Revista do Instituto de Medicina Tropical de São Paulo
-
Rev. Inst. Med. Trop. Sao Paulo · Jul 1993
Review Case Reports[Cryptococcal meningitis in pregnancy. Review of the literature. Report of 2 cases].
Two cases of neurocryptococcosis were diagnosed during pregnancy in São Paulo (Brazil). Amphotericin B was used in the second trimester in one patient. The other, received amphotericin B during the first trimester of pregnancy and 5-fluorocytosine was added in the second trimester. ⋯ The therapy used to treat pregnant women with cryptococcal meningitis is commented. The newborn follow-up is discussed. A review of the literature concerning neurocryptococcosis during pregnancy is presented.
-
Rev. Inst. Med. Trop. Sao Paulo · Mar 1993
Respiratory complications in Brazilian patients infected with human immunodeficiency virus.
To determine how often and by what means an indentifiable pulmonary pathogen can be recognized in human immunodeficiency virus (HIV) infected patients with respiratory disorders in Brazil, which are the most frequently observed microorganisms and what impact specific therapy has on these agents. ⋯ We have determined that tuberculosis, P. carinii and cytomegalovirus pneumonitis are the most common respiratory opportunistic diseases in Brazilian patients infected with HIV. The histologic evaluation was crucial in order to identify the pulmonary pathogens. Tuberculosis in AIDS individuals displayed clinical and radiographic findings atypical for reactivation disease. However, most of the features observed in HIV infected patients had been previously described in infection of the normal host. Furthermore, the AIDS subjects showed a good therapeutic response to anti-tuberculous drugs.
-
Rev. Inst. Med. Trop. Sao Paulo · Jan 1993
Case ReportsFive cases of nosocomial and community-acquired Legionnaires' disease in São Paulo, Brazil.
Legionella sp has been emerging over the last decade as an important cause of pneumonia both hospital and community-acquired. Following an outbreak in a Renal-Transplant Unit stocked serum was tested for antibodies against Legionella pneumophila serogroup 1, and 5 cases of Legionnaires' Disease were reviewed. ⋯ Clinical and laboratorial aspects were similar to those expected for other causes of pneumonia, however jaundice was encountered in two cases. This study suggests that the real incidence of pneumonia caused by Legionella sp is being underestimated and the authors emphasize the importance of considering Legionnaires' Disease when empirically treating community-acquired pneumonia.
-
Rev. Inst. Med. Trop. Sao Paulo · Nov 1992
Non-venomous snake bite and snake bite without envenoming in a Brazilian teaching hospital. Analysis of 91 cases.
A retrospective survey of 473 cases of snake bite admitted to a Brazilian teaching hospital from 1984 to 1990 revealed 91 cases of bite without envenoming and/or caused by non-venomous snakes. In 17 of these cases the snake was identified, and one patient was bitten by a snake-like reptile (Amphisbaena mertensii). In 43 cases diagnosis was made on clinical grounds (fang marks in the absence of signs of envenoming). ⋯ The patient bitten by Drymarcon corais was misdiagnosed as being bitten by a snake of the genus Bothrops, was given the specific antivenom, and developed anaphylaxis. One patient bitten by Sibynomorphus mikanii presented prolonged clotting time, and was also given antivenom as a case of Bothrops bite. Correct identification of venomous snakes by physicians is necessary to provide correct treatment to victims of snake bite, avoiding unnecessary distress to the patient, and overprescription of antivenom, which may eventually cause severe untoward effects.