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1.
ACS Chem Neurosci ; 9(3): 393-394, 2018 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-29411969

RESUMO

Eosinophilic meningitis caused by Angiostrongylus cantonensis is spreading worldwide, and it can manifest as a severe neurological disease. Angiostrongyliasis is a food- and water-borne parasitosis that usually exhibits a seasonal and circumscribed geographical distribution. To improve control and treatment of these infections, further studies of transmission dynamics under natural conditions and the development of better diagnostic tools and treatment options are needed.


Assuntos
Angiostrongylus cantonensis/microbiologia , Eosinofilia/microbiologia , Meningite/etiologia , Infecções por Strongylida/diagnóstico , Infecções por Strongylida/etiologia , Animais , Eosinofilia/diagnóstico , Humanos , Meningite/diagnóstico , Caramujos/microbiologia
2.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 36(2): 120-136, feb. 2018. graf, tab, mapas
Artigo em Espanhol | IBECS | ID: ibc-170701

RESUMO

La detección de eosinofilia periférica es un motivo relativamente frecuente para la remisión de un paciente a una Unidad/Servicio de Enfermedades Infecciosas. En general, se pretende descartar una enfermedad parasitaria, tanto en personas autóctonas como en viajeros o inmigrantes. Excepcionalmente la eosinofilia relacionada con parásitos corresponde a una protozoosis, siendo los helmintos los principales agentes causales de este hallazgo hematológico. La eosinofilia puede ser el único hallazgo anormal o formar parte del cuadro clínico-biológico del paciente. Por otro lado, no todas las helmintosis se asocian de forma sistemática a eosinofilia, y el grado de la misma difiere entre las fases de la infección y el tipo de helminto. El propósito de esta revisión es un estudio sistemático de la relación entre helmintosis y eosinofilia en la literatura española, distinguiendo los casos autóctonos e importados, así como la relación con situaciones de inmunodepresión (AU)


The finding of blood eosinophilia in a patient is a relatively frequent reason to refer him/her to a Clinical Department of Infectious Diseases. The doctor usually intends to rule out a parasitic disease in the autochthonous population, travelers or immigrants. It is uncommon for an eosinophilia to be produced by protozoa infection, whereas helminth parasites are more frequently associated with an increase of eosinophil counts in the infected patient. Eosinophilia can be the only abnormal finding, or it could be part of more complex clinical manifestations suffered by the patient. Furthermore, many, but not all, helminth infections are associated with eosinophilia, and the eosinophil level (low, high) differs according to parasite stages, helminth species, and worm co-infections. The purpose of the present article is to carry out a systematic review of cases and case series on helminth infections and eosinophilia reported in Spain from 1990 to 2015, making a distinction between autochthonous and imported (immigrants and travelers) cases, and studying their relationship with immunodepression situations (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Helmintíase/epidemiologia , Eosinofilia/epidemiologia , Neurocisticercose/microbiologia , Neurocisticercose/epidemiologia , Fatores de Risco , Espanha/epidemiologia , Eosinófilos , Eosinófilos/microbiologia , Emigrantes e Imigrantes/estatística & dados numéricos , Controle Sanitário de Viajantes , Platelmintos/microbiologia , Esquistossomose/epidemiologia , Helmintíase/microbiologia , Eosinofilia/microbiologia
3.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 36(1): 24-28, ene. 2018. mapas, ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-170111

RESUMO

Introducción: La infestación por Strongyloides stercoralis es más prevalente en regiones tropicales, pero existen casos autóctonos en España, principalmente en La Safor (Valencia). Nuestro objetivo era estudiar los casos de un hospital de la provincia de Alicante y conocer si existían casos autóctonos. Procedimiento: Estudio retrospectivo de los casos diagnosticados de estrongiloidiasis en el Hospital Vega Baja (Orihuela, Alicante) entre enero de 1999 y marzo de 2016. Resultados: Se registraron 10 casos, 4 de ellos autóctonos, presentando 2 de ellos un cuadro de hiperinfestación con desenlace fatal. Todos los casos autóctonos fueron en personas ≥69años con síntomas digestivos, cutáneos y/o respiratorios. La serología fue positiva en los 8casos en los que se realizó. En 3 casos se visualizaron larvas en el estudio histopatológico. Conclusiones: Comunicamos los primeros casos autóctonos de estrongiloidiasis en la región Vega Baja. Se deben implantar programas de cribado principalmente en pacientes inmunosuprimidos o en tratamiento corticoideo (AU)


