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da Silva GAR, Eyer-Silva WA, de Azevedo MCVM. The flip-flops sandal sign: A semiotic evidence of chronic venous insufficiency in patients with stasis dermatitis. Int Wound J 2023; 21:e14472. [PMID: 37921039 PMCID: PMC10898410 DOI: 10.1111/iwj.14472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 10/16/2023] [Indexed: 11/04/2023] Open
Affiliation(s)
- Guilherme Almeida Rosa da Silva
- Department of General Medicine, Hospital Universitário Gaffrée e Guinle (UNIRIO), Rio de Janeiro, Brazil
- Department of Neglected Diseases, Instituto de Ciência, Tecnologia e Inovação de Maricá (ICTIM), Rio de Janeiro, Brazil
| | - Walter A Eyer-Silva
- Department of General Medicine, Hospital Universitário Gaffrée e Guinle (UNIRIO), Rio de Janeiro, Brazil
| | - Marcelo Costa Velho Mendes de Azevedo
- Department of General Medicine, Hospital Universitário Gaffrée e Guinle (UNIRIO), Rio de Janeiro, Brazil
- Department of Neglected Diseases, Instituto de Ciência, Tecnologia e Inovação de Maricá (ICTIM), Rio de Janeiro, Brazil
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Eyer-Silva WDA, Wutke LSC, Paiva ADCM, Silva GARD, Ferry FRDA, Signorini DJHP, Oliveira JGD, Lemos ERS. A case of Bartonella neuroretinitis with macular star diagnosed by clinical, epidemiological, serological, and molecular data: resolution after initiation of antimicrobial therapy. Rev Soc Bras Med Trop 2020; 53:e20190516. [PMID: 32578704 PMCID: PMC7310359 DOI: 10.1590/0037-8682-0516-2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 04/14/2020] [Indexed: 11/22/2022] Open
Abstract
The differential diagnosis of optic neuritis is broad and varied. We report the case of a 24-year-old Brazilian man who presented with five-week history of fever, malaise, myalgia, severe fatigue, tender right preauricular lymphadenopathy, and acute vision blurring associated with right optic disc swelling and exudates in a macular star pattern. His illness developed soon after an infestation of fleas broke out among his cats. Diagnosis of ocular bartonellosis was confirmed by serological and molecular analyses targeting amplification of Bartonella spp. htrA gene. Signs and symptoms only improved after initiation of antimicrobial therapy.
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Eyer-Silva WDA, Rosa da Silva GA, Martins CJ. A Challenging Case of Disseminated Subcutaneous Mycosis from Inner Rio de Janeiro State, Brazil. Am J Trop Med Hyg 2019; 97:1280-1281. [PMID: 29140239 PMCID: PMC5817779 DOI: 10.4269/ajtmh.17-0361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Walter de Araujo Eyer-Silva
- Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Guilherme Almeida Rosa da Silva
- Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Carlos José Martins
- Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
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Eyer-Silva WDA, Oliveira TCD, Carvalho RDS, Carvalho-Rangel ID, Basílio-de-Oliveira RP, Araujo LFD, Silva GARD, Neves-Motta R. Gastric cryptococcosis: an unusual presentation of a common opportunistic disorder. Rev Inst Med Trop Sao Paulo 2019; 61:e10. [PMID: 30785564 PMCID: PMC6376925 DOI: 10.1590/s1678-9946201961010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 01/02/2019] [Indexed: 10/27/2022] Open
Affiliation(s)
- Walter de Araujo Eyer-Silva
- Universidade Federal do Estado do Rio de Janeiro, Centro de Ciências Biológicas e da Saúde, Hospital Universitário Gaffrée e Guinle, 10ª Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thaynny Cândida de Oliveira
- Universidade Federal do Estado do Rio de Janeiro, Centro de Ciências Biológicas e da Saúde, Hospital Universitário Gaffrée e Guinle, 10ª Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ricardo de Souza Carvalho
- Universidade Federal do Estado do Rio de Janeiro, Centro de Ciências Biológicas e da Saúde, Hospital Universitário Gaffrée e Guinle, 10ª Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Isabelle de Carvalho-Rangel
- Universidade Federal do Estado do Rio de Janeiro, Centro de Ciências Biológicas e da Saúde, Hospital Universitário Gaffrée e Guinle, 10ª Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rodrigo Panno Basílio-de-Oliveira
