Post-kala-azar dermal leishmaniasis (PKDL) is rarely reported in South America. In spite of the fact that there are many reports about the association of visceral leishmaniasis and AIDS, PKDL is very uncommon in HIV-positive patients, and so far only four cases have been documented in the literature. We present another case with unusual clinicopathological aspects. The patient, a 28-year-old male, from Salvador, Bahia (an endemic area) presented with clinical manifestations of visceral leishmaniasis three years after the diagnosis of AIDS. During treatment for visceral leishmaniasis he developed disseminated miliary papules. Microscopically, the skin biopsy showed a "saw-tooth" pattern with a lichenoid mononuclear infiltrate simulating lichen planus. The histopathological diagnosis was achieved through the finding of amastigotes. The authors discuss the clinicopathological aspects of this case based on a review of the specific literature.
Recebido para publicação em 03/01/97. Brasileira de Medicina Tropical 30(6):511-515, nov-dez, 1997. Rocio (Flaviviridae) na Bahia. Revista da Sociedade Brasileira de Medicina Tropical 30:511-515, nov-dez, 1997. Revista da Sociedade COMUNICAÇÃO Comunicação. Straatmann A, Santos-Torres S, Vasconcelos PFC, Rosa APAT, Rodrigues SG, Tavares-Neto J. Evidências sorológicas da circulação do arbovírus
Resumo No Brasil, os inquéritos sorológicos têm assinalado taxa de infecção pelo vírus do dengue de 25% a 56%, porém esses estudos foram realizados em populações de cidades de médio ou grande porte. No presente estudo, são descritas duas epidemias de febre clássica de dengue (DEN) no Estado da Bahia. A primeira, ocorrida em 1987 e causada pelo sorotipo DEN-1 em Ipupiara e, a segunda, causada pelo DEN-2, em Prado e que ocorreu em 1995. O diagnóstico laboratorial foi realizado utilizando o teste de inibição da hemaglutinação (IH). Em 1995, foram coletadas 461 amostras sorológicas de uma população de 3.868 habitantes em Ipupiara (região da Chapada Diamantina) e 228 de um total de 9.126 habitantes em Prado (Litoral Extremo Sul). A soro-positividade das amostras foi de 11,9% (55/461) em Ipupiara e 17,5% (40/228) em Prado. Não houve diferença, estatisticamente significante, quanto a idade e o gênero entre os indivíduos soro-positivos e negativos das duas cidades estudadas. Entretanto, em Ipupiara os soro-positivos (15,9% vs. 9,3%) relataram, mais freqüentemente (p < 0,03), residência ou viagens para outros Estados do Brasil. Com base nos dados, estimou-se a ocorrência de 460 e 1.597 casos da infecção em Ipupiara e Prado, respectivamente. Em conclusão, nas cidades de menor porte a dinâmica da infecção pelo vírus do dengue, provavelmente, tem características peculiares, porque nessas localidades a prevalência é menor em conseqüência das menores potencialidades de desenvolvimento do Aedes aegypti. Palavras-chaves: Dengue. Epidemia. Inquérito soro-epidemiológico. Bahia.Abstract Serologic studies in Brazil have indicated a 25% to 56% prevalence of dengue virus infections. However, these studies were carried out in populations of middle-sized and larger cities. The present study describes two epidemics of classic dengue fever in two small cities in the State of Bahia. The first occurred in 1987, in Ipupiara and was caused by dengue serotype-1 (DEN-1), the second occurred in 1995, in Prado and was caused by dengue serotype-2 (DEN-2). The laboratory diagnosis was made by the hemagglutination-inhibitation test. 461 serum samples were collected in 1995 in Ipupiara (district of Chapada Diamantina) out of a population of 3,868 and 228 samples out of a total of 9,126 inhabitants of Prado (in the Southernmost coastal region). The seropositivity of the samples was 11.9% (55/461) in Ipupiara and 17.5% (40/228) in Prado. These were no statistically significant differences as to age and sex between seropositive and seronegative individuals of the two cities studied. However, the seropositive cases in Ipupiara indicated a higher percentage (15.9% vs. 9.3%) of residency in or travel to other states of Brazil (p<0.03). Based on these data we estimate the occurrence of 460 and 1,597 cases of infection in Ipupiara and Prado, respectively. In conclusion, dengue virus infections in smaller cities probably have singular characteristics, since they exhibit a lesser prevalence of seropositivity caused by decreased breeding possibilities of Aedes...
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