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Introducción Strongyloides stercoralis es un nematodo endémico en áreas tropicales y templadas de todo el mundo. Una de las características más llamativas de este geo-helminto es su ciclo vital complejo que le permite provocar auto-infestación en el hospedero. En la mayoría de los casos la infección permanece asintomática, en especial en las áreas endémicas. Sin embargo, bajo ciertas condiciones de inmunodepresión, S. stercoralis puede provocar cuadros graves y a veces mortales que incluyen formas de hiperinfestación o diseminadas 1,2 . Es una parasitosis de difícil diagnóstico, ya que el mismo requiere de la visualización directa de las formas larvarias del parásito y no existe una prueba que se asocie con 100% . Among HIV negative patients the following comorbidities were detected: tuberculosis (n = 3) and chronic alcoholism, leprosy treated with corticosteroids, immunosuppressive treatment for psoriasis, and diabetes mellitus (each in one patient). Two patients did not have any predisposing diseases or immunosuppressive treatments. Seventeen patients presented with diarrhea and were classifi ed as chronic intestinal strongyloidiasis (57%), asymptomatic infection with peripheral eosinophilia was diagnosed in 7 (23%), and 6 patients (20%) developed hyperinfection syndrome. Seventeen patients (57%) presented peripheral eosinophilia. Diagnosis was achieved by direct visualization of larvae in feces by Baermann technique (n = 20), by multiple stool smears examinations (n = 2), by combination of both (n = 1), by visualization of the fi lariform larvae in duodenal fl uid and stool (n = 1), and in fecal and bronchoalveolar lavage specimens (n = 6). Overall mortality in this series was 20% (6/30). There was no signifi cant correlation between age and mortality. A signifi cant inverse correlation between the survival rate and CD4 T-cell count as well as eosinophilia was observed. There was also a signifi cant correlation between HIV co-infection and mortality. Twenty-two patients responded favorably to treatment with ivermectin.

SUMMARYParacoccidioidomycosis is one of the most frequent systemic and endemic mycoses of Latin America caused by a dimorphic fungus. In AIDS patients, paracoccidioidomycosis appears as a severe and disseminated disease with a wide spectrum of clinical findings. The CD4 counts are usually less than 200 cell/µL. We present a case of disseminated paracoccidioidomycosis with peripleuritis and subcutaneous abscesses on the chest wall as initial manifestation of AIDS. In endemic countries, paracoccidioidomycosis should be included as an opportunistic infection in AIDS.

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SUMMARYDisseminated histoplasmosis is a relatively common AIDS-defining illness, occurring in almost 4% of patients living in endemic areas and it may be the first clinical expression of the HIV infection. A broad spectrum of clinical skin lesions associated with Histoplasma capsulatum infection have been described in AIDS patients, such as erythematous macules, papules, nodules, and pustules. Herpetic, acneiform, erythema multiforme-like, molluscum contagiosum-like, vasculitic, and exfoliative forms have also been reported. To our knowledge, this is the first case of disseminated histoplasmosis in an AIDS patient presented as a rupioid eruption.

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The incidence of phycomicosis has increased in the last decades. Its diagnosis is very difficult and usually not established ante morten. Early treatment is of crucial importance, because despite the antifungal drugs, the mortality rate remains around 80%. The present report describes a successfully treated diabetic patient with a rhino-orbital form of the disease and an unusual complication--a cerebral abscess--in whom the clinical diagnosis was supported by the CT findings.