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1.
Arq Bras Cardiol ; 109(3 Supl 1): 1-104, 2017 Jan-Feb.
Artigo em Inglês, Português | MEDLINE | ID: mdl-29044300
2.
Arq. bras. cardiol ; 109(3,supl.1): 1-104, Sept. 2017. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-887936
3.
Mycopathologia ; 181(1-2): 125-9, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26346377

RESUMO

Neutropenic patients are at risk of the development of hyalohyphomycosis and mucormycosis. Correct identification is essential for the initiation of the specific treatment, but concomitant mold infections are rarely reported. We report one unprecedented case of concomitant mucormycosis and fusariosis in a neutropenic patient with acute myeloid leukemia. The patient developed rhino-orbital infection by Rhizopus arrhizus and disseminated infection by Fusarium solani. The first culture from a sinus biopsy grew Rhizopus, which was consistent with the histopathology report of mucormycosis. A second sinus biopsy collected later during the patient's clinical deterioration was reported as hyalohyphomycosis, and the culture yielded F. solani. Due to the discordant reports, the second biopsy was reviewed and two hyphae types suggestive of both hyalohyphomycetes and mucormycetes were found. The dual mold infection was confirmed by PCR assays from paraffinized tissue sections. Increased awareness of the existence of dual mold infections in at-risk patients is necessary. PCR methods in tissue sections may increase the diagnosis of dual mold infections. In case of sequential biopsies showing discrepant results, mixed infections have to be suspected.


Assuntos
Fusariose/complicações , Fusariose/diagnóstico , Fusarium/isolamento & purificação , Mucormicose/complicações , Mucormicose/diagnóstico , Rhizopus/isolamento & purificação , Fungemia/complicações , Fungemia/diagnóstico , Fungemia/microbiologia , Fungemia/patologia , Fusariose/microbiologia , Fusariose/patologia , Fusarium/genética , Humanos , Hospedeiro Imunocomprometido , Leucemia Mieloide Aguda/complicações , Masculino , Pessoa de Meia-Idade , Mucormicose/microbiologia , Mucormicose/patologia , Neutropenia/complicações , Patologia Molecular , Reação em Cadeia da Polimerase , Rhizopus/genética , Sinusite/complicações , Sinusite/diagnóstico , Sinusite/microbiologia , Sinusite/patologia
4.
Int J Infect Dis ; 20: 71-3, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24406737

RESUMO

OBJECTIVES: Cytomegalovirus (CMV) is a ubiquitous virus and its reactivation may lead to CMV end-organ disease (CMV EOD) in immunocompromised patients and also in immunocompetent patients when they are critically ill. We aimed to investigate the frequency and the clinical features of proven CMV EOD in previously non-immunosuppressed patients admitted to our institution. METHODS: From January 2000 to March 2013, the records of all patients with a histopathological diagnosis of CMV EOD at our teaching hospital were reviewed retrospectively. CMV EOD was diagnosed histologically by the identification of true cytomegalic viral inclusion involving endothelial, stromal, and/or epithelial cells on hematoxylin and eosin staining, and was subsequently confirmed by immunohistochemistry using specific antibody against CMV antigens. Immunocompromised patients were excluded. RESULTS: CMV EOD manifesting as colitis was diagnosed in 14 previously immunocompetent intensive care unit (ICU) patients. The mean age of the patients was 64 years. All had co-morbidities and developed shock before CMV EOD. The major manifestation was gastrointestinal bleeding. The in-hospital mortality rate was 71.4% despite specific treatment with ganciclovir. CONCLUSIONS: Despite being a rare condition, lower gastrointestinal bleeding in this profile of ICU patients could be the clinical manifestation of CMV colitis, and intensivists should be alert to this condition.


