No abstract

Introducción Strongyloides stercoralis es un nematodo endémico en áreas tropicales y templadas de todo el mundo. Una de las características más llamativas de este geo-helminto es su ciclo vital complejo que le permite provocar auto-infestación en el hospedero. En la mayoría de los casos la infección permanece asintomática, en especial en las áreas endémicas. Sin embargo, bajo ciertas condiciones de inmunodepresión, S. stercoralis puede provocar cuadros graves y a veces mortales que incluyen formas de hiperinfestación o diseminadas 1,2 . Es una parasitosis de difícil diagnóstico, ya que el mismo requiere de la visualización directa de las formas larvarias del parásito y no existe una prueba que se asocie con 100% . Among HIV negative patients the following comorbidities were detected: tuberculosis (n = 3) and chronic alcoholism, leprosy treated with corticosteroids, immunosuppressive treatment for psoriasis, and diabetes mellitus (each in one patient). Two patients did not have any predisposing diseases or immunosuppressive treatments. Seventeen patients presented with diarrhea and were classifi ed as chronic intestinal strongyloidiasis (57%), asymptomatic infection with peripheral eosinophilia was diagnosed in 7 (23%), and 6 patients (20%) developed hyperinfection syndrome. Seventeen patients (57%) presented peripheral eosinophilia. Diagnosis was achieved by direct visualization of larvae in feces by Baermann technique (n = 20), by multiple stool smears examinations (n = 2), by combination of both (n = 1), by visualization of the fi lariform larvae in duodenal fl uid and stool (n = 1), and in fecal and bronchoalveolar lavage specimens (n = 6). Overall mortality in this series was 20% (6/30). There was no signifi cant correlation between age and mortality. A signifi cant inverse correlation between the survival rate and CD4 T-cell count as well as eosinophilia was observed. There was also a signifi cant correlation between HIV co-infection and mortality. Twenty-two patients responded favorably to treatment with ivermectin.

SUMMARYParacoccidioidomycosis is one of the most frequent systemic and endemic mycoses of Latin America caused by a dimorphic fungus. In AIDS patients, paracoccidioidomycosis appears as a severe and disseminated disease with a wide spectrum of clinical findings. The CD4 counts are usually less than 200 cell/µL. We present a case of disseminated paracoccidioidomycosis with peripleuritis and subcutaneous abscesses on the chest wall as initial manifestation of AIDS. In endemic countries, paracoccidioidomycosis should be included as an opportunistic infection in AIDS.

No abstract

No abstract