RESUMO
Two cases of biopsy-proven Microsporidium-associated chronic sinusitis in HIV-seropositive patients are presented. Spores of Septata intestinalis were identified by light microscopy and confirmed by electron microscopy in each case. Both patients displayed severe deficiencies of nasal mucosa CD4-positive cells, demonstrated by immunohistochemical methods. Only two other cases of Septata intestinalis-associated sinusitis have been reported previously. Our observations agree with the theory that functional defects in local mucosal immunity may partially explain the acquisition of opportunistic mucosal infections in many HIV-seropositive patients.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/parasitologia , Microsporida/isolamento & purificação , Microsporidiose/diagnóstico , Sinusite/parasitologia , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Adulto , Animais , Biópsia , Evolução Fatal , Soropositividade para HIV/complicações , Humanos , Hospedeiro Imunocomprometido , Imuno-Histoquímica , Masculino , Microsporidiose/imunologia , Mucosa Nasal/parasitologia , Mucosa Nasal/patologia , Sinusite/diagnóstico , Sinusite/imunologia , Tomografia Computadorizada por Raios XRESUMO
The clinical and electrophysiologic data of four new patients with sarcoidosis involving the peripheral nerves are presented and the subject is reviewed. Two had a symmetric polyneuropathy and two had polyradiculopathy. These plus the few cases in the literature indicate that the findings on electromyography are most consistent with axonal neuropathy, in a multifocal pattern. Needle electrolyography was more useful than nerve conduction studies in identifying lesions.
Assuntos
Doenças do Sistema Nervoso Periférico/etiologia , Sarcoidose/complicações , Adolescente , Adulto , Axônios/fisiologia , Eletromiografia , Humanos , Doenças do Sistema Nervoso Periférico/fisiopatologiaRESUMO
Although cutaneous larva migrans is more commonly seen in the southeastern US and tropical regions of the world, patients with such parasitic involvement may present in other non-endemic areas for various reasons, particularly travelers returning from tropical vacations. Awareness of the clinical presentation and symptomatology of cutaneous larva migrans is important for all physicians, including those practicing in northern climates, for prompt recognition and effective treatment of the disease. Furthermore, cutaneous larva migrans should be of particular interest to podiatrists, because the infestation commonly involves the feet, and a patient may initially present for treatment of secondary manifestations, ie, dermatitis, pruritus, or infection, as in this case report.