Introduction: Strongyloides stercoralis infection is more prevalent in tropical regions but autochthonous cases have been reported in Spain, mainly in La Safor (Valencia). The objective is to describe the strongyloidiasis cases registered in a regional hospital of Alicante province (Spain) and to determine if they were autochthonous cases. Methods: Retrospective study of all diagnosed cases of strongyloidiasis in Vega Baja Hospital (Orihuela, Alicante) between January 1999 and March 2016. Results: A total of 10 cases were found, four of which were autochthonous cases. Two of them presented with a hyper-infection syndrome, with a fatal outcome. All autochthonous cases were in patients ≥69years old with gastrointestinal, cutaneous, and/or respiratory symptoms. Serology was positive in the 8 cases studied. Larvae were found in histopathological samples of the gastrointestinal tract of three patients. Conclusions: We communicate the first autochthonous cases of strongyloidiasis in the region of Vega Baja. Screening programs should be implemented, especially in immunosuppressed patients or patients under chronic corticosteroid treatment (AU)


Assuntos
Humanos , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/diagnóstico , Estrongiloidíase/microbiologia , Biópsia , Fatores de Risco , Imunossupressão/métodos , Strongyloides stercoralis/microbiologia , Estrongiloidíase/patologia , Programas de Rastreamento/métodos , Estudos Retrospectivos , Ensaio de Imunoadsorção Enzimática/métodos , Fezes/microbiologia , Fezes/parasitologia , Eosinofilia/microbiologia , Colo/patologia
4.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 35(10): 617-623, dic. 2017. tab
Artigo em Espanhol | IBECS | ID: ibc-169560

RESUMO

Algunas enfermedades infecciosas han adquirido más relevancia por el aumento de los movimientos poblacionales. La eosinofilia es un hallazgo frecuente en inmigrantes y en viajeros. Una de las causas más frecuentes de eosinofilia es la infección por helmintos y algunos protozoos intestinales. El objetivo de este trabajo es describir las características epidemiológicas de los casos con eosinofilia y su asociación con la presencia de parásitos en la red de datos REDIVI. Se trata de un estudio observacional multicéntrico prospectivo, donde se incluyen los casos diagnosticados de eosinofilia registrados en la Red cooperativa para el estudio de las infecciones importadas por viajeros e inmigrantes (+REDIVI) desde enero de 2009 hasta diciembre de 2012. Se registraron en la red un total de 5.255 episodios durante el periodo de estudio, y la eosinofilia fue un hallazgo en el 8,1 al 31,3% de los casos (dependiendo del tipo migratorio). Fueron hombres el 60,2%, con una mediana de 31,0años, inmigrantes el 72,4% y asintomáticos el 81,2%. Los parásitos más frecuentemente identificados fueron S.stercoralis(34,4%), Schistosoma sp. (11,0%) y uncinarias (8,6%). Existía asociación entre eosinofilia y presencia de parásitos para todos los helmintos (excepto para larva migrans cutánea). La sintomatología y la duración del viaje no determinaron significativamente la presencia de eosinofilia. Ante una eosinofilia en una persona que ha vivido en zonas endémicas de helmintiasis es aconsejable realizar estudios dirigidos para su diagnóstico, independientemente del tipo migratorio, la duración de la estancia o la presencia de sintomatología (AU)


The population movements during the last decades have resulted in a progressively increasing interest in certain infectious diseases. Eosinophilia is a common finding in immigrants and travelers. One of the most common causes of eosinophilia is helminth infection, and some intestinal protozoa. The aim of this paper is to describe the epidemiological characteristics of cases with eosinophilia and its association with the presence of parasites in the REDIVI data network. This is a multicenter prospective observational study that includes patients diagnosed with eosinophilia registered in the cooperative network for the study of infectious diseases in travelers and immigrants (+REDIVI) from January 2009 to December 2012. A total of 5,255 episodes were recorded in the network during the study period, and eosinophilia was observed in 8.1-31.3% of cases (depending on the immigration group). There were 60.2% men, with a median age of 31years. There were 72.4% immigrants, and 81.2% were asymptomatic. The most commonly identified parasites were S.stercoralis (34.4%), Schistosoma sp. (11.0%), and hookworm (8.6%). The relationship between eosinophilia and parasite infection was significant for all helminths (except for cutaneous larva migrans). The symptoms and duration of the journey did not significantly determine the presence of eosinophilia. In the case of eosinophilia in a person who has lived in helminth endemic areas, it is advisable to carry out targeted studies to diagnose the infection, regardless of immigration type, length of stay, or the presence of symptoms (AU)


