RESUMO
The SARS-CoV-2 virus has emerged and rapidly evolved into a current global pandemic. Although bacterial and fungal coinfections have been associated with COVID-19, little is known about parasitic infection. We report a case of a COVID-19 patient who developed disseminated strongyloidiasis following treatment with high-dose corticosteroids and tocilizumab. Screening for Strongyloides infection should be pursued in individuals with COVID-19 who originate from endemic regions before initiating immunosuppressive therapy.
Assuntos
Infecções por Coronavirus/parasitologia , Diabetes Mellitus/parasitologia , Hipertensão/parasitologia , Doenças do Sistema Nervoso Periférico/parasitologia , Pneumonia Viral/parasitologia , Strongyloides stercoralis/patogenicidade , Estrongiloidíase/parasitologia , Corticosteroides/administração & dosagem , Idoso , Animais , Anti-Helmínticos/uso terapêutico , Anticorpos Monoclonais Humanizados/administração & dosagem , Betacoronavirus/patogenicidade , COVID-19 , Coinfecção , Connecticut , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/virologia , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/imunologia , Diabetes Mellitus/virologia , Equador , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/imunologia , Hipertensão/virologia , Fatores Imunológicos/administração & dosagem , Masculino , Pandemias , Doenças do Sistema Nervoso Periférico/tratamento farmacológico , Doenças do Sistema Nervoso Periférico/imunologia , Doenças do Sistema Nervoso Periférico/virologia , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/imunologia , Pneumonia Viral/virologia , SARS-CoV-2 , Estrongiloidíase/tratamento farmacológico , Estrongiloidíase/imunologia , Estrongiloidíase/virologiaRESUMO
Herpes zoster is caused by the reactivation of latent varicella-zoster virus from dorsal root ganglia. Although infrequent, simultaneous damage to the anterior horn cells or anterior nerve roots at the same level may result in motor neuropathy. When motor involvement is localized in the abdominal wall, a pseudohernia may be the clinical presentation. We report a case of abdominal wall post-herpetic pseudohernia, with clinical, ultrasound and MRI correlation. MRI demonstrated increased T2/STIR signal intensity in the abdominal wall muscles, suggesting acute denervation. To our knowledge, this is the first case report of postherpetic pseudohernia with acute denervation demonstrated on MRI.
Assuntos
Músculos Abdominais/patologia , Parede Abdominal/patologia , Hérnia Abdominal/patologia , Herpes Zoster/complicações , Doenças Musculares/patologia , Doenças do Sistema Nervoso Periférico/patologia , Músculos Abdominais/inervação , Músculos Abdominais/virologia , Parede Abdominal/inervação , Parede Abdominal/virologia , Idoso , Gânglios Espinais/virologia , Hérnia/diagnóstico , Hérnia/etiologia , Herpes Zoster/virologia , Herpesvirus Humano 3 , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Doenças Musculares/diagnóstico , Doenças Musculares/etiologia , Doenças do Sistema Nervoso Periférico/diagnóstico , Doenças do Sistema Nervoso Periférico/etiologia , Doenças do Sistema Nervoso Periférico/virologia , Latência ViralRESUMO
Neurological phenotypes of human T cell lymphotropic virus type I (HTLV-1) are numerous and rarely may not manifest the classic HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP). We report a case of HTLV-1-related sensory neuronopathy heralding the classic HAM/TSP.
Assuntos
Infecções por HTLV-I/diagnóstico , Paraparesia Espástica Tropical/diagnóstico , Doenças do Sistema Nervoso Periférico/diagnóstico , Idoso , Brasil , Diagnóstico Diferencial , Feminino , Infecções por HTLV-I/imunologia , Infecções por HTLV-I/patologia , Infecções por HTLV-I/virologia , Vírus Linfotrópico T Tipo 1 Humano/crescimento & desenvolvimento , Vírus Linfotrópico T Tipo 1 Humano/patogenicidade , Humanos , Paraparesia Espástica Tropical/imunologia , Paraparesia Espástica Tropical/patologia , Paraparesia Espástica Tropical/virologia , Doenças do Sistema Nervoso Periférico/imunologia , Doenças do Sistema Nervoso Periférico/patologia , Doenças do Sistema Nervoso Periférico/virologia , Células Receptoras Sensoriais/patologia , Células Receptoras Sensoriais/virologia , Linfócitos T/patologia , Linfócitos T/virologiaRESUMO
The progress on HIV infection treatment has allowed a longer survival for HIV-infected patients. However, chronic comorbidities are emerging. Peripheral Neuropathy (PN) represents one of the most prevalent neurologic disorders among these patients, and comprehensive studies may contribute to a reduction in the morbidity of this condition. This is a cross-sectional analytic study conducted in a tertiary referral hospital in southern Brazil. This study investigates the prevalence of PN among HIV-infected patients and associated demographic, clinical and laboratory variables. A number of 150 HIV-infected patients admitted between January and May 2016 were interviewed, submitted to physical and neurological examination, and data from their medical records were obtained. The prevalence of PN was 31.3%. It was increased among older patients (p=0.02), patients with higher CD4 lymphocytes levels (p=0.02), and smokers (OR=3.4; 95% CI 1.6-6.9; p<0.01). The research identified a high prevalence of PN in HIV-infected patients. Older age and higher CD4 levels have been associated with PN. To the best of our knowledge, this was one of the first studies reporting an association between tobacco use and PN among HIV-infected patients. Further studies are necessary to elucidate the pathological mechanisms linking PN and tobacco.
