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

{"title":"Eosinophilic meningitis caused by Angiostrongylus cantonensis: case report in a patient with false-positive immunological test result for Neisseria meningitides.","authors":"Marcela Nataly Parra Alvarez, Juan Sebastián Sánchez León, Tassiane Moreira da Silva, Renato Dumba Monteiro de Castro, Arlete Hilbig, Leyva Cecilia Vieira de Melo, Carlos Graeff-Teixeira, Alessandro Comarú Pasqualotto","doi":"10.1590/S1678-9946202668017","DOIUrl":"10.1590/S1678-9946202668017","url":null,"abstract":"<p><p>Eosinophilic meningitis caused by Angiostrongylus cantonensis is an uncommon disease in Brazil that occurs by ingesting slugs, water or food contaminated with the parasite. Here we report a case of a 64-year-old patient with neck stiffness, headache, fever, and peripheral and cerebrospinal fluid (CSF) eosinophilia, compatible with eosinophilic meningitis. He had a false-positive result for Neisseria meningitides and received unsuccessful treatment with antibiotics. After extensive investigation, DNA and anti-A.cantonensis antibodies were detected and the patient was successfully treated with prednisone and albendazole. Diagnosis of neuroangiostrongyliasis relies on epidemiological data, as well as clinical and laboratory examinations such as detection of antibodies and DNA of the parasite in CSF. Its timely treatment with corticosteroid therapy reduces damage to neural tissues and manages headache.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e17"},"PeriodicalIF":1.3,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12919915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229757","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":"Comparative performance of Filamentous Fungi 4.0 and Mass Spectrometry Identification 2.0 databases for Aspergillus spp.: identification using a simplified protein extraction method.","authors":"Gustavo Giacon Damiani, Vivian Caso Coelho, Juliana Possato Fernandes Takahashi, Ingrid Gonçalves Costa Leite, Marcia Regina von Zeska Kress, Marcello Mihailenko Chaves Magri, Valdes Roberto Bollela, Roberto Martínez, Gil Benard, Tiago Alexandre Cocio","doi":"10.1590/S1678-9946202668014","DOIUrl":"10.1590/S1678-9946202668014","url":null,"abstract":"<p><p>Aspergillus spp. are major agents of pulmonary aspergillosis, posing diagnostic challenges in clinical laboratories due to morphological similarity among species. This study compared the performance of two spectral databases, Filamentous Fungi v4.0 (Bruker Daltonics) and Mass Spectrometry Identification v2.0 (MSI 2.0), for Aspergillus species identification by MALDI-TOF MS, and evaluated the applicability of the simplified protein extraction method from solid culture medium for routine use in hospital laboratories. Overall, 46 clinical isolates from patients with pulmonary aspergillosis were cultured on Sabouraud Dextrose Agar (SDA) at 37 °C for 48 h. Proteins were extracted directly from colonies and analysed using the Bruker MALDI Biotyper system. Spectra were compared against FF_4.0 and MSI_2.0 databases, and results were correlated with molecular identification by benA, cmd5, and ITS gene sequencing. The extraction method yielded high-quality spectra with peaks between 2-15 kDa. The FF_4.0 database identified 52.17% of isolates at the section level and none at the species level, reflecting limited spectral compatibility and taxonomic coverage. Conversely, MSI_2.0 correctly identified 82.6% of isolates at the species level, 15.23% at the section level, and only 2.17% were not identified. Concordance between MSI_2.0 and sequencing reached 44.7%, without statistical significance (p = 0.627). The simplified solid-medium extraction method combined with MSI 2.0 proved efficient, reproducible, and suitable for clinical routine, offering faster identification of Aspergillus species compared to conventional methods. In contrast, FF_4.0 showed limited applicability for hospital workflows.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e14"},"PeriodicalIF":1.3,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12919299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229783","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":"Non-feline transmission of sporotrichosis: a systematic review of published cases.","authors":"Pamela Rodríguez-Salgado, Andrés Tirado-Sánchez, Valeria Lyzzete Diaz-Molina, Max Carlos Ramírez-Soto, Flavio Queiroz-Telles, Alexandro Bonifaz","doi":"10.1590/S1678-9946202668016","DOIUrl":"10.1590/S1678-9946202668016","url":null,"abstract":"<p><p>Sporotrichosis is a subcutaneous mycosis caused by species belonging to the genus Sporothrix. While zoonotic transmission has been primarily