Revista Do Instituto De Medicina Tropical De Sao Paulo最新文献

{"title":"Factors modulating maternofetal transfer of IgG antibodies following SARS-CoV-2 gestational infection.","authors":"Aline Almeida Bentes, Vivian Mara Gonçalves de Oliveira Azevedo, Stela Maris Aguiar Lemos, Gabriela Soutto Mayor Assumpção Pinheiro, Isadora de Araújo Martins, Nicholas Henrique Silva Cotta, Rafaela Martins Dos Santos Oliveira, Gabriela Lousado Mesquita, Gabriela Cintra Januário, José Nélio Januário, Anuraj H Shankar, Claudia Regina Lindgren Alves","doi":"10.1590/S1678-9946202567029","DOIUrl":"https://doi.org/10.1590/S1678-9946202567029","url":null,"abstract":"<p><p>Early infant immunity to SARS-CoV-2 depends on maternofetal transfer of antibodies. We aimed to analyze the factors modulating the maternofetal transfer of anti-SARS-CoV-2 IgG antibodies following gestational infection during the pandemic in Brazil (April-August 2021). We conducted a retrospective and prospective cohort study involving 509 mother-child dyads tested simultaneously for IgG anti-nucleocapsid antibodies during universal neonatal screening. There were 341 seronegative dyads and 168 seropositive ones. Seropositive neonates were retested two to three months later. We examined the association of neonatal serological status and IgG concentrations with gestational mRNA vaccination, timing of maternal infection, neonatal conditions, and gender. Gestational SARS-CoV-2 infection predicted neonatal IgG seropositivity (OR=3.97; 95%CI=2.69-5.88). Maternal infection in the first, second, or third trimester was associated with progressively greater seropositivity in neonates (34.4%, 51.6%, and 58.2%, respectively; p=0.03). Among seropositive neonates, IgG concentration was higher when mothers reported they had COVID-19 during pregnancy (p=0.04) and tended to be lower in girls (p=0.06). More than half of the seropositive neonates remained seropositive two to three months later (54.1%), which was associated with both maternal and neonatal IgG concentration at birth (p<0.001). Higher neonatal IgG concentrations at birth were associated with the persistence of anti-N IgG antibodies for two to three months in more than half of the seropositive newborns. This study provides an additional understanding of the dynamics of maternofetal antibody transfer.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e29"},"PeriodicalIF":1.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029142","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":"Tocilizumab and IVIG experience during the service follow-up in patients with severe COVID-19 pneumonia.","authors":"Mehmet Ali Tüz, İsmail Türköz, Oytun Aydogan, Emine Gencer, Fadime Özge Aygün-Kaş, Oylum Hunerel, Hande İdil Tüz","doi":"10.1590/S1678-9946202567028","DOIUrl":"https://doi.org/10.1590/S1678-9946202567028","url":null,"abstract":"<p><p>Most SARS-CoV-2 infections are asymptomatic or cause only mild illness, but severe respiratory disease can develop, sometimes requiring oxygen support. Immunopathological damage resulting from an abnormal inflammatory response in patients with severe disease is known to be the main determinant of disease outcome. Studies show that anti-inflammatory therapies work best when used before widespread immunopathological damage has occurred. Similarly, it was thought that intravenous immunoglobulin (IVIG)-holding multiple immunomodulatory effects-would provide clinically favorable results, but recent studies suggest otherwise. Still, the literature shows few studies evaluating the efficacy of IVIG according to the time of administration and there are no studies comparing it with established treatments, such as tocilizumab. In this study, we aimed to evaluate the effects of early administration of tocilizumab and IVIG on clinical outcome in patients with severe COVID-19. Patients with progressive clinical and laboratory deterioration who received tocilizumab or IVIG between 07/2020 and 10/2020 in a public hospital ward were retrospectively evaluated. A total of 74 patients were identified, of whom 29 (39%) received IVIG only and 26 (35%) received tocilizumab only. As a result, patients with severe COVID-19 who received IVIG in early stages of the disease did not have better clinical outcomes regarding mortality, length of hospital stay and ICU admission compared to those who received tocilizumab. Moreover, there is no data to support the use of IVIG in COVID-19 patients with severe disease, as it is associated with more severe side effects and is more expensive than tocilizumab.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e28"},"PeriodicalIF":1.