Estudo clínico, epidemiológico e terapêutico de 402 pacientes com leishmaniose tegumentar americana atendidos no Hospital Universitário de Brasília, DF, Brasil

Abstract

BACKGROUND -American cutaneous leishmaniasis is a disease with high prevalence and incidence in Brazil. The Brazilian Central-Western Region currently holds the third largest incidence and the first growth rate of this disease in the country. OBJECTIVES -to evaluate clinical, epidemiological and treatment features of patients with American cutaneous leishmaniasis seen at the University Hospital of Brasília. METHOD -a case series study with 402 patients was carried out, spanning the period between January 1st, 1994 and February 28th, 2003. The following variables were studied: sex, age, occupation, state of origin, clinical features, diagnostic techniques, treatment with pentavalent antimony and side effects. Follow-up was one year after the end of treatment. RESULTS -the predominant group of patients was composed by male rural laborers who presented mainly the cutaneous form of the illness. The greatest efficacy of the antimony was observed in patients presenting the cutaneous form treated up to six months after the onset of symptoms, and in females in general (both differences were statistically significant in multivariate analysis). The early treatment of the mucocutaneous form also presented better results, although not statistically significant. Electrocardiographical alterations were more frequent in the group of patients receiving a 20mg SbV/Kg/day for a 30-day schedule than those with the same dosage for 20 days. Eosinophilia was found in 17.5%. CONCLUSIONS -Early treatment, female gender and cutaneous form presented higher levels of cure. Electrocardiographic changes rose as time of treatment was increased. The remarkable report of eosinophilia as a side effect of N-methylglucamine deserves further investigation. Keywords: Leishmaniasis, Mucocutaneous/diagnosis; Leishmaniasis, Mucocutaneous/epidemiology; Leishmaniasis, Mucocutaneous/therapy Resumo: FUNDAMENTOS -A leishmaniose tegumentar americana é doença em expansão no Brasil. A região Centro-Oeste é hoje a terceira em incidência e a primeira em crescimento da doença. OBJETIVOS -Avaliar pacientes com leishmaniose tegumentar americana atendidos no Hospital Universitário de

Clinical, laboratory, and therapeutic characteristics of American tegumentary leishmaniasis in the 15 th State Health Division, Northwest Paraná State, Southern Brazil

“…Moreover, we found that the doses prescribed for men were higher than for those prescribed for women with the mucosal form, whereas the number of ampoules administered to women was higher than that for men with the cutaneous form. This is inconsistent with the findings of Name et al (28) , who reported that PA was more effective in females with the cutaneous form. However, no difference in treatment time or the average number of visits for patients with the cutaneous or mucosal forms was noted.…”

“…Similar results were reported by Name et al (28) who found a clinical cure rate of 81.6% in patients with the cutaneous form and 69.6% in patients with the mucocutaneous form in Brasília.…”

“…Moreover, Martins et al (21) reported that the regions of the body most frequently affected were the limbs (59.6%), followed by the face (34%). In addition, Murback et al (27) found that lesions were located in the lower limbs in 34%, in the face in 25.5%, and in the upper limbs in 19.1%, whereas Name et al (28) found that lesions were located in the lower limbs in 56.5%, in the upper limbs in 28.4%, and in the head in 13.6%. The amount of Glucantime® ampoules used did not differ according to the location of lesions at different sites.…”

Leishmania (Viannia) braziliensis is the main species causing cutaneous leishmaniasis in the Federal District of Brazil

“…These findings are similar to those commonly described for this infection (14)(15)(16)(17). The predominance of isolated lesions on the legs reflects the area of exposure to the bite of the vector, while bigger ulcerative lesions could be related to a delay in seeking medical assistance.…”

Tetracycline and trimethoprim/sulfamethoxazole at clinical laboratory: can they help to characterize Staphylococcus aureus carrying different SCCmec types?

“…The municipality of Monte Negro is an historical area of transmission of ACL that accounted for a incidence of 59 cases/100,000 inhabitants in 2010. The nine humans cases followed up in this study was represented for mens between 15 and 50 years old, which is the most susceptible age group, reported by some authors [35][36][37] . The nature of the zoonotic transmission becomes evident when it is noticed that 80% of the patients were engaged in activities associated with the permanence in the forest (hunting, fishing, lumbering), although 20% had not such activities, suggesting peridomestic transmission.…”