RESUMO ABSTRACTIntroduction: Visceral leishmaniasis is a systemic infectious disease of broad geographical distribution, characterized by high potential for lethality. With the purpose of contributing towards reducing mortality and helping healthcare professionals in clinical management of patients with this disease, this paper aimed to investigate the clinical and laboratory characteristics of cases with a fatal outcome in hospitals in Campo Grande, Mato Grosso do Sul, between 2003 and 2008. Methods: Fifty-five medical files on patients who died due to visceral leishmaniasis were analyzed. Results: Among the 55 patients studied, 37 were from the municipality of Campo Grande; 41 (74.5%) were males; and age over 40 years predominated. The patients presented with fever in 89.1% of the cases. The duration of the illness from the onset of symptoms to hospitalization was 78.2 days on average. Leukopenia was seen in 85.5% of the patients. Comorbidities were present in 39 (70.9%) patients; malnutrition and alcoholism were the most frequent of these. Confirmation of the diagnosis occurred on average 6.7 days after admission. Pentavalent antimoniate was the drug most used, and 87.5% of the patients presented some type of adverse reaction. Bacterial infections occurred in 36 patients and were one of the causes of death in 27 (49%). Conclusions: The data showed that early identification of these clinical and laboratory characteristics, at the time when patients are first attended, is extremely important for reducing mortality through instituting efficient therapeutic and prophylactic measures.

A leishmaniose tegumentar americana (LTA) está entre uma das endemias de maior importância em saúde pública no Brasil, devido sua ampla distribuição pelo território nacional, a ocorrência de formas clínicas graves e pelas dificuldades referentes tanto ao diagnóstico como ao tratamento das mesmas 2 14 . Esta enfermidade apresenta um caráter antropozoonótico, sendo causada por diferentes espécies de protozoários parasitas do gênero Leishmania, que são transmitidas ao homem através da picada de insetos vetores hematófagos, os flebotomíneos. Existem pelo menos sete espécies de Leishmania descritas e que estão associadas com a doença humana, sendo que no Brasil Leishmania (Viannia) braziliensis e Leishmania (Leishmania) amazonensis são as espécies mais amplamente distribuídas 8 .

INTRODUCTION: The work was conducted to study phlebotomine fauna (Diptera: Psychodidae) and aspects of American cutaneous leishmaniasis transmission in a forested area where Leishmania (Leishmania) amazonensis occurs, situated in the municipality of Bela Vista, State of Mato Grosso do Sul, Brazil. METHODS: The captures were conducted with modified Disney traps, using hamster (Mesocricetus auratus) as bait, from May 2004 to January 2006. RESULTS: Ten species of phlebotomine sandflies were captured: Brumptomyia avellari, Brumptomyia brumpti, Bichromomyia flaviscutellata, Evandromyia bourrouli, Evandromyia lenti, Lutzomyia longipalpis, Psathyromyia campograndensis, Psathyromyia punctigeniculata, Psathyromyia shannoni and Sciopemyia sordellii. The two predominant species were Ev bourrouli (57.3%) and Bi flaviscutellata (41.4%), present at all sampling sites. Two of the 36 hamsters used as bait presented natural infection with Leishmania. The parasite was identified as Leishmania (Leishmania) amazonensis. CONCLUSIONS: Analysis of the results revealed the efficiency of Disney traps for capturing Bichromomyia flaviscutellata and the simultaneous presence of both vector and the Leishmania species transmitted by the same can be considered a predictive factor of the occurrence of leishmaniasis outbreaks for the human population that occupies the location.

The occurrence of an outbreak of cutaneous leishmaniasis associated with Leishmania (Leishmania)

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