Résumé
Infection by unusual microorganisms can be one of the clinical manifestations of primary immunodeficiency (PID). We report on a four-month-old child with pneumonia caused by the fungus Acremonium kiliense as the first clinical manifestation of chronic granulomatous disease. We emphasize the importance of an active search for unusual organisms in immunodeficient patients, and a precise diagnosis and early institution of specific treatment against such microorganisms for the reduction of the morbidity and mortality of these patients.
Sujets)
Humains , Nourrisson , Mâle , Acremonium/isolement et purification , Granulomatose septique chronique/microbiologie , Mycoses/microbiologie , Infections opportunistes/microbiologie , Pneumopathie infectieuse/microbiologie , Granulomatose septique chronique/complications , Granulomatose septique chronique/diagnostic , Mycoses/diagnostic , Infections opportunistes/complications , Infections opportunistes/diagnostic , Pneumopathie infectieuse/complications , Pneumopathie infectieuse/diagnosticRésumé
Poliomyelitis associated with live strain vaccine is defined as the paralytic form of the acute anterior poliomyelitis related to the vaccine strain. Since these strains behave similarly to the wild-type virus, we can differentiate, epidemiologically, two types of vaccine-associated poliomyelitis: cases in which the patient was vaccinated and cases in which the patient had had contact with vaccinated individuals. We herein present the case of an unvaccinated child, with a clinical picture of an acute anterior poliomyelitis associated with the live strain vaccine, whose brother received the Sabin vaccine 20 days before the onset of the symptoms. Vaccine strain of the type 3 poliovirus was isolated in fecal culture and a presented mutation in nucleotide 472 (C(r)U) in the 5' non-coding region, which is strongly related to the higher strain virulence
Sujets)
Humains , Mâle , Nourrisson , Enfant d'âge préscolaire , Transmission de maladie infectieuse , Poliomyélite/transmission , Vaccin antipoliomyélitique oral/effets indésirables , Fèces/virologie , Poliomyélite/liquide cérébrospinal , Poliomyélite/diagnostic , Vaccin antipoliomyélitique oral/administration et posologieRésumé
Säo descritos dois casos de malária congênita causadas por Plasmodium vivax e Plasmodium falciparum em crianças de 5 e 7 semanas de vida respectivamente, nascidas no Estado de Säo Paulo e Paraná, de mäes oriundas de área endêmica de malária. Os sinais e sintomas clínicos incluíam anemia e hepatoesplenomegalia, sendo que apenas uma delas apresentou quadro febril. As mäes apresentaram episódios de malária durante a gestaçäo. Apesar de a malária congênita ser considerada patologia incomum, o tratamento inadequado dos episódios durante a gravidez pode contribuir para o aumento de sua incidência. Discutem-se os aspectos clínicos e terapêuticos concernentes ao acometimento perinatal.