associated with cats, reports have pointed to sporotrichosis transmission by various non-feline animals, albeit infrequently compared with the aforementioned. These reports suggest the potential for zoonotic or environmentally mediated transmission routes with clinical and epidemiological relevance that have yet to be extensively explored. This systematic review organizes the current knowledge on sporotrichosis acquired by non-feline zoonotic transmission. A comprehensive literature review was conducted from January 1980 to March 2025, leveraging prominent databases like PubMed, SciELO, Web of Science, and EBSCO to identify cases of sporotrichosis transmitted by non-feline animals. A total of 78 cases of sporotrichosis transmitted by non-feline animals were identified in 26 articles. Most cases (76%) were transmitted by vertebrate animals, primarily dogs, whereas 24% were transmitted by invertebrates, such as mosquitoes. Lymphocutaneous presentation predominated among clinical manifestation in 80.7% of cases. Most frequently isolated species was Sporothrix schenckii, whereas Sporothrix brasiliensis was isolated only in infections caused by vertebrate animals. Most patients were young adult males, mainly related with hunting activities. Itraconazole was the most frequently used treatment. Sporotrichosis transmission route via non-feline animals is significant and frequently underestimated. Further research is needed to improve our understanding of the transmission mechanisms, focusing on distinguishing between direct zoonotic transmission and environmental exposure mediated by animal contact. Such enhanced understanding is crucial for improving diagnostic procedures in hyperendemic regions and strengthening epidemiological surveillance.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e16"},"PeriodicalIF":1.3,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12919301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229788","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":"Rezafungin in fluconazole-resistant and refractory candidiasis: the first Brazilian experience.","authors":"Wdson Luis Lima Kruschewsky, Jeanne Aiko de Souza Nakagawa, Lumena Pereira Machado Siqueira, Mariane Taborda, Vítor Falcão de Oliveira, Edson Abdala, Adriana Satie Gonçalves Kono Magri, Marcello Mihailenko Chaves Magri","doi":"10.1590/S1678-9946202668020","DOIUrl":"10.1590/S1678-9946202668020","url":null,"abstract":"<p><p>Invasive candidiasis is associated with high morbidity and mortality, and the rising of antifungal resistance underscores the need for new therapies. Rezafungin, a second-generation echinocandin, enables once-weekly dosing, achieves high plasma concentrations, and shows potent in vitro activity. We report two Brazilian cases showing its clinical utility: (i) fluconazole-resistant Candida tropicalis bloodstream infection in a patient with colorectal cancer and chronic kidney disease and (ii) azole-refractory C. albicans esophagitis in a patient with autoimmune polyglandular syndrome type 1. Both achieved rapid clinical response and microbiological clearance. These are the first documented cases of rezafungin use for invasive candidiasis in Brazil.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e20"},"PeriodicalIF":1.3,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12919916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229765","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":"Fulminant hepatitis secondary to dengue in pediatric patients: a series of four cases.","authors":"Isabelly Victoria Simões Melchiori, Mariana Favero Elias, Jhonny Richard de Sousa, Leonardo Labbate Kalil, João Pedro de Mattos Anacleto, Victor Fernandes Rosa, Ana Cristina Aoun Tannuri","doi":"10.1590/S1678-9946202668015","DOIUrl":"10.1590/S1678-9946202668015","url":null,"abstract":"<p><p>This study reports a case series of four pediatric patients with dengue who developed fulminant hepatitis and acute liver failure requiring transplantation. This study aims to enhance early recognition of dengue-related complications, particularly fulminant hepatitis. The series includes two previously healthy girls, aged one and six years; and two boys, aged 12 and 15 years, with pre-existing hemoglobinopathies. A review was conducted to contextualize these cases with prior reports of dengue-associated fulminant hepatitis in children, focusing on diagnosis and management. All four patients underwent liver transplantation, yet their clinical courses and outcomes were varied. Patient 1, a six-year-old girl, had early warning signs and underwent cadaveric liver transplantation nine days after onset. Patient 2, a one--year-old girl, developed severe disease and