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Biomedical subjects

M A Moraes

Publications and source records attributed to M A Moraes.

At least 55 records · Page 3Linked to original sources

Reduction of spleen size in a child with hyperreactive malarious splenomegaly (HMS) treated outside the Brazilian endemic area of malaria with only one course of quinine.

We report the clinical picture, treatment and evolution of a child with hyperreactive malarious splenomegaly treated outside the endemic area of malaria. The patient presented gross splenomegaly, proceeded from an area where malaria is endemic, showed increased immunoglobulins levels, high antimalarial antibody titres and hepatic sinusoidal lymphocytosis. The child did not return to an area where malaria is endemic and showed a favorable response to only one course of quinine. The response of this patient to limited antimalarial therapy suggests the importance of reinfection with malaria in the development and maintenance of this syndrome.

Administration, Oral↗

[Lymphadenopathies in American cutaneous leishmaniasis: comments on 2 cases].

Two patients, with cervical lymphadenopathies and a presumptive diagnosis of lymphoma or scrofula, were submitted to biopsies of the affected lymph nodes. Unexpectedly, the histological picture revealed a necrotic-granulomatous reaction and the presence of leishmania (amastigotes) in some vacuolated macrophages. The patients were from different endemic areas of leishmaniasis in Brazil, and had no perceptible cutaneous or mucosal lesions. Later, however, one of them developed such lesions, probably as an effect of a treatment for toxoplasmosis. These findings support the idea that the agents of the disease, once in the host organism, would invade the organs of the phagocytic-mononuclear system, there remaining for a long time, maybe for the rest of the host life. Eventually, under the action of several factors, that could modify the host resistance, the parasites migrate to the skin or the mucosal membranes, causing secondary or reactivating lesions.

Adult↗

Polycystic hydatid disease in Brazil. Report of five new human cases and a short review of other published observations.

This paper describes five additional Brazilian human cases of polycystic hydatid disease due to Echinococcus vogeli, reviews the previous cases reported in Brazil, including one report of E. oligarthus (20 in total), and some epidemiological aspects of this disease which is no longer a curiosity but rather a problem that is not medically easy to handle. Its presence should be expected in any rural area of the New World where humans have not eliminated wild felids/canids, bush dogs, pacas, agoutis and other wild rodents.

Adult↗

[Subcutaneous phaeohyphomycosis in the state of Pará: a report of 3 cases].

Three cases of subcutaneous phaeohyphomycosis from the state of Pará, Brazil are reported. This is the first time that this form of phaeohyphomycosis is described in northern Brazil. The etiologic agents could not isolated, and the diagnosis in all cases was established only on histopathological basis, particularly through the demonstration of fungal elements in tissue sections. Hyphal fragments and vesicular cells were very numerous and conspicuous in special (Grocott and Fontana-Masson methods) stained sections, in contrast to their apparent scarcity in routine hematoxilin-eosin preparations. The difference was certainly due to the aspect in the latter of the invasive tissue forms: the thin-walled and light brown pigmented organisms stained poorly and were very difficult to distinguish from the tissue components.

Adult↗

[Intestinal entomothoramycosis: report of a case].

A case of intestinal entomophthoramycosis caused by Entomophthorales in a man with 19 years-old, farmer and without associated disease. The patient was submitted to a intestinal resection and diagnosis was carried through after analysis of the surgical specimen. After a review of the literature, the clinical evolution, clinico-pathologic features, difficulties in diagnosis and treatment are discussed.

Adult↗

[Nasofacial zygomycosis in the state of Pará: the registration of 2 cases].

Two new cases of nasofacial zygomycosis from the state of Pará, Brazil, are reported. Both cases were treated with ketoconazole and the response to the drug was considered to be good; the patients improved rapidly and the nasal obstruction was the first manifestation to disappear. As five cases have been described in recent years from the state of Pará, this form of zygomycosis can no longer be considered as a rare disease in northern Brazil.

Adult↗

[Human adiaspiromycosis. A report of a case treated with ketoconazole].

A case of human disseminated pulmonary adiaspiromycosis is reported. The patient, from Goianésia, GO, was admitted to the Brasilia University Hospital, in November 1992, with wet cough, dyspnea and weight loss--manifestations that had appeared two months before. Prior to admission, he had been treated for a suspected miliary tuberculosis, because a chest roentgenogram had shown a diffuse reticulonodular infiltrate in both lungs. This therapy brought no improvement to the patient status. An open chest biopsy was then performed, and the microscopic examination of the lung tissue revealed the fungal nature of the disease. Ketoconazole, 400mg/day, was started and the patient discharged from the hospital. He was seen again two months later: the respiratory manifestations had disappeared and a new chest roentgenogram showed complete resolution of the pulmonary lesions. The usefulness of ketoconazole is, however, questioned, since, as there is no multiplication of the fungus in the host organism--adiaspiromycosis is believed to be, usually, a self-healing disease--the efficacy of this imidazole derivative against the agent in animal tissues remains to be confirmed.

Adult↗

[Coccidioidomycosis: a new brazilian case].

