Revista da Sociedade Brasileira de Medicina Tropical最新文献

{"title":"The Tuberculosis Response and the Role of the BRICS in the Current Global Emergency.","authors":"Afranio Kritski, Ricardo Arcêncio, Ezio Tavora, Erica Chimara, Pedro Eduardo Almeida Silva, Jose Roberto Lapa E Silva, Martha Maria Oliveira, Monica Kramer de Andrade, Anete Trajman, Julio Croda, Maria Claudia Vater, Margareth Pretti Dalcolmo, Ethel Leonor Maciel","doi":"10.1590/0037-8682-0216-2025","DOIUrl":"10.1590/0037-8682-0216-2025","url":null,"abstract":"","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"58 ","pages":"e02162025"},"PeriodicalIF":2.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837458","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":"Economic Impact in the Treatment of Coagulase-Negative Staphylococci Blood Cultures Contamination in a Middle-Income Country.","authors":"Priscila Gabriella Carraro Merlos, Gustavo Henrique Loesch, Felipe Francisco Tuon","doi":"10.1590/0037-8682-0094-2025","DOIUrl":"10.1590/0037-8682-0094-2025","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess the clinical and economic impacts of blood culture contamination in a hospital situated in a low-middle-income country and the breakeven to implement strategies to avoid unnecessary antimicrobials.</p><p><strong>Methods: </strong>This economic cross-sectional study was conducted at a tertiary hospital, and 8,072 blood cultures were analyzed. Antibiotic duration and cost were calculated in United States dollars (USD). A simulation with a breakeven curve to determine the balance between antimicrobial costs and time-to-result of coagulase-negative staphylococci in one blood culture (suggestive of contamination) was used to define the breakeven point between the cost of the diagnostic tests or prevention strategies and the balance with antimicrobial expense.</p><p><strong>Results: </strong>Of the 8,072 blood culture samples collected, the contamination rate was 9.9%. Antimicrobial therapy was initiated in 69.6% of the 682 cases of contamination. The median duration of unnecessary antibiotic use was 7 days. The direct costs totaled USD 83,910 annually, comprising USD 73,970 for unnecessary antimicrobials and USD 9,940 for microbiological tests. The extended length of hospital stay potentially contributed to an additional USD 3.87 million in annual hospital costs.</p><p><strong>Conclusions: </strong>This study underscores the urgent need for strategies to reduce blood culture contamination, and emphasizes the potential benefits of rapid identification techniques for optimizing patient care and healthcare resource utilization. Addressing this issue is of paramount importance for mitigating unnecessary antibiotic exposure, reducing healthcare costs, and improving patient outcomes.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"58 ","pages":"e00942025"},"PeriodicalIF":2.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837454","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":"Distribution, host origin, and transmission cycles of Trypanosoma cruzi genotypes in the State of Rio Grande do Norte, Brazil.","authors":"George Harisson Felinto Sampaio, Nathan Ravi Medeiros Honorato, Lucas Abrantes Batista, Maricélia de Aquino Santana, Carlos Ramon do Nascimento Brito, Rand Randall Martins, Paulo Marcos da Matta Guedes, Andressa Noronha Barbosa da Silva, Lúcia Maria da Cunha Galvão","doi":"10.1590/0037-8682-0063-2025","DOIUrl":"10.1590/0037-8682-0063-2025","url":null,"abstract":"<p><strong>Background: </strong>The genetic diversity of Trypanosoma cruzi and the epidemiological characteristics of the environments in which the parasite occurs are essential for understanding infection dynamics and controlling Chagas disease. This systematic review aimed to: (i) identify and analyze studies that evaluated the genetic variability and epidemiological aspects of T. cruzi infection in the state of Rio Grande do Norte, Brazil; (ii) summarize the information reported in the literature; and (iii) suggest new control strategies tailored to the region's epidemiological profile.</p><p><strong>Methods: </strong>Following the application of inclusion and exclusion criteria, 13 studies catalogued in PubMed, the Brazilian Virtual Health Library, Scopus, and the Web of Science were selected.</p><p><strong>Results: </strong>T. cruzi isolates were primarily obtained from triatomine species Triatoma brasiliensis, Panstrongylus lutzi, and Triatoma pseudomaculata, as well as from wild mammals such as Euphractus sexcinctus, Galea spixii, and humans. A total of 295 T. cruzi isolates were genotyped: 46.5% (137) were identified as Discrete Typing Unit (DTU) I, 29.1% (86) as DTU II, and 20% (59) as DTU III. Mixed infections were detected in 4.4% (13/295) of hosts. Triatomine species were found in both peridomestic and intradomestic environments and were occasionally infected with T. cruzi.</p><p><strong>Conclusions: </strong>This review provides a comprehensive overview of the circulation of distinct Trypanosoma cruzi genotypes (I, II, and III) in both wild and human-modified environments in Rio Grande do Norte.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"58 ","pages":"e00632025"},"PeriodicalIF":2.