- Universidade Federal do Estado do Rio de Janeiro, Centro de Ciências Biológicas e da Saúde, Hospital Universitário Gaffrée e Guinle, Serviço de Anatomia Patológica, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luciana Ferreira de Araujo
- Universidade Federal do Estado do Rio de Janeiro, Centro de Ciências Biológicas e da Saúde, Hospital Universitário Gaffrée e Guinle, Serviço de Anatomia Patológica, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Guilherme Almeida Rosa da Silva
- Universidade Federal do Estado do Rio de Janeiro, Centro de Ciências Biológicas e da Saúde, Hospital Universitário Gaffrée e Guinle, 10ª Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rogério Neves-Motta
- Universidade Federal do Estado do Rio de Janeiro, Centro de Ciências Biológicas e da Saúde, Hospital Universitário Gaffrée e Guinle, 10ª Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil
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Eyer-Silva WA, de Azevedo MCVM, da Silva GAR, Basílio-de-Oliveira RP, de Araujo LF, do Lago IV, Pereira FCF, Fernandes MBT, Figueiredo-Carvalho MHG, Souza Rabello VBD, Zancopé-Oliveira RM, Almeida-Paes RD, Ferry FRDA, Neves-Motta R. Palate ulcer, uvular destruction and nasal septal perforation caused by Sporothrix brasiliensis in an HIV-infected patient. Med Mycol Case Rep 2018; 23:16-19. [PMID: 30479942 PMCID: PMC6243021 DOI: 10.1016/j.mmcr.2018.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 10/29/2018] [Accepted: 11/08/2018] [Indexed: 01/19/2023] Open
Abstract
Sporotrichosis is a human and animal disease caused by dimorphic pathogenic species of the genus Sporothrix. We report a dramatic presentation of Sporothrix brasiliensis infection, with destruction of the nasal septum, soft palate, and uvula of an HIV-infected woman. She was successfully treated with amphotericin B deoxycholate followed by itraconazole. Sporotrichosis remains a neglected opportunistic infection in patients with AIDS and awareness of this potentially fatal infection is of utmost importance.
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Affiliation(s)
- Walter A. Eyer-Silva
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
- Corresponding author.
| | - Marcelo Costa Velho Mendes de Azevedo
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
| | - Guilherme Almeida Rosa da Silva
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
| | - Rodrigo Panno Basílio-de-Oliveira
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
| | - Luciana Ferreira de Araujo
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
| | - Isabela Vieira do Lago
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
| | - Franciele Cristina Ferreira Pereira
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
| | - Miriã Boaretto Teixeira Fernandes
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
| | | | - Vanessa Brito de Souza Rabello
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brazil 4365, 21040-900 Rio de Janeiro, Brazil
| | - Rosely Maria Zancopé-Oliveira
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brazil 4365, 21040-900 Rio de Janeiro, Brazil
| | - Rodrigo de Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brazil 4365, 21040-900 Rio de Janeiro, Brazil
| | - Fernando Raphael de Almeida Ferry
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
| | - Rogério Neves-Motta
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, 20270-004 Rio de Janeiro, Brazil
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Silva GARD, Motta HLDSN, Souza EFAD, Cardoso PANM, Pilotto JH, Eyer-Silva WA, Ribeiro LCP, Santos MSD, Azevedo MCVMD, Pinto JFDC, Motta RN, Ferry FRDA. Chlamydia trachomatis asymptomatic urethritis recurrence among males living with HIV-1. Rev Inst Med Trop Sao Paulo 2018; 60:e65. [PMID: 30379232 PMCID: PMC6201765 DOI: 10.1590/s1678-9946201860065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 09/21/2018] [Indexed: 11/22/2022] Open
Abstract
A prevalence of 3.47% of asymptomatic Chlamydia trachomatis
urethritis has been previously reported among males living with HIV infection in
Brazil. This study aims to assess the recurrence of C.
