SummaryA comparative study of total saline extract (SE) and cyst vesicular fluid (VF) of Taenia solium metacestodes by ELISA and Western blotting assay (WB) tests was conducted to detect IgG in sera for diagnosis of human cysticercosis. Sera were obtained and analysed by ELISA in 1 : 20 and 1 : 100 dilutions from 208 individuals: 22 confirmed neurocysticercosis (NC) (group 1), 101 suspected NC (group 2), 55 with various intestinal parasitosis (group 3) and 30 healthy individuals (group 4). The WB test was carried out on SE and VF extracts with and without reducing agent, 2-␤-mercaptoethanol (2-ME) in 20 sera of each group. WB using extracts without 2-ME and ELISA at 1 : 100 dilution were compared in 20 sera from each group; sensitivity and specificity were calculated using samples from groups 1, 3 and 4. By ELISA, in the 1 : 100 sera dilution reactivity was reduced for both antigens without changes in the sensitivity of the test. By WB, antigens treated with 2-ME demonstrated low specificity. For SE and VF antigens, the proteins of 24, 39-42, [47][48][49][50][51][52] 56,[64][65][66][67][68] 24,[26][27][28][32][33][34][35][36][47][48][49][50][51][52] 75 kDa, respectively, were considered immunodominant markers, with high indices of specificity, suggesting a profile for NC patients. However, as the sensitivity was found to be low, it might still not be a definitive test for NC when used alone. These data suggest WB as an indicative test to determine exposure to T. solium. ELISA and WB together may supply reliable results for the diagnosis of human cysticercosis, since appropriate purified antigens are not available yet.

RESUMO -O envolvimento do sistema nervoso central na paracoccidioidomicose tem sido raramente descrito na literatura e sua freqüência varia de 9,99% a 27,27%, manifestando-se basicamente sob duas formas clínicas: meníngea e pseudotumoral (abscessos, granulomas, nódulos ou cistos). O Paracoccidioides brasiliensis incide principalmente nos hemisférios cerebrais, podendo acometer ainda cerebelo, ponte, bulbo, meninges cerebrais e raquidianas, sendo excepcional o comprometimento do parênquima medular. Os autores apresentam o caso de um paciente com paracoccidioidomicose com evidências clínicas de comprometimento medular, comprovada por exames complementares indiretos pouco invasivos. Destacam a resposta terapêutica inédita a novo agente antifúngico bistriazólico, o fluconazol, pela primeira vez utilizado nesta forma de apresentação clínica da doença. Salientam a rariedade do comprometimento medular, o diagnóstico através de propedêutica não cirúrgica e a excelente resposta a este novo tratamento. PALAVRAS-CHAVE

We report the case of a 52-year-old male heterosexual patient with acquired immunodeficiency syndrome (AIDS) and reactivation of Chagas' disease manifested by meningoencephalitis and myocarditis, diagnosed post-mortem. Unexplained reactivation of Chagas' disease should be included among the diagnostic criteria of AIDS in human immunodeficiency virus positive patients. On the other hand, AIDS should be considered in the differential diagnosis of patients with unexplained reactivation of Chagas' disease.

SummaryWe compared saline (S) and sodium dodecyl sulphate (SDS) extracts from Taenia solium (homologous species ± HO) and Taenia crassiceps (heterologous species ± HE) metacestodes in order to detect IgG by ELISA and immunoblot assay (IBA) in cerebrospinal¯uid (CSF) for the diagnosis of human neurocysticercosis (NC). CSF samples were obtained from 93 patients. Of these, 40 had NC, ®ve had a diagnosis of probable NC, nine had central nervous system schistosomiasis or strongyloidiasis and 39 had other neurological alterations. Samples were analysed by ELISA and the results were compared with IBA in all samples with con®rmed and probable NC diagnosis, in all samples with other central nervous system parasitic infection, and in 10 of those with another neurological alterations. ELISA sensitivity was 100%, 85%, 95% and 87.5% for the S-HO, S-HE, SDS-HO and SDS-HE extracts, respectively, and ELISA speci®city was 100% for S-HO, S-HE, SDS-HO extracts and 97.9% for SDS-HE antigen. Immunodominant peptides detected by IBA were, by decreasing percentage of recognition: 64±68 and 45 kDa for S-HO; 108±114, 92±95, 64±68, 83 and 88 kDa for S-HE; 64±68, 108±114, 77 and 86 kDa for SDS-HO; and 108±114, 88 and 92±95 kDa for SDS-HE. Overall the homologous antigenic extracts showed higher sensitivity than the heterologous extracts in the diagnosis of NC in CSF samples. The heterologous extracts contained most of the immunodominant peptides presented in the homologous extracts, which are recognized by IgG antibodies in CSF samples.

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