Y. Higaki

Comprometimento da medula óssea e eosinofilia na paracoccidioidomicose

Sao descritos 3 casos de paracoccidioidomicose com a forma aguda da doenca, nos quais formas leveduriformes de Paracoccidioides brasiliensis foram visualizadas ao exame direto de medula ossea, sendo a cultura tambem positiva em um caso. Salienta-se o acometimento do sistema fagocitico-mononuclear e a ausencia de resposta as provas cutâneas de hipersensibilidade tardia a antigenos microbianos e de P. brasiliensis em todos, bem como a gravidade do quadro clinico e lesoes osseas generalizadas em um caso, com 20.260 eosinofilos/mm3 no sangue periferico. Os autores discutem o possivel papel do eosinofilo na interacao hospedeiro-parasita na paracoccidioidomicose, sugerindo que a ativacao de subpopulacao TH 2 e o aumento de secrecao de IL 5 e de GM-CSF possam estar relacionados a grande eosinofilia presente no caso mais grave

Infecção por clonorchis sinensis em imigrantes asiáticos no Brasil: tratamento com praziquantel

Fifteen adult patients with assymptomatic infection due to Clonorchis sinensis, diagnosed by coprological examination, were studied. They all came from Asia (twelve from Taiwan, two from South Korea and one from Hong Kong) and were examined at the Adolfo Lutz Institute and the Department of Infectious Diseases, School of Medicine, University of São Paulo, in São Paulo, Brazil. Six patients were women and nine men. All studied patients were admitted to hospital and treated with praziquantel (60 mg/kg). Previous to treatment and on the 15th, 30th and 60th days after praziquantel administration, patients were submitted to quantitative stool examinations, according to Kato-Katzs technique and to hematological and biochemical serum analysis. After a 60 day follow-up nine patients (60%) were negative for C. sinensis eggs in stools. Those not cured after praziquantel administration (six patients, 40%) revealed a sharp decline in faecal elimination of C. sinensis eggs.Estudaram-se quinze pacientes com infeccao assintomatica por Clonorchis sinensis, revelada atraves de exame parasitologico de fezes. Todos eram de origem asiatica e procuraram o Laboratorio Central do Instituto Adolfo Lutz para se submeterem a exames laboratoriais necessarios a regularizacao de sua situacao, face a nova legislacao sobre imigrantes. Eram todos individuos adultos, seis pertencendo ao sexo feminino e nove ao masculino. Os quinze pacientes com clonorquiase foram internados no Hospital das Clinicas da FMUSP e tratados com Praziquantel, na dosagem de 60 mg/kg de peso corporal, dividida em duas tomadas. Foram realizados exames coprologicos quantitativos (metodo de Kato-Katz), antes do tratamento especifico e no 15o, 30o e 60o dias apos a terapeutica. Na ultima avaliacao (60? dia apos terapeutica), em nove pacientes (60,0%) nao se encontraram ovos do trematodeo nas fezes e nos seis (40,0%), que continuavam eliminando ovos, notou-se reducao na quantidade eliminada (superior a 90% em cinco e a 30% no paciente restante). Os pacientes foram tambem submetidos a exames subsidiarios, para avaliacao do estado geral e funcao hepatica, antes da administracao de Praziquantel e, posteriormente, no seguimento ambulatorial. A medicacao foi relativamente bem tolerada pelos pacientes, verificando-se a ocorrencia de efeitos colaterais representados por nauseas e vomitos (dois casos), vertigens e tonturas (dois casos), epigastralgia (dois casos) e diarreia no 3? dia apos tratamento (um caso).

Calazar em clínica especializada, na cidade de São Paulo, Brasil

Em um servico especializado de hospital universitario da cidade de Sao Paulo, Brasil, ficaram analisados o numero de pacientes com calazar atendidos e as localidades onde a parasitose foi adquirida, bem como alguns fatos correlatos. Em periodo de 12 anos e tres meses ocorreu internacao de 62 enfermos, configurando a taxa de 0,91% em relacao a 6.798 individuos. Esse valor e a cifra de obitos, correspondente a 19,33%, representaram a expressividade da doenca, que nao e incomum e desprovida de gravidade.In order to figure out basically a situation strictly connected with medical assistance work and also to cooperate with public health authorities, analysis of patients with kala-azar was made in a specialized ward of a university hospital of the city of S. Paulo (Brazil). The patients, the locale where their protozoosis was acquired, and related data were analyzed. This study was made of patients hospital registered in 12 years and 3 months. Sixty-two were bearers of kala-azar, at a rate of 0.91% out of a total of 6,798 hospitalized patients. Sixty-two were bearers of kala-azar, 0.91% of the total. Mortality was 19.3%. Both figures, 0.91% and 19.3%, define the importance of the disease, which is severe and rather frequent. The date obtained from the survey, especially that related to the geographic distribution of the infection, will undoubtedly help to better evaluate the protozoosis in question.

Kala-azar in a specialized clinic in Sao Paulo City, Brazil.

Em um servico especializado de hospital universitario da cidade de Sao Paulo, Brasil, ficaram analisados o numero de pacientes com calazar atendidos e as localidades onde a parasitose foi adquirida, bem como alguns fatos correlatos. Em periodo de 12 anos e tres meses ocorreu internacao de 62 enfermos, configurando a taxa de 0,91% em relacao a 6.798 individuos. Esse valor e a cifra de obitos, correspondente a 19,33%, representaram a expressividade da doenca, que nao e incomum e desprovida de gravidade.In order to figure out basically a situation strictly connected with medical assistance work and also to cooperate with public health authorities, analysis of patients with kala-azar was made in a specialized ward of a university hospital of the city of S. Paulo (Brazil). The patients, the locale where their protozoosis was acquired, and related data were analyzed. This study was made of patients hospital registered in 12 years and 3 months. Sixty-two were bearers of kala-azar, at a rate of 0.91% out of a total of 6,798 hospitalized patients. Sixty-two were bearers of kala-azar, 0.91% of the total. Mortality was 19.3%. Both figures, 0.91% and 19.3%, define the importance of the disease, which is severe and rather frequent. The date obtained from the survey, especially that related to the geographic distribution of the infection, will undoubtedly help to better evaluate the protozoosis in question.

Kala-azar in the city of S. Paulo (Brazil) and in an infectious disease ward

Em um servico especializado de hospital universitario da cidade de Sao Paulo, Brasil, ficaram analisados o numero de pacientes com calazar atendidos e as localidades onde a parasitose foi adquirida, bem como alguns fatos correlatos. Em periodo de 12 anos e tres meses ocorreu internacao de 62 enfermos, configurando a taxa de 0,91% em relacao a 6.798 individuos. Esse valor e a cifra de obitos, correspondente a 19,33%, representaram a expressividade da doenca, que nao e incomum e desprovida de gravidade.In order to figure out basically a situation strictly connected with medical assistance work and also to cooperate with public health authorities, analysis of patients with kala-azar was made in a specialized ward of a university hospital of the city of S. Paulo (Brazil). The patients, the locale where their protozoosis was acquired, and related data were analyzed. This study was made of patients hospital registered in 12 years and 3 months. Sixty-two were bearers of kala-azar, at a rate of 0.91% out of a total of 6,798 hospitalized patients. Sixty-two were bearers of kala-azar, 0.91% of the total. Mortality was 19.3%. Both figures, 0.91% and 19.3%, define the importance of the disease, which is severe and rather frequent. The date obtained from the survey, especially that related to the geographic distribution of the infection, will undoubtedly help to better evaluate the protozoosis in question.