SUMMARYTo identify the clinical and epidemiological profile of cryptococcosis diagnosed at the University Hospital of the Federal University of Mato Grosso do Sul, Brazil, medical records of 123 patients admitted from January 1995 to December 2005 were analyzed. One hundred and four cases (84.5%) had HIV infection, six (4.9%) had other predisposing conditions and 13 (10.6%) were immunocompetent. Male patients predominated (68.3%) and their age ranged from 19 to 69 years (mean: 35.9). Most patients (73.2%) were born and lived lifelong in the state of Mato Grosso do Sul. Involvement of the central nervous system occurred in 103 patients (83.7%) and headache and vomiting were the most frequent symptoms. In 77 cases it was possible to identify the Cryptococcus species: 69 (89.6%) C. neoformans and eight (10.4%) C. gattii. Amphotericin B was the drug of choice for treatment (106/123), followed by fluconazole in 60% of cases. The overall lethality rate was 49.6%, being 51% among the HIV infected patients and 41.2% among the non-HIV infected (p > 0.05). Although cryptococcosis exhibited in our region a similar behavior to that described in the literature, the detection of an important rate of immunocompetent individuals and five C. gattii cryptococcosis in HIV-infected patients is noteworthy.

Thirty cases of histoplasmosis observed at the University Hospital of the Federal University of Mato Grosso do Sul (HU-UFMS) from January 1998 to December 2005 are reported. Most (83.3%) of the patients were men, average 33.4 years old, 63.3% of them were born and living in Mato Grosso do Sul and 83.3% presented AIDS as an underlying disease. In almost all cases (96.7%) the disease occurred in its disseminated form and the most frequent clinical manifestations were: fever (83.3%), weight loss (70.0%), cough (63.3%), hepatomegaly and splenomegaly (40.0%), and lymph node enlargement (36.7%). The laboratory diagnosis was obtained in 29 patients by isolation of Histoplasma capsulatum from various clinical specimens cultivated in Sabouraud dextrose and brain heart infusion agar and in 16 patients the fungus was observed by direct microscopy of Giemsa-stained smears. The observed mortality was 40%. This is the first report in the literature of the occurrence of histoplasmosis in Mato Grosso do Sul State.

RESUMO:Pesquisa descritiva, quantitativa, que se propôs a levantar a frequência de acidentes ocupacionais, envolvendo materiais biológicos potencialmente contaminados, que ocorreram entre os profissionais que atuam em um hospital de ensino e caracterizar aqueles que acometeram a equipe de higienização e limpeza e lavanderia. Foram analisadas 238 fichas de investigações de acidentes de trabalho do Serviço de Epidemiologia do período de 2004 a 2009. Destas, 10,9% (26/239) correspondiam a acidentes ocorridos com profissionais da limpeza hospitalar, 2,5% de profissionais da lavanderia. Foi predominante o sexo feminino, faixa etária de 30-40 anos, do tipo percutâneo, destacando-se os quirodáctilos como a área corporal mais atingida e o líquido potencialmente contaminado foi o sangue. Três grandes pilares de assistência devem ser fortalecidos: o sistema de informação para subsidiar a política institucional, a formação continuada dos profissionais que geram resíduos perfurantes e a aquisição de materiais com dispositivos de segurança. PALAVRAS-CHAVE: Exposição ocupacional; Patógenos transmitidos pelo sangue; Serviços hospitalares de apoio. OCCUPACIONAL EXPOSURE WITH POTENTIALLY HAZARDOUS BIOLOGICAL MATERIAL AMONG WORKERS IN HOSPITAL SERVICESABSTRACT:This is a descriptive and quantitative research which aimed to study the annual frequency of workplace accidents that occurred among health professionals and to characterize the occurrence of work acidentes involving hospital hygiene staff. 238 professional accidents' reports were analyzed, from the Epidemiology Department in an University Hospital, from [2004][2005][2006][2007][2008][2009]. From the total, 10,9% (26/238) corresponded to accidents with hygiene staff , and 2,5% with the ones who worked at the laundry service. Data were gathered from the form of Surveillance System PSBio. It was observed that there was a greater frequency of accidents, especially among the female workers, aged from 30-40 years, with predominance of percutaneous exposure, especially the fingers as the most affected part of the body. Three pillars of assistance should be strengthened: the information system to support the institutional policy, continuing education of professionals who generate perforating residues and purchase of materials with safety devices. KEYWORDS: Occupational exposure; Blood-Borne pathogens; Hospital services. EXPOSICIÓN OCUPACIONAL CON MATERIAL POTENCIALMENTE CONTAMINADO ENTRE PROFESIONALES DEL ÁREA DE APOYO RESUMEN:Investigación descriptiva, cuantitativa, que se propuso a levantar la frecuencia de accidentes ocupacionales, envolviendo materiales biológicos potencialmente contaminados, que ocurrieron entre los profesionales que actúan en un hospital de enseñanza y caracterizar aquellos acometieron el equipo de higienización y limpieza y lavandería. Fueron analizados 238 informes de expedientes de accidentes de trabajo del Servicio de Epidemiología entre 2004 -2009) correspondían a accidentes ocurridos con profesionales de la limpieza hospitalaria, 2.5% de profesionales ...

Cryptococcosis is a systemic mycosis usually affecting immunodeficient individuals. In contrast, immunologically competent patients are rarely affected. Dissemination of cryptococcosis usually involves the central nervous system, manifesting as meningitis or meningoencephalitis. Prostatic lesions are not commonly found. A case of prostate cryptococcal infection is presented and cases of prostatic cryptococcosis in normal and immunocompromised hosts are reviewed. A fifty-year-old HIV-negative man with urinary retention and renal insufficiency underwent prostatectomy due to massive enlargement of the organ. Prostate histopathologic examination revealed encapsulated yeast-like structures. After 30 days, the patient's clinical manifestations worsened, with headache, neck stiffness, bradypsychia, vomiting and fever. Direct microscopy of the patient's urine with China ink preparations showed capsulated yeasts, and positive culture yielded Cryptococcus neoformans. This fungus was later isolated from cerebrospinal fluid and blood cultures, demonstrating thus its dissemination. The patient was discharged after 27 days in hospital and, despite a regimen of amphotericin B, he died four months later. This case points to cryptococcosis as a possible cause of prostatic disease and reinforces the importance of communication between the medical team and pathology and microbiology laboratories aiming at a more accurate diagnosis and successful treatment

Background: N95 respiratory protection masks are used by healthcare professionals to prevent contamination with infectious microorganisms transmitted by droplets or aerosols.Methods: We conducted a rapid review of the literature analyzing the effectiveness of decontamination methods for mask reuse. The review was carried out in April 2020 using a simpli cation of the formal systematic review process. A total of 166 articles were retrieved of which 17 laboratory-based studies were selected. Results: Two of the studies only examined the effectiveness of decontamination methods, seven only reported on the maintenance of mask integrity, and eight considered both outcomes. Twelve decontamination methods were included in the studies.Conclusions: Positive results should be considered with caution as they represent a small number of studies, re ect ideal laboratory conditions, and may have limited applicability in realistic situations and for health systems. Nonetheless, ve methods appear promising: hydrogen peroxide vapor, ultraviolet irradiation, dry heat, wet heat/pasteurization, and microwave ovens.

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