RESUMO
Sixty eight patients with localized cutaneous leishmaniasis from an area with Leishmania (Viannia) braziliensis transmission had cultures performed with a modified Marzochís vacuum aspiratory puncture technique to establish sensitivity and contamination rate with this new method. Overall sensitivity of three aspirates was 47.1%; (CI95% 39.4; 59.4) significantly greater than the sensitivity of a single one aspirate. Fungal contamination was observed in 6/204 (2.9%) inoculated culture tubes. We recommend that this useful technique should be adopted as routine for primary isolation of L. (V.) braziliensis from localized cutaneous ulcers.
Assuntos
Leishmania braziliensis/isolamento & purificação , Leishmaniose Cutânea/diagnóstico , Adulto , Animais , Anticorpos Monoclonais , Biópsia por Agulha , Brasil , Meios de Cultura , Doenças Endêmicas , Feminino , Humanos , Leishmaniose Cutânea/epidemiologia , Leishmaniose Cutânea/parasitologia , Masculino , Estudos Retrospectivos , População Rural , Sensibilidade e EspecificidadeRESUMO
Twenty nine patients with localized cutaneous leishmaniasis had lymph node and skin ulcer aspirations for culture of Leishmania with the modified Marzochís vacuum aspiratory technique. Sensitivity of lymph node aspiration was 58.6% and 34.5% for skin ulcer aspiration (P=0.06). Combined sensitivity of the two methods was 79.3%. There was no agreement between methods (Kappa Index = -0.084; CI95% -0,45; 0,28) showing the potential complementary roles in diagnostic approach.
Assuntos
Leishmania braziliensis/isolamento & purificação , Leishmaniose Cutânea/patologia , Doenças Linfáticas/parasitologia , Animais , Biópsia , Leishmaniose Cutânea/parasitologia , Doenças Linfáticas/patologia , Sensibilidade e EspecificidadeRESUMO
In 1996, 20 of 21 patients with mucosal leishmaniasis, treated in 1994 with aminosidine sulfate, 16mg/kg/day salt, by intramuscular injection for 20 days, were clinically evaluated. One patient died due to disease not related to mucosal leishmaniasis. Seven of 14 patients (66.7% N = 21) who achieved complete remission three months after treatment remained clinically cured 24 months later and seven relapsed in the same period (50% N = 14). Sorological follow-up showed poor correlation with the results of clinical examination.
Assuntos
Amebicidas/uso terapêutico , Leishmaniose Mucocutânea/tratamento farmacológico , Paromomicina/uso terapêutico , Amebicidas/administração & dosagem , Animais , Seguimentos , Humanos , Injeções Intramusculares , Leishmania braziliensis , Paromomicina/administração & dosagemRESUMO
In 1996, 20 of 21 patients with mucosal leishmaniasis, treated in 1994 with aminosidine sulfate, 16mg/kg/day salt, by intramuscular injection for 20 days, were clinically evaluated. One patient died due to disease not related to mucosal leishmaniasis. Seven of 14 patients (66.7% N = 21) who achieved complete remission three months after treatment remained clinically cured 24 months later and seven relapsed in the same period (50% N = 14). Sorological follow-up showed poor correlation with the results of clinical examination.
Em 1996 foram avaliados clinicamente 20 dos 21 pacientes com leishmaniose mucosa, tratados em 1994 com sulfato de aminosidine 16mg do sal/kg/dia, intramuscular, por 20 dias. Um paciente foi a óbito por causas não relacionadas com a leishmaniose mucosa. Dos 14 pacientes (66,7% N = 21) que inicialmente alcançaram a remissão completa dos sinais e sintomas durante os três primeiros meses de seguimento, sete (50% N = 14) permaneceram livres de doença por 24 meses e sete pacientes apresentaram recidiva neste período. O acompanhamento sorológico mostrou pobre correlação com a avaliação clínica.
Assuntos
Animais , Humanos , Amebicidas/uso terapêutico , Leishmaniose Mucocutânea/tratamento farmacológico , Paromomicina/uso terapêutico , Amebicidas/administração & dosagem , Seguimentos , Injeções Intramusculares , Leishmania braziliensis , Paromomicina/administração & dosagemRESUMO
We report the long-term clinical follow-up of two patients with unresponsive mucosal leishmaniasis due to Leishmania (Viannia) braziliensis from the Três Braços area in Bahia State, Brazil. Both were agricultural male workers with extensive upper respiratory mucosal involvement that was not cured with conventional and experimental therapy.
Assuntos
Leishmania braziliensis , Leishmaniose Mucocutânea/tratamento farmacológico , Adulto , Animais , Humanos , MasculinoRESUMO
O autor apresenta seu ponto de vista pessoal sobre a situação atual do controle da doença de Chagas nos países da América Latina. Compara a situação com a tripanossomíase africana. Comenta a existência de casos em outros Continentes. Acentua o êxito da luta contra os triatomíneos domiciliados, através do uso de inseticidas residuais. Defende outras formas de transmissão do Trypansoma cruzi.
The author presents his personal point of view on the present situation of Chagas' disease control in Latin America countries. He compares the situation with African trypanosomiasis. He comments on the existence of cases in other Continents. He emphasizes the success of the fighting against domiciliated triatomine bugs by using residual insecticides. He discusses other forms of Trypanosoma cruzi transmission.
Assuntos
Animais , Humanos , Doença de Chagas/prevenção & controle , Doença de Chagas/transmissão , Controle de Insetos , Insetos Vetores , América do Sul , TriatominaeRESUMO
Often in tropical practice there is not time or conditions to do a proper autopsy on a patient who has died. A needle biopsy technique is described for limited closed autopsy examination to clarify organ histology. In this way the clinician may resolve puzzling fatal disease.
Assuntos
Autopsia/instrumentação , Agulhas , Autopsia/métodos , Desenho de Equipamento , HumanosRESUMO
We treated six patients with mucosal leishmaniasis who failed to respond to glucantime (20 mg/kg/day) with ambisome (2-5 grams total dose). The daily dose was 2-3 mg/kg/day given for a minimum of 20 days. After 26-38 months of follow up, five patients were clinically cured. One relapsed after six months. No side effects of therapy were observed apart from headache after infection. Ambisome is a therapeutic option for patients with mucosal leishmaniasis unresponsive to antimonials.
Assuntos
Anfotericina B/uso terapêutico , Antiprotozoários/uso terapêutico , Leishmaniose Mucocutânea/tratamento farmacológico , Adulto , Resistência a Medicamentos , Humanos , Masculino , Meglumina/uso terapêutico , Antimoniato de Meglumina , Pessoa de Meia-Idade , Compostos Organometálicos/uso terapêuticoAssuntos
Anfotericina B/uso terapêutico , Antibacterianos/uso terapêutico , Antiprotozoários/uso terapêutico , Leishmaniose Mucocutânea/tratamento farmacológico , Meglumina/uso terapêutico , Compostos Organometálicos/uso terapêutico , Adulto , Portadores de Fármacos , Resistência a Medicamentos , Seguimentos , Humanos , Lipossomos , Masculino , Antimoniato de Meglumina , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
The author presents his personal point of view on the present situation of Chagas' disease control in Latin America countries. He compares the situation with African trypanosomiasis. He comments on the existence of cases in other Continents. He emphasizes the success of the fighting against domiciliated triatomine bugs by using residual insecticides. He discusses other forms of Trypanosoma cruzi transmission.