trachomatis urethritis three years later in the same cohort of
patients and analyze associated risk factors. A total of 115 male patients
diagnosed with HIV infection, with no symptoms of urethritis and observed since
May of 2015 in followup visits were enrolled. They had urine samplers tested by
PCR for C. trachomatis and N. gonorrhoeae
between February and March 2018. Results: Three of the four patients who had
asymptomatic C. trachomatis urethritis three years before were
recurrently positive for C. trachomatis urethritis. Two new
patients were diagnosed as positives, accounting for a total asymptomatic
C. trachomatis urethritis prevalence of 4.34%. The
prevalence during the whole study was 5.21%. The relative risk for a new
urethritis episode among those previously diagnosed with urethritis is RR=41.62
(95% CI: 9.42-183.84), p < 0.01. Patients who presented asymptomatic
urethritis anytime and who were recurrently positive for C.
trachomatis had a lower mean age (p<0.01). Married individuals
were protected regarding asymptomatic urethritis [p<0.01, OR = 0.04
(0.005-0.4)] and had lower risk to develop recurrence [p<0.01, RR = 0.86
(0.74-0.99)]. Illicit drugs users had risk associated to asymptomatic urethritis
[p=0.02, OR= 5.9 (1.03-34)] and higher risk to develop recurrence [p<0.01,
RR=1.1 (1-1.22)]. Conclusion: The recurrence of asymptomatic C.
trachomatis urethritis after treatment among males living with HIV
infection in Brazil can be considered high and should not be neglected.
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Affiliation(s)
- Guilherme Almeida Rosa da Silva
- Universidade Federal do Estado do Rio de Janeiro, Serviço de Clínica Médica, 10ᵃ Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil.,Fundação Oswaldo Cruz, Laboratório de AIDS e Imunologia, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Erik Friedrich Alex de Souza
- Universidade Federal do Estado do Rio de Janeiro, Serviço de Clínica Médica, 10ᵃ Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - José Henrique Pilotto
- Fundação Oswaldo Cruz, Laboratório de AIDS e Imunologia, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Walter Araujo Eyer-Silva
- Universidade Federal do Estado do Rio de Janeiro, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Mônica Soares Dos Santos
- Hospital Universitário Gaffrée e Guinle, Laboratório de Imunologia, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Jorge Francisco da Cunha Pinto
- Universidade Federal do Estado do Rio de Janeiro, Serviço de Clínica Médica, 10ᵃ Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rogerio Neves Motta
- Universidade Federal do Estado do Rio de Janeiro, Serviço de Clínica Médica, 10ᵃ Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil
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de Almeida TB, de Azevedo MCVM, Pinto JFDC, Ferry FRDA, da Silva GAR, de Castro IJ, Baker P, Tanuri A, Haas DW, Cardoso CC. Drug metabolism and transport gene polymorphisms and efavirenz adverse effects in Brazilian HIV-positive individuals. J Antimicrob Chemother 2018; 73:2460-2467. [PMID: 29868865 PMCID: PMC6105872 DOI: 10.1093/jac/dky190] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/13/2018] [Accepted: 04/22/2018] [Indexed: 01/11/2023] Open
Abstract
Objectives There are limited data regarding efavirenz pharmacogenetics in admixed populations. The Brazilian population is highly admixed. In a Brazilian cohort, we sought to characterize associations between efavirenz adverse effects (all-cause and CNS) and polymorphisms in seven genes known or suspected to affect efavirenz metabolism and transport. Methods We studied 225 HIV-positive individuals who had been prescribed efavirenz-containing regimens at a hospital in Rio de Janeiro, Brazil. Eighty-nine cases had efavirenz adverse effects, including 43 with CNS adverse effects, while 136 controls had no adverse effect of any antiretroviral after treatment for at least 6 months. A total of 67 candidate polymorphisms in ABCB1, CYP2A6, CYP2B6, CYP3A4, CYP3A5, NR1I2 and NR1I3 genes were selected for association analysis. Admixture was assessed using 28 ancestry-informative polymorphisms previously validated for the Brazilian population. Associations were evaluated with logistic regression models adjusted for sex and genetic ancestry. Results There was extensive African, European and Native American admixture in the cohort. Increased all-cause adverse effects were associated with the CYP2B6 genotype combination 15582CC-516TT-983TT (OR = 7.26, P = 0.003) and with the CYP2B6 slow metabolizer group 516TT or 516GT-983CT (OR = 3.10, P = 0.04). CNS adverse effects were nominally associated with CYP3A4 rs4646437 (OR = 4.63, P = 0.014), but not after adjusting for multiple comparisons. Conclusions In a highly admixed Brazilian cohort, the CYP2B6 slow metabolizer genotype was associated with an increased risk of efavirenz adverse effects.
