Revista da Sociedade Brasileira de Medicina Tropical最新文献

{"title":"Acute oral Chagas disease following armadillo blood ingestion: a case report.","authors":"Estefanía Gartner-López, Raúl Andrés Vallejo-Serna, Stephany Barbosa-Balaguera, Sebastián Ayala-Zapata","doi":"10.1590/0037-8682-0078-2026","DOIUrl":"https://doi.org/10.1590/0037-8682-0078-2026","url":null,"abstract":"<p><p>A 70-year-old man from rural Colombia presented with new-onset atrial fibrillation, dyspnea, and palpitations. A peripheral blood smear revealed a Trypanosoma cruzi trypomastigote, which was confirmed by molecular testing. He reported ingesting armadillo blood 3 weeks earlier, identifying oral transmission as the likely route. Treatment with nifurtimox, oral metoprolol, and enoxaparin resulted in conversion to sinus rhythm and symptomatic improvement, although a parasitological cure could not be confirmed. Because the patient had several competing risk factors for atrial fibrillation-advanced age, long-standing hypertension, heavy smoking, and active small-cell lung carcinoma-a causal relationship with the infection could not be established. Acute Chagas disease was therefore proposed only as a possible, potentially reversible contributing factor. To our knowledge, this is among the few reported cases of acute oral Chagas disease presenting as reversible atrial fibrillation, highlighting an underrecognized cultural risk practice in non-endemic settings.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e00782026"},"PeriodicalIF":2.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possible correlation between Mycobacterium abscessus subsp. massiliense spondylodiscitis and spinal anesthesia: Diagnostic and therapeutic challenges.","authors":"Henrique Soares Casaccio, Júlia Lustosa Martinelli, Pedro Augusto Simão Vasconcellos, Mariani de Lima Garcia, Lucas de Noronha Lima, Matheus Oliveira Povoa, Andressa Caroline Paranhos, Alessa de Andrade Santana, Julia Domingues Gatti, Nanci Michele Saita Santos, Aline Gonzalez Vigani, Elisa Teixeira Mendes, Lucieni de Oliveira Conterno, Raquel Silveira Bello Stucchi, Francisco Hideo Aoki, Márcia Teixeira Garcia, Mariângela Ribeiro Resende, Antonio Camargo Martins","doi":"10.1590/0037-8682-0009-2026","DOIUrl":"https://doi.org/10.1590/0037-8682-0009-2026","url":null,"abstract":"<p><p>Spinal infections caused by Mycobacterium abscessus are rare and difficult to treat. We report the first case of M. abscessus subsp. massiliense spondylodiscitis temporally associated with spinal anesthesia. A 57-year-old man developed back pain after undergoing spinal anesthesia for prostate surgery. Six months later, decompressive laminectomy was performed; results for bacterial and fungal culture and molecular testing for Mycobacterium tuberculosis were negative. Two years later, a mycobacterial culture of material from a paravertebral abscess revealed the presence of M. abscessus, later identified as subsp. massiliense. Treatment with imipenem, amikacin, tigecycline, clofazimine, and clarithromycin resulted in clinical and radiological improvement. This report highlights the diagnostic and therapeutic challenges of this case.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e00092026"},"PeriodicalIF":2.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rabies virus circulation in domestic mammals from a peri-urban area at the Pedra Branca Forest, Rio de Janeiro, Brazil.","authors":"Natasha Avila Bertocchi, Ellen Schmidt, Roberto Leonan Morim Novaes, Ademar Luiz Gomes do Couto, Jaíne Gonçalves Garcia, Helena Beatriz de Carvalho Ruthner Batista, Ricardo Moratelli","doi":"10.1590/0037-8682-0228-2026","DOIUrl":"https://doi.org/10.1590/0037-8682-0228-2026","url":null,"abstract":"","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e02282026"},"PeriodicalIF":2.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tension Pneumothorax Following Spontaneous Enucleation of a Hydatid Cyst into the Pleural Cavity.","authors":"Yener Aydin, Ali Bilal Ulas, Zehra Nur Cavdar","doi":"10.1590/0037-8682-0219-2026","DOIUrl":"https://doi.org/10.1590/0037-8682-0219-2026","url":null,"abstract":"","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e02192026"},"PeriodicalIF":2.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Submucosal Buccal Nodule: A Rare Case of Oral Dirofilariasis.","authors":"Low Yin Kuan, Mohd Farifzul Anuar Mohd Zuki, Tan Chuey Chuan, Wanninayake M Tilakaratne, Nurul Izyan Zainuddin","doi":"10.1590/0037-8682-0101-2026","DOIUrl":"https://doi.org/10.1590/0037-8682-0101-2026","url":null,"abstract":"","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e01012026"},"PeriodicalIF":2.