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063276","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":"Leptospirosis and coinfections leading to fatal multiple organ and system failure.","authors":"Luiza Schettini Marotto, Marcia Schettini Marotto, Tomás Zecchini Barrese, Cinthya Dos Santos Cirqueira Borges, Juliana Mariotti Guerra, Leonardo José Tadeu de Araújo, Camila Santos da Silva Ferreira, Amir Nassar Filho, Paulo Cesar Fumagalli Marotto","doi":"10.1590/S1678-9946202567026","DOIUrl":"https://doi.org/10.1590/S1678-9946202567026","url":null,"abstract":"<p><p>Coinfection with leptospirosis and other infectious agents pose major challenges in medical practice, often due to difficulties in isolating these agents, symptoms overlap, and lack of specific investigation protocols in areas with emerging and re-emerging diseases. Consequently, knowledge regarding these coinfections and their impact on clinical outcomes are limited. A previously healthy 33-year-old woman, with no history of chronic or malignance diseases, was admitted with febrile icteric illness, pulmonary hemorrhage, acute kidney injury, thrombocytopenia, and shock. Leptospirosis, COVID-19, human rhinovirus, and dengue in the acute phase were clinically and pathologically diagnosed. Multiple coinfections can rapidly lead to multiple organ and system failure, often resulting in a fatal outcome.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e26"},"PeriodicalIF":1.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992272","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":"Psoas muscle abscess as initial manifestation of disseminated tuberculosis in a previously healthy man: a case report.","authors":"Pedro Henrique Moreira Barbosa, Ezequias Batista Martins, Billy McBenedict, Remberto Maurício de La Cruz Vargas Vilte, Karla Regina Oliveira de Moura Ronchini, Natalia Chilinque Zambão da Silva, Patrícia Yvonne Maciel Pinheiro, Thais de Oliveira Vieira, Bianca Balzano de la Fuente Villar","doi":"10.1590/S1678-9946202567025","DOIUrl":"https://doi.org/10.1590/S1678-9946202567025","url":null,"abstract":"<p><p>Psoas muscle abscess is an insidious disease, with varied clinical manifestations and a challenging diagnosis. This pathology has been more frequently identified due to the increased availability of high-quality radiological imaging, such as computed tomography. In Brazil, Mycobacterium tuberculosis is the most common secondary etiologic agent of psoas abscess. We report the case of a 28-year-old immunocompetent man diagnosed with disseminated tuberculosis, affecting the lungs, lumbar spine, and psoas muscle, leading to permanent locomotion sequelae. This case is very relevant for osteoarticular complaints, as low back pain and limping were the initial symptoms. Diagnosis was confirmed by ultrasound-guided percutaneous drainage of the psoas muscle abscess and detection of the M. tuberculosis complex via Xpert MTB/RIF. A 12-month treatment with antitubercular drugs was effective.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e25"},"PeriodicalIF":1.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029110","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":"Erratum.","authors":"","doi":"10.1590/S1678-9946202567024err","DOIUrl":"10.1590/S1678-9946202567024err","url":null,"abstract":"<p><p>[This corrects the article doi: 10.1590/S1678-9946202466024].</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e24err"},"PeriodicalIF":1.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804779","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":"Furazolidone susceptibility of Helicobacter pylori isolated from patients with gastroduodenal diseases in Colombia.","authors":"Brandonn Lopera, Kellys Lemos, José Danilo Atehortúa, Joaquín Valencia-Cárdenas, Diego Vélez-Gómez, Alonso Martinez, Tania Pérez-Cala, Beatriz Salazar","doi":"10.1590/S1678-9946202567020","DOIUrl":"10.1590/S1678-9946202567020","url":null,"abstract":"<p><p>Estimates suggest that over 50% of the global population suffer from Helicobacter pylori infections. Nowadays, first-line quadruple therapy is recommended to eradicate the bacteria due to the increasing failures of the standard triple therapy. Thus, antibiotics such as furazolidone have emerged as a new treatment due to their success rate (>90%) in rescue therapies. Nevertheless, furazolidone is not routinely used for treatment of H. pylori in Colombia. Still, some Asian countries commonly prescribe it. This study aimed to determine the susceptibility of H. pylori to furazolidone in isolates from patients with gastroduodenal diseases in Colombia that were extracted from 2019-2022. A descriptive study was carried out with 179 patients with gastroduodenal diseases. Susceptibility was determined by the agar dilution method. The gene oorD from resistant isolates was amplified by polymerase chain reaction, and their PCR products were sequenced. The frequency of H. pylori equaled 23.5% (42/179); the bacterium was isolated in 84 gastric biopsies. Moreover, 1.7% (3/179) of patients had one resistant isolate to furazolidone in at least one of the two gastric biopsies, corresponding to 5.95% (5/84) of the isolates resisting furazolidone. Overall, three new mutations in the oorD gene occurred in one isolate, and two of the mutations in the five isolates had been reported in Iran, Brazil, and China. This research found low in vitro resistance of H. pylori isolates to furazolidone in Colombia. Finally, all five isolates showed mutations in the oorD gene.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e20"},"PeriodicalIF":1.