Assuntos
Humanos , Eosinofilia/epidemiologia , Eosinofilia/prevenção & controle , Saúde do Viajante , Fatores de Risco , Emigrantes e Imigrantes , Protocolos Clínicos , Doenças Transmissíveis/epidemiologia , Estudos Prospectivos , Eosinofilia/microbiologia , Medicina de Viagem/normas , Eosinofilia/parasitologia
6.
J Allergy Clin Immunol ; 140(2): 407-417.e11, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28042058

RESUMO

BACKGROUND: Asthmatic patients have higher microbiome diversity and an altered composition, with more Proteobacteria and less Bacteroidetes compared with healthy control subjects. Studies comparing airway inflammation and the airway microbiome are sparse, especially in subjects not receiving anti-inflammatory treatment. OBJECTIVE: We sought to describe the relationship between the airway microbiome and patterns of airway inflammation in steroid-free patients with asthma and healthy control subjects. METHODS: Bronchoalveolar lavage fluid was collected from 23 steroid-free nonsmoking patients with asthma and 10 healthy control subjects. Bacterial DNA was extracted from and subjected to Illumina MiSeq sequencing of the 16S rDNA V4 region. Eosinophils and neutrophils in the submucosa were quantified by means of immunohistochemical identification and computerized image analysis. Induced sputum was obtained, and airway hyperresponsiveness to mannitol and fraction of exhaled nitric oxide values were measured. Relationships between airway microbial diversity and composition and inflammatory profiles were analyzed. RESULTS: In asthmatic patients airway microbial composition was associated with airway eosinophilia and AHR to mannitol but not airway neutrophilia. The overall composition of the airway microbiome of asthmatic patients with the lowest levels of eosinophils but not asthmatic patients with the highest levels of eosinophils deviated significantly from that of healthy subjects. Asthmatic patients with the lowest levels of eosinophils had an altered bacterial abundance profile, with more Neisseria, Bacteroides, and Rothia species and less Sphingomonas, Halomonas, and Aeribacillus species compared with asthmatic patients with more eosinophils and healthy control subjects. CONCLUSION: The level of eosinophilic airway inflammation correlates with variations in the microbiome across asthmatic patients, whereas neutrophilic airway inflammation does not. This warrants further investigation on molecular pathways involved in both patients with eosinophilic and those with noneosinophilic asthma.


Assuntos
Asma/microbiologia , Eosinofilia/microbiologia , Microbiota , Adulto , Asma/imunologia , Asma/metabolismo , Asma/fisiopatologia , Bactérias/genética , Bactérias/isolamento & purificação , Líquido da Lavagem Broncoalveolar/microbiologia , DNA Bacteriano/análise , Eosinofilia/imunologia , Eosinofilia/metabolismo , Eosinofilia/fisiopatologia , Eosinófilos/imunologia , Feminino , Volume Expiratório Forçado , Humanos , Contagem de Leucócitos , Masculino , Manitol/farmacologia , Neutrófilos/imunologia , Óxido Nítrico/metabolismo , Escarro/citologia , Adulto Jovem
8.
Transpl Infect Dis ; 18(5): 765-767, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27422045
9.
Fetal Pediatr Pathol ; 35(3): 149-58, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27064841

