Forty patients with a diagnosis of snake bite were studied at the Infectious and Parasitic Disease Service of the Faculty of Medicine of Botucatu. Thirty were males and 10 females, ranging in age from 16 to 70 years. All were farm laborers and 35 of them were bitten in the lower limbs. Two of the 9 patients seen more than 6 hours after the bite died. The low mortality rate (5%) observed could be explained by the early care provided, by the use of appropriate doses of anti-crotalus serum, parenteral hydration, urine alkalinization with sodium bicarbonate and induction of osmotic diuresis with a mannitol solution. Anatomopathological examination of one of the patients who died revealed extensive hepatic necrosis. The authors discuss the possibility of the effect of a factor of snake venom in the genesis of hepatic necrosis and in the increased transaminase levels.

Thirty-one patients bitten by venomous snakes in Botucatu area (State of São Paulo - Brazil), sixteen by Bothrops spp. and fifteen by Crotalus durissus terrificus, were studied. The group comprised twenty-nine males and two females, ranging from fourteen to sixty-three years of age (mean 33 ± 15). Leukocytosis with neutrophilia and lymphopenia, increase of mucoproteins and C-reactive protein, decrease of total serum protein and albumin, were observed on the first day after the accident. In addition, increased serum levels of the cytokines IL-6 and IL-8, but not of IL-1b and TNF-a, were observed. The alterations were generally more intense in patients bitten by Crotalus durissus terrificus than by Bothrops spp. It is concluded that these snakebite envenomations closely resemble an acute trauma, inducing a typical acute-phase response

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Despite the existence of highly sensitive tests, inconclusive serological results are frequent in chronic chagasic infection. This study aimed to define a diagnostic conduct for 30 individuals with inconclusive serology (G3) for chagasic infection assisted at the Outpatient Unit for Infectious and Parasitic Diseases of the Botucatu School of Medicine. Twenty-one individuals with negative serology (G1) and 33 with positive serology (G2) were also studied. Serological methods ELISA, HAI, IFI and immunoblotting TESA-cruzi were used for G1, G2 and G3, and parasitological methods xenodiagnosis, hemoculture and PCR-LIT were used for G2 and G3 individuals. ELISA, HAI and IFI were performed in 5 different blood samples in G2 and G3. TESA-cruzi was carried out only once in G1, G2 and G3 and, since it is the most sensitive, it was utilized as standard. In G3, positivity for ELISA reached 86% in the fifth blood sample; the ELISA+HAI+IFI combination showed a maximum of 44.8% in the second sample; and TESA-cruzi, 76% in one single sample. Xenodiagnosis positivity was 9.4%; hemoculture showed 15.2%; and PCR-LIT exhibited 22% positivity in G2. Nevertheless, in G3, positivity percentage was 3.4% for xenodiagnosis, 6.7% for PCR-LIT, and no positive result was found for hemoculture. In G3, PCR-LIT resolved one case which was still inconclusive according to serology tests. In order to define inconclusive diagnoses, the results suggest the combined use of ELISA+HAI+IFI in 2 blood samples, decreasing the occurrence of false positive/negative results. If results remain inconclusive, the performance of TESA-cruzi and PCR-LIT, if necessary, is recommended.

Among domestic animals, dogs are considered to be the major reservoirs of trypanosomatids and, due to their proximity to man, the presence of these parasites in dogs is an alert to actions aiming at triatomine control. Fifty dogs (26 males and 24 females), aged from 2 months to 15 years, belonging to 30 chronic Chagas' disease individuals from 15 different municipalities in the western region of São Paulo State, Brazil, were subjected to blood collection for the following tests: artificial xenodiagnosis, blood culture, and Polymerase Chain Reaction (PCR). Fortythree (86%) out of 50 dogs were positive to at least one of the tests performed; 34 (68%) were positive to xenodiagnosis, 30 (60%) to blood culture, and 25 (50%) to PCR for T. cruzi and/or T. rangeli. Although triatomines were not detected during the intra and peridomiciliary inspections in the dog owners' residences, the results obtained demonstrate that there is a transmission cycle whereby triatomine vector may be participating in the infection epidemiological chain.

No abstract

The biopsy specimens were the best for demonstrating bone marrow involvement by PCM. The lesions varied from compact and focal granulomas with few fungal cells to numerous disseminated fungal cells within a loose granulomatous inflammatory reaction, with a continuum between these extremes suggesting a spectrum of immune response to the fungi. Other findings such as bone marrow fibrosis, parenchymal coagulative necrosis and bone necrosis were also observed in the affected areas.

ABSTRACT. Thirty-one patients bitten by venomous snakes in Botucatu area (State of São Paulo -Brazil), sixteen by Bothrops spp. and fifteen by Crotalus durissus terrificus, were studied. The group comprised twenty-nine males and two females, ranging from fourteen to sixty-three years of age (mean 33 ± 15). Leukocytosis with neutrophilia and lymphopenia, increase of mucoproteins and C-reactive protein, decrease of total serum protein and albumin, were observed on the first day after the accident. In addition, increased serum levels of the cytokines IL-6 and IL-8, but not of IL-1b and TNF-a, were observed. The alterations were generally more intense in patients bitten by Crotalus durissus terrificus than by Bothrops spp. It is concluded that these snakebite envenomations closely resemble an acute trauma, inducing a typical acute-phase response.