Assuntos
Infecções por Citomegalovirus/tratamento farmacológico , Infecções por Citomegalovirus/epidemiologia , Citomegalovirus/isolamento & purificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Antivirais/uso terapêutico , Comorbidade , Cuidados Críticos , Estado Terminal/epidemiologia , Citomegalovirus/efeitos dos fármacos , Infecções por Citomegalovirus/diagnóstico , Feminino , Ganciclovir/uso terapêutico , Mortalidade Hospitalar , Humanos , Imunocompetência/efeitos dos fármacos , Hospedeiro Imunocomprometido/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
5.
Braz J Infect Dis ; 15(3): 285-7, 2011 May-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21670932

RESUMO

We report a case of a 67 year-old-male patient admitted to the intensive care unit in the post-coronary bypass surgery period who presented cardiogenic shock, acute renal failure and three episodes of sepsis, the latter with pulmonary distress at the 30th post-operative day. The patient expired within five days in spite of treatment with vancomycin, imipenem, colistimethate and amphotericin B. At autopsy severe adenovirus pneumonia was found. Viral pulmonary infections following cardiovascular surgery are uncommon. We highlight the importance of etiological diagnosis to a correct treatment approach.


Assuntos
Infecções por Adenovirus Humanos/patologia , Bronquiolite Viral/patologia , Complicações Pós-Operatórias/patologia , Idoso , Bronquiolite Viral/virologia , Ponte de Artéria Coronária , Evolução Fatal , Cardiopatias/cirurgia , Humanos , Unidades de Terapia Intensiva , Masculino , Necrose , Complicações Pós-Operatórias/virologia
6.
Braz. j. infect. dis ; 15(3): 285-287, May-June 2011. ilus
Artigo em Inglês | LILACS | ID: lil-589963

RESUMO

We report a case of a 67 year-old-male patient admitted to the intensive care unit in the post-coronary bypass surgery period who presented cardiogenic shock, acute renal failure and three episodes of sepsis, the latter with pulmonary distress at the 30th post-operative day. The patient expired within five days in spite of treatment with vancomycin, imipenem, colistimethate and amphotericin B. At autopsy severe adenovirus pneumonia was found. Viral pulmonary infections following cardiovascular surgery are uncommon. We highlight the importance of etiological diagnosis to a correct treatment approach.


Assuntos
Idoso , Humanos , Masculino , Infecções por Adenovirus Humanos/patologia , Bronquiolite Viral/patologia , Complicações Pós-Operatórias/patologia , Bronquiolite Viral/virologia , Ponte de Artéria Coronária , Evolução Fatal , Cardiopatias/cirurgia , Unidades de Terapia Intensiva , Necrose , Complicações Pós-Operatórias/virologia
8.
Rev Inst Med Trop Sao Paulo ; 44(5): 293-6, 2002 Sep-Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12436172

RESUMO

The present study was carried out to evaluate the Malar-Check trade mark Pf test, an immunochromatographic assay that detects Plasmodium falciparum Histidine Rich Protein II, does not require equipment, and is easy and rapid to perform. In dilution assays performed to test sensitivity against known parasite density, Malar-Check were compared with thick blood smear (TBS), the gold standard for diagnosis. Palo Alto isolate or P. falciparum blood from patients with different parasitemias was used. The average cut-off points for each technique in three independent experiments were 12 and 71 parasites/mm3 (TBS and Malar-Check, respectively). In the field assays, samples were collected from patients with fever who visited endemic regions. Compared to TBS, Malar-Check yielded true-positive results in 38 patients, false-positive results in 3, true-negative results in 23, and false-negative result in 1. Malar-Check performed with samples from falciparum-infected patients after treatment showed persistence of antigen up to 30 days. Malar-Check should aid the diagnosis of P. falciparum in remote areas and improve routine diagnosis even when microscopy is available. Previous P. falciparum infection, which can determine a false-positive test in cured individuals, should be considered. The prompt results obtained with the Malar-Check for early diagnosis could avoid disease evolution to severe cases.


