RESUMEN
Strongyloidiasis is a parasitic infestation caused by the helminth Strongyloides stercoralis. It is essentially gastrointestinal and in general asymptomatic but can sometimes present with skin signs. Immunocompromised patients can develop the disseminated form of the disease due to the parasite's opportunistic behavior, as in cases of coinfection by the human T-lymphotropic type 1 virus (HTLV-1). This article presents a case of a patient infected with HTLV-I and Strongyloides stercoralis who developed the disseminated form. There were purpuric reticulated periumbilical lesions as well as vibices on the patient's flanks. Histopathologic exam of a skin lesion revealed the presence of larvae in the deep reticular dermis. We emphasize the relevance of awareness regarding interaction between HTLV-1 and strongyloidiasis, besides identification of the cutaneous manifestations of the disease to reach an appropriate therapeutic diagnosis.
Asunto(s)
Infecciones por HTLV-I/inmunología , Huésped Inmunocomprometido , Estrongiloidiasis/diagnóstico , Animales , Virus Linfotrópico T Tipo 1 Humano , Humanos , Masculino , Persona de Mediana Edad , Púrpura/etiología , Strongyloides stercoralis , Estrongiloidiasis/etiologíaRESUMEN
BACKGROUND: Education is a major component of prevention strategies to reduce the risk of occupational transmission of bloodborne pathogens to health care personnel. METHODS: This study describes the results of an Internet-based project, "Projeto Riscobiologico.org", for which the main objectives are to disseminate information in the Portuguese language about occupational exposures to bloodborne pathogens through a mailing list and Web site as well as to increase case reports of these events in Brazil. RESULTS: The mailing list expanded quickly with a total of 2078 participants (from 337 different cities and all Brazilian states), and 5613 messages were exchanged over a 5-year period. Mean length of participation was almost 2 years (697 days). Most of the participants (74%) reported that they frequently manage occupational exposures. Nevertheless, results showed an important lack of basic knowledge regarding this issue. In contrast with the high participation in the mailing list, a small number of institutions started to participate in the voluntary surveillance system. CONCLUSION: The Internet can be used as a tool to increase knowledge and improve practices in the prevention of occupational bloodborne pathogen exposures. In addition, it may represent a unique opportunity to implement a national surveillance system.