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837453","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":"Follow-up evaluation of long COVID syndrome in patients with SARS-CoV-2 infection.","authors":"Sezin Hoşgel Sevdimbaş, Ayşe Seza İnal, Ferit Kuşcu, Behice Kurtaran, Aslıhan Candevir, Yeşim Taşova, Süheyla Kömür","doi":"10.1590/0037-8682-0046-2025","DOIUrl":"10.1590/0037-8682-0046-2025","url":null,"abstract":"<p><strong>Background: </strong>Long COVID, which refers to persistent symptoms following acute COVID-19, is being increasingly reported. However, available data regarding its prevalence and characteristics are limited. This study was conducted to evaluate the occurrence and presentation of long COVID in patients with COVID-19 who were followed up in outpatient, ward, or intensive care settings.</p><p><strong>Methods: </strong>This study included patients who were diagnosed with COVID-19 at least four weeks prior to the start of the study. The patients underwent symptom assessment at baseline and 1, 3, 6, and 12 months post-infection. Functional status was evaluated using the Post-COVID-19 Functional Status (PCFS) Scale, and quality of life was assessed using the SF-36 Health Survey questionnaire.</p><p><strong>Results: </strong>A total of 134 patients (71 males [54.2%]), with a mean age of 43.7 (15.3) years, participated in this study. The distribution of patients across care settings was as follows: 51.1% outpatients, 35.9% in wards, and 13% in intensive care units (ICUs). Fatigue during exertion was the most frequently reported long COVID symptom. Patients treated in ICUs experienced a higher burden of long COVID symptoms than those treated in outpatient or ward settings. Furthermore, patients treated in ICUs and wards had a significantly poorer quality of life and functional status than the outpatients.</p><p><strong>Conclusions: </strong>Long COVID poses a significant ongoing health concern, particularly for patients who require intensive care during acute COVID-19. Vigilant monitoring of long-term sequelae, particularly those that affect quality of life and functional status, is crucial for individuals recovering from COVID-19.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"58 ","pages":"e00462025"},"PeriodicalIF":2.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837455","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":"Scorpionism in Pará, Brazil: Clinical assessment of neuromuscular manifestations.","authors":"Rosicléia Freitas Borges, Joyce Nascimento Dergan, Pasesa Pascuala Quispe Torrez, Vera Lúcia Teixeira de Freitas, Maria Rita Bertolozzi, Átila Barros Magalhães, Fernanda Jacqueline Teixeira Cardoso, Rogério Bertani, Francisco Oscar de Siqueira França","doi":"10.1590/0037-8682-0053-2025","DOIUrl":"10.1590/0037-8682-0053-2025","url":null,"abstract":"<p><strong>Background: </strong>In the western region of Pará (Brazil), the clinical manifestations of scorpionism exhibit unique characteristics, and there is currently no proposal for a quantitative assessment of this condition. This manuscript proposes and applies a classification system for assessing the severity of scorpionism, comparing it with the system used by the Ministry of Health.</p><p><strong>Methods: </strong>This quantitative, descriptive, observational, cross-sectional study evaluated victims of scorpionism treated at the Municipal Hospital of Rurópolis in Pará, Brazil. Clinical and therapeutic data were collected using instruments and scales, particularly the International Cooperative Scale for the Evaluation of Ataxias.</p><p><strong>Results: </strong>Thirty-four patients were assessed between January and July 2023. The majority were young males. All presented with pain, an 'electric shock sensation' and myoclonus. Muscle spasms were observed in 65% of patients, postural changes in 64%, dysmetria in 55%, altered eye movements in 50%, and dysarthria in 44%. While these manifestations are transitory, they cause significant discomfort to the patient. The classification proposed in this study was compared to the Ministry of Health's Severity Classification, and low agreement between the two classifications was shown (only in 50% of cases). The proposed classification raised the severity of 17 patients by one degree: fifteen from mild to moderate and two from moderate to severe, one of whom developed rhabdomyolysis and acute kidney injury.</p><p><strong>Conclusions: </strong>The proposed classification was beneficial and could be used in the future to assess the effectiveness of therapeutic interventions for this frequent and neglected condition in the Amazon.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"58 ","pages":"e00532025"},"PeriodicalIF":2.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837457","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":"Two Decades of Human Rabies in Brazil: Epidemiological Trends, Emerging Risks and Treatment Challenges.","authors":"Raquel Gomes Catozo, Cesar Martin Leyva Molina, Amanda Lopes da Silva, Joana Rocha da Silveira Barreto de Aguiar, Luiza Barbosa, Bruno Luiz Miranda Guedes, Mariene Ribeiro Amorim, Paulo Eduardo Brandão, Camila Malta Romano","doi":"10.1590/0037-8682-0110-2025","DOIUrl":"10.1590/0037-8682-0110-2025","url":null,"abstract":"<p><strong>Background: </strong>Rabies poses a serious public health challenge in Brazil, and its epidemiology has undergone significant changes over the past two decades. Although canine transmission of rabies has been controlled through national vaccination programs, new risks have emerged, particularly from wildlife reservoirs.