[Disseminated cutaneous leishmaniasis due to Leishmania viannia braziliensis in the state of Maranhão, Brazil]. / Leishmaniose cutânea disseminada produzida por Leishmania viannia braziliensis no Estado do Maranhão--Brasil.

The authors describe a case of a patient from Barreirinhas, MA with disseminated cutaneous leishmaniasis, who presented 58 lesions spread all over his body, with many different aspects, but ulcerative lesions were predominant. They discuss the difficulty of laboratory diagnosis in the beginning of the investigation and its therapeutics implications. The parasite isolated was identified as Leishmania viannia braziliensis using monoclonal antibodies in the fluorescent antibody test. This form of the disease is different from the diffuse cutaneous leishmaniasis found in Maranhão, due to Leishmania (Leishmania) amazonensis which is responsible for most of the cases of cutaneous leishmaniasis in our state. The possible mechanisms of lesions dissemination are discussed.

[Fonsecaea pedrosoi-caused chromoblastomycosis in the state of Maranhão. I. The clinical, epidemiological and evolutionary aspects]. / Cromoblastomicose produzida por Fonsecaea pedrosoi no Estado do Maranhão. I--Aspectos clínicos, epidemiologicos e evolutivos.

The aim of this study was to observe the clinical and of epidemiological behavior of chromoblastomycosis in the State of Maranhão. A retrospective and prospective study of 13 cases was performed at the infectious diseases section of the Hospital dos Servidores do Estado do Maranhão, from November, 1988 to July, 1991. In the investigation a protocol record was used with a view to further analysis. A higher prevalence between 50 and 60 years of age (46.1%) and in male patients (92.3%) was noted. Twelve patients (92.3%) were from Maranhão State, and 10 of them (76.9%) came from the western microregion of the State of Maranhão. Regarding occupation, 92.3% were land workers, and most of them presented the lesions on the lower limbs (84.6%) of a vegetant warty aspect, brown in color with itching. Histopathological examination diagnosed chromomycosis in 100% of the cases. Culture was performed in 11 cases, and Fonsecaea pedrosoi isolated in 9 of them. Treatment with 5-fluorocytosine resulted in a good evolutive response. This study indicates the existence of a probable endemic area of chromomycosis in hinterland of Maranhão (western microregion) that hither to unknown.

[Rhinoentomophthoramycoses. Report of 4 cases]. / Rinoentomoftoramicose. Apresentaçao de quatro casos.

Four cases of rhynoentomophthoramycosis are reported from urban areas of the states of Bahia and Maranhão, Brazil. The lesions presented with infiltration, redness and heat of the skin of the nose and infraorbital areas and accompanying nasal stuffiness. In on case the infiltration also involved the lips and mandibular area causing severe facial deformity. Microscopically, granulomatous reactions with small abcesses, fibrosis and a dense infiltration of eosinophils were found. Hyphae were seen frequently, always associated with the Splendore phenomenon. Three cases were treated completely with iodine. The one case resistant to iodine was cured with prolonged administration of sulphona. In two cases, plastic surgery was performed for facial reconstruction and nasal-unblocking respectively. Including the cases presented here, only 8 cases of rhynoentomophthoramycosis have been reported in Brazil, but the authors believe that this pathology muta occur more frequently. The lack of knowledge of its clinico-pathological aspects may be responsible for the delay or lack of diagnosis of this entity which occurred in two of the cases reported here.