[Usefulness of routine investigation of fungal infections through bronchoscopy in HIV-infected and non-HIV-infected patients in a general hospital, reference to AIDS]

[Paracoccidioidomycosis at Brasilias university hospital]

Seventy-six paracoccidioidomycosis patients attended at the university hospital of Brasília from 1984 to 2005 were studied. 82.9% were male and the mean age was 42 years. 54.9% of the patients were engaged in farming activities. Among the patients with the chronic form, 87% were smokers and 55.3% consumed alcohol. Among 71 patients without HIV/AIDS coinfection: a) paracoccidioidomycosis was recurrent in 21 (29.6%); b) the chronic or mixed form affected 77.5% of patients, predominantly in the oropharynx (70.9%) and lungs (67.3%), with lymph node lesions in 29.8%, laryngeal lesions in 27.3% and cutaneous lesions in 16.4%; c) in the acute/subacute form, lymph node lesions predominated (81.3%), followed by cutaneous lesions in 43.8%, which resulted in severe disease in 62.5% and moderate disease in 37.5%. Five patients had HIV/AIDS coinfection and three of them presented disseminated fungal infection together with marked immunosuppression.

Bronchoscopy in children in South America

Bronchoscopy is an important tool in the study of the airway. Diagnostic and therapeutic uses are well described in the literature and standardisation of the technique is well defined. Most relevant publications on bronchoscopy come from Europe and the United States, and in some countries they are used as guidelines for local hospitals. In spite of the limited experience published from South America, and the scarcity of financial resources, important information and research pathways have been developed in paediatric bronchoscopy. The information in this review was compiled from local publications, case reports, review articles, brief reports and congress presentations to provide an overview and share the experience about bronchoscopy in South American children.

[Disseminated histoplasmosis and AIDS. The role of culture medium for the bronchoscopic clinical specimens]

Fiberoptic bronchoscopy is a useful procedure in the diagnosis of histoplasmosis, when the clinical material is adequately processed. Ten cases of disseminated histoplasmosis in patients with AIDS are presented here, with a mycological evaluation in culture, Mycosel and Sabouraud's chloramphenicol agar of clinical specimens obtained through fiberoptic bronchoscopy. The yield of Mycosel culture was 60%, while in Sabouraud's chloramphenicol agar it was 20%, supporting the importance of selective medium in the isolation of Histoplasma capsulatum var capsulatum from potentially contaminated clinical specimens, as well as the importance of clinical information for the laboratory as the key for a correct diagnosis.