Vaccine-associated paralytic poliomyelitis: a case report of domiciliary transmission.

Poliomyelitis associated with live strain vaccine is defined as the paralytic form of the acute anterior poliomyelitis related to the vaccine strain. Since these strains behave similarly to the wild-type virus, we can differentiate, epidemiologically, two types of vaccine-associated poliomyelitis: cases in which the patient was vaccinated and cases in which the patient had had contact with vaccinated individuals. We herein present the case of an unvaccinated child, with a clinical picture of an acute anterior poliomyelitis associated with the live strain vaccine, whose brother received the Sabin vaccine 20 days before the onset of the symptoms. Vaccine strain of the type 3 poliovirus was isolated in fecal culture and a presented mutation in nucleotide 472 (C-->U) in the 5' non-coding region, which is strongly related to the higher strain virulence.

[Positive conversion of AARB results in gastric lavage, in a child with AIDS and tuberculosis, after endoscopic endobronchial puncture]. / Positivação da pesquisa de baar em lavado gástrico, em criança com AIDS e tuberculose, após realizaçao de punção endobrônquica via endoscópica.

A case of tuberculosis in a pediatric AIDS patient, submitted to bronchoscopy and transbronchial biopsy as a part of chronic pulmonary disease evaluation, is presented. No AFB (acid-fast bacillus) detection was identified by gastric lavage before the bronchoscopy, nevertheless after the bronchoscopic procedure the patient became contagious, and persisted with positive baciloscopy until the 56th day of therapy.

Human cryptosporidiosis: detection of specific antibodies in the serum by an indirect immunofluorescence.

Cryptosporidium sp., a coccidian parasite usually found in the faeces of cattle, has been recently implicated as an agent of human intestinal disease, mainly in immunocompromised patients. In the study realized, by an indirect immunofluorescence technique, specific immunoglobulins (IgG and IgM) have been demonstrated in human serum against Cryptosporidium oocysts. Purified oocysts were used as antigens in the indirect immunofluorescence assay. After analyzing this test in sera from selected groups of patients, the frequency of both specific IgG and IgM of immunocompetent children who were excreting oocysts in their faeces was 62% and in children with negative excretion of oocytes was 20% and 40%, respectively. In adults infected with the human immunodeficiency virus (HIV) and who were excreting Cryptosporidium in their stools, the frequency was 57% for IgG but only 2% for IgM. Twenty three percent of immunocompromised adults with not determined excretion of oocysts in their stools had anti-Cryptosporidium IgG in their sera. Children infected with human immunodeficiency virus had no IgM and only 14% had IgG detectable in their sera. The indirect immunofluorescence assay, when used with other parasitological techniques appears to be useful for retrospective population studies and for diagnosis of acute infection. The humoral immune response of HIV positive patients to this protozoan agent needs clarification.

[Congenital Malaria. Case reports and a brief review of literature]. / Malária congênita. Descrição de casos e breve revisão da literatura.

Two cases of congenital malaria due to Plasmodium vivax and Plasmodium falciparum respectively are reported. The children were born in São Paulo and Paraná to mothers from endemic area of malaria. The mothers had malaria during pregnancy. The children were admitted with severe anemia and hepatosplenomegaly. Despite congenital malaria is being considered a rare event it is a preventable disease and these cases should draw attention to the importance of adequate treatment during pregnancy. Clinical manifestations and management of congenital malaria are also discussed.