received living-donor transplantation 20 days after onset. Both had favorable postoperative outcomes. Patient 3, a 12-year-old boy with SC hemoglobinopathy, underwent transplantation on day seven of illness but died on the fifth postoperative day. Patient 4, a 15-year-old boy with sickle cell anemia, underwent transplantation on day four of symptoms but suffered multiple cardiorespiratory arrests during recovery and died on postoperative day 24. Although rare, dengue can lead to fulminant hepatitis in previously healthy children, with worse outcomes in those with comorbidities. Early recognition of severe manifestations is critical for appropriate management. Larger studies are warranted to identify prognostic factors and optimize decision-making for pediatric patients requiring liver transplantation.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e15"},"PeriodicalIF":1.3,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12919304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229793","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":"Yellow fever virus resurgence in Sao Paulo State, Brazil, 2024-2025.","authors":"Mariana Sequetin Cunha, Juliana Mariotti Guerra, Márcio Junio Lima Siconelli, Benedito Antonio Lopes da Fonseca, Jessica Caroline de Almeida Dias, Gisele Dias de Freitas, Ester Cerdeira Sabino, Erika Regina Manuli, Geovana Maria Pereira, Ian Nunes Valença, Patrícia Sayuri Silvestre Matsumoto, Nuno Rodrigues Faria, Natália Coelho Couto de Azevedo Fernandes","doi":"10.1590/S1678-9946202668013","DOIUrl":"10.1590/S1678-9946202668013","url":null,"abstract":"<p><p>We report the detection of yellow fever virus in Campinas and Ribeirao Preto city areas (two geographic areas within Sao Paulo State, Brazil) from September 2024 to February 2025. Phylogenetic analysis of six new genomes showed a re-introduction in 2022 from Midwest Brazil followed by persistence in Sao Paulo State. Continued surveillance in neotropical primates is required to prevent cases in humans.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e13"},"PeriodicalIF":1.3,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12919302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229889","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":"Streptococcus suis infection as an emerging zoonotic threat in Brazil: a One Health-based review.","authors":"Luís Arthur Brasil Gadelha Farias, Osvaldo Mariano Viana Neto, Ednaldo Pereira Lima Sobrinho, Antonio Gutierry Neves Dantas de Melo, Isabela Melo Pontes, Bruna Batista Schmid Gonçalves, Helena Pinheiro Benevides, Susana Pereira de Oliveira Maia, Jorge Luiz Nobre Rodrigues, Lauro Vieira Perdigão Neto","doi":"10.1590/S1678-9946202668019","DOIUrl":"10.1590/S1678-9946202668019","url":null,"abstract":"<p><p>Streptococcus suis infection is an emerging zoonotic pathogen of growing concern in Brazil, particularly in the Northeast-a region lacking swine-focused surveillance. Although human contamination remains rare, they have been increasingly reported among individuals exposed to pigs or pork products, and most commonly present as central nervous system infections. Diagnostic challenges persist, especially related to culture-based methods, highlighting the need for advanced molecular tools like polymerase chain reaction and metagenomic Next-Generation Sequencing. Veterinary data reveal a high diversity of serotypes and concerning rates of antimicrobial resistance. These studies remain scarce in regions with reports of human infection. This review highlights the clinical, epidemiological, and microbiological aspects of S. suis in Brazil and underscores the importance of One Health approaches to enhance detection and prevention.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e19"},"PeriodicalIF":1.3,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12919919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229910","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":"Occlusion body-incorporated SARS-CoV-2 S-RBD via cypovirus polyhedrin-derived peptide: a novel insect cell-expressed antigen for high-accuracy COVID-19 diagnosis, and humoral immune response and hybrid immunity evaluation.","authors":"Murilo Barros-Silveira, Fabricio da Silva Morgado, Laurine Lacerda Pigosso, Fernanda Cortez Roriz Pontes, Ethiane Rozo Dos Santos, Rosana Pereira Morais, Yves Mauro Fernandes Ternes, Célia Maria de Almeida Soares, Bergmann Morais Ribeiro, Fátima Ribeiro-Dias","doi":"10.1590/S1678-9946202668012","DOIUrl":"10.1590/S1678-9946202668012","url":null,"abstract":"<p><p>Accurate serological assays are critical for monitoring antibody responses to SARS-CoV-2 and for assessing vaccine efficacy. In this study, we engineered