Community-acquired Acinetobacter baumannii pneumonia: a rare case in Brazil

ABSTRACT Acinetobacter baumannii, a common pathogen in nosocomial infections, is a rare cause of community-acquired pneumonia. This report highlights the difficulties in its early diagnosis and effective treatment, as it is a multidrug-resistant microorganism with rapid, unfavorable progression. To better understand its clinical outcome, we searched the literature for similar cases but found no community-acquired cases in Brazil.

Epidemiological survey of hepatitis C in a region considered to have high prevalence: the state of Minas Gerais, Brazil

Abstract INTRODUCTION: The prevalence of hepatitis C virus (HCV) infection is affected by demographic, virological, clinical, and lifestyle-related factors and varies in different regions in Brazil or worldwide. The present study aimed to clarify the epidemiological patterns of HCV infection in the interior region of Brazil. METHODS: This study was conducted in the Southern Triangle Macro-region of the state of Minas Gerais, Brazil, according to the guidelines of the National Program for the Prevention and Control of Viral Hepatitis. The participants answered a structured questionnaire on social and epidemiological factors. Immunochromatographic rapid tests were used for the qualitative detection of antibodies against HCV in whole blood (Alere HCV® Code 02FK10) in adult subjects by a free-standing method. RESULTS: Of 24,085 tested individuals, 184 (0.76%) were anti-HCV positive. The majority of anti-HCV-positive individuals were born between 1951 and 1980 (n=146 [79.3%]), with 68 women and 116 men. Identified risk factors included syringe and/or needle sharing (p = 0.003), being in prison (p = 0.004), and having tattoos or piercings (p = 0.005) and were significantly associated with the decade of birth. CONCLUSIONS: The study shows the importance of testing populations at risk for HCV infection, including incarcerated individuals, those with tattoos or piercings, those who share or have shared syringes or needles, and those in high-risk birth cohorts (1950s, 1960s, and 1970s) in the Southern Triangle Macro-region.

Cirrose por HCV genótipo 1a, tratada com 7 semanas de interferon peguilado/ribavirina, transplantada por hepatocarcinoma, em RVS / Cirrhosis by HCV genotype 1a, treated with 7 weeks of pegylated interferon/ribavirin, transplanted for hepatocellular carcinoma, on SVR

A hepatopatia crônica causada pelo vírus da hepatite C (HCV) é a indicação mais comum de transplante hepático no mundo. A recorrência da hepatite C após o transplante hepático é elevada e em grande parte dos pacientes pode evoluir com cirrose e perda do enxerto de forma acelerada. Relatamos caso de portadora de cirrose por hepatite C genótipo 1a, tratada durante sete semanas com Interferon Peguilado e Ribavirina, em Resposta Viral Sustentada (RVS), mesmo após transplante hepático por hepatocarcinoma.

Chronic liver disease caused by hepatitis C virus (HCV) is the most common indication for liver transplantation in the world. The recurrence of hepatitis C after liver transplantation is high and most patients can develop cirrhosis and graft loss in an accelerated manner. A case of a patient with cirrhosis due to hepatitis C genotype 1a, treated for seven weeks with pegylated interferon and Ribavirin in Sustained Viral Response (SVR), even after liver transplantation for hepatocellular carcinoma.

Deixo ela no canto e vou tocar minha vida?: significados de viver com HIV para homens com adesão irregular à terapia antirretroviral / I leave it alone and then I go on with my life?: meanings of living with HIV for men in irregular adherence to antiretroviral therapy / La dejo y voy a seguir con mi vida?: signifcados de vivir con VIH en hombres con adhesión irregular a la terapia antiretroviral

Descrever e analisar os significados de viver com o vírus da imunodeficiência humana (HIV) para homens com adesão irregular à terapia antirretroviral (TARV). Métodos: Pesquisa qualitativa, realizada em um ambulatório de um hospital universitário no interior de Minas Gerais, com participação de 10 homens. Os dados foram coletados entre maio e setembro de 2011 através de entrevista semiestruturada e submetidos à análise de conteúdo, resultando nas categorias temáticas ?Descobrindo a contaminação pelo HIV? e ?(Com)Vivendo com o HIV?. Resultados: Os significados de viver com HIV são marcados pela coexistência de algumas concepções equivocadas sobre HIV/AIDS, consolidadas no início da epidemia, com novas percepções, provenientes dos ganhos advindos da utilização da TARV, associadas à valorização de características que trazem uma percepção de invulnerabilidade pelo homem. Esses aspectos podem ser compreendidos como fatores que se refletem diretamente na formacomo os sujeitos aderem ou não à TARV. Além disso, destacam-se também as limitações impostas pelas condições concretas de vida dos sujeitos, principalmente no que se refere ao âmbito socioeconômico e cultural. Conclusão: O processo de viver com HIV caracteriza-se pela complexidade, o que suscita o planejamento de ações de saúde, numa perspectiva de gênero que atenda às especificidades do universo masculino...

