RESUMO
The objective of this study was to report a case of a hydronephrotic patient with Strongyloides stercoralis infection, with discharge of rhabditoid larvae exclusively in urine. In 2013, a 72-yr-old male patient, hypertensive, obese, and diagnosed with hydronephrosis secondary to renal calculi, reported lumbar pain, polyuria, polaciuria, and dysuria, as well as frequent urinary tract infections. The microscopic analysis of urine sediment showed the presence of S. stercoralis rabditoid larvae. However, parasitological examinations by Baermann-Moraes, agar plate culture, and spontaneous sedimentation performed with 3 fecal samples on alternate days had negative results. The patient was treated with albendazole and to date has shown negative results in both parasitological and urine tests. This report deals with the unusual finding of S. stercoralis in a urine sample of an immunocompetent individual and absence of disseminated infection, but with hydronephrosis. Patients with nephropathies from S. stercoralis-endemic areas should be monitored periodically, as early detection may prevent the worsening of symptoms and renal failure.
Assuntos
Hidronefrose/complicações , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/parasitologia , Infecções Urinárias/parasitologia , Urina/parasitologia , Idoso , Albendazol/uso terapêutico , Animais , Antinematódeos/uso terapêutico , Fezes/parasitologia , Humanos , Hidronefrose/etiologia , Cálculos Renais/complicações , Masculino , Estrongiloidíase/tratamento farmacológico , Urina/citologia , Urina/microbiologiaRESUMO
The goal of this study was to determine the prevalence of Metabolic Syndrome (MS) in a semi-arid rural area in Bahia, motivated by the increase of impaired glucose tolerance in rural populations and the scant national data about the occurrence of MS. Total sample involved 240 adults > or = 25 years, randomly selected, 102 (42.5%) men and 138 (57.5%) women, mean age 49.5 +/- 14.9, ranging from 25 to 87 years. Diagnosis was based on the I Diretriz Brasileira de Diagnóstico e Tratamento da SM. Crude prevalence was 30.0% while the age-adjusted prevalence was 24.8%. MS frequency was higher in women (38.4%) than in men (18.6%), more elevated among individuals with age > or = 45 years (41.4%) than among those with age < 45 years (15.9%). Stratification performed according to sex and age revealed higher prevalence among women > or = 45 years (56.9%), probably associated to menopause. Presence of MS in the absence of impaired fasting glycemia and obesity, namely its best-established constituents, suggests the importance of the syndromic diagnosis, indicated by the high predictive value of some isolated metabolic alterations. High prevalence of MS requires attention for the treatment of the whole syndrome, retarding or preventing future consequences, like diabetes and cardiovascular disease.