RESUMO
Streptococcus dysgalactiae has two main subspecies: Streptococcus dysgalactiae subsp. equisimilus (SDSE) and Streptococcus dysgalactiae subsp. dysgalactiae (SDSD). The vast majority of human infections belonging to Streptococcus dysgalactiae have been associated with SDSE. There are only three cases of SDSD found in humans in literature. We present a case of SDSD cellulitis and bacteremia in a 49-year-old female patient from Houston, Texas with no major exposure to animals or trauma.
RESUMO
BACKGROUND: Hepatitis C virus (HCV) is a known carcinogen with considerable genetic heterogeneity: six different genotypes have been identified. HCV genotype distribution varies from country to country. In the United States, the most prevalent genotypes are 1a, and 1b followed by genotypes 2, and 3. OBJECTIVES: To examine whether the distribution of HCV genotypes differed by cancer status among patients in the same area. STUDY DESIGN: We reviewed epidemiologic and virological data of 636 patients with HCV infection evaluated at 3 institutions in Houston, Texas, in 2008 and 2009. RESULTS: We included 129 cancer patients (53 with hematologic malignancies and 76 with solid tumors), 333 immunocompetent patients, and 102 HIV-co-infected patients. The prevalence of genotype 1 (G-1) was 66% among cancer patients, 84% among immunocompetents (P=0.00004), and 99% among HIV-co-infected patients (P<0.00001). G-2 and G-3 were more common in cancer patients than other patients. Demographics, risk factors, and duration of HCV infection were similar between cancer and immunocompetent patients. G-1 was more prevalent in immunocompetents (84%) than in patients with hepatocellular carcinoma (74%, P=0.08) or lymphoma (59%, P=0.001). G-2 was more prevalent in lymphoma patients (24%) than in immunocompetents (8%, P=0.003); cancer risk was 3 times as great with G-2 as with other genotypes (OR 3.72, 95% CI 1.38-9.76). CONCLUSIONS: This multicenter retrospective study provides evidence of differences in HCV genotype distribution by underlying disease among geographically related patients and suggests a possible greater carcinogenic potential of some variants. Large-scale prospective studies are warranted to investigate HCV genotype distribution in other regions.
Assuntos
Infecções por HIV/complicações , Hepacivirus/classificação , Hepacivirus/genética , Hepatite C/epidemiologia , Hepatite C/virologia , Neoplasias/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Genótipo , Hepacivirus/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Texas/epidemiologia , Adulto JovemAssuntos
Alopecia/induzido quimicamente , Inibidores da Protease de HIV/efeitos adversos , Oligopeptídeos/efeitos adversos , Piridinas/efeitos adversos , Ritonavir/efeitos adversos , Adulto , Sulfato de Atazanavir , Quimioterapia Combinada , Infecções por HIV/tratamento farmacológico , Humanos , MasculinoAssuntos
Antivirais/efeitos adversos , Infecções por HIV/complicações , Hepatite C Crônica/complicações , Hiperpigmentação/induzido quimicamente , Interferon-alfa/efeitos adversos , Ribavirina/efeitos adversos , Doenças da Língua/induzido quimicamente , Antivirais/administração & dosagem , Feminino , Humanos , Interferon alfa-2 , Interferon-alfa/administração & dosagem , Pessoa de Meia-Idade , Polietilenoglicóis , Proteínas Recombinantes , Ribavirina/administração & dosagem , População BrancaAssuntos
Carbamatos/administração & dosagem , Deficiência de Glucosefosfato Desidrogenase/diagnóstico , Deficiência de Glucosefosfato Desidrogenase/tratamento farmacológico , Infecções por HIV/complicações , Inibidores da Protease de HIV/administração & dosagem , Organofosfatos/administração & dosagem , Sulfonamidas/administração & dosagem , Relação Dose-Resposta a Droga , Esquema de Medicação , Quimioterapia Combinada , Feminino , Seguimentos , Furanos , Deficiência de Glucosefosfato Desidrogenase/etiologia , Infecções por HIV/diagnóstico , Hemoglobinas/efeitos dos fármacos , Hemoglobinas/metabolismo , Humanos , Masculino , Probabilidade , Estudos Retrospectivos , Fatores de Risco , Resultado do TratamentoRESUMO
We describe an HIV-positive female patient who had acute abdominal pain as the initial presentation of Strongyloides stercoralis infection. The diagnosis was established by identifying rhabditiform larvae in stool. She also had intra-abdominal tuberculosis without intestinal perforation. To our knowledge, this is the first reported case of such a presentation.
Assuntos
Infecções por HIV/complicações , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/complicações , Tuberculose Gastrointestinal/complicações , Adulto , Albendazol/uso terapêutico , Animais , Anti-Helmínticos/uso terapêutico , Antituberculosos/uso terapêutico , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Laparotomia , Estrongiloidíase/diagnóstico , Estrongiloidíase/tratamento farmacológico , Tuberculose Gastrointestinal/tratamento farmacológicoRESUMO
We describe a rare case of Histoplasma infection, which manifested only as a brain histoplasmoma, in a previously healthy woman who had no underlying predisposing conditions. Only a few cases of such intracranial histoplasmomas have been reported but this entity can mimic a brain neoplasm and should be a diagnostic consideration during the evaluation of ring-enhancing brain lesions.