RESUMO

A higher than 350 eosinophils/mm(3) is strongly associated with Chlamydia trachomatis in term born babies coursing with respiratory distress. However, in preterm newborns infected with this pathogen, the levels of eosinophils are unknown. Forty newborn infants with clinical data of respiratory problems and/or sepsis were analyzed. DNA of leukocytes from peripheral blood was used to identify C. trachomatis. Detection of chlamydial infection was performed by amplifying the ompA gene by an in-house PCR, and eosinophil levels were evaluated in an XT-2000-hematology analyzer. Eighteen infants showed chlamydial infection and 14 of them showed pneumonia (RR = 2.6; CI95% 1.03-6.5; p =.027). Their eosinophil levels were 719 ± 614 cells/mm(3). A significant association between eosinophilia ≥1250 cells/mm(3) and gestational age of less than 29 weeks (RR = 5.8; 1.35; CI95% [1.4-24.5], p <.008) was observed. The preterm infants with chlamydial infection did not show higher eosinophil levels than uninfected infants.


Assuntos
Infecções por Chlamydia/patologia , Chlamydia trachomatis , Eosinofilia/patologia , Pneumonia/patologia , Adulto , Estudos de Casos e Controles , Infecções por Chlamydia/complicações , Infecções por Chlamydia/microbiologia , Eosinofilia/complicações , Eosinofilia/microbiologia , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Pneumonia/microbiologia , Reação em Cadeia da Polimerase , Sepse/microbiologia , Sepse/patologia , Adulto Jovem
10.
Respirology ; 21(4): 683-8, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26969485

RESUMO

BACKGROUND AND OBJECTIVE: Patients presenting with refractory postinfectious cough may respond to glucocorticosteroids but it is unclear whether airway eosinophilic inflammation exists in those patients. We aimed to determine the airway inflammation and causes of subacute cough following acute upper respiratory tract infection (AURTI). METHODS: One hundred and sixteen patients with persistent cough lasting 3-8 weeks after upper respiratory tract infection were evaluated with differential cell count in induced sputum, spirometry and methacholine bronchial challenge testing. RESULTS: In patients with subacute cough, sputum eosinophilia (median 8.5%,3.0-73.0%) was identified in 35 (33.6%) patients, 22 (18.5%) without bronchial hyperresponsiveness (BHR) were diagnosed as non-asthmatic eosinophilic bronchitis (NAEB), 13 (14.3%) of whom with BHR were diagnosed as cough variant asthma (CVA). Cough in patients with sputum eosinophilia improved after treatment with corticosteroids. Compared with postinfectious cough (PIC) and NAEB, CVA had significantly higher median eosinophil count in induced sputum (0.5% vs 7.5% vs 20.0%, P < 0.01). MMEF in CVA was significantly lower than PIC and NAEB (P < 0.05). The common causes of subacute cough following acute upper respiratory tract infection (AURTI) were PIC (37.8%), NAEB (18.5%), CVA (14.3%) and upper airway cough syndrome (UACS) (10.1%). Atopic cough (AC) (5.2%) and gastroesophageal reflux-related cough (GERC) (3.4%) were less common in subacute cough following AURTI, while 9 (7.8%) patients had unexplained cough. CONCLUSION: Subacute cough following AURTI can be attributed to different entities, eosinophilic airway inflammation is common. Induced sputum should be considered when evaluating patients with subacute cough following acute upper respiratory tract infection.


Assuntos
Asma/diagnóstico , Bronquite/diagnóstico , Tosse/patologia , Eosinofilia/diagnóstico , Eosinófilos , Infecções Respiratórias/complicações , Doença Aguda , Adulto , Idoso , Asma/complicações , Hiper-Reatividade Brônquica/complicações , Testes de Provocação Brônquica , Bronquite/microbiologia , Doença Crônica , Tosse/microbiologia , Eosinofilia/microbiologia , Feminino , Refluxo Gastroesofágico/complicações , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Escarro/citologia , Adulto Jovem
12.
J Allergy Clin Immunol ; 137(5): 1398-1405.e3, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-26627545

