Infecção bacteriana em pacientes portadores de Leishmaniase visceral

Abstract

In an analysis of 63 hospitalized cases with visceral leishmaniasis, the clinical or post-mortem diagnosis of bacterial infection was performed in 33; 13 (39.3%) patients had respiratory infection, 4 (12.1%) had skin infection, 4 had urinary tract infection, 3 (9.0%) showed ear infection and 2 (6.6%) had infection of the oral cavity. It is worth mentioning that in 7 (21%) cases there was infection in multiple sites. Gram positive and/or Gram negative organisms were isolated from 10 patients. In only two (autopsied) cases, infection with less common organisms was recorded, one with disseminated candidiasis and another with disseminated tuberculosis. Death occurred in 9 of the 63 cases, and in 8 of these, concomitant bacterial infection of importance was documented. Patients who had serum globulins lower than 4 g% had significantly more infection (p less than 0.05) than patients with globulin levels higher than 4 g%; there was no significant difference when the number of leucocytes and neutrophils in patients with associated infection was compared with those in patients without bacterial infection. The present study demonstrates that bacterial infection frequently occurs in patients with visceral leishmaniasis, and indicates an unfavourable prognosis. Even though the mechanism of increased susceptibility to infection in this condition was unclear, the widespread range of infections and of infective agents, suggests a multifactorial process.

Leishmaniose visceral: características clínico-epidemiológicas em crianças de área endêmica

“…Reduced length hospital stays and the resulting reductions in exposure to nosocomial germs may have had an influence on the incidence of nosocomial infections; an aspect which should be better explored ion future studies. As has been explained by other authors, [20][21][22] in this sample, a number of different factors, in association or isolation, may have been associated with infection. Of these factors, average hemoglobin, leukocyte and neutrophil levels deserve special attention.…”

“…It affects people of all ages and in its classic form is associated with a fatal outcome in around 50% of cases. 11,21,22 In this investigation, infection was found to have been present in 10.9% of the patients at the time of admission, developed in 24.4% of cases during hospitalization and was associated with leishmaniasis in 72.7% of the patients who died. The most common infections were pneumonia, otitis, skin infections and sepsis.…”

“…7,19,24 The main immediate causes of death were similar to those described by other authors: infection, hemorrhage, anemia and liver failure. 5,9,11,22,23 Despite previous knowledge of the main immediate causes of death, they persist over the years even though there is evidence of a general decrease in lethality. 6 This being the case, there are both indications and space for vigorous activities with the objective of achieving significant reductions in lethality.…”

Predicting death from kala-azar: construction, development, and validation of a score set and accompanying software

“…Therefore, the criteria for defi ning sepsis, pneumonia, and urinary tract infection were modifi ed in order to increase the specifi city of the operational defi nition. Therefore, less severe presentations of pneumonia, sepsis without organ dysfunction, hypoperfusion or hypotension, and urinary infection may have not been detected (53) (54) (55) . A fi nal comment on the absence of anemia as a risk factor in the score set is required, because it was described as a component of another score system and as a prognostic factor (6) (24) .…”

Infecção Hospitalar Em Crianças Com Leishmaniose Visceral Admitidas Em Um Hospital De Referência Na Região De Montes Claros/Mg

“…Foi encontrado infecção bacteriana em 52% dos pacientes internados com LV. 20,24,25 Vários fatores estão associados a maior incidência de infecções bacterianas e virais durante a fase aguda da LV, destacando-se a desnutrição, a anemia, a leucopenia, as possíveis alterações nas funções dos neutrófilos, anormalidades na síntese de anticorpos contra novos antígenos e depressão da resposta imune mediada por células.…”