Osteomyelitis caused by Sporothrix schenckii in an immunocompetent patient

Abstract Sporotrichosis is the most common subcutaneous mycosis in South America and its association with zoonotic transmission remains a relevant public health problem in Rio de Janeiro, Brazil. The disease most commonly presents as subacute or chronic cutaneous lesions, although dissemination to various organs and systems occurs in rare cases, mainly in immunosuppressed individuals. This report describes a case of sporotrichosis with severe bone and subcutaneous damage in an immunocompetent patient who did not exhibit the characteristic skin lesions of sporotrichosis, including ulcers, nodules, and lymphangitis.

Subcutaneous phaeohyphomycosis caused by Cladophialophora sp: a case report

A case of subcutaneous phaeohyphomycosis caused by Cladophialophora sp. is reported. The patient, an immunosuppressed host presented a nodule on the dorsum of the right hand which relapsed four months after excision. Dematiaceous septate hyphal and yeast like elements were seen in mycological and histological examination. The isolated fungus was identified on the basis of micro-macromorphological and physiologic characteristics.

É descrito caso de feohifomicose subcutânea causada por Cladophialophora sp. O paciente, imunossuprimido, apresentou nódulo no dorso da mão direita que recidivou quatro meses após excisão. Os exames micológico e histopatológico evidenciaram hifas septadas demácias e células leveduriformes. O fungo foi identificado com base no estudo micro-macromorfológico e fisiológico.

A prospective randomized trial to reduce oral Candida spp. colonization in patients with hyposalivation

Low salivary flow rates are associated with higher oral Candida spp. counts, which may predispose to oral candidiasis. The aim of this study was to compare the effect of stimulating salivary flow rates with that of a regimen of chlorhexidine mouth rinse on the intensity of Candida colonization in patients with reduced salivary flow rates. Thirty-one outpatients were randomized to stimulate salivary output (group 1) or to receive chlorhexidine mouth rinses (group 2). Evaluations were performed at baseline (T0), at end of treatment (T1), and 15 days after last day of treatment (T2). Chewing-stimulated whole saliva samples were collected at each visit. Group 1 showed a constant reduction in median cfu counts, although the difference was significant only between T0 and T2 (p = 0.004). Group 2 showed a reduction in median Candida cfu counts between T0 and T1 (p = 0.01), but the counts increased at T2 (p = 0.01), and the difference between T0 and T2 was not significant (p = 0.8). In conclusion, patients who received salivary stimulation showed reductions of Candida cfu counts in saliva and a trend for increasing salivary flow rates between baseline and end of study evaluations. The use of chlorhexidine mouth rinses dramatically reduced Candida cfu counts, but when patients discontinued treatment, intensity of colonization rose again.

O fluxo salivar reduzido está associado a maior quantidade de Candida spp. na boca, predispondo a candidíase. O objetivo deste estudo foi comparar o efeito da estimulação salivar ao efeito do uso de bochechos de clorexidina sobre a intensidade de colonização por Candida em pacientes com fluxo salivar reduzido. Trinta e um pacientes de ambulatório foram aleatoriamente incluídos nos protocolos de estimulação salivar (grupo 1) ou de bochecho com clorexidina (grupo 2). As avaliações foram realizadas no dia inicial (T0), ao final do tratamento (T1) e 15 dias após o final do tratamento (T2). A cada consulta foram coletadas amostras de saliva total estimulada. O grupo 1 mostrou uma redução constante nas contagens medianas de UFC de Candida, embora a diferença estatística tenha sido apenas entre T0 e T2 (p = 0,004). O grupo 2 mostrou redução nas contagens de UFC de Candida entre T0 e T1 (p = 0,01), mas a contagem de UFC aumentou em T2 (p = 0,01), sendo a diferença entre T0 e T2 não significante (p = 0,8). Concluiu-se que os pacientes que realizaram procedimentos de estimulação salivar apresentaram a quantidade de UFC de Candida salivar reduzida, além de apresentarem tendência ao aumento do fluxo. O uso de bochechos de clorexidina reduziu drasticamente a quantidade de UFC de Candida salivar, mas após o final do tratamento houve novo aumento.

Dermatophytoses in children: study of 137 cases

Dermatophytoses are common fungal infections caused by dermatophytes but there are few data about this condition in the childhood. 137 children below the age of 12 and clinically diagnosed as tineas were investigated prospectively at Instituto de Puericultura e Pediatria, Rio de Janeiro, from 1994 to 1999. Hair, skin/nails scraping and pus swabs were collected from lesions and processed for fungus. Male children from 2 to 12 years were mostly affected; tinea capitis (78 cases) mainly caused by Microsporum canis (46 cases) was the most common clinical form. Tinea corporis (43 cases) mainly caused by Trichophyton rubrum (17 cases) accounted for the second most frequent clinical form. Tinea cruris (10 cases) with Trichophyton rubrum (5 cases) as the most common etiologic agent accounted for the third most frequent clinical form. Tinea pedis and tinea unguium were much less frequent (3 cases each). Trichophyton rubrum was the most common etiologic agent isolated in these cases (3 cases)

Microsporum gypseum infection in Aids patient: a case report

Relato de caso de tinea corporis por Microsporum gypseum em paciente com Aids de 36 anos. Segundo a literatura, este dermatófito näo é um agente comum neste grupo de pacientes. As lesöes eram psoriasiformes, generalizadas e näo responderam ao tratamento com cetoconazol e itraconazol

Diagnóstico do Helicobacter pylori pelo exame endoscópico / Endoscopic exam for diagnosis of Helicobacter pylori

Foi pesquisada a presença de Helicobacter pylori pela biópsia endoscópica antral em 386 pacientes. Os fragmentos obtidos foram submetidos a quatro técnicas de determinaçäo. Todos os doentes tinham queixas dispépticas altas. Correlacionou-se o achado endoscópico com a positividade. O método mais sensível foi o da urease (92,6 por cento), seguido da coloraçäo direta (82,6 por cento). Tal determinaçäo deve ser incluída na rotina endoscópica