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One Health to Advance Tuberculosis Elimination in Brazil: A New Area of the Brazilian Tuberculosis Research Network.","authors":"Fernando Nogueira Souza, Jane Megid, Marcos Bryan Heinemann, Franciarli Silva da Paz, Erica Chimara, Ricardo Alexandre Arcêncio, José Roberto Lapa E Silva","doi":"10.1590/0037-8682-0063-2026","DOIUrl":"10.1590/0037-8682-0063-2026","url":null,"abstract":"","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e00632026"},"PeriodicalIF":2.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerating Proficiency in Minimally Invasive Autopsy for Infectious Disease Diagnosis and Research: A Strategic Framework.","authors":"Fabiana Santana Souza, Carlos Gustavo Regis-Silva, Ricardo Khouri, Luiz Antônio Rodrigues de Freitas, Milena Botelho Pereira Soares, Bruno Solano de Freitas Souza, Carolina Kymie Vasques Nonaka, Reneé Amorim Dos Santos Félix, Maria Fernanda Rios Grassi, Washington Luis Conrado Dos-Santos, Geraldo Gileno de Sá Oliveira","doi":"10.1590/0037-8682-0037-2026","DOIUrl":"10.1590/0037-8682-0037-2026","url":null,"abstract":"<p><strong>Background: </strong>Conventional autopsy is the gold standard for postmortem examination, but its use is constrained by biosafety, infrastructure, and acceptability concerns. Ultrasound-guided minimally invasive autopsy and ultrasound-guided minimally invasive tissue sampling (US-MITS) offer practical alternatives for tissue sampling in infectious diseases. The aim of this study was to present a standardized protocol for multiorgan US-MITS and evaluate its performance in terms of success rates, accuracy, and sample quality.</p><p><strong>Methods: </strong>An observational study was conducted on 13 decedents with reverse transcription-polymerase chain reaction (RT-PCR)-confirmed coronavirus disease 2019 in Salvador, Brazil. Using a portable ultrasound machine and 14G semi-automatic Tru-Cut needles, samples were collected from the skin, liver, spleen, kidneys, pancreas, lungs (four-quadrant bilateral sampling), heart, brain, and skeletal muscle. The workflow included routine histological examinations (hematoxylin and eosin, and special stains), electron microscopy, and molecular testing via Ion Torrent sequencing for severe acute respiratory syndrome coronavirus 2 variant calling. Performance was evaluated by measuring the success rates and accuracy (ratio of target tissue to contaminants) using high-resolution slide scanning and digital morphometry.</p><p><strong>Results: </strong>Sampling success ranged from 77% to 100% across the heart, lungs, liver, spleen, and kidneys. Four-quadrant lung sampling yielded comprehensive histological representation. Contamination was generally low, except in the pancreas and lower medial lung quadrant. Tissue suitable for electron microscopy was obtained from most organs; severe acute respiratory syndrome coronavirus 2 was detected in all 13 lungs, and variants were assigned in 10 cases.</p><p><strong>Conclusion: </strong>With minimal training, teams can perform US-MITS. Using a traceable, standardized workflow accelerates proficiency while enabling diagnostic-grade samples to be produced for histological examinations, ultrastructural analysis, and molecular testing in resource-limited and outbreak settings.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e00372026"},"PeriodicalIF":2.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Entomological findings in a focus of visceral leishmaniasis transmission in Embu das Artes Municipality: Contributions for prevention and surveillance.","authors":"Sarah Kovalenkinas Xavier de Lima, Rodrigo Accioli Almeida, Fredy Galvis Ovallos, Eunice Aparecida Bianchi Galati","doi":"10.1590/0037-8682-0156-2026","DOIUrl":"10.1590/0037-8682-0156-2026","url":null,"abstract":"<p><strong>Background: </strong>Leishmaniasis occurs in Embu das Artes, where Lutzomyia longipalpis is absent, but secondary vectors are present.</p><p><strong>Methods: </strong>Sandflies were collected using Shannon and CDC (Center for Disease Control) light traps in a household with seropositive dogs; presence of flagellates was investigated by dissection.