Leishmaniose visceral adquirida no Estado de São Paulo (Brasil)

A case of visceral leishmaniasis in a two-year-old child who has always lived in Capão Redondo, situated in Greater S. Paulo (Brazil), was reported. Although congenital transmission or blood transfusion were considered, it is probable that the infection originated in the usual mechanism, thus constituting an autochthonous occurrence in the State of S. Paulo. The State Health Department was notified of the case in order that it could be investigated and necessary measures taken.Foi descrita a notificação de um caso de leishmaniose visceral em uma criança com dois anos de idade, tendo sempre residido em Capão Redondo, localidade situada na Grande São Paulo (Brasil). Apesar de transmissão congênita ou por transfusão de sangue ter sido cogitada, é provável que a infecção tenha decorrido de mecanismo habitual, consubstanciando ocorrência autóctone relativa do Estado de São Paulo

Rapidly progressive antineutrophil cytoplasm antibodies associated with pulmonary-renal syndrome in a 10-year-old girl

CONTEXT: The term pulmonary-renal syndrome has been used frequently to describe the clinical manifestations of a great number of diseases in which pulmonary hemorrhage and glomerulonephritis coexist. The classic example of this type of vasculitis is Goodpasture´s syndrome, a term used to describe the association of pulmonary hemorrhage, glomerulonephritis and the presence of circulating antiglomerular basement membrane antibodies (anti-GBM). Among the several types of systemic vasculitides that can present clinical manifestations of the pulmonary-renal syndrome, we focus the discussion on two types more frequently associated with antineutrophil cytoplasm antibodies (ANCA), microscopic polyangiitis and Wegener´s granulomatosis, concerning a 10 year old girl with clinical signs and symptoms of pulmonary-renal syndrome, with positive ANCA and rapidly progressive evolution. CASE REPORT: We describe the case of a 10-year-old girl referred to our hospital for evaluation of profound anemia detected in a primary health center. Five days before entry she had experienced malaise, pallor and began to cough up blood-tinged sputum that was at first attributed to dental bleeding. She was admitted to the infirmary with hemoglobin = 4 mg/dL, hematocrit = 14%, platelets = 260,000, white blood cells = 8300, 74% segmented, 4% eosinophils, 19% lymphocytes and 3% monocytes. Radiographs of the chest revealed bilateral diffuse interstitial alveolar infiltrates. There was progressive worsening of cough and respiratory distress during the admission day, when she began to cough up large quantities of blood and hematuria was noted. There was rapid and progressive loss of renal function and massive lung hemorrhage. The antineutrophil cytoplasm antibody (ANCA) test with antigen specificity for myeloperoxidase (anti-MPO) was positive and the circulating anti-GBM showed an indeterminate result

Leishmaniose visceral adquirida no Estado de São Paulo (Brasil) A case of visceral leishmaniasis contracted in the State of S. Paulo, Brazil

Foi descrita a notificação de um caso de leishmaniose visceral em uma criança com dois anos de idade, tendo sempre residido em Capão Redondo, localidade situada na Grande São Paulo (Brasil). Apesar de transmissão congênita ou por transfusão de sangue ter sido cogitada, é provável que a infecção tenha decorrido de mecanismo habitual, consubstanciando ocorrência autóctone relativa do Estado de São Paulo.<br>A case of visceral leishmaniasis in a two-year-old child who has always lived in Capão Redondo, situated in Greater S. Paulo (Brazil), was reported. Although congenital transmission or blood transfusion were considered, it is probable that the infection originated in the usual mechanism, thus constituting an autochthonous occurrence in the State of S. Paulo. The State Health Department was notified of the case in order that it could be investigated and necessary measures taken