A clinical case of a patient bearing systemic paracoccidioidomycosis with regional ganglionic and oral exposure and later pulmonary involvement is presented. The patient was treated with specific drugs (amphotericin B, itraconazole, sulfamethoxazole-trimethoprim) and followed throughout a 6-year period and eventually died showing an extensive involvement of the central nervous system.
The pattern of ECG changes of 150 black individuals from rural areas of southern Rio Grande do Sul, Brazil, was compared with that of a group of 150 whites of similar age, sex and geographical residence. The mean age of the study group was 39.2 years (9-78 years), and 62% were women. 84 out of the 150 showed positive serological reactions to infection by Trypanosoma cruzi. The prevalence of ECG changes was significantly higher among the blacks, irrespective of their serological state. Those changes which were considered as suggestive of Chagas cardiopathy were more common among blacks with positive serological reactions. Blacks with seronegative reactions had more frequent ECG changes which were of increased severity, than those of whites with negative reactions. The increased prevalence and severity of ECG changes among black might be attributed to several factors, including: higher levels of poverty, leading to strenuous working conditions; poorer housing quality facilitating infestations by triatominae; inadequate feeding habits. In addition, the increased levels of arterial tension found among the blacks, might be associated with possible racial factors, in collaborating to increase the likelihood of myocardial lesions.
São estudados 666 pares de indivíduos, sendo 344 masculinos e 322 femininos, com sorologia positiva/negativa para doença de Chagas, obtidos em inquérito sorológico-eletrocardiográfico entre populações rurais não selecionadas de 17 municípios do sul Rio Grande do Sul, Brasil. Na análise dos eletrocardiogramas foram consideradas só as alterações sugestivas de cardiopatia chagásica: bloqueio átrio-ventricular de 1º, e 2º e 3º, BCRD isolado ou associado ao HBAE, HBAE isolado, extrasístoles ventriculares freqüentes e/ou polifocais e/ou bigeminadas e trigeminadas; alterações de ST e T; zonas eletricamente inativas. Com este critério apresentaram eletrocardiogramas alterados 201 pessoas soropositivas (30,2%) e 66 soronegativas (9,9%). O gradiente de 20,3%, sendo 21,5% nos homens e 18,9% nas mulheres, mostrou-se significativo ao nível de p < 0,001.
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