Biomedical subjects
Publications and source records attributed to L C Severo.
We report a case of mycetoma caused by Rhodococcus in a 62-year-old man who presented with multiple draining sinuses of the left foot. Biopsy specimen showed granulomatous reaction and microabcesses contained granules. These granules were composed by rod and coccoid Gram-positive and partially acid-fast elements. Culture grew a 'Nocardia-like organism', confirmed at the Center for Disease Control as Rhodococcus spp.
Five cases of paracoccidioidomas are reviewed. One case with multiple coin-lesions simulating Wegener's granulomatosis is described.
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Paracoccidioidomycosis is an important Latin American endemy. The lung is the portal of entrance of the infection and the lesions are confined to this organ in, at least, 30 per cent of the progressive cases. Twelve case histories of patients with the progressive pulmonary form are presented in order to illustrate the repetitious clinical manifestations but the large variety of radiological presentations. The mycologic diagnosis is also emphasized.
During a seventeen day period an A. niger fungus ball evolved within a healed tuberculous cavity of a patient. Symptoms were a cough with a chocolate brown expectoration and dyspnea. The patient died and necropsy was performed. Crystals of calcium oxalate were deposited in the cavity lining and in the adjacent tissue of the lung. Fibrosis, mononuclear infiltration and intraalveolar purulent exudate were seen in these tissues. Some small vessels presented recent thrombosis and deposition of calcium oxalate. The bronchus connected with the cavity presented a disrupted epithelial layer, edema, polymorphonuclear infiltration and birefringent crystals. Scattered areas of tubular atrophy, glomerular sclerosis and lymphoid infiltration were seen in the cortex of the kidney. Oxalate crystals were also seen within the renal tubuli.
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A 53 year-old man had a three-year recurrent respiratory infection. No fungi was detected in sputum examinations. Immunodiffusion test with paracoccidiodin revealed two precipitin bands. Very small forms and hyphae of a fungus were seen on silver methenamine stained serial sections from lung's lesion. P. brasiliensis was identified on the basis of the rare multibudding small forms.
A case of an acute pulmonary paracoccidioidomycosis following the use of immunosuppressive therapy in a solid cancer patient is reported.
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The first two Brazilian cases of human pulmonary nocardiosis are reported. Diagnosis was established on material obtained by direct lung puncture. A review of selected aspects on pulmonary nocardiosis in Latin American countries is presented.
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We inquiry, in the epidemiologic history of 42 patients with cryptococcosis, the contact with pigeon, trying to find the possible source of infection. Of these patients, the information compatible with ecologic niche of Cryptococcus neoformans was positive in 16. Fifty nine samples were recovered from soil, associated with pigeon habitat. We found C. neoformans in four occasions, one in the capital and three in the interior of state. C. neoformans, serotype A, recovered from a central spine fluid coincides with the serotype of the fungus recovered downtown Porto Alegre, in a place suggested by the patient as possible source of infection, characterizing of a case of Cryptococcus neoformans. var. neoformans.
Two cases of subcutaneous scedosporiosis, caused by Scedosporium apiospermum, are reported. Both patients had lesions localized in the forearm: a solitary ulceration in one and a sporotrichoid-like lesion in the other. The literature is reviewed.
Two cases of Chronic Pulmonary Histoplasmosis are reported and other eleven cases, collected from Brazilian literature, are commented. After being clinically cured, one of our patients presented an Aspergillus fungus ball inside a cavitation in the wall of which H. capsulatum was disclosed. Comments are also done on the diagnosis of the mycosis.
A case of a solitary pulmonary nodule due to Scedosporium apiospermum (Pseudallescheria boydii) is related. A review of the pertinent literature was done and, in addition, similar lesions caused by other opportunistic fungi are commented.
A case of sporotrichosis in a woman presenting 63 cutaneous lesions distributed all over the tegument is related. The patient had both humoral (Immunoglobulins) and cellular (Lymphocytes subpopulations) immunity within normal limits, but was under treatment with steroid during a long time (Prednisone 10 mg daily for 2 years), due to a sciatic pain. In addition a review of the Brazilian literature on this type of lesions was carried out and commented.
The first case of eumycetoma by Madurella grisea occurred in Southern Brazilian Region is herein related. In addition, Brazilian literature on this subject was reviewed and, the geographic distribution of this eumycetoma is presented.