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Affiliation(s)
- Tailah Bernardo de Almeida
- Laboratório de Virologia Molecular, Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | - Jorge Francisco da Cunha Pinto
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | | | | | - Izana Junqueira de Castro
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Paxton Baker
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Amilcar Tanuri
- Laboratório de Virologia Molecular, Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - David W Haas
- Vanderbilt University School of Medicine, Nashville, TN, USA
- Meharry Medical College, Nashville, TN, USA
| | - Cynthia C Cardoso
- Laboratório de Virologia Molecular, Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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Eyer-Silva WDA, Souza VPBD, Silva GARD, Brasil FV, Portela ADS, Carvalho RDS, Neves-Motta R, Martins CJ. Secondary syphilis presenting as a corymbiform syphilide: case report and review. Rev Inst Med Trop Sao Paulo 2018; 60:e40. [PMID: 30133600 PMCID: PMC6103325 DOI: 10.1590/s1678-9946201860040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 07/16/2018] [Indexed: 11/23/2022] Open
Abstract
It is essential that healthcare providers are familiar with the full spectrum of
clinical presentations of syphilis. A rare manifestation of secondary syphilis
is the corymbiform (or corymbose) arrangement, in which a central greater papule
is surrounded by smaller satellite lesions. Very few reports of corymbiform
syphilis are available in current biomedical databases. We present the case of a
28 year-old HIV-infected male patient on regular, successful antiretroviral
therapy who developed an asymptomatic corymbiform maculopapular lesion in the
medial aspect of the right thigh. There were also a few brownish macular lesions
on the left sole. New serological tests for syphilis (which had been negative in
the past) were reactive. The coymbiform lesion slowly regressed and the
non-treponemal test reverted to negative after benzathine penicillin G
treatment. A review of the literature is provided. This is the first report of
corymbiform syphilis in an HIV-infected patient.
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Affiliation(s)
- Walter de Araujo Eyer-Silva
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Viviane Primo Basílio de Souza
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Guilherme Almeida Rosa da Silva
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernando Vieira Brasil
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alessandra Dos Santos Portela
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ricardo de Souza Carvalho
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rogerio Neves-Motta
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carlos José Martins
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
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Eyer-Silva WDA, Silva GARD, Ferry FRDA. Olecranon Bursitis, Beau's Lines, Biett's Collarettes, and Crown of Venus. Am J Trop Med Hyg 2018; 96:261-262. [PMID: 28179551 PMCID: PMC5303019 DOI: 10.4269/ajtmh.16-0386] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 10/11/2016] [Indexed: 11/18/2022] Open
Affiliation(s)
- Walter de Araujo Eyer-Silva
- Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Guilherme Almeida Rosa da Silva
- Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Fernando Raphael de Almeida Ferry
- Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
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Eyer-Silva WDA, Azevedo MCVMD, Silva GARD. Oral cavity syphilides. Rev Soc Bras Med Trop 2018; 51:254-255. [DOI: 10.1590/0037-8682-0149-2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 06/19/2017] [Indexed: 11/21/2022] Open
