ABSTRACT
Histoplasmosis is a systemic mycosis that is considered an important public health problem. In this work, we performed a descriptive, observational, cross-sectional and retrospective study with a secondary data analysis of medical records from 2000 to 2012 at a tertiary hospital. The study sample consisted of 275 patients with laboratory-confirmed Disseminated Histoplasmosis (DH)/AIDS. The results showed that the prevalence of DH associated with AIDS was 4.4%. The majority of patients were young adult men with fever in 84.2%, cough in 63.4%, weight loss in 63.1%, diarrhoea in 44.8% and skin manifestations in 27.6% of patients. In the overall cohort, the CD4 counts were low, but not significantly different in survivors and non-survivors. Higher levels of urea and lower levels of haemoglobin and platelets were observed in non-survivor patients (<.05). The global lethality was 71.3% (196/275). The results with high prevalence and lethality highlight the need to adopt measures to facilitate early diagnosis, proper treatment and improved prognosis.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Histoplasmosis/epidemiology , Opportunistic Infections/epidemiology , Acquired Immunodeficiency Syndrome/epidemiology , Acquired Immunodeficiency Syndrome/mortality , Adolescent , Adult , Aged , Antifungal Agents/therapeutic use , Brazil/epidemiology , CD4 Lymphocyte Count , Child , Cohort Studies , Cross-Sectional Studies , Female , Hemoglobins/analysis , Histoplasmosis/drug therapy , Histoplasmosis/mortality , Humans , Male , Medical Records , Middle Aged , Opportunistic Infections/drug therapy , Opportunistic Infections/mortality , Platelet Count , Prevalence , Retrospective Studies , Tertiary Care Centers/statistics & numerical data , Urea/analysis , Young AdultABSTRACT
Sixty clinical isolates of Cryptococcus neoformans from AIDS from Goiânia, state of Goiás, Brazil, were characterized according to varieties, serotypes and tested for antifungal susceptibility. To differentiate the two varieties was used L-canavanine-glycine-bromothymol blue medium and to separate the serotypes was used slide agglutination test with Crypto Check Iatron. The Minimal Inhibitory Concentration (MIC) of fluconazole, itraconazole, and amphotericin B were determined by the National Committee for Clinical Laboratory Standards macrodilution method. Our results identified 56 isolates as C. neoformans var. neoformans serotype A and 4 isolates as C. neoformans var. gattii serotype B. MIC values for C. neoformans var. gattii were higher than C. neoformans var. neoformans. We verified that none isolate was resistant to itraconazole and to amphotericin B, but one C. neoformans var. neoformans and three C. neoformans var. gattii isolates were resistant to fluconazole. The presence of C. neoformans var. gattii fluconazole resistant indicates the importance of determining not only the variety of C. neoformans infecting the patients but also measuring the MIC of the isolate in order to properly orient treatment.
Subject(s)
Amphotericin B/pharmacology , Antifungal Agents/pharmacology , Cryptococcus neoformans/drug effects , Fluconazole/pharmacology , Itraconazole/pharmacology , AIDS-Related Opportunistic Infections/microbiology , Adolescent , Adult , Agglutination Tests , Cryptococcus neoformans/classification , Cryptococcus neoformans/isolation & purification , Female , Humans , Male , Microbial Sensitivity Tests , Middle Aged , SerotypingABSTRACT
The essential oil and the aqueous, hexane and methanolic fractions from Hyptis ovalifolia leaves were evaluated for their antifungal activity in vitro against 60 strains of dermatophytes: 10 strains of Microsporum canis, 10 of M. gypseum, 20 of Trichophyton rubrum and 20 of T. mentagrophytes. The extracts inhibited growth of the dermatophytes tested at different concentrations. The most biologically active was the essential oil from the leaves which inhibited 57 isolates (95 percent) at a concentration of ú 500 æg/ml.
Subject(s)
Antifungal Agents , Arthrodermataceae , Dose-Response Relationship, Drug , Microbial Sensitivity Tests , Plant ExtractsABSTRACT
The essential oil and the aqueous, hexane and methanolic fractions from Hyptis ovalifolia leaves were evaluated for their antifungal activity in vitro against 60 strains of dermatophytes: 10 strains of Microsporum canis, 10 of M. gypseum, 20 of Trichophyton rubrum and 20 of T. mentagrophytes. The extracts inhibited growth of the dermatophytes tested at different concentrations. The most biologically active was the essential oil from the leaves which inhibited 57 isolates (95%) at a concentration of 500 g/ml.
