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Luiz Carlos Severo

Publications and source records attributed to Luiz Carlos Severo.

At least 19 recordsLinked to original sources
PubMed2006

Sinusitis caused by the fungus Xylaria enteroleuca in a lung transplant recipient.

We report the 1st case of sinusitis and human infection by Xylaria enteroleuca (anamorph Nodulisporium sp.), a rare fungal endophyte of rain forest trees. The patient was a Brazilian woman who had her lung transplanted. Diagnosis was established by direct microscopic examination, computed tomographic scan, cultures, and sequencing of a ribosomal RNA gene. The in vitro antifungal susceptibility of the isolate is provided.

Ascomycota↗
PubMed2006

Candida guilliermondii as the aetiology of candidosis.

Candida guilliermondii is one of the components of human microbiota. This yeast has been infrequently associated with human infections, which may be related to its low pathogenicity. The aim of this study was to provide clinical and epidemiological data for patients infected with C. guilliermondii at Santa Casa Complexo Hospitalar, Brazil. From October 1997 to October 2003, C. guilliermondii was isolated from clinical samples from 11 patients. Three patients were excluded because the isolation of the yeast represented colonisation. Specimens from the eight patients included in the study corresponded to blood (n = 5), ascitis fluid (n = 2), and oesophagus biopsy (n = 1). Three patients (37.5%) had major immunosuppressed conditions, including solid organ transplantation, AIDS, and leukaemia. Previous use of antibiotics occurred in 87.5%. Main invasive medical procedures were central venous catheter (50.0%), abdominal surgery (25.0%), and peritoneal dialysis (50.0%). No susceptibility data was obtained. Although risk factors for candidaemia were similar amongst patients infected by with C. guilliermondii or other Candida species, mortality associated with C. guilliermondii was significantly lower.

Adult↗
PubMed2006

Candidaemia and cancer: patients are not all the same.

BACKGROUND: Most of the studies about invasive Candida infections in cancer patients have focused on haematological patients. The aim of this study was to provide information about risk factors for candidaemia in patients with solid tumours. METHODS: Retrospective cohort study. During a 9-year period (1995-2003) we reviewed all cases of candidaemia that affected cancer patients in Santa Casa Complexo Hospitalar, Brazil. RESULTS: During the period of study, 210 patients had the diagnosis of candidaemia in our medical centre, and 83 of these patients had cancer (39.5%). The majority of patients with cancer had solid tumours (77.1%), mostly in the alimentary tract. Most of solid cancers were non-metastatic (71.9%). Major diagnoses in patients with haematological neoplasia were acute leukaemia (n = 13), high grade non-Hodgkin lymphoma (n = 5) and Hodgkin's disease (n = 1). Non-Candida albicans species caused 57.8% of the episodes of candidaemia in patients with cancer, mainly in patients with haematological malignancies (p = 0.034). Neutropenia and treatment with corticosteroids were more frequent in the haematological group, in comparison with patients with solid tumours. Only 22.2% of patients with solid tumours were neutropenic before candidaemia. Nonetheless, the presence of ileus and the use of anaerobicides were independent risk factors for candidaemia in patients with solid cancers. The overall mortality in cancer patients with candidaemia was 49.4%. We then compared 2 groups of adult patients with candidaemia. The first was composed of non-neutropenic patients with solid tumours, and the second group included patients without cancer. We found that central venous catheters and gastrointestinal surgery were independently associated with candidaemia in patients with solid tumour. CONCLUSION: Cancer patients with candidaemia seem to have very different predisposing factors to acquire the infection when stratified according to baseline diseases. This study provides some useful clinical information regarding risk for candidaemia in patients with solid tumours.

Adolescent↗
PubMed2006

[Nosocomial infection due to Trichosporon asahii: clinical revision of 22 cases].

Twenty two cases of nosocomial infection caused by Trichosporon asahii, detected during a period of six years (1999-2005) is described. The patients were predominantly males with an average age of 47.3 years-old. The predominant diseases in the study group were respiratory insufficiency, cancer, diabetes, chronic renal insufficiency, cirrhosis and AIDS. The main predisposing conditions were antibiotic therapy, mechanical ventilation, urethral catheterization, catheter, corticoids, transplant, immunosuppressive therapy, chemotherapy, granulocytopenia, surgical procedures and continuous ambulatory peritoneal dialysis. The most used antifungal drugs were fluconazole and amphotericin B. In some cases several antifungals were administered. Five patients did not receive antifungal treatment, and one patient received granulocyte colony stimulating factor (G-CSF). Nine patients showed clinical improvement, nine died and the progress of four patients is unknown. T. asahii is an emergent pathogen in patients with immunodeficiency and its presence in these type hosts can not be considered colonization, as there is an important risk of invasive infection. So, in susceptible patients to develop trichosporonosis it is advisable to take into consideration this disease especially in intensive clinical care units.

Adult↗
PubMed2006

Isolated central nervous system histoplasmosis in immunocompetent hosts: a series of 11 cases.

