Characterization of the non-apparent clinical form in the initial phase of schistosomiasis mansoni

In this paper the history of 115 recruits that had bathed simultaneously in streams contaminated with Schistosoma mansoni, during military maneuvers, is reported. Thirty four of the infected patients presented the initial phase of the infection diagnosed through epidemiologic, clinical and laboratorial parameters. Three out of the 34 patients did not reveal the clinical picture of the infection, thus being considered representatives of the non-apparent form of the disease. Differences between the intensity of blood eosinophilia, the area of immediate cutaneous reaction and the number of Schistosoma eggs eliminated in the stools proved not to be statistically significant (p>0.05) when the non-apparent and acute cases of schistosomiasis were compared. These cases actually may be considered evidences of the non-apparent form hitherto merely taken for granted in the literature.

Laboratory acquired infection by the virus SP H 114202 (Arenavirus: Arenaviridae): clinical and laboratory findings

Here in is described the clinical and laboratorial findings of a laboratory-acquired infection caused by the virus SP H 114202 (Arenavirus, family Arenaviridae) a recently discovered agent responsible for a viral hemorrhagic fever. The patient was sick for 13 days. The disease had an abrupt onset characterized by high fever (39ºC.), headache, chills and myalgias for 8 days. In addition, on the 3rd day, the patient developed nauseas and vomiting, and in the 10th, epigastralgia, diarrheia and gengivorrhagia. Leucopenia was seen within the 1 st week of onset, with counts as low as 2,500 white cells per mm³. Counts performed after the 23th day of the onset were within normal limits. With the exception of moderate lymphocitosis, no changes were observed in differential counts. An increase in the liter of antibodies by complement fixation, neutralization and ELISA (IgM) was detected. Suckling mice and baby hamsters were inoculated intracerebrally with 0.02 ml of blood samples collected in the 2nd and 7th days of disease. Attempts to isolate the virus were also made in Vero cells. No virus was isolated. This virus was isolated before in a single occasion in São Paulo State, in 1990, from the blood of a patient with hemorrhagic fever with a fatal outcome. The manipulation of the virus under study, must be done carefully, since the transmission can occur through aerosols.

Presença de ovos de Toxocara spp em praças públicas da cidade de Uberlândia, Minas Gerais, Brasil

O objetivo deste trabalho foi verificar a presença de ovos de Toxocara spp nos solos de praças públicas da cidade de Uberlândia, região do Triângulo Mineiro, no período de outubro de 1991 a janeiro de 1992. A cidade possui 89 praças distribuídas em 39 bairros. Para que se tivesse um perfil da ocorrência do parasita, foram colhidas amostras de terra e areia (quando existente) de uma praça, determinada por sorteio, por bairro. As amostras de solo homogeneizadas de 5 pontos distintos das 39 praças foram colhidas em frascos plásticos e analisadas empregando-se os métodos de flutuação em solução saturada de cloreto de sódio e de solução saturada de sulfato de magnésio contendo 5% de iodeto de potássio. Para cada amostra foram realizados os dois métodos em duplicata. Os resultados mostraram estarem contaminados os solos de 9 praças (23,07%), das quais 6 localizavam-se próximas ao centro da cidade. A realização de mais de um método laboratorial permitiu a identificação do agente em maior porcentagem de locais.

Colonização de ecótopos artificiais pelo Panstrongylus megistus na ilha de Santa Catarina, Florianópolis, Santa Catarina, Brasil

Objetivando verificar a colonização de Panstrongylus megistus em ecótopos artificiais em Florianópolis foram examinados, de 1985 a 1992, 779 anexos peridomiciliares (524 galinheiros, 46 currais e 209 ranchos) em 9 localidades e 443 domicílios no distrito de Lagoa, todos na Ilha de Santa Catarina. Todo o ecótopo, incluindo forro e porão das casas, era examinado após aplicação de líquido insentífugo (Pirisa a 5%). A pesquisa nos anexos peri-domiciliares revelou 3 galinheiros e um rancho positivo no distrito de Lagoa, onde foram também encontrados 2 domicílios colonizados pelo P. megistus, com a captura de ovos, ninfas e adultos em todos os ecótopos. Pesquisas dirigidas foram realizadas em dois outros domicílios e em uma escola, nos quais os moradores haviam detectado anteriormente exemplares de P. megistus e, em todos os 3, foi confirmada a colonização pelo triatomíneo. Nos 9 ecótopos artificiais foram coletados 559 ovos, 305 ninfas e 24 adultos de P. megistus, com um índice de infecção pelo T. cruzi de 53,3% (182/329). Índice de infecção semelhante, de 56,5% (78/ 138), foi também encontrado nos adultos de P. megistus oriundos dos ecótopos silvestres e capturados nos domicílios pelos moradores, no período de 1983 a 1991. Os testes de precipitina revelaram, em 94,0% dos insetos examinados (170/181), sangue de uma única fonte alimentar e presença de sangue humano em 80,6% (25/31) dos adultos e em 5,8% (1/17) das ninfas capturados nos domicílios. Os resultados encontrados sugerem a necessidade de adoção de medidas de vigilância epidemiológica com a participação da comunidade, face o risco potencial de domiciliação do P. megistus.

