ABORDAGEM TERAPEUTICA DE ABSCESSOS CEREBRAIS MÚLTIPLOS DE CAUSA IDIOPÁTICA EM PACIENTE IMUNOCOMPETENTE: RELATO DE CASO.

Introduction: Multiple brain abscesses are centers of pyogenic cerebral parenchymal infections that require immediate and effective attention to reduce morbidity and mortality. The identification of the etiologic agent and the infectious focus are usually of great value in terms of therapeutic planning. This paper seeks to report a rare case of multiple brain abscesses in an immunocompetent patient with no evident risk factors and the fundamental role that empirical antibiotic therapy plays in the resolution of the case. Case report: A 75-year-old patient with no evidence of immunosuppression and previous illnesses began to experience changes in her basic daily live activities, confusion in time and space, hypersomnia, gait slowing, dysarthria and stabbing pain in the right temporal region of the brain that would not cease even with use of analgesics. Magnetic Resonance revealed multiple abscesses in the temporal region generating mass effect and intracranial hypertension. It was performed craniotomies with drainage of purulent secretions and it was prepared cultures out of the material which resulted in no identification of the etiological agent. Discussion: The therapeutic approach of brain abscesses has not yet been defined. As a result, each case has been conducted in an individualized manner according to the location of the lesions, their evolutionary stage and the patient's clinical conditions. In the case of this report, the abscess’ origin was not identified and the resolution of the condition was obtained through surgical drainage in association with empirical antibiotic therapy. With advances in neuroimaging and pharmacology, reduction in mortality from brain abscesses reduced to less than 10%. However, failure to identify an etiologic agent and several neurosurgical approaches may lead to more comorbidities for the patient. We present a rare case of cerebral abscesses in an immunocompetent patient without identification of an aggressor organism and the importance of empirical antibiotic therapy in the resolution of the case. Key words: brain abscess; immunocompetence; diagnosis; therapeutics; anti-infective agentsIntrodução: Abscessos cerebrais múltiplos são focos de infecções piogênicas do parênquima cerebral que requerem uma atenção imediata e eficaz para reducão de morbimortalidade. A identificação do agente etiológico e do foco infeccioso normalmente é de grande valia na programação terapêutica. Esse trabalho busca relatar um raro caso de abscessos cerebrais múltiplos em paciente imunocompetente e sem fatores de risco evidentes, e o papel fundamental da antibioticoterapia empírica na resolução do caso. Relato do caso: Paciente, 75 anos, sem evidência de imunossupressão e doenças prévias iniciou quadro de alterações das atividades básicas da vida diária, confusão de tempo e espaço, hipersonia, lentificação da marcha, disartria e dor em pontada na região temporal direita que não cessava ao uso de analgésicos. Em Ressôncia magnética evidenciou-se múltiplos abscessos em região temporal gerando efeito de massa e hipertensão intracraniana. Realizado craniotomias com drenagens de secreções purulentas e culturas do material que não identificaram o agente etiológico. Discussão: A abordagem terapêutica dos abscessos cerebrais ainda não se encontra definida. Em virtude disso, cada caso tem sido conduzido de forma individualizada de acordo com a localização das lesões, seu estágio evolutivo e as condições clínicas do paciente. No caso em questão não indentificou-se a origem dos abscessos e a resolução do quadro foi obtida através das drenagens cirúrgicas em associação a antibioticoterapia empírica. Com os avanços da neuroimagem e da farmacologia, a redução da mortalidade por abscessos cerebrais reduziu para menos de 10%. Porém, a não identificação de um agente etiológico e diversas abordagens neurocirúrgicas podem acarretar em mais comorbidades para o paciente. Apresentamos um raro caso de abcessos cerebrais em paciente imunocompetente sem identificação de organismo agressor e o papel da antibioticoterapia empírica na resolução do caso.   Palavras-chave: abscesso encefálico; imunocompetência; diagnóstico;  terapêutica; antimicrobianos. ABSTRACT Introduction: Multiple brain abscesses are centers of pyogenic cerebral parenchymal infections that require immediate and effective attention to reduce morbidity and mortality. The identification of the etiologic agent and the infectious focus are usually of great value in terms of therapeutic planning. This paper seeks to report a rare case of multiple brain abscesses in an immunocompetent patient with no evident risk factors and the fundamental role that empirical antibiotic therapy plays in the resolution of the case. Case report: A 75-year-old patient with no evidence of immunosuppression and previous illnesses began to experience changes in her basic daily live activities, confusion in time and space, hypersomnia, gait slowing, dysarthria and stabbing pain in the right temporal region of the brain that would not cease even with use of analgesics. Magnetic Resonance revealed multiple abscesses in the temporal region generating mass effect and intracranial hypertension. It was performed craniotomies with drainage of purulent secretions and it was prepared cultures out of the material which resulted in no identification of the etiological agent. Discussion: The therapeutic approach of brain abscesses has not yet been defined. As a result, each case has been conducted in an individualized manner according to the location of the lesions, their evolutionary stage and the patient's clinical conditions. In the case of this report, the abscess’ origin was not identified and the resolution of the condition was obtained through surgical drainage in association with empirical antibiotic therapy. With advances in neuroimaging and pharmacology, reduction in mortality from brain abscesses reduced to less than 10%. However, failure to identify an etiologic agent and several neurosurgical approaches may lead to more comorbidities for the patient. We present a rare case of cerebral abscesses in an immunocompetent patient without identification of an aggressor organism and the importance of empirical antibiotic therapy in the resolution of the case. Keywords: brain abscess; immunocompetence; diagnosis; therapeutics; anti-infective agents

Neotropical freshwater fisheries : A dataset of occurrence and abundance of freshwater fishes in the Neotropics

The Neotropical region hosts 4225 freshwater fish species, ranking first among the world's most diverse regions for freshwater fishes. Our NEOTROPICAL FRESHWATER FISHES data set is the first to produce a large-scale Neotropical freshwater fish inventory, covering the entire Neotropical region from Mexico and the Caribbean in the north to the southern limits in Argentina, Paraguay, Chile, and Uruguay. We compiled 185,787 distribution records, with unique georeferenced coordinates, for the 4225 species, represented by occurrence and abundance data. The number of species for the most numerous orders are as follows: Characiformes (1289), Siluriformes (1384), Cichliformes (354), Cyprinodontiformes (245), and Gymnotiformes (135). The most recorded species was the characid Astyanax fasciatus (4696 records). We registered 116,802 distribution records for native species, compared to 1802 distribution records for nonnative species. The main aim of the NEOTROPICAL FRESHWATER FISHES data set was to make these occurrence and abundance data accessible for international researchers to develop ecological and macroecological studies, from local to regional scales, with focal fish species, families, or orders. We anticipate that the NEOTROPICAL FRESHWATER FISHES data set will be valuable for studies on a wide range of ecological processes, such as trophic cascades, fishery pressure, the effects of habitat loss and fragmentation, and the impacts of species invasion and climate change. There are no copyright restrictions on the data, and please cite this data paper when using the data in publications

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora