RESUMO
Histoplasmosis is a fungal infection caused by Histoplasma capsulatum, and Japan is considered a non-endemic area for histoplasmosis. Most patients diagnosed with histoplasmosis in the past usually have exposure to caves and bat guano with travel history to endemic areas. Therefore, travel history and risk activities should be comprehensively assessed when suspecting histoplasmosis because this important information may be overlooked. Although few, possibilities of indigenous cases have also been suggested. Moreover, it is assumed that the number of travelers and endemic mycoses has decreased with the recent coronavirus disease 2019 epidemic. However, clinicians should carefully consider the differential diagnosis of histoplasmosis for travelers traveling to endemic areas. In this case report, we describe an immunocompetent Japanese woman who developed histoplasmosis due to a history of travel to an endemic country. Our case report suggests that clinicians should not exclude histoplasmosis from the differential diagnosis even in the absence of risk features such as activities or immunodeficiencies during travel.
Assuntos
COVID-19 , Histoplasmose , Adulto , Feminino , Histoplasma , Histoplasmose/diagnóstico , Histoplasmose/tratamento farmacológico , Humanos , Japão , SARS-CoV-2 , América do Sul , ViagemRESUMO
Multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants with higher transmission potential have been emerging globally, including SARS-CoV-2 variants from the United Kingdom and South Africa. We report 4 travelers from Brazil to Japan in January 2021 infected with a novel SARS-CoV-2 variant with an additional set of mutations.
Assuntos
Tratamento Farmacológico da COVID-19 , Doenças Transmissíveis Importadas , SARS-CoV-2 , Adulto , Número Básico de Reprodução , Brasil/epidemiologia , COVID-19/epidemiologia , COVID-19/terapia , COVID-19/transmissão , COVID-19/virologia , Doenças Transmissíveis Importadas/epidemiologia , Doenças Transmissíveis Importadas/fisiopatologia , Doenças Transmissíveis Importadas/terapia , Doenças Transmissíveis Importadas/virologia , Hospitalização , Humanos , Japão/epidemiologia , Masculino , Mutação , Quarentena/métodos , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação , Avaliação de Sintomas/métodos , Doença Relacionada a Viagens , Resultado do TratamentoRESUMO
We describe a case of intermediate leptospirosis resulting from Leptospira licerasiae infection in a traveler returning to Japan from Brazil. Intermediate leptospirosis should be included in the differential diagnosis for travelers with fever returning from South America. This case highlights the need for strategies that detect pathogenic and intermediate Leptospira species.
Assuntos
Leptospira/classificação , Leptospira/isolamento & purificação , Leptospirose/microbiologia , Viagem , Adulto , Antibacterianos/uso terapêutico , Anticorpos Antibacterianos , Brasil/epidemiologia , Ceftriaxona/uso terapêutico , Humanos , Japão , Leptospira/genética , Leptospirose/tratamento farmacológico , MasculinoAssuntos
Febre de Chikungunya/transmissão , Febre de Chikungunya/virologia , Vírus Chikungunya , Doenças Transmissíveis Importadas , Viagem , Adulto , Biomarcadores , Febre de Chikungunya/diagnóstico , Febre de Chikungunya/epidemiologia , Vírus Chikungunya/classificação , Vírus Chikungunya/genética , Cuba , Humanos , Japão , Masculino , Filogenia , RNA Viral , Avaliação de SintomasRESUMO
A multi-national working group on antibiotic stewardship, from the International Society of Chemotherapy, put together ten recommendations to physicians prescribing antibiotics to outpatients. These recommendations are: (1) use antibiotics only when needed; teach the patient how to manage symptoms of non-bacterial infections; (2) select the adequate ATB; precise targeting is better than shotgun therapy; (3) consider pharmacokinetics and pharmacodynamics when selecting an ATB; use the shortest ATB course that has proven clinical efficacy; (4) encourage patients' compliance; (5) use antibiotic combinations only in specific situations; (6) avoid low quality and sub-standard drugs; prevent prescription changes at the drugstore; (7) discourage self-prescription; (8) follow only evidence-based guidelines; beware those sponsored by drug companies; (9) rely (rationally) upon the clinical microbiology lab; and (10) prescribe ATB empirically - but intelligently; know local susceptibility trends, and also surveillance limitations.