Schistosomiasis: predisposing cause for the formation of hepatic abscesses? Case report

An adult patient with chronic schistosomiasis from an endemic area, complained about a seven day fever, along with jaundice and lumbar backache on the right side. Image exams showed multiple pyogenic liver abscesses. All the classic etiologies were discarded through clinical, radiological and laboratorial criteria. Schistosomiasis can cause pylephlebitis as a complication, along with immunesuppression, granulomatous reaction with central lobular liver necrosis and a greater risk of infection. The authors suggest that schistosomiasis in its chronic form may be the predisposing cause of multiple pyogenic liver abscesses, especially in endemic areas.

Systematic reviews on leptospirosis

OBJECTIVES: To find the existing clinical evidence on interventions for leptospirosis. The objective is to evaluate the effectiveness and safety of any intervention on leptospirosis through systematic reviews of randomized controlled trials (RCTs). DATA SOURCE: The sources of studies used (where there were no limitations concerning language, date, or other restrictions) were: EMBASE, LILACS, MEDLINE, the Cochrane Controlled Clinical Trials Database, and the Cochrane Hepato-Biliary Group Randomized Trials register. SELECTION OF STUDIES: Type of Study: All systematic reviews of randomized controlled trials. Participants: patients with clinical and/or laboratorial diagnosis of leptospirosis, and subjects potencially exposed to leptospirosis as defined by the authors Interventions: any intervention for leptospirosis (as antibiotics or vaccines for prevention or treatment). DATA COLLECTION: The assessment will be independently made by the reviewers and cross-checked. The external validity was assessed by analysis of: studies, interventions, and outcomes. DATA SYNTHESIS: Located 163 studies using the search strategy described above, at the electronic databases above. Only 2 hits were selected, which are protocols of systematic reviews of Cochrane Collaboration, and not full reviews. One of the protocols evaluates antibiotics for treatment, and the other evaluates antibiotics for prevention of leptospirosis. CONCLUSIONS: There were not complete systematic reviews on interventions for leptospirosis. Any interventions for leptospirosis, such as prevention and treatment remains unclear for guidelines and practice.

Salmonella enterica subsp houtenae serogroup O:16 in a HIV positive patient: case report

We described a case of salmonellosis in a 33-year old HIV-infected patient. The patient presented oral and esophageal candidiasis, intense epigastric and retrosternal pain. During the physical examination he was hypochloraemic, acyanotic, hypohydrated, anicteric and afebrile. Admittance laboratorial tests indicated: red cells 3.6 millions/mm³; hemoglobin, 10.1 g/dL; leukocyte count, 3,000/mm³, with 1% of eosinophils, 14% of non-segmented and 53% of segmented neutrophils and 31% of lymphocytes. The blood culture was positive for Salmonella enterica subsp houtenae serogroup O:16. This is probably the first human report of bacteremia due to Salmonella enterica subsp houtenae in Brazil associated to HIV-infected patient.

Neurocryptococcosis: diagnosis by PCR method

Cryptococcus neoformans detection was optimized using PCR technique with the objective of application in the clinical laboratory diagnosis. The amplification area was ITS and 5,6S which encodes the ribosomal RNA (rRNA). A total of 72 cerebrospinal fluid (CSF) samples were used, obtained from cases with and without AIDS. The patients had cryptococcal meningitis (n = 56) and meningitis caused by other agents (n = 16). The results demonstrated that PCR test had the highest sensitivity rates, superior to culture (85.7%) and to India ink test (76.8%). PCR was found to be sensitive in detecting 1 cell/mL and highly specific since it did not amplify other fungal DNA. The comparative analysis of the methods showed that PCR is more sensitive and specific and is applicable as an important laboratorial resource for neurocryptococcosis diagnosis.