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Silva GARD, Motta HLDSN, Souza EFAD, Cardoso PANM, Pilotto JH, Eyer-Silva WA, Ribeiro LCP, Santos MSD, Azevedo MCVMD, Pinto JFDC, Motta RN, Ferry FRDA. Prevalence of asymptomatic urethritis by Chlamydia trachomatis and Neisseria gonorrhoeae and associated risk factors among males living with HIV-1. Rev Inst Med Trop Sao Paulo 2018. [PMID: 29538508 PMCID: PMC5962100 DOI: 10.1590/s1678-9946201860011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives The increase in HIV transmissibility in non-ulcerative sexually transmitted infection is already well-established. It is estimated that symptomatic carriers of N. gonorrhoeae and C. trachomatis have a relative risk of 4.8-fold and 3.6-fold, respectively, for the sexual acquisition of HIV. This type of evaluation for asymptomatic urethritis is necessary to reinforce strategies to combat HIV transmission. This study aims to assess the prevalence of patients with asymptomatic urethritis among men diagnosed with HIV-1 and determine the risk factors associated with this infection. Methods We enrolled a total of 115 male patients aged 18 years or older who have been diagnosed with HIV infection and have no symptoms of urethritis or other sexually transmitted infections and who have been evaluated between May and August 2015 in a follow-up visit at the Immunology Outpatient Clinic of a Brazilian University Hospital. Results Four asymptomatic patients were positive for C. trachomatis and were considered asymptomatic carriers of urethritis. Prevalence was 3.47%. Patients who were positive for C. trachomatis urethritis had a lower mean age (p = 0.015). Conclusion The presence of asymptomatic sexually transmitted infection is a challenge in clinical practice. We recommend that, in outpatient practice, the habit of inquiring on previous sexual behavior to obtain more information about risks and associations with asymptomatic sexually transmitted infection, a routine physical examination and complementary tests to detect STI pathogens should be performed to discard these conditions. The development of rapid tests for this purpose should also be encouraged.
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Affiliation(s)
- Guilherme Almeida Rosa da Silva
- Universidade Federal do Estado do Rio de Janeiro, Serviço de Clínica Médica 10ª Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Erik Friedrich Alex de Souza
- Universidade Federal do Estado do Rio de Janeiro, Serviço de Clínica Médica 10ª Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - José Henrique Pilotto
- Fundação Oswaldo Cruz, Laboratório de AIDS e Imunologia, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Walter Araujo Eyer-Silva
- Universidade Federal do Estado do Rio de Janeiro, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Mônica Soares Dos Santos
- Hospital Universitário Gaffrée e Guinle, Laboratório de Imunologia, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Jorge Francisco da Cunha Pinto
- Universidade Federal do Estado do Rio de Janeiro, Serviço de Clínica Médica 10ª Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rogerio Neves Motta
- Universidade Federal do Estado do Rio de Janeiro, Serviço de Clínica Médica 10ª Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil
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Affiliation(s)
- Walter de Araujo Eyer-Silva
- Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Fabio Bettini Pitombo
- Departamento de Biologia Marinha, Universidade Federal Fluminense, Niterói, RJ, Brasil
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Eyer-Silva WDA, Azevedo MCVMD, Silva GARD, Neves-Motta R. A malar rash from inner Rio de Janeiro State, Brazil. IDCases 2018; 12:99-100. [PMID: 29942762 PMCID: PMC6010967 DOI: 10.1016/j.idcr.2018.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
A 49-year-old previously healthy woman from Rio de Janeiro State, Brazil, presented with a right malar rash that started as a tiny pustule and progressed to an ulcerated papulonodular lesion within ten weeks. A presumptive diagnosis of zoonotic sporotrichosis was made based on excellent response to treatment and epidemiological linkage with a diseased cat.
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Affiliation(s)
- Walter de Araujo Eyer-Silva
- Corresponding author at: Ambulatório de Alergia & Imunologia Clínica, Hospital Universitário Gaffrée e Guinle, Rua Mariz e Barros, 775, 20270-004 Rio de Janeiro/RJ, Brazil.