A case of pulmonary coccidioidomycosis from the rural zone of Bertolinia, PI, is reported. The patient, a farm worker, attributed his illness to the dust inhaled while digging a water well during the dry season of the year, some weeks before the onset of the clinical manifestations. The main symptoms of the disease were severe chest pain and moderate fever. The diagnosis was made histopathologically: tissue phase fungal organisms--immature spherules and spherules with endospores--were observed in histological sections of a lung fragment obtained by open chest biopsy. This is the twelfth autochthonous case of coccidioidomycosis found so far in Brazil. All of them involved native inhabitants of the semi-arid part of Northeastern Brazil. The hot and dry environment of the region seems to favor the development of C. immitis in the soil. Humans and animals probably acquire the infection by digging the soil, when they become exposed to the conidium-bearing dust raised by this activity.

Adult↗

[Pulmonary adiaspiromycosis: casual finding in a patient who died of yellow fever].

During an outbreak of yellow fever (rural form of the infection) occurred recently in the State of Goiás, Brazil, a patient, with clinical manifestations suggestive of the infection, died in the University Hospital of Brasilia, DF, on the fifth day from admission. Postmortem examination revealed, microscopically, the characteristic alterations of the infection, and discovered in the lungs and hilar lymph nodes round microrganisms identified as adiaconidia of Emmonsia parva var. crescens.

Chrysosporium↗

[Dermatophytic pseudomycetoma: report of a case caused by Trichophyton tonsurans].

A case of dermatophytic pseudomycetoma, in a patient with a history of recurrent lesions in the scalp, for over two years, is reported. Histopathological examination of the affected tissues revealed the mycelial aggregates or pseudogranules characteristic of the disease. Cultures of fresh tissues samples detected a fungus identified as Trichophyton tonsurans. Additional examinations failed to demonstrate lesions of tinea capitis, a probable source of the deep infection. Dermatophytic pseudomycetoma is an extremely rare form of dermatophytosis, and the rarity of such cases is the motive for the present communication.

Adult↗

[Mansonella ozzardi in the Federal Territory of Roraima, Brazil. Distribution and finding of a new vector in the area of Surumu River].

A survey conducted among the Makuxi Indians from 15 settlements in the northeastern part of the Territory of Roraima, Brazil, revealed the occurrence of Mansonella ozzardi in 3,2% (21/652) of the persons examined. The absence of demonstrable infection--with one exception--in persons under 15 years of age, and the low microfilaria density in adults suggest that mansonelliasis has been acquired by the Makuxi Indians outside their villages. As many Indians from the region pan gold on the Upper Maú (Ireng) river--where black flies occur in great quantity--the mining camps are probably the sites of transmission. Experimental infection with M. ozzardi of Simulium oyapockense s.l. (or Simulium roraimense) showed that this species, at the least in the Surumu river area, is capable of supporting the full development of the microfilariae. Although S. oyapockense has a wide distribution in the extreme north of Brazil, it does not appear to be an efficient vector, since only 20,6% (19/92) of the specimens collected after a blood meal on a naturally infected Indian contained larval stages of M. ozzardi (with an average of 1-2 larvae per fly). The high prevalence rate of infection found, in a previous survey, among the Sanumá and Mayongong, two Indian groups living at the Auaris river area, on the other side of the Territory of Roraima, indicates that a more competent intermediate host should exist in that region.

Animals↗

[The Brazilian focus of onchocerciasis: new observations in the areas of the Mucajaí and Catrimâni rivers, Territory of Roraima].

A recent survey for onchocerciasis conducted among the Yanomami Indians living on the middle reaches of the Mucajaí and Catrimâni Rivers (Territory of Roraima) has failed to show any alteration in the local pattern of the disease. In fact, after a decade from the first surveys in these areas located at the periphery of the Yanomami focus, the prevalence and the intensity of infection have not experienced a significant change. Considering only the residents in the villages inside the surveyed areas, the prevalence varied from zero in the neighbourhood of the Catrimâni mission to 3.1 per cent near the Mucajaí mission. Had there been a competent vector of Onchocerca volvulus in the region higher rates might be expected due to the Yanomami custom of periodic visits among the groups of the tribe. In some of these visits, numbers of highly infected Indians from the central and mountainous part of the Yanomami territory--where more than 90 per cent of the adults have onchocerciasis--come to the villages in the lowland area, attracted by the facilities offered by the mission posts. As the visitors stay in the host villages for several days or weeks, the residents could become exposed to the disease. Simulium oyapockense s.1., a man-biting species of black fly, widely distributed in Northern Brazil, is the only possible vector of O. volvulus in the investigated areas, on the grounds of its local abundance.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Identification of vector species (Diptera:Simuliidae) of human onchocerciasis in the amazonia focus of Brazil and Venezuela.

The taxonomic status of three Amazonian simuliid species, Simulium guianese Wise, S. oyapockense Floch & Abonnenc and S. yarzabali Ramirez Perez is reviewed. Simulium cuasisanguineum Ramirez Perez, Yarzabal & Peterson is synonymized with S. oyapockense, and S. yarzabali is revalidated from its synonymy with S. incrustatum Lutz. The role of these three species in the transmission of human onchocerciasis and mansonelliasis in Amazonia is reviewed.

Animals↗

[Labrea hepatitis].

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Adolescent↗