Revista da Sociedade Brasileira de Medicina Tropical
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Rev. Soc. Bras. Med. Trop. · Jul 2008
Case Reports[Strongyloides stercoralis hyperinfection: autopsy case report].
Asymptomatic infection due to Strongyloides stercoralis may result in potentially fatal disease in immunodepressed patients. A case of Strongyloides stercoralis hyperinfection discovered at autopsy in a 55-year-old man who had been undergoing treatment for multiple myeloma is reported, emphasizing the clinical and pathological findings. One day earlier, he presented severe headache, abdominal pain and oliguria, from which he developed acute respiratory failure and septic shock. Because of difficulty in reaching this diagnosis, empirical treatment before starting immunosuppressive therapy may be the best strategy for preventing hyperinfection by this worm.
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Rev. Soc. Bras. Med. Trop. · Jan 2008
Comparative Study[Comparison between the epidemiology of accidents and the clinical features of envenoming by snakes of the genus Bothrops, among elderly and non-elderly adults].
This study had the aim of ascertaining epidemiological and clinical differences in envenoming caused by Bothrops spp between elderly adults (>60 years) and non-elderly adults (20 to 59 years). The data were obtained from 1,930 medical records of patients attended at the Butantan Institute between 1981 and 1992. ⋯ Necrosis was more common among the elderly patients (p < 0.05) and renal failure was more common among patients aged 50 years or over (p < 0.05), in relation to younger patients. It was concluded that elderly individuals are more often bitten on the hands and less often on the feet, and that they develop local necrosis and renal failure more frequently than do younger individuals.
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Rev. Soc. Bras. Med. Trop. · Sep 2007
[Envenomation by Bothrops in the State of Bahia: epidemiological and clinical aspects].
This study describes the clinical and epidemiological characteristics of 655 cases of Bothrops snakebites that were attended by and/or notified to the Bahia Antivenin Information Center, State of Bahia, Brazil, in 2001. The annual incidence in the State was 5.0 cases/100,000 inhabitants and lethality was 1%. The incidence was greatest in the North Coast microregion (21.9/100,000 inhabitants) and the municipality of Itanagra (92.9/100,000 inhabitants). ⋯ However, a few cases presented neurological manifestations, which are not usually attributed to Bothrops snakebites. The antivenin therapy used (7.7 blisters/patient) reflected the fact that the majority of the cases were moderate. Antivenins other than the univalent type were used in 2.3% of the cases.
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Rev. Soc. Bras. Med. Trop. · May 2007
Comparative Study[Meningococcal disease: comparison between clinical forms].
In order to asses the clinical forms of meningococcal disease, we reviewed 201 cases diagnosed as meningococcal disease in the University Hospital of the Fluminense Federal University in Rio de Janeiro, 185 of which met the inclusion criteria. Clinical and laboratorial characterization allowed for grouping of the cases as follows: meningococcal meningitis, 18%; meningitis with septicemia, 62%; and septicemia, 20%. Available epidemiological data did not differentiate clinical forms. ⋯ The following were significantly predominant in septicemia: shock; fatal outcome and higher partial thromboplastin time. Septicemia and meningitis with septicemia were differentiated from meningococcal meningitis in the following: duration of clinical history; occurrence of focal neurological signs; disseminated intravascular coagulation; and arthritis. Clinical and laboratory data lead us to admit meningococcal meningitis as a localized form of Meningococcal disease, and meningitis with septicemia and septicemia as variations in severity of the systemic form of the disease.