RESUMO
BACKGROUND: Sporotrichosis is the most common subcutaneous mycosis caused by Sporothrix spp. Traditionally, it is transmitted through injuries involving plant debris. However, over the past few decades, there has been an epidemic increase in human cases resulting from contact with infected animals, particularly cats, in various regions of Brazil. In this report, we report a notable increase in both human and animal cases within the Brazilian Amazon state. METHODOLOGY/PRINCIPAL FINDINGS: An ecological study was conducted by analyzing official records of human and animal sporotrichosis diagnosed in the state of Amazon from 2020 to 2023. Data including patient demographics, clinical manifestations, mycological examination results, and species identification through PCR confirmation were evaluated. During this period, a total of 950 human cases and 2,823 animal cases of sporotrichosis were reported at an exponential rate, since no human cases were registered in 2020. The spatial and temporal dispersion of human sporotrichosis followed that of animal cases, moving from downtown areas to the periphery. Contact with infected animals was reported in 77.7% of cases, with cats being the most commonly implicated (73.5%). Only 66.7% of individuals underwent mycological examination. Among the positive cultures for Sporothrix spp., 65.4% were identified as S. brasiliensis. All patients were treated with systemic antifungals. CONCLUSIONS/SIGNIFICANCE: This study highlights a rising incidence of sporotrichosis among animals and humans in the Brazilian Amazon region over the past four years, with S. brasiliensis being the predominant agent. Collaborative efforts involving healthcare professionals, veterinarians, and public health authorities are crucial to implement effective control measures, educate populations at risk, and promote responsible guidance for pet guardians. These measures are essential to mitigate the burden of epidemic sporotrichosis in Brazil.
Assuntos
Surtos de Doenças , Sporothrix , Esporotricose , Zoonoses , Esporotricose/epidemiologia , Esporotricose/microbiologia , Esporotricose/veterinária , Brasil/epidemiologia , Animais , Humanos , Zoonoses/epidemiologia , Zoonoses/microbiologia , Zoonoses/transmissão , Gatos , Sporothrix/isolamento & purificação , Sporothrix/genética , Masculino , Feminino , Adulto , Saúde Pública , Pessoa de Meia-Idade , Adolescente , Adulto Jovem , Idoso , CriançaRESUMO
BACKGROUND: The Clinical Trial for Uniform Multidrug Therapy for Leprosy Patients in Brazil (U-MDT/CT-BR), designed to evaluate the effectiveness of a six-months regimen, assessed the adverse effects caused by the drugs. OBJECTIVE: Describe adverse effects due to MDT in U-MDT/CT-BR, comparing the uniform regimen (U-MDT) to the current WHO regimen (R-MDT). PATIENTS AND METHODS: After operational classification, patients were randomly allocated to the study groups. U-MDT PB and U-MDT MB groups, received the U-MDT regimen, six doses of MB-MDT (rifampicin, dapsone and clofazimine). R-MDT PB and R-MDT MB groups, received the WHO regimens: six doses (rifampicin and dapsone) for PB and 12 doses (rifampicin, dapsone and clofazimine) for MB. During treatment, patients returned monthly for clinical and laboratorial evaluation. Patients with single lesion were not included in this trial. RESULTS: Skin pigmentation (21.7%) and xerosis (16.9%) were the most frequent complaints among 753 patients. Laboratory exams showed hemoglobin concentration lower than 10g/dL in 23.3% of the patients, glutamic oxaloacetic transaminase (GOT) above 40U/L in 29.5% and glutamic pyruvic transaminase (GPT) above 40U/L in 28.5%. Twenty-four patients (3.2%) stopped dapsone intake due to adverse effects, of whom 16.6% due to severe anemia. One case of sulfone syndrome was reported. STUDY LIMITATIONS: Loss of some monthly laboratory sample collection. CONCLUSIONS: There was no statistical difference regarding adverse effects in the R-MDT and U-MDT groups but anemia was greater in patients from R-MDT/MB group, therefore adverse effects do not represent a constraint to recommend the six-month uniform regimen of treatment for all leprosy patients.
