Revista da Sociedade Brasileira de Medicina Tropical最新文献

Sporotrichosis is caused by fungi belonging to the genus Sporothrix, and is generally acquired by traumatic inoculation. A 26-year-old man developed pustular lesions and a 6-kg weight loss after developing a lesion on his right hand 6 months previously. He was diagnosed with acquired human immunodeficiency syndrome (AIDS) and disseminated sporotrichosis cultures of bone and muscle biopsy and blood samples grew Sporothrix schenckii. The patient underwent reconstructive surgery and 9 months of treatment with amphotericin B and itraconazole, and showed complete wound healing and improved hand functionality. Suspicion of the disease is necessary in immunosuppressed patients living in endemic areas.

Background: This paper reports the occurrence of Panstrongylus guentheri Berg, 1879 in the State of Mato Grosso (MT).

Methods: Triatomines were captured in rural environments in municipalities of MT. Specimens were identified, and Trypanosoma cruzi infection was investigated.

Results: Nineteen specimens of Panstrongylus guentheri were found, primarily inside houses. The geographical distribution of this species was recorded in nine municipalities of Mato Grosso, and parasitological tests did not detect T. cruzi on P. guentheri.

Conclusions: The distribution of this species in Brazil has been recently updated.

Snakebites from the genus Bothrops are common and are responsible for the highest mortality rate in Brazil. Factors related to the species, treatment, and patient influence the clinical manifestations and prognosis of the condition. Young patients without comorbidities have better prognoses and rarely develop severe systemic complications. This report discusses a case of brain death of an 11-year-old boy due to intracranial hypertension following possible Bothrops snakebite. Despite receiving antivenom therapy, the patient experienced seizures, mental confusion, and decreased consciousness. Autopsy, epidemiology, clinical presentation, and laboratory results indicated a snakebite with unconventional symptoms as the cause of death.

Background: This study investigated the self-rated general health, mental health, and work absenteeism among patients with laboratory-confirmed chikungunya.

Methods: Telephone interviews were conducted with 63 patients ≥22 months after infection.

Results: Patients who reported (N=42) or did not report (N=21) chronic arthralgia, defined by duration ≥90 days, had different frequencies for low scores for general health (68.3% vs. 30.0%, respectively; prevalence ratio, 95% confidence interval: 2.3, 1.1-4.6), symptoms of depression (31.7% vs. 15.0%; 2.1, 0.7-6.6), symptoms of anxiety (43.9% vs. 35.0%; 1.3, 0.6-2.5), and work absenteeism (76.5% and 40.0%; 1.9, 0.9-4.2).

Conclusions: Chikungunya chronic arthralgia impacts long-term health and work.

Epidemics and outbreaks caused by the dengue virus pose risks to populations and have high mortality rates, causing burdens and economic costs worldwide. Brazil recently experienced an explosive increase in the number of dengue cases and fatalities. Dengue is an acute febrile illness that can progress to severe forms. It affects more than 100 countries, presenting ongoing challenges in Brazil and globally since its identification. Other conditions may be overlooked or mistaken for dengue. The most important differential diagnoses are other infectious diseases and rheumatological, hematological, gastroenterological, and neurological disorders. In this article, we discuss the primary differential diagnoses of dengue and offer a literature review highlighting the key clinical differences among clinicians. This review emphasizes the critical importance of differentiating dengue fever from infectious diseases such as meningococcemia and malaria and autoimmune and rheumatological conditions such as systemic lupus erythematosus to ensure timely and appropriate management.

Background: Vector distribution influences arbovirus persistence. This study examined the diversity of mosquito breeding sites in an Atlantic Forest fragment in Rio de Janeiro, Brazil.

Methods: Mosquito specimens were collected at Fazenda dos Cordeiros, Silva Jardim, Brazil. Tire, plastic, bamboo, and sapucaia traps were evaluated for oviposition preferences using ecological indices.

Results: Tire traps had the highest density. Bamboo traps showed the highest diversity. Plastic container was the most divergent site. The key recorded vector species included Aedes albopictus and Haemagogus leucocelaenus.

Conclusions: Identifying the breeding sites that contribute the most to mosquito density is essential for optimizing control strategies.

Background: This study aimed to evaluate the effectiveness and safety of direct-acting antivirals (DAAs) for hepatitis C treatment by measuring sustained virologic response (SVR) and serious adverse events to help design effective interventions for reducing disease prevalence.

Methods: This was a retrospective, observational, real-life study of patients with chronic hepatitis C receiving DAA treatment in the state of Ceará, Brazil. Data were collected in REDCap and analyzed using R® software by the Student's t, chi-square, and Fisher's exact tests, with a significance level of 5%.

Results: In this study, 1075 patients who were diagnosed with hepatitis C infection between October 2015 and October 2023 were included. The mean age of the participants was 56.6 ± 11 years and 60.2% were men. The sample included 51 HIV-infected patients (6.6%), 166 (15,4%) liver transplant recipients, 34 (3,1%) kidney transplant recipients, and 446 patients with cirrhosis (41.4%). The overall SVR rate was 96.4%. The sofosbuvir/daclatasvir/ribavirin regimen used in 354 (32.9%) patients achieved an SVR of 96%. The cure rate was 96.5%, with a lower SVR in patients with cirrhosis (93.4%) than in those with less severe fibrosis (97.9%) (p=0.0015). Serious adverse events associated with ribavirin use occurred in 3.5% of patients.

Conclusions: DAA treatment for hepatitis C achieved SVR in real life in all patient profiles, including transplant recipients, HIV carriers, and patients with cirrhosis. Although these drugs are safe, a few decompensated patients with cirrhosis died during treatment.

Background: Chagas disease, a significant global health concern rooted in social inequalities and political oversights, remains a challenging public health issue impacting millions worldwide. The increasing detection of triatomines, the vectors of Chagas disease, in urban areas complicates the situation.

Methods: This study investigated the incidence of Rhodnius neglectus in the urban areas of Jaboticabal, São Paulo, Brazil, following several reports and previous collections of triatomines in the city. An educational approach was adopted, distributing informational materials and engaging the community through social networks to generate notifications that would enable the identification of triatomines. Specimens were collected using various methods, including passive surveillance actions, light traps, and active searches in palm trees.

Results: Rhodnius neglectus was found in urban areas, invading homes in Jaboticabal, and was identified in palm trees. The educational approach led to the collection of 93 triatomines. Colonization was observed in a residence, with eggs, nymphs, and a concerning record of blood-feeding on a resident child. The houses where specimens were captured often had nearby palm trees with birds and nests, facilitating the passive transport of these insects and increasing the risk of invasion due to light attraction. No triatomines infected with Trypanosoma cruzi were identified.

Conclusions: These findings emphasize the need for preventive measures to reduce the prevalence of R. neglectus in urban environments. The data elucidate the occurrence of R. neglectus in the city of Jaboticabal, associated with its potential behavioral adaptation in urban environments, underscoring the need for innovative control strategies.

Background: Local studies are essential to determine the prevalence and risk factors of hepatitis C.

Methods: We conducted a mixed methods study aimed at strengthening hepatitis C elimination efforts in Brazil, with concomitant triangulation of techniques and integration of qualitative and quantitative approaches.

Results: The study resulted in the development of the following technical-technological products: a) institutional documents, b) organization of committees, c) mobilization strategies, d) models for improving intersectoral awareness, e) decision-making flowcharts, f) forms, and g) health service protocols and search strategies.

Conclusions: The application of these research techniques generated valuable knowledge that could be adopted in various regions across Brazil, particularly in areas with economic and sociocultural diversity.