ABSTRACT
Disseminated cutaneous leishmaniasis (DCL) is an uncommon form of Leishmania braziliensis infection. It remains unknown why some people develop this clinical condition. We describe 14 DCL patients in Northeast Brazil during 2015-2018. These patients regularly drank large amounts of alcohol, possibly increasing their risk for DCL.
Subject(s)
Alcoholism , Leishmania braziliensis , Leishmaniasis, Cutaneous , Brazil/epidemiology , Ethanol , Humans , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/epidemiologyABSTRACT
Postmortem examination of 7 neonates with congenital Zika virus infection in Brazil revealed microcephaly, ventriculomegaly, dystrophic calcifications, and severe cortical neuronal depletion in all and arthrogryposis in 6. Other findings were leptomeningeal and brain parenchymal inflammation and pulmonary hypoplasia and lymphocytic infiltration in liver and lungs. Findings confirmed virus neurotropism and multiple organ infection.
Subject(s)
Pregnancy Complications, Infectious , Zika Virus Infection/congenital , Zika Virus Infection/diagnosis , Zika Virus , Autopsy , Brain/pathology , Brain/virology , Brazil , Female , Humans , Infant, Newborn , Microcephaly , Phenotype , Pregnancy , Zika Virus/classification , Zika Virus/genetics , Zika Virus Infection/virologySubject(s)
Antigens, Protozoan/blood , Blood Donors , DNA, Protozoan/blood , Leishmania infantum/genetics , Leishmaniasis, Visceral/epidemiology , Animals , Antigens, Protozoan/immunology , Asymptomatic Diseases , Brazil/epidemiology , DNA, Protozoan/genetics , Enzyme-Linked Immunosorbent Assay , Humans , Insect Vectors/parasitology , Leishmania infantum/isolation & purification , Leishmaniasis, Visceral/blood , Leishmaniasis, Visceral/diagnosis , Leishmaniasis, Visceral/transmission , Polymerase Chain Reaction , Prevalence , Psychodidae/parasitologySubject(s)
Communicable Diseases, Emerging/epidemiology , Disease Outbreaks/prevention & control , Measles/epidemiology , Adolescent , Adult , Age Factors , Brazil/epidemiology , Child , Child, Preschool , Communicable Disease Control , Communicable Diseases, Emerging/prevention & control , Humans , Infant , Infant, Newborn , Male , Measles/prevention & control , Public Health Surveillance , Risk Factors , Vaccination , Young AdultABSTRACT
A modified imprint method, Press-Imprint-Smear, was compared with histopathology for the diagnosis of cutaneous leishmaniasis. Amastigotes were seen in 69 (92%) of 75 individuals in one or both assays. The Press-Imprint-Smear was positive in 85.3%, and histopathology was positive in 44%. Press-Imprint-Smear is a rapid and relatively sensitive method for the diagnosis of cutaneous leishmaniasis.
Subject(s)
Biopsy/methods , Leishmania braziliensis/isolation & purification , Leishmaniasis, Cutaneous/diagnosis , Brazil , Humans , Sensitivity and SpecificityABSTRACT
Pyogenic liver abscesses caused by Salmonella enterica serotype Typhi, although rare, can occur especially in patients with pre-existing hepatobiliary disease, hepatocellular carcinoma, and metastatic liver tumors. We present a case of Salmonella liver abscesses complicating metastatic melanoma in a 24-year-old alcoholic male.
Subject(s)
Liver Abscess, Pyogenic/complications , Liver Neoplasms/secondary , Melanoma/secondary , Neoplasms, Unknown Primary/complications , Salmonella typhi , Typhoid Fever/complications , Humans , Male , Melanoma/complications , Young AdultABSTRACT
We report for the first time the successful use of fluconazole to treat cutaneous leishmaniasis due to Leishmania braziliensis. We used escalating doses from 5 to 8 mg/kg per day. At a dose of 5 mg/kg per day, 75% patients were cured, and at 8 mg/kg per day, the cure rate was 100%. Fluconazole was well tolerated.
