Coinfection by Strongyloides stercoralis in blood donors infected with human T-cell leukemia/lymphoma virus type 1 in São Paulo City, Brazil.

The frequency of coinfection with Strongyloides stercoralis and human T-cell leukemia/lymphoma virus type 1 (HTML-1) was determined in 91 blood donors examined at the blood bank of a large hospital in São Paulo city, Brazil. As control group 61 individuals, not infected by HTLV-1, were submitted to the same techniques for the diagnosis of S. stercoralis infection. In HTLV-1 infected patients the frequency of S. stercoralis infection was 12.1%; on the other hand, the control group showed a frequency significantly lower of S. stercoralis infection (1.6%), suggesting that HTLV-1 patients should be considered as a high risk group for strongyloidiasis in São Paulo city.

[Acute diarrhea in children less than 3 years of age: Enteropathogens isolated in patient's stools, compared with a control group] / Diarréia aguda em crianças menores de 3 anos de idade: recuperação de enteropatógenos nas amostras fecais de pacientes comparada à de grupo controle.

OBJECTIVES: To observe the occurrence of different etiological agents of acute diarrhea (AD) in stool specimens of patients and children in a control group. MATERIAL AND METHODS: 100 children less than three years of age with AD were studied as well as 100 controls, between November 1993 and May 1994. Stool specimens were collected in both groups and the following enteropathogens were searched for: Rotavirus, Escherichia coli (EPEC, ETEC, EIEC, EHEC), Salmonella sp, Shigella sp, Campylobacter jejuni, Campylobacter coli, Yersinia enterocolitica, Cryptosporidium sp, Giardia lamblia, Entamoeba histolytica. Statistical analysis using the exact Fisher test (at significance level p<0,05) was done. The mean age was 12,5 months, with more cases in patients less than 6 months (35%). Children were seen at the emergency section on an average fifth day after the start of the diarrhea. Most came from homes with basical sanitary conditions. Watery diarrhea was more frequent than bloody diarrhea with mucus, at a proportion of 4:1. RESULTS: Rotavirus was the most frequent agent: 21% in the AD group and 3% in the control group (p= 0,0001). Shigella sp was isolated in 7% of the AD group and none of the control group (p= 0,0140). EPEC was detected in 13% of AD cases and 7% in the control group (p= 0,2381) but the classical subgroups O55, O111, O119 were only isolated from the patients with AD. The other enteropathogens were infrequently detected or in equal proportion in both groups. Rotavirus and EPEC were the more frequently isolated agents in watery diarrhea, while Shigella sp was the predominant agent found in bloody stools with mucus. CONCLUSIONS: Rotavirus was the most common causative agent in AD. The detection of Rotavirus and Shigella sp nearly exclusively in patients with AD confirms the high patogenicity of these etiological agents when compared to the others. Escherichia coli (EPEC) diagnosed by polyvalent sera does not confirm its respective diarrheogenic property due to isolation in the same proportion among patients with AD and controls. Monovalent antisera made possible the detection of classical subgroups of EPEC O111, O119, O55 isolated only from AD patients, confirming the already known high patogenicity of these strains.

Infection by Cryptosporidium parvum in renal patients submitted to renal transplant or hemodialysis.

The frequency of infection by Cryptosporidium parvum was determined in two groups of renal patients submitted to immunosuppression. One group consisted of 23 renal transplanted individuals, and the other consisted of 32 patients with chronic renal insufficiency, periodically submitted to hemodialysis. A third group of 27 patients with systemic arterial hypertension, not immunosuppressed, was used as control. During a period of 18 months all the patients were submitted to faecal examination to detect C. parvum oocysts, for a total of 1 to 6 tests per patient. The results showed frequencies of C. parvum infection of 34.8%, 25% and 17.4%, respectively, for the renal transplanted group, the patients submitted to hemodialysis and the control group. Statistical analysis showed no significant differences among the three groups even though the frequency of C. parvum infection was higher in the transplanted group. However, when the number of fecal samples containing C. parvum oocysts was taken in account, a significantly higher frequency was found in the renal transplanted group.

