Dyslipidemia, weight gain, and decreased growth velocity in a 14-year-old male.

A 14-year-old male was referred for dyslipidemia. His findings were consistent with metabolic syndrome. Although he lacked the typical physical appearance, his accelerated weight gain combined with a decreased linear growth velocity suggested Cushing syndrome. He was subsequently found to have adrenocorticotropic hormone-independent Cushing syndrome secondary to primary pigmented nodular adrenal disease without Carney Complex. After bilateral adrenalectomy, his lipid profile returned to normal. In this article, we discuss the role of glucocorticoids on lipid and lipoprotein metabolism.

Bilateral anomaly in Evandromyia evandroi (Diptera: Psychodidae: Phlebotominae) captured in Vicência municipality, Northern Rainforest region of Pernambuco State, Brazil.

Approximately 800 species of phlebotomine sand flies, many of which are vectors of Leishmania, have been described. Besides morphological similarities within groups, the occurrence of anomalies within a species may lead to an erroneous description of new species. This paper describes one phlebotomine sand fly, Evandromyia evandroi, with a symmetrical bilateral anomaly in the number of spines on the gonostyle. In this specimen, the anomalous spine is located in the external region of gonostyle, inserted between the upper external and the lower external spines. It is important to document morphological anomalies, so as to avoid erroneous sand fly identifications.

Cutaneous and visceral leishmaniasis in dogs from a rural community in northeastern Brazil.

A community-based epidemiological study was carried out in a rural area in northeastern Brazil, where visceral leishmaniasis is endemic, but the primary vector Lutzomyia longipalpis has never been found. Forty-one dogs were screened by an indirect immunofluorescence antibody test (IFAT) for the presence of anti-Leishmania antibodies and 12 (29.3%) of them were positive. One of the IFAT-positive dogs was also positive for Leishmania amastigotes in bone marrow cytology and for Leishmania infantum by real-time polymerase chain reaction (PCR) on blood. One IFAT-negative dog was positive for L. infantum by PCR on bone marrow and other for Leishmania amastigotes in skin stained-smears. When tested for L. braziliensis by PCR, 20 dogs were positive. Considering all diagnostic tests, the estimated prevalence of Leishmania spp. infection in the studied rural dog population was 58.5%. There was no significant difference in IFAT-positivity in relation to age, gender, and clinical status of the dogs. When tested for L. infantum by real-time PCR, 20 ticks collected from IFAT-positive dogs were all negative. This study shows a high level of exposure to Leishmania spp. infection in dogs from a rural community in northeastern Brazil. In general, the results do not support the participation of ticks as vectors of L. infantum in this area, which is likely to be transmitted by Lutzomyia spp. other than L. longipalpis. Finally, this study highlights that the use of IFAT in areas where both L. infantum and L. braziliensis are present should be withdraw in order to avoid the unnecessary culling of dogs that are actually infected only by L. braziliensis.

A case of tuberous sclerosis complex that progressed to end-stage renal disease.

BACKGROUND: A 31-year-old woman with tuberous sclerosis complex presented with a 1 week history of subjective fever, chills, rigors, poor appetite and dizziness. INVESTIGATIONS: Physical examination, urine and blood analysis, CT of the abdomen, chest and brain, and chest X-ray. DIAGNOSIS: End-stage renal disease, septic shock and urinary tract infection secondary to huge bilateral angiomyolipomas of the kidney associated with tuberous sclerosis complex. MANAGEMENT: Antibiotic therapy, vasopressor treatment and bilateral nephrectomy, followed by hemodialysis while awaiting renal transplantation.

Portal de Saúde Pública

Criado e mantido por médicos com atuação na área de saúde pública em Potugal e Macau. Disponibiliza informação dirigida a médicos e profissionais de saúde sobre doenças infecciosas, imunização, metodologia para investigação e estatística e utilização do software EpiInfo; para comerciantes e hoteleiros sobre higiene em estabelecimentos comerciais; e para educadores e estudantes sobre prevenção de doenças, toxicomania e temas de educação em saúde.