Histoplasmosis of the central nervous system occurs in a significant percentage of patients with Histoplasma capsulatum infection, but has usually been described in association with immunosuppression and/or disseminated histoplasmosis. We aim to review the clinical and laboratory features of isolated histoplasmosis of the central nervous system in the immunocompetent host by presenting a series of 11 cases with this condition. Most of these patients presented with headache, meningeal irritation signs and mental status changes, comprising a somewhat different picture from that described in immunosuppressed patients. Moreover, almost all patients had signs of ventricular dilatation in neuroimaging studies, and 8 of the 11 patients had a ventriculoperitoneal shunt at the time of diagnosis, suggesting hydrocephalus to be an important feature of this condition and/or the possibility of shunt infection by the fungus. Immunodiffusion analysis of the cerebrospinal fluid appeared to be the most efficient way to reach the diagnosis and should be considered in immunocompetent patients with chronic lymphocytic meningitis, especially in those who have ventricular shunt or live in endemic areas of Histoplasma capsulatum.

Adolescent↗
PubMed2005

Mediastinal histoplasmosis: report of the first two Brazilian cases of mediastinal granuloma.

This report documents the first two Brazilian cases of mediastinal granuloma due to histoplasmosis, presenting selected aspects on the diagnosis. Tissue samples revealing histoplasmosis were obtained from each of the patients by mediastinoscopy and thoracotomy. In the second patient, a subcarinal calcified mass eroded into the bronchial tree, leading to secondary bilateral aspiration pneumonitis one week after thoracotomy. Although rare, histoplasmosis should be included in the differential diagnosis of mediastinal granuloma, specially if there are calcifications greater than 10 mm in dimension.

Adult↗
PubMed2005

[Pulmonary histoplasmoma in Rio Grande do Sul].

A retrospective analysis of sixteen patients with pulmonary nodules diagnosed as histoplasmoma by histopathologic evidence of Histoplasma capsulatum var capsulatum was done in an endemic area for histoplasmosis. Brazilian literature was reviewed. All patients were white, nine were men, mean age at diagnosis was 50.8 years. Six (37.5%) patients had a relevant epidemiologic story. The pulmonary nodules were 0.7-2.7 cm in diameter, presenting as granulomatous lesions with caseous necrosis. Twelve (75%) patients had solitary nodules. Histoplasmoma as a rule is a solitary nodule of up to 3 cm in an asymptomatic patient. The diagnosis is made from histopathologic evidence of the fungus, which is accomplished using a special fungus stain, Gomori-Grocott methenamine silver. Cultures or seromycology do not help the diagnosis.

Adolescent↗
PubMed2005

Simultaneous chronic pulmonary paracoccidiodomycosis and disseminated cryptococcosis in a non-HIV patient.

An unusual case of chronic pulmonary paracoccidiodomycosis and disseminated cryptococcosis in a non-HIV infected patient is reported in a 72-year-old previously healthy man. A chest radiograph disclosed a bilateral diffused interstitial infiltrate involving middle and lower lung fields. Specimen samples taken from the tracheal tube revealed yeast-like organisms suggestive of Cryptococcus neoformans and Paracoccidiodes brasiliensis. Blood and cerebrospinal fluid culture was positive for C. neoformans and the immunodiffusion test against paracoccidiodin revealed a precipitation band. The patient died 24 days after the admission.

Aged↗
PubMed2005

An outbreak of Pichia anomala fungemia in a Brazilian pediatric intensive care unit.

OBJECTIVE: To report an outbreak of Pichia anomala fungemia that occurred in a Brazilian pediatric intensive care unit (ICU) from October 2002 to January 2004. DESIGN: Unmatched case-control study. METHODS: We randomly selected four control-patients for each case-patient from a list of all patients admitted to the ICU for at least 48 hours during the outbreak. A second control group was composed of all consecutive patients with nosocomial candidemia in the ICU during the outbreak. An environmental study was performed, and genetic relatedness among the clinical isolates was characterized by randomly amplified polymorphic DNA assay. RESULTS: During the study period, 1,046 children were admitted to the pediatric ICU, 17 of whom developed P. anomala fungemia (attack rate, 1.6%). The median age was 1.1 years, and the main underlying conditions were congenital malformations (35.3%) and neoplastic diseases (11.8%). The overall mortality rate was 41.2%. Two patients received no antifungal treatment; all of the others were treated with amphotericin B. On multivariate analysis, only the presence of a central venous catheter was significantly associated with P. anomala fungemia. The yeast was not found on healthcare workers' hands or in the environment. Molecular studies showed that the outbreak was caused by a single strain. The distribution of risk factors was similar between patients with P. anomala fungemia and control-patients with candidemia. CONCLUSIONS: This study highlights the importance of P. anomala as an emerging nosocomial fungal pathogen. Patients with P. anomala fungemia seem to have risk factors in common with those who have candidemia.

Age Distribution↗
PubMed2004

Candidemia in a Brazilian tertiary care hospital: species distribution and antifungal susceptibility patterns.

