ABSTRACT
Malignant syphilis is an uncommon, but not unknown, ulcerative variation of secondary syphilis. The lesions typically begin as papules, which quickly evolve to pustules and then to ulcers with elevated edges and central necrosis. It is usually, but not mandatory, found in patients with some level of immunosuppression, such as HIV patients, when the TCD4(+) cell count is >200 cells/mm(3). Despite the anxiety the lesions cause, this form of the disease has a good prognosis. The general symptoms disappear right after the beginning of treatment, and lesions disappear over a variable period. This study reports the case of a 27-year-old man who has been HIV positive for 6 years, uses antiretroviral therapy incorrectly, has a TCD4(+) cell count of 340 cells/mm(3), a VDRL of 1:128 and itchy disseminated hyperchromic maculopapular lesions with rupioid crusts compatible with malignant syphilis.
Subject(s)
Acquired Immunodeficiency Syndrome/diagnosis , Coinfection , Syphilis/diagnosis , Acquired Immunodeficiency Syndrome/drug therapy , Adult , Anti-Bacterial Agents/therapeutic use , Antiretroviral Therapy, Highly Active , Homosexuality, Male , Humans , Male , Skin/pathology , Syphilis/drug therapy , Treatment OutcomeABSTRACT
No período de janeiro à dezembro de 2003 foram enviados ao Laboratório Central do estado do Ceará ( LACEN-Ce), 1.028 espécimes clínicos (urina), coletados de 112 pacientes com suspeita de tuberculose urogenital, onde 79 (7,7) destes espécimes apresentaram baciloscopia e cultura positiva para o complexo Mycobacterium tuberculosis. Dos 112 pacientes apenas 40 (35,7)...
Subject(s)
Male , Female , Humans , Tuberculosis, Urogenital , Clinical Laboratory Techniques , Mycobacterium tuberculosisABSTRACT
We bacteriologically analyzed 156 species of Enterobacteriaceae, isolated from 138 patients with community-acquired diabetic foot ulcers, in a prospective study made at a diabetic center and at the Federal University of Ceará, Brazil, from March, 2000, to November, 2001. The samples were cultured using selective media, and identification, susceptibility tests and detection of plasmid-mediated-extended-spectrum-beta-lactamase (ESBL) producing strains were made with conventional and automated methods. The most frequently occurring pathogens were K. pneumoniae (21.2%), Morganella morganii (19.9%) and E. coli (15.4%). High resistance rates were noted for ampicillin, first generation cephalosporin, trimethoprim/sulfamethoxazole, tetracycline, amoxicillin-clavulanic acid and chloramphenicol. ESBL-producing strains were detected in 6% of the patients. Resistance among gram-negative bacteria has become increasingly common, even in community-acquired infections.
Subject(s)
Anti-Bacterial Agents/pharmacology , Diabetic Foot/microbiology , Enterobacteriaceae/enzymology , beta-Lactamases/metabolism , Diabetes Mellitus, Type 2/microbiology , Enterobacteriaceae/drug effects , Enterobacteriaceae/isolation & purification , Humans , Plasmids , Prospective Studies , beta-Lactam ResistanceABSTRACT
We bacteriologically analyzed 156 species of Enterobacteriaceae, isolated from 138 patients with community-acquired diabetic foot ulcers, in a prospective study made at a diabetic center and at the Federal University of Ceará, Brazil, from March, 2000, to November, 2001.The samples were cultured using selective media, and identification, susceptibility tests and detection of plasmid-mediated-extended-spectrum-beta-lactamase (ESBL) producing strains were made with conventional and automated methods. The most frequently occurring pathogens were K. pneumoniae (21.2 percent), Morganella morganii (19.9 percent) and E. coli (15.4 percent). High resistance rates were noted for ampicillin, first generation cephalosporin, trimethoprim/sulfamethoxazole, tetracycline, amoxicillin-clavulanic acid and chloramphenicol. ESBL-producing strains were detected in 6 percent of the patients. Resistance among gram-negative bacteria has become increasingly common, even in community-acquired infections