RESUMO

BACKGROUND: The lung has a diverse microbiome that is modest in biomass. This microbiome differs in asthmatic patients compared with control subjects, but the effects of clinical characteristics on the microbial community composition and structure are not clear. OBJECTIVES: We examined whether the composition and structure of the lower airway microbiome correlated with clinical characteristics of chronic persistent asthma, including airflow obstruction, use of corticosteroid medications, and presence of airway eosinophilia. METHODS: DNA was extracted from endobronchial brushings and bronchoalveolar lavage fluid collected from 39 asthmatic patients and 19 control subjects, along with negative control samples. 16S rRNA V4 amplicon sequencing was used to compare the relative abundance of bacterial genera with clinical characteristics. RESULTS: Differential feature selection analysis revealed significant differences in microbial diversity between brush and lavage samples from asthmatic patients and control subjects. Lactobacillus, Pseudomonas, and Rickettsia species were significantly enriched in samples from asthmatic patients, whereas Prevotella, Streptococcus, and Veillonella species were enriched in brush samples from control subjects. Generalized linear models on brush samples demonstrated oral corticosteroid use as an important factor affecting the relative abundance of the taxa that were significantly enriched in asthmatic patients. In addition, bacterial α-diversity in brush samples from asthmatic patients was correlated with FEV1 and the proportion of lavage eosinophils. CONCLUSION: The diversity and composition of the bronchial airway microbiome of asthmatic patients is distinct from that of nonasthmatic control subjects and influenced by worsening airflow obstruction and corticosteroid use.


Assuntos
Corticosteroides/uso terapêutico , Asma/tratamento farmacológico , Asma/microbiologia , Brônquios/microbiologia , Líquido da Lavagem Broncoalveolar/microbiologia , Microbiota , Adulto , Asma/fisiopatologia , Bactérias/genética , Bactérias/isolamento & purificação , Eosinofilia/microbiologia , Feminino , Volume Expiratório Forçado , Humanos , Masculino , RNA Bacteriano/genética , RNA Ribossômico 16S/genética
13.
BMJ Case Rep ; 20152015 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-26682840

RESUMO

A 51-year-old African-American man with underlying pulmonary, hepatic and splenic sarcoidosis, reported a 3-day history of headache, neck stiffness and photophobia. He was not using medication for chronic sarcoidosis. Physical examination was significant for nuchal rigidity. Lumbar puncture revealed marked eosinophilia in the cerebrospinal fluid, which, on further analysis, demonstrated a positive cryptococcal antigen. HIV antibody and PCR tests were negative. Bronchoscopy and fungal blood cultures were also negative. The patient was started on amphotericin B and flucytosine, with significant clinical improvement. He recovered well without any neurological sequelae and remained symptom-free at 2-week follow-up. Cryptococcal central nervous infections are uniformly fatal if left untreated. Prompt diagnosis and treatment is essential, to prevent the associated high morbidity and mortality.


Assuntos
Eosinofilia/microbiologia , Meningite Criptocócica/microbiologia , Sarcoidose/complicações , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Eosinofilia/líquido cefalorraquidiano , Eosinofilia/tratamento farmacológico , Flucitosina/uso terapêutico , Humanos , Masculino , Meningite Criptocócica/líquido cefalorraquidiano , Meningite Criptocócica/tratamento farmacológico , Pessoa de Meia-Idade , Rigidez Muscular , Punção Espinal
14.
Bull Exp Biol Med ; 159(3): 323-6, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26212806

RESUMO

We studied possible mechanisms of immunosuppression mediated by regulatory T cells that promotes suppression of antigen-specific immune response to Mycobacterium tuberculosis in patients with pulmonary tuberculosis and eosinophilia. It was shown that the number of CD4(+)CD25(+)Foxp3(+) regulatory T cells with immunosuppressive activity (Treg) increased in the peripheral blood of patients with disseminated destructive forms of pulmonary tuberculosis with multiple resistance of the causative agent to antituberculosis substances and eosinophilia. These changes were accompanied by imbalance in secretion of Treg-associated cytokines (in vitro) manifested in hyperproduction of TGFß and IL-10 and decreased production of IL-2.


