RESUMO
Se presenta un paciente con sarcoma de Kaposi (SK) localizado en pie derecho, acompañado de herpes bucal recidivante con repercusión general (astenia, mialgias, artralgias). Se realizó la resección de la lesión cutánea como diagnóstico y tratamiento. Los estudios serológicos mostraron: HIV-1 y HIV-2 negativos y HHV8 IgG positivo. Estudios inmunológicos: proteinograma por electroforesis y cuantificación de inmunoglobulinas, normales; recuento de linfocitos T CD4+, disminuido; linfocitos T CD8+, normales; relación CD4 CD8, disminuida y pruebas cutáneas de hipersensibilidad retardada negativas (anergia cutánea). Se estableció el diagnóstico de sarcoma de Kaposi asociado con linfocitopenia CD4+ idiopática. La resección biopsia sirvió de tratamiento local de la lesión además, se administró timomodulina como inmunoestimulante, en lo que se asistió a una mejoría del cuadro clínico general, del recuento de linfocitos T CD4+ y de las pruebas cutáneas de hipersensibilidad retardada (AU)
Assuntos
Adulto , Masculino , Humanos , Sarcoma de Kaposi/complicações , T-Linfocitopenia Idiopática CD4-Positiva/imunologia , Herpes Simples/complicações , Hipersensibilidade Tardia/diagnóstico , Testes Cutâneos/métodosRESUMO
OBJECTIVE: Determine the seroprevalence of Trypanosoma cruzi infection in Ushuaia, Argentina, which is the southernmost city in the world. METHODS: Serum samples were analyzed from 2,991 people, obtained between January 1995 and December 1996. The samples were processed using indirect hemagglutination and either enzyme-linked immunosorbent assay or indirect immunofluorescence. RESULTS: The general seroprevalence of T. cruzi infection was 6.8%. According to the residents' country of origin, prevalence was 41.1% among Bolivians, 5.0% among Argentines, and 0.9% among Chileans. The prevalence found in pregnant women was 5.9%; in compulsory examinations (such as for a job or for immigrants settling permanently in Argentina), it was 6.3%; and in examinations done based on clinical or epidemiological reasons to suspect infection with Chagas' disease, it was 30.8%. CONCLUSIONS: There is an alarming level of T. cruzi infection in this region, where the insect vector does not even exist. Given the risk of transmission congenitally and from blood transfusions, controls must be maintained on donated blood. In addition, follow-up of children of infected women should be strengthened so that these children receive early diagnosis and timely treatment of the infection.