Subject(s)
Antiprotozoal Agents/administration & dosage , Fluconazole/administration & dosage , Leishmania braziliensis/drug effects , Leishmania braziliensis/isolation & purification , Leishmaniasis, Cutaneous/drug therapy , Leishmaniasis, Cutaneous/parasitology , Adolescent , Adult , Aged , Aged, 80 and over , Antiprotozoal Agents/adverse effects , Child , Child, Preschool , Female , Fluconazole/adverse effects , Humans , Male , Middle Aged , Treatment Outcome , Young AdultABSTRACT
Melioidosis, which is caused by the bacterium Burkholderia pseudomallei, is a potentially fatal tropical infection, little known outside its main endemic zone of Southeast Asia and northern Australia. Though it has received more attention in recent years on account of its claimed suitability as a biological weapon agent, the principal threat from melioidosis is a result of naturally occurring events. Occasional case clusters, sporadic cases outside the known endemic zone and infections in unusual demographic groups highlight a changing epidemiology. As melioidosis is the result of an environmental encounter and not person-to-person transmission, subtle changes in its epidemiology indicate a role environmental factors, such as man-made disturbances of soil and surface water. These have implications for travel, occupational and tropical medicine and in particular for risk assessment and prevention. Practical problems with definitive laboratory diagnosis, antibiotic treatment and the current lack of a vaccine underline the need for prevention through exposure avoidance and other environmental health measures. It is likely that the increasing population burden of the tropical zone and extraction of resources from the humid tropics will increase the prevalence of melioidosis. Climate change-driven extreme weather events will both increase the prevalence of infection and gradually extend its main endemic zone.
Subject(s)
Burkholderia pseudomallei/isolation & purification , Melioidosis , Public Health , Bioterrorism , Global Health , Humans , Medical Laboratory Personnel , Melioidosis/diagnosis , Melioidosis/epidemiology , Melioidosis/prevention & control , Melioidosis/transmission , Occupational Diseases/diagnosis , Occupational Diseases/prevention & control , Tropical ClimateABSTRACT
Cutaneous leishmaniasis caused by Leishmania (Vianna) braziliensis is a major health problem in the state of Ceará in northeastern Brazil. We propose that the disease emerged as a consequence of the displacement of persons from Ceará to the Amazon region following the Great Drought and smallpox epidemic of 1877-1879. As the economic and social situation in Ceará deteriorated, approximately 55,000 residents migrated to the Amazon region to find work, many on rubber plantations. Those that returned likely introduced L. (V.) brazilensis into Ceará, where the first cases of cutaneous leishmaniasis were reported early in the 20th century. The absence of an animal reservoir in Ceará, apart from dogs, supports the hypothesis. The spread of HIV/AIDS into the region and the possibility of concurrent cutaneous leishmaniasis raise the possibility of future problems.
Subject(s)
Communicable Diseases, Emerging/epidemiology , Disease Outbreaks , Droughts , Leishmania braziliensis , Leishmaniasis, Cutaneous/epidemiology , Smallpox/epidemiology , Animals , Brazil/epidemiology , Child , Child, Preschool , Communicable Diseases, Emerging/parasitology , Female , History, 19th Century , History, 20th Century , History, 21st Century , Humans , Leishmaniasis, Cutaneous/parasitology , MaleABSTRACT
Melioidosis, which is caused by the bacterium Burkholderia pseudomallei, is a potentially fatal tropical infection, little known outside its main endemic zone of Southeast Asia and northern Australia. Though it has received more attention in recent years on account of its claimed suitability as a biological weapon agent, the principal threat from melioidosis is a result of naturally occurring events. Occasional case clusters, sporadic cases outside the known endemic zone and infections in unusual demographic groups highlight a changing epidemiology. As melioidosis is the result of an environmental encounter and not person-to-person transmission, subtle changes in its epidemiology indicate a role environmental factors, such as man-made disturbances of soil and surface water. These have implications for travel, occupational and tropical medicine and in particular for risk assessment and prevention. Practical problems with definitive laboratory diagnosis, antibiotic treatment and the current lack of a vaccine underline the need for prevention through exposure avoidance and other environmental health measures. It is likely that the increasing population burden of the tropical zone and extraction of resources from the humid tropics will increase the prevalence of melioidosis. Climate change-driven extreme weather events will both increase the prevalence of infection and gradually extend its main endemic zone.
