Parinaud’s Oculoglandular Syndrome Caused by Sporothrix schenckii

A síndrome oculoglandular de Parinaud consiste em forma especial de conjuntivite granulomatosa, muitas vezes relacionada à doença da arranhadura do gato, cuja apresentação clássica se caracteriza por uma síndrome febril acompanhada de granuloma conjuntival e linfonodomegalia ipsilateral. As doenças associadas a esta síndrome são doença da arranhadura do gato, infecção por herpes simples, esporotricose, blastomicose e coccidioidomicose, dentre outras. Relatamos o caso de uma paciente com quadro de enantema conjuntival unilateral à direita acompanhado do aparecimento de nódulos em pálpebra ipsilateral. Os exames complementares incluindo cultura confirmaram o diagnóstico de esporotricose. A paciente foi tratada com itraconazol com resolução do quadro.Parinaud's oculoglandular syndrome consists of a special form of granulomatous conjunctivitis, often related to cat scratch disease, whose classic presentation is characterized by a fever, conjunctival granuloma and ipsilateral lymph node enlargement. Diseases associated with this syndrome are cat-scratch disease, herpes simplex infection, sporotrichosis, blastomycosis and coccidioidomycosis, among others. We report the case of a patient with a unilateral conjunctival enanthema on the right eye and nodules on the ipsilateral eyelid. Complementary examinations including culture confirmed the diagnosis of sporotrichosis. The patient was treated with itraconazole and got cured

Hiperpigmentação na Doença de Addison: Relato de Caso

The primary adrenal insufficiency or Addison's disease is a rare disorder of the adrenal glands and is a risk factor, since its diagnosis is often not recognized in the early stages of the disease. Currently, its main cause is idiopathic atrophy, but it can occur due to infectious, traumatic and neoplastic causes. Symptoms of the condition include: asthenia, weakness, nausea, weight loss, hypotension, and hyperpigmentation. The skin and mucosa hyperpigmentation is the most characteristic symptom of the disease, but may be present in other differential diagnoses, such as hemochromatosis, chronic kidney disease, hyperthyroidism, ocronosis, among others. We report a case of a patient who was referred for investigation of diffuse cutaneous and mucosa hyperpigmentation. The patient also indicated complaints of weight loss, fatigue, anorexia, hypotension and constipation. Several tests were conducted to research and accomplished the diagnosis of Addison's disease.A insuficiência adrenal primária ou doença de Addison é um raro distúrbio das glândulas supra-renais e representa uma condição de risco, já que seu diagnóstico é frequentemente não reconhecido nas fases inicias da doença. Atualmente sua principal causa é a atrofia idiopática, mas pode decorrer devido a causas infecciosas, traumáticas e neoplásicas. Os sintomas da patologia incluem: astenia, náuseas, perda de peso, hipotensão arterial e hiperpigmentação. A hiperpigmentação cutânea e mucosa é o sinal mais característico da doença, porém pode estar presente em outros diagnósticos diferencias, como: hemocromatose, doença renal crônica, hipertireoidismo, ocronose, entre outras. Relatamos um caso de uma paciente que foi encaminhada para investigação de hiperpigmentação cutânea difusa e mucosa. A paciente ainda referia queixas de perda de peso, fadiga, anorexia, hipotensão e obstipação. Foram realizados diversos exames para investigação e realizado o diagnóstico de doença de Addison

SARS-CoV-2 uses CD4 to infect T helper lymphocytes

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the agent of a major global outbreak of respiratory tract disease known as Coronavirus Disease 2019 (COVID-19). SARS-CoV-2 infects mainly lungs and may cause several immune-related complications, such as lymphocytopenia and cytokine storm, which are associated with the severity of the disease and predict mortality. The mechanism by which SARS-CoV-2 infection may result in immune system dysfunction is still not fully understood. Here, we show that SARS-CoV-2 infects human CD4+ T helper cells, but not CD8+ T cells, and is present in blood and bronchoalveolar lavage T helper cells of severe COVID-19 patients. We demonstrated that SARS-CoV-2 spike glycoprotein (S) directly binds to the CD4 molecule, which in turn mediates the entry of SARS-CoV-2 in T helper cells. This leads to impaired CD4 T cell function and may cause cell death. SARS-CoV-2-infected T helper cells express higher levels of IL-10, which is associated with viral persistence and disease severity. Thus, CD4-mediated SARS-CoV-2 infection of T helper cells may contribute to a poor immune response in COVID-19 patients.</p

SARS-CoV-2 uses CD4 to infect T helper lymphocytes

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the agent of a major global outbreak of respiratory tract disease known as Coronavirus Disease 2019 (COVID-19). SARS-CoV-2 infects mainly lungs and may cause several immune-related complications, such as lymphocytopenia and cytokine storm, which are associated with the severity of the disease and predict mortality. The mechanism by which SARS-CoV-2 infection may result in immune system dysfunction is still not fully understood. Here, we show that SARS-CoV-2 infects human CD4+ T helper cells, but not CD8+ T cells, and is present in blood and bronchoalveolar lavage T helper cells of severe COVID-19 patients. We demonstrated that SARS-CoV-2 spike glycoprotein (S) directly binds to the CD4 molecule, which in turn mediates the entry of SARS-CoV-2 in T helper cells. This leads to impaired CD4 T cell function and may cause cell death. SARS-CoV-2-infected T helper cells express higher levels of IL-10, which is associated with viral persistence and disease severity. Thus, CD4-mediated SARS-CoV-2 infection of T helper cells may contribute to a poor immune response in COVID-19 patients.</p

Mycobacterium marinum infection: a case report

AbstractThe infection by Mycobacterium marinum in humans is relatively uncommon. When it occurs, it mainly affects the skin, usually with a chronic, indolent and benign evolution. The diagnosis requires a high index of suspicion, and a significant delay may be observed between the first symptoms to the final diagnosis. This present case reports a M. marinum infection in an immunocompetent patient that had a chronic undiagnosed injury on the dominant hand for at least five years. The patient had several medical consultations, without proper suspicion, hampering adequate diagnostic investigation. Histopathology detected tuberculoid granulomas, but showed no acid-fast bacilli. The culture in appropriate medium and the polymerase chain reaction-restriction enzyme analysis (PRA)-hsp65 confirmed the diagnosis. Treatment with clarithromycin (1 g/day) for three months was effective. Although uncommon, this infection is a contact zoonosis. Therefore, it is important for clinicians to be aware of this diagnosis and properly guide preventable measures to professionals that are in risk group