FUNDAMENTOS: Os métodos para diagnosticar Pediculus humanus var. capitis são controvertidos e a maioria dos estudos tem usado o exame visual direto. OBJETIVOS: O objetivo deste estudo foi comparar a eficácia no diagnóstico do exame visual direto em contraposição ao uso do pente metálico de aço com dentes microcanaliculados. MÉTODOS: Investigaram-se 946 crianças e adolescentes de quatro a 19 anos. O cabelo de cada criança foi examinado duas vezes, para detectar infestação pelos diferentes estádios, por meio da observação visual direta e com o pente metálico. RESULTADOS: O diagnóstico visual apontou infestação em 30,7% dos casos, enquanto que o pente metálico indicou um resultado de 51,5%. O sexo feminino foi o mais acometido, de acordo com ambos os métodos. As formas parasitárias detectadas com o exame visual direto foram: somente piolhos (adultos e/ou ninfas); 1,4%; somente lêndeas vivas, 64,8%; e lêndeas vivas mais piolhos, 33,8%; com o pente metálico, foram 6,4%, 23,6% e 70%, respectivamente. A média de tempo para descobrir um piolho foi de 57 segundos com o pente metálico e de 116,4 segundos com a observação visual direta. CONCLUSÕES: O diagnóstico é duas vezes mais rápido e 3,6 vezes mais eficiente com o pente metálico microcanaliculado. O método visual leva a uma subestimação das infestações ativas e revela as passadas não ativas.
We present a case report of a male patient of 36 years old, truck driver, with out any morbid history, that after a travel to Amazonian region of Brazil, by truck, start with fever, malaise, joint pain. He consulted to the Emergency Room of a General Hospital in Los Andes (Chile,) after one week of illness. In the hospital it was quantified the fever, and it was found the liver enzymes increased, with anaemia .and platelets diminished. He was transferred to the hospital of San Felipe, because it was thought that he could need some support measures of Intensive Care Unit. With the epidemiological history of the patient It was suspected the diagnosis of Malaria, so a thick and a thin smear were performed, and indirect tests also (pLDH by the optiMAL Test kit), in the Public Health Institute, that confirmed the diagnosis of Malaria by Plasmodium falciparum. He was treated with Chloroquine in the recommended regimen, with clinical improvement. Malaria by P. falciparum is described as the one with more hepatic and haematological compromise, and with high parasitic index in blood. With the improvements in travelling, to endemic regions, the risk of appearance of malaria cases in non endemic areas is increasing, as the reported case. So the health network must be prepared to manage this cases, and to have a close contact with the reference laboratory, to send the samples and to notify the cases. In the case, the diagnosis was made in a quick way, thanks to the anamnesis and the clinical suspicious.
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