Effect of wide spectrum anti-helminthic drugs upon Schistosoma mansoni experimentally infected mice.

Mebendazole, albendazole, levamisole and thiabendazole are well known as active drugs against several nematode species, and against cestodes as well, when the first two drugs are considered. None of the drugs have proven activity, however, against trematodes. We tested the effect of these drugs on the fecal shedding of schistosome eggs and the recovering of adult schistosomes, after portal perfusion in Schistosoma mansoni experimentally infected mice. Balb/c mice infected with 80 S. mansoni cercariae were divided into three groups, each in turn subdivided into four other groups, for each tested drug. The first group was treated with each one of the studied drugs 25 days after S. mansoni infection; the second group was submitted to treatment with each one of the drugs 60 days after infection. Finally, the third group, considered as control, received no treatment. No effect upon fecal shedding of S. mansoni eggs and recovering of schistosomes after portal perfusion was observed when mice were treated with either mebendazole or albendazole. Mice treated with either levamisole or thiabendazole, on the other hand, showed a significant reduction in the recovering of adult schistosomes after portal perfusion, mainly when both drugs were given during the schistosomula evolution period, i.e., 25 days after cercariae penetration, probably due to unspecific immunomodulation.

Ascariasis in the subdistrict of Cavacos, municipality of alterosa (MG), Brazil: effect of mass treatment with albendazole on the intensity of infection.

The clinical and epidemiologic aspects of infection with Ascaris lumbricoides were studied in a random stratified sample of the population of the subdistrict of Cavacos, municipality of Alterosa (Minas Gerais, Brazil). The effect of mass treatment with a single dose of albendazole on the prevalence and intensity of infection was also studied six months later in the same population. During the first phase of the study, a questionnaire was applied to 248 individuals to obtain information about the socioeconomic, sanitary and clinical conditions of the population surveyed. A total of 230 fecal samples were also examined by the Kato-Katz technique in order to determine the intensity of A. lumbricoides infection. Two hundred and two individuals were simultaneously submitted to blood counts and 70 children aged 12 years or less were evaluated for nutritional status. The presence of A. lumbricoides and other helminth eggs was also determined in 22 soil samples collected in the urban zone of Cavacos. Infection with enteroparasitic helminths was detected in 29.1% of the sample, with a predominance of A. lumbricoides (23.9%). Parasitism and/or intensity of A. lumbricoides infection were significantly correlated with age range (15 years or less), social class, sanitary and living conditions (water, sewage and domiciliary area per person), and presence of abdominal pain. However, these parameters were not correlated with nutritional status or hematocrit levels. During the second phase of the study, a slight but not statistically significant decrease in the prevalence of A. lumbricoides infection was detected after treatment with albendazole. However, an important and significant reduction in the amount of A. lumbricoides eggs eliminated through the feces was detected, indicating that the intensity of A. lumbricoides infection was lower in all the age ranges of the Cavacos population, especially among younger individuals, even six months after administration of the anthelminthic agent.

Infeccao cutanea por Lagochilascaris minor - tratamento e cura rapida pelo levamisol. / Cutaneous infection caused by Lagochilascaris minor - treatment and rapid cure with levamisole

Relata-se o caso de uma paciente branca de 25 anos com tumoracoes no pescoco, uma das quais fistulizada. Havia eliminacao de pequenos vermes pela fistula e pela cavidade bucal. O estudo parasitologico permitiu classificar esses vermes como helmintos da especie Lagochilascaris minor. O presente caso e o 15o.da literatura mundial e o 4o. observado no Brasil. A paciente foi tratada com levamisol, 150 mg por dia, durante tres dias consecutivos. Obteve-se cura rapida e completa da doenca