Alberto Thomaz Londero

Paracoccidioidomicose: estudo clínico e epidemiológico de 422 casos observados no Estado de Mato Grosso do Sul

Clinical and epidemiological features of 422 cases of paracoccidioidomycosis attended at University Hospital of Universidade Federal de Mato Grosso do Sul (Campo Grande, Mato Grosso do Sul, Brazil) from January 1980 to August 1999, were analysed. The mean age was 43.4 years old and the male: female ratio was 10:1. Nearly half (45.5%) of the patients were agricultural workers at the moment of diagnosis. In the acute/subacute form (juvenile type) the phagocytic-monocytic system was very much impaired and mainly marked by lymphadenopathy (95.4%), hepatomegaly (40%), splenomegaly (23.1%). The chronic form (adult type) presents more lesions in oropharynx (66.4%), dysphonia (31.4%) and cough (50.7%). Mycological diagnosis was obtained by direct microscopy of wet mounts in 185/365 (50.7%) patients and by histopathological examination of biopsies in 294/302 (97.3%) patients. The treatment of choice was Sulfamethoxazole/ trimethoprim (Co-trimoxazole), used in 90.3% patients. Sequelae occurred in 30.3% and death in 7.6% of the cases.

Histoplasmosis in Rio Grande do Sul, Brazil: a 21-year experience

Of 156 cases of histoplasmosis observed in the State of Rio Grande do Sul (Brazil), during a 21-year period (1978-1999) 137 were included in this study. Sixty-seven per cent of the patients had hematogeneous disseminated histoplasmosis, 24% had a self-limited syndrome (acute pulmonary histoplasmosis, histoplasmoma or primary pulmonary lymph node complex), and 9 per cent had chronic pulmonary histoplasmosis. Clinical, mycological, and epidemiological data were reviewed and commented.

Occurrence of subcutaneous zygomycosis caused by Basidiobolus haptosporus in Brazil

There were described the first three South American cases of subcutaneous zygomycosis caused by B. haptosporus. The patients were children from nearby towns lying just north of 13 ° latitude S. The diagnosis was based on histopathological aspects plus cultural isolation of the fungus.

The gamut of progressive pulmonary paracoccidioidomycosis

Paracoccidioidomycosis is an important Latin American endemy. The lung is the portal of entrance of the infection and the lesions are confined to this organ in, at least, 30 per cent of the progressive cases. Twelve case histories of patients with the progressive pulmonary form are presented in order to illustrate the repetitious clinical manifestations but the large variety of radiological presentations. The mycologic diagnosis is also emphasized.

The status of histoplasmosis in Brazil.

Thirty four cases of the progressive form of histoplasmosis, five epidemics of the mycosis, many histoplasmin skin test surveys and few clinical or histological evidences of the benign form of the disease were reported in Brazil. The occurrence of the infection in animals and the isolation ofH. capsulatum from soil have also been reported.

Cerebral phaeohyphomycosis caused by Cladophialophora bantiana in a Brazilian drug abuser

We present a case of cerebral phaeohyphomycosis caused by Cladophialophora bantiana in an apparently immunocompetent patient with a history of intravenous drug use. The diagnosis was achieved in specimens obtained at necropsy by histological and mycological examination, with subsequent identification of the isolate in culture.

Pulmonary paracoccidioidomycosis in a nine year old girl

A case of pulmonary paracoccidioidomycosis in a nine year old girl is reported. This is the first proven case of exclusive pulmonary paracoccidioidal lesions observed in a child. A review of the mycosis among children 0 to 10 years old is also presented.

Progressive pulmonary paracoccidioidomycosis a study of 34 cases observed in Rio Grande do Sul (Brazil).

Data on 34 patients with progressive pulmonary paracoccidioi domycosis seen in the State of Rio Grande do Sul (Brazil) are reviewed. Clinical manifestations were similar to those of a prolonged or a recurrent undifferentiated respiratory infection. Roentgenographic findings were also non-characteristic. A mycologic diagnosis was readily made when sputum was available.

The spectrum of computerized tomography (CT) findings in central nervous system (CNS) infection due to Cryptococcus neoformans var. gattii in immunocompetent children

Cranial CT scans of eleven immunocompetent children with central nervous system (CNS) infection due to Cryptococcus neoformans var. gattii were retrospectively reviewed. These children had an average age of 8.8 years and positive culture for C. n. var. gattii in cerebrospinal fluid. The most common signs and symptoms were headache, fever, nuchal rigidity, nausea and vomiting. No normal cranial CT was detected in any patient. Hypodense nodules were observed in all patients. The remaining scan abnormalities were as follows: nine had diffuse atrophy, six had hydrocephalus, and five had hydrocephalus coexistent with diffuse atrophy.

Dermatophilus congolensis human infection

Four cases of human dermatophilosis observed in Rio de Janeiro, Brazil, are reported. Data that suggest nail infection by Dermatophilus congolensis are presented. The clinical spectrum of the disease ranged from an asymptomatic infection to a pustular eruption. Our findings suggest that epidermal Langerhans cells play a role in the pathogenesis of the infection.