Assuntos
Cromatografia/métodos , Imunoensaio/métodos , Malária Falciparum/diagnóstico , Plasmodium falciparum/imunologia , Kit de Reagentes para Diagnóstico , Animais , Antígenos de Protozoários/análise , Brasil , Reações Cruzadas , Reações Falso-Positivas , Humanos , Sensibilidade e Especificidade
9.
Rev. Inst. Med. Trop. Säo Paulo ; 44(5): 293-296, Oct. 2002. ilus, tab
Artigo em Inglês | LILACS | ID: lil-324504

RESUMO

The present study was carried out to evaluate the Malar-CheckTM Pf test, an immunochromatographic assay that detects Plasmodium falciparum Histidine Rich Protein II, does not require equipment, and is easy and rapid to perform. In dilution assays performed to test sensitivity against known parasite density, Malar-CheckTMwere compared with thick blood smear (TBS), the gold standard for diagnosis. Palo Alto isolate or P. falciparum blood from patients with different parasitemias was used. The average cut-off points for each technique in three independent experiments were 12 and 71 parasites/mm³ (TBS and Malar-CheckTM, respectively). In the field assays, samples were collected from patients with fever who visited endemic regions. Compared to TBS, Malar-CheckTMyielded true-positive results in 38 patients, false-positive results in 3, true-negative results in 23, and false-negative result in 1. Malar-CheckTMperformed with samples from falciparum-infected patients after treatment showed persistence of antigen up to 30 days. Malar-CheckTM should aid the diagnosis of P. falciparum in remote areas and improve routine diagnosis even when microscopy is available. Previous P. falciparum infection, which can determine a false-positive test in cured individuals, should be considered. The prompt results obtained with the Malar-CheckTM for early diagnosis could avoid disease evolution to severe cases


Assuntos
Animais , Humanos , Cromatografia , Imunoensaio , Malária Falciparum , Antígenos de Protozoários , Brasil , Reações Cruzadas , Estudos de Avaliação , Reações Falso-Positivas , Plasmodium falciparum , Kit de Reagentes para Diagnóstico , Sensibilidade e Especificidade
10.
Rev. Inst. Med. Trop. Säo Paulo ; 44(5): 293-296, Oct. 2002. ilus, tab
Artigo em Inglês | Sec. Est. Saúde SP, SESSP-SUCENPROD, Sec. Est. Saúde SP | ID: ses-3388

RESUMO

The present study was carried out to evaluate the Malar-CheckTM Pf test, an immunochromatographic assay that detects Plasmodium falciparum Histidine Rich Protein II, does not require equipment, and is easy and rapid to perform. In dilution assays performed to test sensitivity against known parasite density, Malar-CheckTMwere compared with thick blood smear (TBS), the gold standard for diagnosis. Palo Alto isolate or P. falciparum blood from patients with different parasitemias was used. The average cut-off points for each technique in three independent experiments were 12 and 71 parasites/mm (TBS and Malar-CheckTM, respectively). In the field assays, samples were collected from patients with fever who visited endemic regions. Compared to TBS, Malar-CheckTMyielded true-positive results in 38 patients, false-positive results in 3, true-negative results in 23, and false-negative result in 1. Malar-CheckTMperformed with samples from falciparum-infected patients after treatment showed persistence of antigen up to 30 days. Malar-CheckTM should aid the diagnosis of P. falciparum in remote areas and improve routine diagnosis even when microscopy is available. Previous P. falciparum infection, which can determine a false-positive test in cured individuals, should be considered. The prompt results obtained with the Malar-CheckTM for early diagnosis could avoid disease evolution to severe cases (AU)


Assuntos
Estudo Comparativo , Humanos , Animais , Malária Falciparum/diagnóstico , Imunoensaio/métodos , Cromatografia/métodos , Plasmodium falciparum/imunologia , Sensibilidade e Especificidade , Reações Cruzadas , Antígenos de Protozoários/análise , Kit de Reagentes para Diagnóstico , Reações Falso-Positivas , Brasil , Estudos de Avaliação
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