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804781","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":"Renal tuberculosis with genitourinary sequelae: a case report.","authors":"Raphael Rocco, Bianca Balzano de la Fuente Villar, Laura da Cunha Ferreira, Remberto Maurício de La Cruz Vargas Vilte, Billy McBenedict, Natalia Chilinque Zambão da Silva, Karla Regina Oliveira de Moura Ronchini, Ianick Souto Martins, Danyelle Cristina de Souza, Patricia Yvonne Maciel Pinheiro, Ezequias Batista Martins","doi":"10.1590/S1678-9946202567022","DOIUrl":"10.1590/S1678-9946202567022","url":null,"abstract":"<p><p>Urogenital tuberculosis (UGT) constitutes a significant extrapulmonary form of tuberculosis, often presenting non-specific symptoms and a prolonged indolent course that leads to delayed diagnosis and treatment, which can result in severe and irreversible complications such as urinary strictures, renal failure, and infertility. This report describes a case of a 38-year-old man with a five-month history of low back pain, hematuria, dysuria, and altered urinary frequency. Initial treatment for a presumed urinary tract infection failed, and subsequent diagnostic investigations showed stones, nodules, and cysts in his left kidney. A positive tuberculin skin test confirmed the diagnosis of UGT and identification of Mycobacterium tuberculosis in urine samples. The patient underwent standard six-month antituberculosis therapy and subsequent retreatment due to persistent symptoms. Despite significant symptom amelioration, irreversible urological sequelae, including infundibular stenosis, polyuria, and nocturia, remained. This case underscores the importance of early suspicion, accurate diagnosis, and timely treatment of UGT to minimize long-term complications. It also highlights the potential need for extended treatment length in complex cases to improve outcomes and reduce sequelae, warranting further research in this area.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e22"},"PeriodicalIF":1.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804804","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":"Infectivity studies of Leishmania (Leishmania) infantum chagasi isolated from non-ulcerated cutaneous leishmaniasis.","authors":"Gabriela Venicia Araujo Flores, Carmen Maria Sandoval Pacheco, Thaise Yumie Tomokane, Wilfredo Humberto Sosa Ochoa, Fernando Tobias Silveira, Concepción Zúniga, Carlos Eduardo Pereira Corbett, Rodrigo Pedro Pinto Soares, Luiz Felipe Domingues Passero, Marcia Dalastra Laurenti","doi":"10.1590/S1678-9946202567021","DOIUrl":"10.1590/S1678-9946202567021","url":null,"abstract":"<p><p>In Honduras, Leishmania (Leishmania) infantum chagasi, the etiological agent of visceral leishmaniasis (VL), is responsible for non-ulcerated cutaneous leishmaniasis (NUCL). We characterized NUCL and VL Honduran strains to understand intraspecies infectivity. Based on in-vitro assays, we aimed to elucidate certain host-parasite interactions in VL and NUCL isolates through a hamster model. To assess the capacity of these strains to infect peritoneal macrophages, we exposed them to promastigotes from NUCL and VL patients at varying temperatures and time intervals (32, 34, and 36 °C; 24 and 48 h) and infection-index (II) was determined. No significant differences were observed over time for dermotropic strains; however, a higher II was noted at lower temperatures (32 and 34 °C). Interestingly, only the VL strain exhibited a higher II at elevated temperatures (34 and 36 °C) at 48 h. Low levels of oxygen and nitrogen-derived metabolites were detected in both NUCL and VL strains. For in-vivo assays, hamsters were infected subcutaneously (SC) and intraperitoneally (IP) with 107-promastigotes from NUCL and VL patients. After 90 days of infection, parasite-load and histopathological changes were assessed from spleen samples. Regardless of the administration route, no substantial differences were observed in the histopathological features between NUCL and VL strains. In conclusion, lower temperatures may favor parasite infection for NUCL strains, mirroring conditions found in the skin. This contrasts with the VL strain, which demonstrated a superior II at higher temperatures, a condition normally found in the viscera. Our data also indicate that M. auratus is susceptible to Honduran L. (L.) infantum chagasi strains, circumventing the skin barrier by IP or SC injection.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e21"},"PeriodicalIF":1.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804800","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":"Erratum.","authors":"","doi":"10.1590/S1678-9946202567013err","DOIUrl":"10.1590/S1678-9946202567013err","url":null,"abstract":"<p><p>[This corrects the article doi: 10.1590/S1678-9946202567013].</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e13err"},"PeriodicalIF":1.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804770","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":"Erratum.","authors":"","doi":"10.1590/S1678-9946202567002err","DOIUrl":"10.1590/S1678-9946202567002err","url":null,"abstract":"<p><p>[This corrects the article doi: 10.1590/S1678-9946202567002].</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e2err"},"PeriodicalIF":1.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804767","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}