a recombinant baculovirus to express the SARS-CoV-2 spike receptor-binding domain (RBD) fused to an N-terminal peptide of cypovirus polyhedrin (S-RBD-POLH), thereby enabling its potential encapsulation within occlusion bodies. The construct was expressed in insect cells and employed to establish an in-house enzyme-linked immunosorbent assay (ELISA-S) for COVID-19 diagnosis and evaluation of the humoral immune response to SARS-CoV-2. We compared the performance of ELISA-S with a commercial lateral flow immunoassay (LFIA), a chemiluminescence immunoassay (CLIA), and an in-house ELISA targeting Escherichia coli-produced nucleocapsid (N) protein (ELISA-N). Both in-house ELISAs had excellent diagnostic performance (overall accuracy = 0.90), with ELISA-S achieving 98.9% sensitivity and 100% specificity. Inter-assay concordance was high (kappa coefficient > 0.92), with near-perfect agreement between ELISA-S and LFIA (kappa = 0.99). Longitudinal analysis revealed increasing anti-RBD IgG titers over time, in contrast to declining anti-N IgG levels, consistent with expected post-infection kinetics. Moreover, ELISA-S reliably detected antibodies in individuals with hybrid immunity across different periods of the pandemic. These findings establish a scalable platform for antigen encapsulation and production in insect cells to enhance antibody detection. The ELISA-S system represents a robust and adaptable approach for evaluating humoral immunity following infection, vaccination, or hybrid immunity, and can be used for all variants.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e12"},"PeriodicalIF":1.3,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12919303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229738","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":"Molecular identification of Bartonella henselae in dogs with clinical suspicion of visceral leishmaniasis.","authors":"Verônica Domingos Miranda, Luciene Silva Dos Santos, Mariana Medeiros Torres, Osvaldo Campos Dos Santos Nonato, Adriano Cappellazzo Coelho, Paulo Eduardo Neves Ferreira Velho, Marina Rovani Drummond","doi":"10.1590/S1678-9946202668018","DOIUrl":"10.1590/S1678-9946202668018","url":null,"abstract":"<p><p>The genus Bartonella includes species responsible for severe infections. Bartonella henselae, commonly linked to human disease, also infects dogs with or without symptoms. In Brazil, visceral leishmaniasis (VL) caused by Leishmania infantum is prevalent in Mato Grosso State, Brazil, particularly in Rondonopolis city, affecting both humans and dogs. Although reports of co-infection with Bartonella spp. and L. infantum exist in other countries, Brazilian studies are scarce. This study investigates the presence of B. henselae using culture and molecular methods in dogs suspected of having VL in Rondonopolis, while also assessing potential co-infections and evaluating diagnostic limitations of VL. Results showed B. henselae DNA in 53.75% (43/80) of these dogs, with Leishmania spp. DNA found in 65.11% (28/43) of them. Of the 80 dogs, 43.75% (35) lacked VL serological confirmation, yet 48.57% (17/35) were positive for B. henselae. This is the first report of B. henselae bacteremia in dogs from Rondonopolis. The high occurrence of dogs with clinical VL suggests a need for further research to understand the bacterium's role in VL-suspected cases, regardless of diagnostic confirmation. The study highlights a significant finding: approximately half of the dogs suspected of zoonotic parasitosis, with or without serological confirmation, were infected with B. henselae. Additionally, the detection of Leishmania sp. DNA in dogs not confirmed by Brazil's Health Department serological criteria suggests that these diagnostic standards may need reevaluation by health authorities, though caution is warranted due to the limitations of blood-based PCR for Leishmania sp. detection.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e18"},"PeriodicalIF":1.3,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12919914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229779","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":"Reflections on the study \"Central sterile supply department management on hospital-associated infections: a systematic review and meta-analysis\" by Shuai et al.","authors":"Eliane Molina Psaltikidis","doi":"10.1590/S1678-9946202668011","DOIUrl":"10.1590/S1678-9946202668011","url":null,"abstract":"","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e11"},"PeriodicalIF":1.7,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12863464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121064","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}