hepatite de intensidade moderada. O tratamento da esquistossomose com a oxamniquine induziu melhora clinica progressiva culminando com a cura da salmonelose e da esquistossomose. O reconhecimento da associacao Salmonella-S. mansoni em pacientes com AIDS mostra-se importante nesses casos pois o tratamento da esquistossomose melhora o prognostico da bacteriemia por Salmonella que pode tornar-se recorrente e fatal nos pacientes com AIDS


Asunto(s)
Humanos , Masculino , Adulto , Diarrea/etiología , Infecciones Oportunistas Relacionadas con el SIDA/parasitología , Salmonella/aislamiento & purificación , Síndrome de Inmunodeficiencia Adquirida/parasitología , Biopsia , Ensayo de Inmunoadsorción Enzimática , Hepatitis , Infecciones por Salmonella/diagnóstico , Infecciones por Salmonella/terapia , Oxamniquina/uso terapéutico , Factores de Riesgo , Esquistosomiasis/diagnóstico , Esquistosomiasis/terapia , Signos y Síntomas
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