Assuntos
Eosinofilia/imunologia , Eosinofilia/microbiologia , Linfócitos T Reguladores/metabolismo , Tuberculose Pulmonar/imunologia , Tuberculose Pulmonar/microbiologia , Adolescente , Adulto , Linfócitos T CD4-Positivos/metabolismo , Eosinofilia/metabolismo , Feminino , Fatores de Transcrição Forkhead/metabolismo , Humanos , Interleucina-10/metabolismo , Interleucina-2/metabolismo , Subunidade alfa de Receptor de Interleucina-2/metabolismo , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/imunologia , Mycobacterium tuberculosis/patogenicidade , Fator de Crescimento Transformador beta/metabolismo , Tuberculose Pulmonar/metabolismo , Adulto Jovem
15.
J Cutan Pathol ; 42(8): 554-8, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25997023

RESUMO

The differential diagnosis for eosinophil-rich skin lesions often includes a drug reaction, allergic contact dermatitis and rarely, response to a helminth infection. However, many unrelated entities, such as infections, neoplasms and inflammatory dermatoses, can have a prominent eosinophilic infiltrate. Syphilis is classically associated with plasma cells, but other patterns of inflammation have been reported, including ulcerative, granulomatous and eosinophil-rich. Classic teaching might indicate that the presence of eosinophils argues against a diagnosis of syphilis. We present four cases of secondary syphilis with increased eosinophils, ranging from 8 to >200 eosinophils per 10 high-power fields (×400 magnification). Patient 1 had lesions on the penis and scrotum, with greater than 200 eosinophils per 10 high-power fields. Patient 2 had lesions on the back, with 150 eosinophils per 10 high-power fields. Patient 3 had lesions on the bilateral arms, with 8 eosinophils per 10 high-power fields. Patient 4 had lesions involving the anus, with 17 eosinophils per 10 high-power fields. These cases highlight that the presence of an eosinophil-rich infiltrate on skin biopsy should not exclude syphilis from the differential diagnosis.


Assuntos
Eosinofilia/microbiologia , Eosinófilos/patologia , Dermatopatias/microbiologia , Sífilis/patologia , Adulto , Biópsia , Diagnóstico Diferencial , Eosinofilia/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Dermatopatias/sangue , Dermatopatias/patologia , Sífilis/sangue , Sífilis/tratamento farmacológico , Sífilis/microbiologia , Treponema pallidum/isolamento & purificação
16.
J Laryngol Otol ; 129(2): 155-8, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25599929

RESUMO

OBJECTIVE: This study compared the results of nasal Staphylococcus aureus carriage and nasal cytology in men with and without a moustache. METHODS: The study group comprised 118 adult men with a moustache, and the control group consisted of 123 adult men without a moustache. Samples were taken from the participants' right nasal cavity for cytology and from the left nasal cavity for microbiology. RESULTS: The results for S aureus were positive in 19.5 per cent (n = 23) of participants with a moustache and in 20.3 per cent (n = 25) of men without a moustache. This difference was not significant (p > 0.05). However, nasal cytology revealed rich eosinophil clusters in participants with a moustache. CONCLUSION: The presence or absence of a moustache had no effect on nasal S aureus colonisation. However, further research is needed to understand whether the presence of a moustache increases the risk of allergic or non-allergic rhinitis.


Assuntos
Cabelo/microbiologia , Cavidade Nasal/microbiologia , Mucosa Nasal/microbiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/crescimento & desenvolvimento , Adulto , Portador Sadio/imunologia , Portador Sadio/microbiologia , Eosinofilia/diagnóstico , Eosinofilia/imunologia , Eosinofilia/microbiologia , Face , Humanos , Masculino , Cavidade Nasal/patologia , Mucosa Nasal/patologia , Rinite/imunologia , Rinite/microbiologia , Rinite/patologia , Infecções Estafilocócicas/imunologia , Infecções Estafilocócicas/patologia , Infecções Estafilocócicas/prevenção & controle
17.
World J Gastroenterol ; 20(43): 16368-71, 2014 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-25473198

RESUMO

Eosinophilic gastroenteritis is a rare disease of unknown etiology. It is characterized by patchy or diffuse eosinophilic infiltration of the bowel wall to a variable depth and various gastrointestinal manifestations. We describe a case of severe eosinophilic gastroenteritis presenting as frequent bowel obstruction and diarrhea in a 35-year-old man. The patient was misdiagnosed and underwent surgery because of intestinal obstruction when he was first admitted to a local hospital. Then he was misdiagnosed as having Crohn's disease in another university teaching hospital. Finally, the patient asked for further treatment from our hospital because of the on-going clinical trial for treating refractory Crohn's disease by fecal microbiota transplantation. Physical examination revealed a slight distended abdomen with diffuse tenderness. Laboratory investigation showed the total number of normal leukocytes with neutrophilia as 90.5%, as well as eosinopenia, monocytopenia and lymphocytopenia. Barium radiography and sigmoidoscopy confirmed inflammatory stenosis of the sigmoid colon. We diagnosed the patient as having eosinophilic gastroenteritis by multi-examinations. The patient was treated by fecal microbiota transplantation combined with oral prednisone, and was free from gastrointestinal symptoms at the time when we reported his disease. This case highlights the importance of awareness of manifestations of a rare disease like eosinophilic gastroenteritis.


