5 research outputs found
Diagnóstico de paracoccidioidomicose disseminada grave em aspirado de medula óssea: relato de caso
Descreve-se caso de um paciente adulto, portador de forma crônica multifocal grave de paracoccidioidomicose, cujo diagnóstico etiológico foi feito pelo achado do fungo em aspirado de medula óssea, a partir da obsemação direta e da mielocultura. Os autores destacam a importância destes exames na propedêutica de pacientes suspeitos de portarem a forma sistêmica da micose.<br>Acute or chronic disseminated paracoccidioidomycosis can be associated with changes in blood and bone marrow cell counts, mainly in the severe forms of this disease. However, there are few reports about the microbiological confirmation of the mycosis in bone marrow tissue. The present report describes a case of an adult patient with severe chronic multifocal paracoccidioidomycosis, whose etiological diagnosis has been done by the microscopical exam and culture of the bone marrow aspirate. The authors emphasize the importance of these exams as an alternative way for the diagnosis of suspected cases of severe paracoccidioidomycosis
Mutations in Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthase of isolates from the Amazon region of Brazil
Since the late 1970s pyrimethamine-sulfadoxine (PS; FansidarTM
Hoffman-LaRoche, Basel) has been used as first line therapy for
uncomplicated malaria in the Amazon basin. Unfortunately, resistance
has developed over the last ten years in many regions of the Amazon and
PS is no longer recommended for use in Brazil. In vitro resistance to
pyrimethamine and cycloguanil (the active metabolite of proguanil) is
caused by specific point mutations in Plasmodium falciparum
dihydrofolate reductase (DHFR), and in vitro resistance to sulfadoxine
has been associated with mutations in dihydropteroate synthase (DHPS).
In association with a proguanil-sulfamethoxazole clinical trial in
Brazil, we performed a nested mutation-specific polymerase chain
reaction to measure the prevalence of DHFR mutations at codons 50, 51,
59, 108 and 164 and DHPS mutations at codons 436, 437, 540, 581 and 613
at three sites in the Brazilian Amazon. Samples from two isolated towns
showed a high degree of homogeneity, with the DHFR
Arg-50/Ile-51/Asn-108 and DHPS Gly-437/Glu-540/Gly-581 mutant genotype
accounting for all infections in Peixoto de Azevedo (n = 15) and 60% of
infections in Apiacs (n = 10), State of Mato Grosso. The remaining
infections in Apiacs differed from this predominant genotype only by
the addition of the Bolivia repeat at codon 30 and the Leu-164 mutation
in DHFR. By contrast, 17 samples from Porto Velho, capital city of the
State of Rondnia, with much in- and out-migration, showed a wide
variety of DHFR and DHPS genotypes
Fungal agents in different anatomical sites in Public Health Services in Cuiabá, state of Mato Grosso, Brazil
INTRODUCTION: A contribution to the regional epidemiological profile of the most common fungal agents in Public Health Services in Cuiabá, state of Mato Grosso, including university hospitals and polyclinics. METHODS: Clinical specimens (n = 1,496) from 1,078 patients were collected, submitted to direct mycological exam (potash or stick tape method) and cultured in specific mediums. Dermatophytic and non-dermatophytic agents were identified according to micromorphology (Ridell technique). RESULTS: The majority of the 1,496 specimens were skin (n = 985) and nail exams (n = 472). Of the 800 positive cultures, 246 (30.8%) corresponded to dermatophytes and 336 (42%) to yeasts of the genus Candida, 190 (23.7%) to other yeasts, 27 (3.4%) to non-dermatophytic filamentous fungi and one (0.1%) the agent of subcutaneous mycosis. Lesions considered primary occurred in greater numbers (59.5%) than recurrent lesions (37.4%), with a greater concentration of positivity occurring on the arms and legs. CONCLUSIONS: Comorbidities, allergies and diabetes mellitus were conditions associated with greater positivity in direct mycological exams and cultures. Positive culture was considered a definitive diagnosis of fungal infection and confirmed 47.8% of diagnostic hypotheses