Assuntos
Clofazimina/efeitos adversos , Dapsona/efeitos adversos , Hansenostáticos/efeitos adversos , Hanseníase/tratamento farmacológico , Rifampina/efeitos adversos , Adolescente , Adulto , Anemia/sangue , Anemia/induzido quimicamente , Brasil , Criança , Clofazimina/administração & dosagem , Dapsona/administração & dosagem , Quimioterapia Combinada/efeitos adversos , Feminino , Hemoglobinas/análise , Humanos , Hansenostáticos/administração & dosagem , Hanseníase/sangue , Hanseníase/complicações , Masculino , Pessoa de Meia-Idade , Rifampina/administração & dosagem , Fatores de Risco , Resultado do Tratamento , Adulto JovemRESUMO
Abstract: BACKGROUND: The Clinical Trial for Uniform Multidrug Therapy for Leprosy Patients in Brazil (U-MDT/CT-BR), designed to evaluate the effectiveness of a six-months regimen, assessed the adverse effects caused by the drugs. OBJECTIVE: Describe adverse effects due to MDT in U-MDT/CT-BR, comparing the uniform regimen (U-MDT) to the current WHO regimen (R-MDT). Patients and methods: After operational classification, patients were randomly allocated to the study groups. U-MDT PB and U-MDT MB groups, received the U-MDT regimen, six doses of MB-MDT (rifampicin, dapsone and clofazimine). R-MDT PB and R-MDT MB groups, received the WHO regimens: six doses (rifampicin and dapsone) for PB and 12 doses (rifampicin, dapsone and clofazimine) for MB. During treatment, patients returned monthly for clinical and laboratorial evaluation. Patients with single lesion were not included in this trial. RESULTS: Skin pigmentation (21.7%) and xerosis (16.9%) were the most frequent complaints among 753 patients. Laboratory exams showed hemoglobin concentration lower than 10g/dL in 23.3% of the patients, glutamic oxaloacetic transaminase (GOT) above 40U/L in 29.5% and glutamic pyruvic transaminase (GPT) above 40U/L in 28.5%. Twenty-four patients (3.2%) stopped dapsone intake due to adverse effects, of whom 16.6% due to severe anemia. One case of sulfone syndrome was reported. STUDY LIMITATIONS: Loss of some monthly laboratory sample collection. CONCLUSIONS: There was no statistical difference regarding adverse effects in the R-MDT and U-MDT groups but anemia was greater in patients from R-MDT/MB group, therefore adverse effects do not represent a constraint to recommend the six-month uniform regimen of treatment for all leprosy patients.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Rifampina/efeitos adversos , Clofazimina/efeitos adversos , Dapsona/efeitos adversos , Hansenostáticos/efeitos adversos , Rifampina/administração & dosagem , Brasil , Hemoglobinas/análise , Fatores de Risco , Resultado do Tratamento , Clofazimina/administração & dosagem , Dapsona/administração & dosagem , Quimioterapia Combinada/efeitos adversos , Anemia/induzido quimicamente , Anemia/sangue , Hansenostáticos/administração & dosagem , Hanseníase/complicações , Hanseníase/tratamento farmacológico , Hanseníase/sangueRESUMO
Abstract: In this review, the most relevant and current epidemiological data, the main clinical, laboratory and therapeutical aspects of leprosy are presented. Detailed discussion of the main drugs used for leprosy treatment, their most relevant adverse effects, evolution of the therapeutic regimen, from dapsone as a monotherapy to the proposed polychemotherapy by World Health Organization (WHO) can be found in this CME. We specifically highlight the drug acceptability, reduction in treatment duration and the most recent proposal of a single therapeutic regimen, with a fixed six months duration, for all clinical presentations, regardless of their classification.
Assuntos
Humanos , Hansenostáticos/uso terapêutico , Hanseníase/patologia , Hanseníase/tratamento farmacológico , Rifampina/uso terapêutico , Resultado do Tratamento , Satisfação do Paciente , Clofazimina/uso terapêutico , Dapsona/uso terapêutico , Quimioterapia CombinadaRESUMO
In this review, the most relevant and current epidemiological data, the main clinical, laboratory and therapeutical aspects of leprosy are presented. Detailed discussion of the main drugs used for leprosy treatment, their most relevant adverse effects, evolution of the therapeutic regimen, from dapsone as a monotherapy to the proposed polychemotherapy by World Health Organization (WHO) can be found in this CME. We specifically highlight the drug acceptability, reduction in treatment duration and the most recent proposal of a single therapeutic regimen, with a fixed six months duration, for all clinical presentations, regardless of their classification.