Assuntos
Terapia Biológica/métodos , Erros de Diagnóstico , Enterite/terapia , Eosinofilia/terapia , Fezes/microbiologia , Gastrite/terapia , Glucocorticoides/uso terapêutico , Prednisona/uso terapêutico , Adulto , Biópsia , Colonoscopia , Meios de Contraste , Enterite/complicações , Enterite/diagnóstico , Enterite/microbiologia , Eosinofilia/complicações , Eosinofilia/diagnóstico , Eosinofilia/microbiologia , Gastrite/complicações , Gastrite/diagnóstico , Gastrite/microbiologia , Humanos , Masculino , Valor Preditivo dos Testes , Resultado do Tratamento
18.
Intern Med ; 53(13): 1407-11, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24990332

RESUMO

OBJECTIVE: The diagnosis of allergic bronchopulmonary mycosis (ABPM) has traditionally relied widely on Rosenberg's criteria, which emphasize immunologic responses while overlooking the investigation of mucous plugs as a primary criterion. Therefore, the characteristics of biopsy-proven ABPM require further elucidation. The aim of this study was to analyze the clinical characteristics of biopsy-proven ABPM and address whether full compliance with clinical criteria, such as the presence of asthma, and certain laboratory findings is necessary to establish a diagnosis of ABPM. METHODS: We retrospectively analyzed 17 patients with biopsy-proven ABPM focusing on causative fungi and laboratory findings. RESULTS: Causative fungi included Aspergillus sp. in seven patients, Schizophyllum commune in four patients, Penicillium sp. in two patients and unknown in five patients. Bronchial asthma was observed in 10 patients, eosinophilia was observed in 10 patients and an increased serum immunoglobulin (Ig) E level was observed in 14 of the 17 patients. IgG for Aspergillus sp. was positive in six of the seven patients with ABPM due to Aspergillus and turned positive in the remaining patient during follow-up. Technological limitations prevented the measurement of specific IgE for S. commune and IgG for S. commune and Penicillium sp. in most patients. Computed tomography revealed central bronchiectasis, pulmonary infiltration and mucous plugs in all patients. CONCLUSION: Causative fungi other than Aspergillus sp. are not uncommon, and immunological tests for other fungi should be popularized. Asthma and characteristic laboratory findings, such as peripheral blood eosinophilia, increased serum IgE and precipitating antibodies, may not always be required to diagnose ABPM. The importance of typical pathologic findings of mucous plugs for diagnosing ABPM requires reevaluation. Further studies are needed to establish more elaborate diagnostic criteria for ABPM.


Assuntos
Asma/diagnóstico , Asma/microbiologia , Aspergilose Pulmonar Invasiva/diagnóstico , Aspergilose Pulmonar Invasiva/microbiologia , Adulto , Idoso , Anticorpos Antifúngicos/sangue , Aspergillus/isolamento & purificação , Biópsia , Bronquiectasia/diagnóstico por imagem , Eosinofilia/diagnóstico , Eosinofilia/microbiologia , Feminino , Humanos , Imunoglobulina E/sangue , Imunoglobulina G/sangue , Pulmão/diagnóstico por imagem , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Penicillium/isolamento & purificação , Estudos Retrospectivos , Schizophyllum/isolamento & purificação , Tomografia Computadorizada por Raios X
19.
Rev. iberoam. micol ; 31(2): 141-144, abr.-jun. 2014.
Artigo em Espanhol | IBECS | ID: ibc-121256

