ABSTRACT
Se determinó la frecuencia y características clínicas de las micosis sistémicas endémicas asociadas a tuberculosis en el estado Bolívar. Se revisaron las historias clínicas de los casos con diagnóstico confirmado de micosis sistémicas y tuberculosis en un período de cinco años. Se detectaron 7 casos de las micosis sistémicas endémicas en la región, Paracoccidioidomicosis e Histoplasmosis, asociadas a tuberculosis. Todos los pacientes procedían del estado Bolívar, sólo uno era del sexo femenino y ninguno tenía serología positiva para la infección por el Virus de Inmunodeficiencia Humana. Todos presentaron manifestaciones pulmonares, la mayoría sintomáticos y con pérdida de peso (6 de 7). En todos los casos, se evidenciaron alteraciones en el estudio radiológico del tórax, con diferentes patrones, predominando el compromiso alveolar difuso bilateral. En 6 de los 7 pacientes, se observaron bacilos ácidos resistentes en muestras de esputo. La micosis más frecuentemente asociada a tuberculosis fue Paracoccidioidomicosis (6 de 7). Todos los pacientes recibieron tratamiento antimicótico y tratamiento antituberculoso con cuatro drogas y todos mostraron mejoría. La asociación de micosis sistémicas endémicas con tuberculosis no es rara en el estado Bolívar, por tanto, la asociación de estas infecciones deberían investigarse sistemáticamente.
The frequency and clinical characteristics of endemic systemic mycosis associated with tuberculosis were determined in Bolívar State. Clinical case records with confirmed diagnoses of systemic mycosis and tuberculosis were reviewed for a 5-year period. Seven cases of systemic mycoses endemic to the region were detected: Paracoccidioidomycosis and Histoplasmosis, associated with tuberculosis. All patients came from Bolívar state; only one was feminine and no one was seropositive for the Human Immunodeficiency Virus. All presented pulmonary compromise, mostly symptomatic, accompanied by weight loss (6 of 7). In all cases, alterations appeared on the radiological study of the thorax, mainly diffuse bilateral alveolar compromise. In 6 of the 7 patients, acid-resistant bacilli were observed in sputum samples. The mycosis most frequently associated with tuberculosis was Paracoccidioidomycosis (6 of 7); the other associated mycosis was Histoplasmosis (1 of 7). All patients received antimycotic and 4-drug anti-tuberculosis treatments and all of them improved. The association of endemic systemic mycosis with tuberculosis is not unusual in Bolívar state and therefore, the association of these infections should be systematically investigated.
Subject(s)
Humans , Male , Female , Histoplasmosis/diagnosis , Mycoses/diagnosis , Mycoses/therapy , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/therapy , Tuberculosis/diagnosis , Tuberculosis/therapy , Venezuela/epidemiologyABSTRACT
Dove's excreta samples from state Bolívar several places in Venezuela, were evaluated to determine the presence of primary pathogen fungi in dove's excreta. Filamentous fungi such as: Aspergillus spp (31.1%), Mucor spp (20.2%), Penicillium spp (9.5%) and Fusarium spp (6.7%) were the most frequently isolated strains. Species such as Candida albicans (4.1%), Cryptococcus albidus and Rhodotorula spp (2.7%), C. neoformans var neoformans (1.4%), Trichosporum asahii (1.4%), Curvularia, Microsporum and Phoma as well as Histoplasma capsulatum (1.3%) were less frecuently isolated. This study shows the presence of C. neoformans and H. capsulatum in dove's excreta from Bolívar state, it remarks infection risk with these pathogens fungi and the necessity to avoid accumulation of dove's excreta.
Subject(s)
Bird Diseases/epidemiology , Columbidae/microbiology , Cryptococcosis/veterinary , Cryptococcus neoformans/isolation & purification , Feces/microbiology , Histoplasma/isolation & purification , Histoplasmosis/veterinary , Animals , Bird Diseases/microbiology , Cryptococcosis/epidemiology , Disease Reservoirs , Fungi/isolation & purification , Histoplasmosis/epidemiology , Mycoses/epidemiology , Mycoses/microbiology , Mycoses/veterinary , Urban Health , Venezuela/epidemiologyABSTRACT
To estimate the prevalence of mycoses in the Universitary Hospital "Ruiz y Páez" (Bolivar State, Venezuela) during 2002, a retrospective study was carried out. Four hundred and fifty six mycoses were diagnosed in 250,956 patients. The most frequent mycoses, the cutaneous form (94.5%), were produced by dermatophytes, Malassezia furfur and Candida spp. in 90%. Deep mycoses were detected in 4.7% and consisted of histoplasmosis (2.6%), paracoccidioidomycosis (1.7%) and cryptococcosis (0.4%). Several patients with deep mycoses presented HIV infection, tuberculosis and hematological disorders (neoplasias among them). The frequency of mycoses in the general population that attend the Hospital Universitario "Ruiz y Páez" is low, superficial mycoses are predominant, and some conditions seem to predispose to deep mycoses.
Subject(s)
Mycoses/epidemiology , Adolescent , Adult , Candidiasis/epidemiology , Cross-Sectional Studies , Cryptococcosis/epidemiology , Dermatomycoses/epidemiology , Female , Histoplasmosis/epidemiology , Hospitals, University , Humans , Malassezia , Male , Middle Aged , Paracoccidioidomycosis/epidemiology , Retrospective Studies , Venezuela/epidemiologyABSTRACT
Con el objetivo de determinar la prevalencia de las micosis en el Hospital Universitario "Ruiz y Páez" (Ciudad Bolívar, Venezuela) durante el año 2002, se realizó un estudio retrospectivo de los casos con diagnóstico de micosis. Hubo 456 casos de micosis de un total de 250.956 pacientes atendidos en el período 2002 (0,2 por ciento). El 94,5 por ciento eran micosis cutáneas. Estas infecciones fueron debidas a dermatofitos, Malassezia furfur y Candida spp. en el 90,0 por ciento de las veces. Las micosis profundas ocurrieron en un 4,7 por ciento, consistentes en histoplasmosis (2,6 por ciento), paracoccidioidomicosis (1,7 por ciento) y criptococosis (0,4 por ciento). Varios de los pacientes afectos de micosis sistémicas presentaban otras patologías concomitantes, como infección por el Virus de la Inmunodeficiencia Humana, tuberculosis, neoplasias y trastornos hematológicos. La frecuencia de micosis en la población general atendida en el Hospital Universitario "Ruiz y Páez" es baja, predomina la afectación superficial, y la profunda suele evidenciarse en pacientes con factores predisponentes
Subject(s)
Humans , Male , Female , Mycoses , Prevalence , Microbiology , VenezuelaABSTRACT
OBJECTIVE: To determine the prevalence of histoplasmosis and paracoccidiomycosis in Upata, a city in Bolivar state, Venezuela. METHODS: Cutaneous tests on 397 volunteers, 204 with histoplasmine and 193 with paracoccidioidine. Epidemiological data were collected in a protocol sheet. Readings were performed at 24 and 48 h post-injection, by the same observer, and a positive reaction was defined as hardened papule of 5 mm or more. RESULTS: Histoplasmine tests were positive in 19.6% and 34.0% at 24 and 48 h after antigens injection with a significant increase of reactivity (P=0.0019). Paracoccidiodine tests were positive in 11.3% and 19.7% at 24 and 48 h respectively and this difference was also significant (P=0.004). Risk factors which could explain these levels of reactivity could not be clearly identified. Cultures and animal inoculation from soil samples for fungus isolation were negative. CONCLUSIONS: Paracoccidioidomycoses and histoplasmosis are endemic in Upata.
