Cryptococcus neoformans var. neoformans was repeatedly isolated from decaying wood forming hollows in living trees growing in urban areas of Rio de Janeiro, Brazil. A new natural habitat for C. neoformans var. neoformans has been found that is not associated with specific trees.
An increasing number of cases of abdominal angiostrongyliasis have recently been diagnosed in southern Brazil. A comparative study of 19 confirmed cases and 15 suspected cases was undertaken to review the anatomo-pathology of the disease and to establish histopathological criteria for its diagnosis. The results were similar in both groups, except for the identification of the worm in the confirmed cases. Macroscopic features comprised two types: a predominant thickening of the intestinal wall (pseudo-neoplastic pattern) and a congestive necrotic lesion (ischemic-congestive pattern). Microscopically, three fundamental histopathological findings were detected: (1) a massive infiltration of eosinophils in all layers of the intestinal wall, (2) a granulomatous reaction and (3) eosinophilic vasculitis affecting arteries, veins, lymphatics and capillaries. We conclude that observation of this histopathological triplet excludes other causes of "eosinophilic gastroenteritis" and establishes the diagnosis of probable abdominal angiostrongyliasis.
This study followed up 2,126 pregnant women cared for at SUS day-care clinics (Public Health Insurance System) of the northwest of the State of Rio Grande do Sul, Brazil. After serological screening we performed a follow up of all pregnant women and their babies. Serologic tests included: IgG, IgM, IgA and IgG avidity levels, mice inoculation and polymerase chain reaction (PCR) also placentas and umbilical materials were tested using immunoperoxidase as well as clinical evaluation. Of all the pregnant women screened, 74.5% were reactive to toxoplasmosis, and 3.6% presented IgM seropositivity. At ophthalmic evaluation ten women had ocular lesions and one infant presented eye lesions and brain calcification. The presence of anti-T.gondii specific IgM throughout the entire pregnancy did not characterize acute phase infection, for this, complementary tests were necessary. The importance is underscored for attendance of the newborn of mothers presenting serology compatible with this infection even in the absence of signs and symptoms of congenital toxoplasmosis.
Most of the cases of abdominal angiostrongyliasis in Brazil were reported from the southern States of São Paulo, Paraná, Santa Catarina and Rio Grande do Sul (RS). A study in 27 cases from RS revealed a distinct local epidemiology. Peasants were usually affected, either adults or children, from the mountainous areas in the north of the Suite. There was a seasonal increase in the number of cases, from late spring to autumn, that does not coincide with the rainy season. Besides the most common clinical features of abdominal pain, fever and cosinophilia in the leucogram, painful relapsing episodes were detected in some patients. The abdominal pain could be either localized or diffuse during the rapid evolution to a surgical abdominal condition, with a letality of 7.4%. The use of a serological test and the greater awareness of physicians working in endemic areas is expected to improve the recognition of uncomplicated and benign courses of the disease. This study confirms the known clinical manifestations of abdominal angiostrongyliasis and demonstrates the diversity of its epidemiology.
SummaryAbdominal angiostrongyliasis is a nematode disease produced by Angiostrongylus costaricensis, a metastrongylid parasite of wild rodents. Accidental human infection occurs through ingestion of food or water contaminated with third-stage larvae present in the mucous secretion of terrestrial molluscs. An ELISA test was standardized for detection of IgG antibodies recognizing a surface antigen prepared from female worms. Competitive absorption of sera with Ascaris suum crude antigen resulted in a test with 86% sensitivity and 83% specificity. The disease is endemic in Southern Brazil and a number of cases are diagnosed every year through anatomo-pathological examination of biopsies or surgical specimens, since no other diagnostic method is available. According to seroepidemiological studies, prevalences in two transmission foci are 29.8 and 66%, attesting to the widespread occurrence of the infection in those endemic areas. keywords angiostrongyliasis, ELISA, Brazil correspondence C. Graeff-Teixeira, Rua Marquês do Pombal, 799/801, CEP 90540-010,
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