RESUMO

Antecedentes. La paracoccidioidomicosis es la micosis sistémica más frecuente en las zonas tropicales y subtropicales de Latinoamérica; el agente etiológico es Paracoccidioides. La enfermedad se presenta preferentemente en la población adulta, por lo que existen pocos reportes en la edad pediátrica. El objetivo del presente trabajo es describir las características clínicas, epidemiológicas y diagnósticas, y la evolución de los casos de paracoccidioidomicosis diagnosticados en el Hospital de Pediatría Prof. Dr. Juan P. Garrahan entre los años 2000 y 2010. Casos clínicos. Se presentan los casos de 4 pacientes previamente sanos procedentes del norte argentino con paracoccidioidomicosis diseminada juvenil y diagnóstico confirmatorio anatomopatológico o microbiológico. Conclusiones. La paracoccidioidomicosis debe ser considerada dentro de los diagnósticos diferenciales en niños con síndrome febril y compromiso linfoganglionar, acompañado por anemia, hipereosinofilia e hipergammaglobulinemia, procedentes de áreas endémicas del país (AU)


Background. Paracoccidioidomycosis is the most frequent systemic mycosis in Latin America, caused by the dimorphic fungus Paracoccidioides. Paracoccidioidomycosis in children is uncommon. Our aim is to describe clinical features of patients who had a confirmed diagnosis of paracoccidioidomycosis in our hospital in the last 10 years. Case reports. We describe 4 cases of paracoccidioidomycosis in previously healthy children from the north of our country. Diagnoses were made by biopsy or culture. Conclusions. The diagnosis of paracoccidioidomycosis should be considered in a patient coming from regions where Paracoccidioides is endemic, and presenting with a lymphoproliferative syndrome, anemia, eosinophilia and hypergammaglobulinemia (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Paracoccidioidomicose/complicações , Paracoccidioidomicose/microbiologia , Micoses/epidemiologia , Micoses/prevenção & controle , Diagnóstico Diferencial , Hipergamaglobulinemia/complicações , Hipergamaglobulinemia/diagnóstico , Paracoccidioidomicose/epidemiologia , Infecções Fúngicas do Sistema Nervoso Central/complicações , Infecções Fúngicas do Sistema Nervoso Central/epidemiologia , Eosinofilia/microbiologia
20.
Laryngoscope ; 124(9): E347-53, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24615892

RESUMO

OBJECTIVES/HYPOTHESIS: The role of fungi in chronic rhinosinusitis (CRS) is still controversial. The present study was conducted to detect and identify fungal species from the nasal polyp tissues of eosinophilic and noneosinophilic CRS, and to determine the role of fungal antigens in cytokine production. STUDY DESIGN: Prospective study. METHODS: Thirty-five specimens of nasal polyps were collected from patients with CRS and examined for fungus using culture, histology, and polymerase chain reaction analysis. The secretion of 14 cytokines stimulated by fungal extracts using dispersed nasal polyp cells (DNPCs) was determined by multiplex immunoassay. RESULTS: There was no microbiological growth (including fungus) in the cultures of homogenized nasal polyps. Furthermore, Grocott methanamine silver staining for all nasal polyps showed no fungal bodies. Sixteen of 35 samples of the nasal polyps showed amplification of fungal DNA. In none of the mucosa of the sphenoid sinus was fungal DNA detected. The number of eosinophils in the nasal polyps in which fungal DNA was detected was significantly higher than in the nasal polyps in which fungal DNA was not detected (P < .01). The extract of fungus enhanced the secretion of eosinophil-associated cytokines such as interleukine (IL)-5, IL-13, IL-17A, and RANTES (regulated on activation normal T-cell expressed and secreted), and proinflammatory cytokines such as IL-6, IL-8, tumor necrosis factor-α, and granulocyte-macrophage colony-stimulating factor from DNPCs. CONCLUSIONS: The present study offers direct evidence supporting that fungal elements modify the inflammatory response in the nasal polyps of eosinophilic CRS.


Assuntos
Citocinas/imunologia , Eosinofilia/imunologia , Eosinofilia/microbiologia , Fungos/isolamento & purificação , Pólipos Nasais/microbiologia , Rinite/imunologia , Rinite/microbiologia , Sinusite/imunologia , Sinusite/microbiologia , Adulto , Idoso , Doença Crônica , Eosinofilia/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pólipos Nasais/complicações , Estudos Prospectivos , Rinite/complicações , Sinusite/complicações , Adulto Jovem
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