Assuntos
Hansenostáticos/uso terapêutico , Hanseníase/tratamento farmacológico , Hanseníase/patologia , Clofazimina/uso terapêutico , Dapsona/uso terapêutico , Quimioterapia Combinada , Humanos , Satisfação do Paciente , Rifampina/uso terapêutico , Resultado do TratamentoRESUMO
Mycobacterium abscessus is a rapidly growing mycobacterium that has been affecting people undergoing invasive procedures, such as videosurgery and mesotherapy. This bacterium has global distribution, being found in numerous niches. The frequency of published reports of infection by rapidly growing mycobacteria associated with tattooing procedures has increased in recent years. However, in Brazil there were no case reports of M. abscessus after tattooing in the literature until now. In this paper, we describe the case of a patient with a nine-month history of lesion on a tattoo site. The diagnosis of infection with Mycobacterium abscessus was established by correlation between dermatological and histopathological aspects, culture and molecular biology techniques. The patient had significant improvement of symptoms with the use of clarithromycin monotherapy.
Assuntos
Infecções por Mycobacterium não Tuberculosas/etiologia , Dermatopatias Bacterianas/etiologia , Tatuagem/efeitos adversos , Adulto , Brasil , Feminino , Humanos , Infecções por Mycobacterium não Tuberculosas/patologia , Micobactérias não Tuberculosas , Dermatopatias Bacterianas/patologiaRESUMO
AbstractMycobacterium abscessus is a rapidly growing mycobacterium that has been affecting people undergoing invasive procedures, such as videosurgery and mesotherapy. This bacterium has global distribution, being found in numerous niches. The frequency of published reports of infection by rapidly growing mycobacteria associated with tattooing procedures has increased in recent years. However, in Brazil there were no case reports of M. abscessus after tattooing in the literature until now. In this paper, we describe the case of a patient with a nine-month history of lesion on a tattoo site. The diagnosis of infection with Mycobacterium abscessus was established by correlation between dermatological and histopathological aspects, culture and molecular biology techniques. The patient had significant improvement of symptoms with the use of clarithromycin monotherapy.
Assuntos
Adulto , Feminino , Humanos , Infecções por Mycobacterium não Tuberculosas/etiologia , Dermatopatias Bacterianas/etiologia , Tatuagem/efeitos adversos , Brasil , Infecções por Mycobacterium não Tuberculosas/patologia , Micobactérias não Tuberculosas , Dermatopatias Bacterianas/patologiaRESUMO
A Teledermatologia estuda o uso das tecnologias de telecomunicação e informática na assistência dermatológica sem a atuação presencial do especialista. Neste trabalho, é relatado o processo diagnóstico de um caso de escabiose crostosa (sarna norueguesa) em paciente idoso da região do Alto Rio Solimões, por meio de recursos de Teledermatologia. Além disso, os autores discutem os avanços dessa tecnologia que possibilita a assistência a distância para comunidades ribeirinhas e indígenas, sobretudo em áreas isoladas da Amazônia Legal, nas quais inúmeras doenças são negligenciadas e subdiagnosticadas.
Teledermatology uses telecommunication technology and informatics on dermatologic practice without the presence of a specialist. This paper describes the diagnostic process of a Crusted Scabies (Norwegian Scabies) case in an elderly patient from the Alto Solimões River region using teledermatology resources. Moreover, the authors discuss the progress of these technologies, which allow healthcare assistance for those living in remote indigenous and riverine communities, particularly in isolated areas of the Legal Amazon where many diseases are neglected or underdiagnosed.
La Teledermatología usa las tecnologías de las telecomunicaciones y de la informática para dar asistencia dermatológica sin la presencia de un especialista. Este artículo describe el proceso de diagnóstico de un caso de escabiosis costrosa (sarna norueguesa) en un paciente anciano de la región del Alto Rio Solimões, a través de recursos de la Teledermatología. Además, los autores discuten los avances de estas tecnologías que permiten llevar asistencia médica a las comunidades costeras e indígenas remotas, especialmente a aquellas de zonas aisladas del Legal Amazon, en las cuales numerosas enfermedades son negligenciadas y subdiagnosticadas.