Recent studies have shown differences in the epidemiology of invasive infections caused by Candida species worldwide. In the period comprising August 2002 to August 2003, we performed a study in Santa Casa Complexo Hospitalar, Brazil, to determine Candida species distribution associated with candidemia and their antifungal susceptibility profiles to amphotericin B, fluconazole and itraconazole. Antifungal susceptibility was tested according to the broth microdilution method described in the NCCLS (M27A-2 method). Only one sample from each patient was analyzed (the first isolate). Most of the episodes had been caused by species other than C. albicans (51.6%), including C. parapsilosis (25.8%), C. tropicalis (13.3%), C. glabrata (3.3%), C. krusei (1.7%), and others (7.5%). Dose-dependent susceptibility to itraconazole was observed in 14.2% of strains, and dose-dependent susceptibility to fluconazole was found in 1.6%. Antifungal resistance was not found, probably related to low use of fluconazole. Further epidemiological surveillance is needed.

Amphotericin B↗
PubMed2004

Paracoccidioidomycosis in organ transplant recipient: case report.

Paracoccidioidomycosis is a common disease in Latin America but it is rare in organ transplant recipient patients. We report on a case of such mycosis in a renal transplant recipient. The patient presented with a large lung cavity on the left lower lobe, a rare radiological presentation of paracoccidioidomycosis. Unusual clinical and radiological manifestations of Paracoccidioides brasiliensis infection can occur in immunocompromised patients.

Adult↗
PubMed2004

Histoplasmosis presenting as addisonian crisis in an immunocompetent host.

A 71-year-old man with presumptively treated pulmonary tuberculosis ten years earlier and previous alcoholism presented with adrenal insufficiency. HIV serology was negative. A computerized tomography scan of the abdomen showed enlarged right adrenal. He recovered after emergency treatment with hydrocortisone IV. Right adrenalectomy was performed. Histoplasmosis was diagnosed and the patient was treated with itraconazole, corticosteroid replacement, and discharged with good health.

Addison Disease↗
PubMed2004

[Cryptococcal mastitis after corticosteroid therapy].

We described a case of cryptococcal mastitis in a 46 years old female patient receiving corticosteroids for sarcoidosis. There was radiological pulmonary deterioration and a cystic lesion was found in the left breast. The mycosis was diagnosed by histopathology and cryptococcal antigens. We emphasized the sarcoid granuloma diagnostic's dilemma an the rare manifestation of cryptococcal infection as mastitis.

Cryptococcosis↗
PubMed2004

Cryptococcemia. An analysis of 28 cases with emphasis on the clinical outcome and its etiologic agent.

Clinical protocols of 28 cases of cryptococcemia studied between April 1995 and November 2002 were reviewed. The varieties of Cryptococcus neorformans, the underlying disease, and the severity and outcome of the disease were emphasized. Most patients were immunossupressed (89.3% with AIDS) and Cryptococcus neoformans var. grubii was the main recovered variety (92.8%). Regardless of antifungal treatment, in-hospital mortality was 41% strongly associated with APACHE II score, >14 (p<0.01).

AIDS-Related Opportunistic Infections↗
PubMed2003

Species distribution and antifungal susceptibility profile of Candida spp. bloodstream isolates from Latin American hospitals.

From March 1999 to March 2000, we conducted a prospective multicenter study of candidemia involving five tertiary care hospitals from four countries in Latin America. Yeast isolates were identified by classical methods and the antifungal susceptibility profile was determined according to the National Committee for Clinical Laboratory Standards microbroth assay method. During a 12 month-period we were able to collect a total of 103 bloodstream isolates of Candida spp. C. albicans was the most frequently isolated species accounting for 42% of all isolates. Non-albicans Candida species strains accounted for 58% of all episodes of candidemia and were mostly represented by C. tropicalis (24.2%) and C. parapsilosis (21.3%). It is noteworthy that we were able to identify two cases of C. lusitaniae from different institutions. In our casuistic, non-albicans Candida species isolates related to candidemic episodes were susceptible to fluconazole. Continuously surveillance programs are needed in order to identify possible changes in the species distribution and antifungal susceptibility patterns of yeasts that may occurs after increasing the use of azoles in Latin American hospitals.

Antifungal Agents↗
PubMed2002

Zygomycosis: A report of eleven cases and a review of the Brazilian literature.

Eleven cases of zygomycosis (mucormycosis) observed throughout an eighteen year period (1982-2000) have been reviewed. The most important demographic and clinical data of seven patients were tabulated. The remaining four are related as illustrative cases. Seven patients presented with the pulmonary form of the disease; two patients presented with the pulmonary manifestation associated with sinusitis; and two patients presented with the rhinocerebral form. Predisposing conditions, in decreasing order of frequency, were diabetes mellitus (6), renal transplantation (2), associated with pancreas-kidney transplantation and diabetes (1), bone marrow aplasia (1), and chronic obstructive lung disease treated with corticosteroids (1). The diagnoses were based on the detection of characteristic zygomycetous hyphae in tissue. The causative organim was isolated and identified in only four cases; three were due to Rhizopus arrhizus, and one to Absidia corymbifera. In addition the Brazilian literature on zygomycosis is reviewed.

Journal Article↗