</p><p><strong>Results: </strong>From 11 species, 1,224 sand flies were collected, predominantly Pintomyia (Pi.) fischeri (88.6%) and Migonemyia (Mg.) migonei (8.4%). Shannon traps captured most specimens, mainly in peridomicile. Abundance was higher during spring/summer. Flagellates were detected only in Evandromyia (Ev.) edwardsi, with a 0.13% overall infection rate.</p><p><strong>Conclusion: </strong>Pi. fischeri predominance and kennel association of Mg. migonei reinforce their epidemiological importance for local leishmaniasis transmission.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e01562026"},"PeriodicalIF":2.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and estimated costs of hospitalizations potentially associated with respiratory syncytial virus among children in Brazil, 2014-2025.","authors":"Felipe Cotrim de Carvalho, Walquiria Aparecida Ferreira de Almeida, Daiana Araújo da Silva, Francisco José de Paula Júnior, Dalva Maria de Assis, Rafaela Gomes Andrade, Marcela Santos Corrêa da Costa, Marcelo Ferreira da Costa Gomes, Priscila Leal E Leite, Nelson J Alvis-Zakzuk, Paula Couto, Jorge Jara, Paola Cristina Resende, Marilda M Siqueira, Fernando do Couto Motta, Wildo Navegantes de Araújo, Mitermayer Galvão Reis","doi":"10.1590/0037-8682-0120-2026","DOIUrl":"10.1590/0037-8682-0120-2026","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus, a major cause of respiratory infections and hospitalizations in young children, especially bronchiolitis, is an important burden to the health system in Brazil. This study evaluated the trends, seasonality, and economic impact of hospitalizations associated with respiratory syncytial virus in Brazilian children.</p><p><strong>Methods: </strong>This study analyzed hospitalizations for acute bronchitis and bronchiolitis (International Code of Diseases-10 J20-J21) in Brazilian children <5 years of age from January 2014 and March 2025 using data from the Brazil's Unified Health System. Annual trends were assessed with linear regression, while time series decomposition evaluated seasonality. Direct medical costs were adjusted for inflation and converted to international dollars (Int$). Pearson's correlation coefficient was employed to analyze associations between length of stay and hospitalization cost.</p><p><strong>Results: </strong>A total of 727,808 hospitalizations were recorded, with 86.8% occurring in children under 5 years old. Hospitalizations increased by 307.8%, with marked declines in 2020 during the coronavirus disease-2019 pandemic and consistent seasonal peaks between March-June. Direct medical costs totaled Int$ 166.8 million, with 55.5% of expenditures after 2020. The mean cost per hospitalization increased by Int$ 21.48 between 2014-2024 (Int$ 118.16-139.64). Length of stay correlated moderately with cost (r = 0.55), particularly strongly in southeastern and southern Brazil.</p><p><strong>Conclusions: </strong>Our findings revealed distinct seasonal and regional patterns in hospitalizations and a post-pandemic increase in costs. The association between prolonged hospitalization and higher expenditures underscores the need for targeted, region-specific preventive strategies and timely clinical interventions, to reduce the growing economic burden on the system.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e01202026"},"PeriodicalIF":2.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacovigilance in the treatment of cutaneous leishmaniasis: adverse event profile at a reference center.","authors":"Ana Luiza Silva Rezende, Janaína de Pina Carvalho, Beatriz Prado Noronha, Sarah Nascimento Silva","doi":"10.1590/0037-8682-0038-2026","DOIUrl":"10.1590/0037-8682-0038-2026","url":null,"abstract":"<p><strong>Background: </strong>Cutaneous leishmaniasis treatment is frequently associated with adverse events (AEs). We investigated the profile of AEs and examined their associations.</p><p><strong>Methods: </strong>This prospective observational study was conducted at a Brazilian reference center to describe AEs according to their occurrence rate, severity, and seriousness.</p><p><strong>Results: </strong>Among 318 AEs recorded in 92 patients, the highest AE occurrence rate was among those treated with miltefosine. The highest rate of serious AEs was among patients treated with liposomal amphotericin B. Local therapy using meglumine antimoniate showed a more favorable safety profile.</p><p><strong>Conclusion: </strong>The different profiles highlight the importance of pharmacovigilance in real-world settings.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e00382026"},"PeriodicalIF":2.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}