Assuntos
Linfócitos T CD4-Positivos/patologia , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Doenças do Sistema Nervoso Periférico , Adulto , Brasil/epidemiologia , Feminino , Infecções por HIV/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso Periférico/epidemiologia , Doenças do Sistema Nervoso Periférico/etiologia , Doenças do Sistema Nervoso Periférico/virologia , PrevalênciaRESUMO
This review follows the contributions of researchers from the Caribbean in improving the understanding of the disease mechanisms, clinical features and aetiology of neurological syndromes manifesting as diseases of the spinal cord and peripheral nerves. The evolution from the initial descriptions of neuropathies of presumed nutritional aetiology and later the recognition of two distinct subgroups, an ataxic neuropathy and a spastic myelopathy, are highlighted. The link between the natural history of human T-cell leukaemia/lymphoma virus type-1 (HTLV-1) infection and the immunopathogenesis of tropical spastic paraparesis is explored.
Assuntos
Infecções por HTLV-I , Vírus Linfotrópico T Tipo 1 Humano , Doenças do Sistema Nervoso Periférico/virologia , Doenças da Medula Espinal/virologia , Infecções por HTLV-I/imunologia , Infecções por HTLV-I/patologia , Humanos , Jamaica , Paraparesia Espástica Tropical/imunologia , Paraparesia Espástica Tropical/virologiaRESUMO
This review follows the contributions of researchers from the Caribbean in improving the understanding of the disease mechanisms, clinical features and aetiology of neurological syndromes manifesting as diseases of the spinal cord and peripheral nerves. The evolution from the initial descriptions of neuropathies of presumed nutritional aetiology and later the recognition of two distinct subgroups, an ataxic neuropathy and a spastic myelopathy, are highlighted. The link between the natural history of human T-cell leukaemia/lymphoma virus type-1 (HTLV-1) infection and the immunopathogenesis of tropical spastic paraparesis is explored.
Este examen sigue las contribuciones de investigadores del Caribe encaminadas a mejorar la comprensión de los mecanismos de la enfermedad, rasgos clínicos y la etiología de los síndromes neurológicos que se manifiestan como enfermedades de la médula espinal y los nervios periféricos. El trabajo resalta la evolución de las descripciones iniciales de las neuropatías de etiología nutricional presuntiva y el posterior reconocimiento de dos subgrupos claramente distintos: la neuropatía atáxica, y la mielopatía espástica. Se explora el vínculo entre la historia natural de la infección por el virus humano de células tipo 1 (HTLV-1) en la leucemia/linfoma, y la inmunopatogénesis de la paraparesia espástica tropical.
Assuntos
Humanos , Infecções por HTLV-I , Vírus Linfotrópico T Tipo 1 Humano , Doenças do Sistema Nervoso Periférico/virologia , Doenças da Medula Espinal/virologia , Infecções por HTLV-I/imunologia , Infecções por HTLV-I/patologia , Jamaica , Paraparesia Espástica Tropical/imunologia , Paraparesia Espástica Tropical/virologiaRESUMO
HIV-individuals are at risk for human T-lymphotropic virus (HTLV) coinfection and neurological diseases. Little is known about the impact of HAART among coinfected patients. In this study, 47 out of 428 HIV individuals were coinfected with HTLV (10.9%). Coinfection was an independent variable associated with neurological outcome (odds ratio 8.73). Coinfection was associated with myelopathy [chi square (X(2)) = 93, P < 0.001], peripheral neuropathy (X(2) = 6.5, P = 0.01), and hepatitis C virus infection (X(2) = 36.5, P < 0.001). HAART did not appear to protect against neurological diseases and had no impact on HTLV proviral load.
Assuntos
Terapia Antirretroviral de Alta Atividade , Anticorpos Antideltaretrovirus/sangue , Infecções por HIV/fisiopatologia , Infecções por HTLV-II/fisiopatologia , Vírus Linfotrópico T Tipo 1 Humano/patogenicidade , Doenças do Sistema Nervoso Periférico/virologia , Carga Viral , Contagem de Linfócito CD4 , Coinfecção , Feminino , Infecções por HIV/complicações , Infecções por HTLV-II/complicações , Anticorpos Anti-Hepatite C/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Doenças do Sistema Nervoso Periférico/fisiopatologia , Doenças da Medula Espinal/virologiaRESUMO
We sought to identify and summarize the incidence and prevalence of neuropathy among HIV patients and subgroups. A systematic search of the literature was performed using MEDLINE and EMBASE. The relevant literature was identified based on predefined criteria. Prevalence data were collected from cross-sectional and cohort studies. Incidence data were collected from cohort and case-control studies. Thirty-seven studies were included of which there were 23 cohort studies, 13 cross-sectional studies, and one case-control study. The prevalence of neuropathy among HIV patients derived from 25 studies varied from 1.2% to 69.4%. Regarding the development of neuropathy among HIV-positive patients, standardized by study duration, the rates per 100 person-years ranged from 0.7 to 39.7. Among older patients there is a greater risk of neuropathy. The same seems to be the case for patients with more severe disease. Currently available studies providing information on the incidence and prevalence of neuropathy among HIV patients suggest a significant burden, but there is a great variation in results across studies. There is no definitive explanation for the variation. However, it underscores the fact that complexity of the disease, along with absence of standardized diagnostic criteria, has considerably influenced the methodologies and outcomes of the studies.