</p><p><strong>Methods: </strong>We performed a retrospective analysis of human rabies cases reported in Brazil between 2001 and 2025 using epidemiological surveillance data, scientific literature, and public health reports. We focused on trends in transmission sources, changes in affected populations, and challenges in prevention and treatment, particularly regarding the availability of post-exposure prophylaxis (PEP).</p><p><strong>Results: </strong>A total of 188 human rabies cases were reported in Brazil between 2001 and 2025 (average: 7.52 cases per year). Most of the cases occurred in the northern and northeastern regions of the country. Bats were the most common source of transmission, followed by dogs and non-human primates. Although rabies is preventable, most of the cases reported within the study period resulted in death. PEP was administered in most cases; however, the treatment may have been delayed, incomplete, or initiated after the onset of symptoms, which limited its effectiveness. Only two patients survived, and both of them received intensive care and were treated using modified therapeutic protocols.</p><p><strong>Conclusion: </strong>The transition from canine- to bat-mediated rabies highlights the need for enhanced surveillance and targeted prevention strategies. Despite advances in canine rabies control, ensuring PEP accessibility and strengthening public health interventions in high-risk areas remain critical for reducing the incidence of human rabies in Brazil.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"58 ","pages":"e0110"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789865","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":"Cutaneous cryptococcosis resembling keratoacanthoma.","authors":"Alex Panizza Jalkh, Naira Sulany Oliveira de Sousa, Juan Diego Ribeiro de Almeida, Flávia da Silva Fernandes, Kátia Santana Cruz, Hagen Frickmann, Marcus Vinícius Guimarães Lacerda, João Vicente Braga de Souza","doi":"10.1590/0037-8682-0300-2024","DOIUrl":"10.1590/0037-8682-0300-2024","url":null,"abstract":"<p><p>Cutaneous cryptococcosis is a manifestation of systemic cryptococcal infection, characterized by polymorphic skin lesions that can make diagnosis challenging. We report an HIV-positive patient with a solitary facial nodule, initially diagnosed as keratoacanthoma. Histopathology, fungal culture, and cerebrospinal fluid analysis confirmed disseminated cryptococcosis with central nervous system involvement caused by Cryptococcus neoformans genotype VNI. He was treated with amphotericin B followed by fluconazole, resulting in complete clinical resolution. This case underscores the need to consider disseminated cryptococcosis in the differential diagnosis of tumorlike skin lesions, particularly in HIV-positive patients.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"58 ","pages":"e03002024"},"PeriodicalIF":1.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609223","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":"The CT target sign as a criterion for the differential diagnosis between tuberculosis and organizing pneumonia.","authors":"Elcio Bakowski, Gláucia Zanetti, Edson Marchiori","doi":"10.1590/0037-8682-0095-2025","DOIUrl":"10.1590/0037-8682-0095-2025","url":null,"abstract":"","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"58 ","pages":"e00952025"},"PeriodicalIF":1.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609228","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":"Unveiling Silent Patent Ductus Arteriosus with COVID-19.","authors":"Nurhayat Yakut, Kahraman Yakut, Mehmet Gumustas, Serap Bas, Ibrahim Cansaran Tanidir","doi":"10.1590/0037-8682-0086-2025","DOIUrl":"10.1590/0037-8682-0086-2025","url":null,"abstract":"","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"58 ","pages":"e00862025"},"PeriodicalIF":1.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609230","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":"Cerebral Abscess and epidural empyema in a young immunocompetent patient caused by Streptococcus constellatus.","authors":"Matheus Felipe Dantas Krause, Mariângela Ribeiro Resende, Gabriela Romantini Salioni, Vinicius de Menezes Jarry, Fabiano Reis","doi":"10.1590/0037-8682-0031-2025","DOIUrl":"10.1590/0037-8682-0031-2025","url":null,"abstract":"<p><p>Streptococcus constellatus, a member of the Streptococcus anginosus group, is a commensal bacterium that causes pyogenic infections, particularly abscesses. This report describes the case of a 28-year-old immunocompetent man who developed a brain abscess and epidural empyema after pneumonia. MRI suggested an abscess, which was confirmed by culture, revealing S. constellatus. Treatment included abscess drainage and ceftriaxone administration, which led to a full recovery. Diagnosis is challenging because of overlapping features with other bacteria. Imaging and culturing are crucial for identification. This case highlights the importance of considering S. constellatus in central nervous system infections, even in immunocompetent individuals.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"58 ","pages":"e00312025"},"PeriodicalIF":1.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609209","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}