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As there was not any data on Chlamydia pneumoniae (TWAR) infections in Brazil so far, a prospective cohort study of adult patients hospitalized due to CAP was carried out for one year in a Brazilian university general hospital to detect the incidence of CAP by Chlamydophila pneumoniae (TWAR) for one year. During a whole year 645 consecutive patients hospitalized due to an initial presumptive diagnosis of respiratory diseases by ICD-10 (J00-J99), excluding upper respiratory diseases, were screened; 59 consecutive patients with CAP were diagnosed. They had determinations of serum antibodies to C. pneumoniae by microimmunofluorescence at the Infectious Diseases Laboratory of University of Louisville (KY, USA); 37 patients (63.8%) had seroreactivity to TWAR antigens, from which 23 (39.6%) had previous infection; 3 patients (5.2%) were diagnosed with CAP by TWAR and got cured. The incidence of TWAR CAP in our hospital by seroconversion was 5.2%. Our incidence of 5.2% is probably underestimated since TWAR culture was not available; we suggest that Real-Time PCR be used along with other diagnostic methods in future studies to detect the actual incidence of TWAR CAP. We propose that the serological criterion of IgM ≥1:16 alone to the diagnosis of acute infection by TWAR are discontinued due a lack of specificity.

Objectives The oral rehydration solution is the most efficient method to treat cholera; however, it does not interfere in the action mechanism of the main virulence factor produced by Vibrio cholerae, the cholera toxin (CT), and this disease still stands out as a problem for human health worldwide. This review aimed to describe therapeutic alternatives available in the literature, especially those related to the search for molecules acting upon the physiopathology of cholera. Key findings New molecules have offered a protection effect against diarrhoea induced by CT or even by infection from V. cholerae. The receptor regulator cystic fibrosis channel transmembrane (CFTR), monosialoganglioside (GM1), enkephalinase, AMP-activated protein kinase (AMPK), inhibitors of expression of virulence factors and activators of ADP-ribosylarginine hydrolase are the main therapeutic targets studied. Many of these molecules or extracts still present unclear action mechanisms. Conclusions Knowing therapeutic alternatives and their molecular mechanisms for the treatment of cholera could guide us to develop a new drug that could be used in combination with the rehydration solution.

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