To describe and analyze the meanings of living with the Human Immunodeficiency Virus (HIV) for men with irregular adherence to Antiretroviral Therapy (ART). Methods: Qualitative research conducted at an ambulatory of a school hospital in Minas Gerais, Brazil, with 10 men. Data was collected from May to September 2011 through semi-structured interview and submitted to content analysis, resulting in the categories ?Discovering the HIV infection? and ?Living with HIV?. Results: The meanings of living with HIV are distinguished by the coexistence of some misconceptions about HIV/AIDS, consolidated in the epidemic onset, with new perceptions, derived from the gains resulting from use of ART, associated to the valuation of features that bring a sense of non-vulnerability to the man. These aspects can be understood as factors that are directly reflected in the way that the participant men adhere (or not) to ART. Moreover, the limitations imposed by the real conditions of the individuals? life are highlighted, especially concerning the socioeconomic and cultural context. Conclusion: The process of living with HIV is characterized by complexity, which indicates the planning of health actions from a gender perspective to address the specificities of the masculine universe...

Describir y analizar los significados de vivir com el virus de inmunodeficiencia humana (VIH) en hombres con adhesión irregular a la terapia antiretroviral (TARV). Métodos: Investigación cualitativa realizada en un ambulatório de un hospital universitario en un pueblo de Minas Gerais com participación de 10 hombres. Los datos fueron recogidos entre mayo y septiembre de 2011 a través de entrevista semi-estructurada y sometidos al análisis de contenido resultando en las categorias temáticas ?Descubriendo la contaminación por el VIH? y ?(Con) Viviendo con el VIH?. Resultados: Los significados de vivir com el VIH son marcados por la coexistencia de algunas concepciones equivocadas sobre VIH/SIDA consolidadas en el inicio de La epidemia con nuevas percepciones provenientes de las ganâncias advenidas de la utilización de la TARV asociadas a la valorización de características que traen una percepción de invulnerabilidad del hombre. Eses aspectos pueden ser comprendidos como factores que se reflejan directamente en la forma como los sujetos adhieren o no a la TARV. Además, se destaca también las limitaciones impuestas por las condiciones concretas de vida de los sujetos, principalmente en lo que se refiere al ámbito socioeconómico y cultural. Conclusión: El proceso de vivir con VIH se caracteriza por la complejidad, lo que suscita el planeamiento de acciones en salud en una perspectiva de género que atienda a lãs especificidades del universo masculino...

Aureobasidium pullulans infection in a patient with chronic lymphocytic leukemia

Saprophytic fungi are being increasingly recognized as etiologic agents of mycoses in immunosuppressed patients. We report a case of subcutaneous infiltration by Aureobasidium pullulans, likely due to traumatic inoculation, in a neutropenic patient during chemotherapy for chronic lymphocytic leukemia. The patient was treated with amphotericin B deoxycholate but was subsequently switched to itraconazole, which improved the lesion. This case highlights the importance of considering unusual fungal infections in critically ill patients such as those who are immunosuppressed due to chemotherapy. Diagnostic techniques and effective antifungal therapy have improved the prognosis of these cases.

Hepatitis C and cutaneous alterations / Hepatite C e alterações cutâneas

While most of those infected with hepatitis C virus (HCV) are asymptomatic or only develop liver manifestations, a significant percentage evolves with autoimmune and lymphoproliferative disorders, resulting in a clinical condition called HCV syndrome. This work involving case studies of six patients with hepatitis C and varied skin manifestation aimed to report skin lesions occurring with HCV infection and its treatment. Skin manifestations in hepatitis C have been based on epidemiological studies. This justifies the need for studies that correlate HCV infection and its treatment with skin manifestations.

A maioria dos infectados pelo vírus da hepatite C (VHC) é assintomática ou apresenta somente manifestações hepáticas, porém uma significativa porcentagem evolui com desordens autoimunes e linfoproliferativas resultando na síndrome da hepatite C. Este trabalho envolve seis estudos de casos de pacientes com hepatite C e várias manifestações cutâneas, visando relacionar lesões dermatológicas ao VHC e ao seu tratamento. Manifestações dermatológicas na hepatite C têm sido baseadas em estudos epidemiológicos. Isto justifica a necessidade de estudos que correlacionem infecção pelo VHC e seu tratamento com as manifestações dermatológicas.

Disseminated toxoplasmosis presenting as sepsis in two AIDS patients

This report describes two patients who presented acute disseminated and severe toxoplasmosis as the first opportunistic disease related to acquired immunodeficiency syndrome. At admission, clinical and laboratory findings were similar to sepsis or septic shock and a fast evolutive course to death occurred in both cases. At necropsy, an inflammatory reaction and presence of a great number of Toxoplasma gondii cysts and tachyzoites were observed in most organs examined.

O presente relato descreve dois pacientes que apresentaram toxoplasmose aguda, disseminada e grave como primeira manifestação oportunista da síndrome da imunodeficiência adquirida. Os achados clínicos e laboratoriais foram similares aos de sepse ou choque séptico e, em ambos os casos houve evolução rápida para óbito. A necropsia, foi observada reação inflamatória e presença de taquizoítos e cistos de Toxoplasma gondii na maioria dos órgãos examinados.