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Eyer-Silva WDA, Freire MAL, Silva GARD. Drug-induced hypersensitivity syndrome after initiation of darunavir and raltegravir. Rev Soc Bras Med Trop 2017; 50:575-576. [PMID: 28954087 DOI: 10.1590/0037-8682-0373-2016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 10/21/2016] [Indexed: 11/22/2022] Open
Affiliation(s)
- Walter de Araujo Eyer-Silva
- Centro de Ciências Biológicas e da Saúde, Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Guilherme Almeida Rosa da Silva
- Centro de Ciências Biológicas e da Saúde, Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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15
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Eyer-Silva WDA, Martins CJ, Silva GARD, Acakpovi G, Pinto JFDC. Secondary syphilis presenting as leucoderma syphiliticum: case report and review. Rev Inst Med Trop Sao Paulo 2017; 59:e74. [PMID: 29116294 PMCID: PMC5679686 DOI: 10.1590/s1678-9946201759074] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 08/22/2017] [Indexed: 11/22/2022] Open
Abstract
Leucoderma syphiliticum (LS), originally described as syphilide
pigmentaire, encompasses a spectrum of dyschromic lesions that emerge
during the course of secondary syphilis. Very few case reports are available in
modern biomedical databases. We present the case of a 57-year-old HIV-infected male
patient who presented with several round to oval, non-scaling, slightly raised and
well-demarcated hypochromic lesions scattered over the trunk, abdomen, dorsum, and
arms. Prior non-treponemal tests were negative for syphilis, but novel studies
yielded positive results at high titers. Skin lesions slowly regressed and the
hypochromic areas repigmented a few weeks after benzathine penicillin G treatment.
This is the first report of LS in an HIV-infected patient. A review of modern and
ancient literature was performed. The present case report emphasizes the need for
clinicians to have a heightened awareness of the varied and unusual clinical
phenotypes of syphilis.
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Affiliation(s)
- Walter de Araujo Eyer-Silva
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carlos José Martins
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Guilherme Almeida Rosa da Silva
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Giresse Acakpovi
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jorge Francisco da Cunha Pinto
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
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Eyer-Silva WDA, Soares PEMA, Azevedo MCVMD, Silva GARD, Signorini DJHP, Neves-Motta R, Pinto JFDC, Moura LM, Basílio-de-Oliveira RP, Araujo LFD, Favacho ARDM, Lemos ERS. An unusual case of bacillary angiomatosis in the oral cavity of an AIDS patient who had no concomitant tegumentary lesions - case report and review. Rev Inst Med Trop Sao Paulo 2017; 59:e59. [PMID: 28902296 PMCID: PMC5574626 DOI: 10.1590/s1678-9946201759059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/04/2017] [Indexed: 11/22/2022] Open
Abstract
Bacillary angiomatosis (BA) is an angioproliferative disease of immunocompromised patients that usually presents as vascular tumors in the skin and subcutaneous tissues. It is caused by chronic infections with either Bartonella henselae or B. quintana. Oral cavity BA is exceedingly rare and even rarer without simultaneous cutaneous disease. We report herein the case of a 51-year-old HIV-infected man who presented severe odynophagia and an eroded lesion on the hard palate that progressed to an oronasal fistula. No cutaneous lesions were recorded. Doxycycline led to complete resolution. To the best of our knowledge, only six previous cases of oral BA without tegumentary disease have been previously reported and none of them progressed to fistula.
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Affiliation(s)
- Walter de Araujo Eyer-Silva
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pedro Eugênio Mendes Arena Soares
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcelo Costa Velho Mendes de Azevedo
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Guilherme Almeida Rosa da Silva
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Dario José Hart Pontes Signorini
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rogerio Neves-Motta
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jorge Francisco da Cunha Pinto
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lívia Machado Moura
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rodrigo Panno Basílio-de-Oliveira
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luciana Ferreira de Araujo
- Universidade Federal do Estado do Rio de Janeiro, Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Elba Regina Sampaio Lemos
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Hantaviroses e Rickettsioses, Rio de Janeiro, Rio de Janeiro, Brazil
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Eyer-Silva WDA, Silva GARD, Ferry FRDA, Pinto JFDC. Facial botryomycosis-like pyoderma in an HIV-infected patient: remission after initiation of darunavir and raltegravir. Rev Soc Bras Med Trop 2017; 50:277-279. [PMID: 28562771 DOI: 10.1590/0037-8682-0061-2016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 10/18/2017] [Indexed: 11/21/2022] Open
Abstract
Botryomycosis is an uncommon, chronic, suppurative, bacterial infection that primarily affects the skin and subcutaneous tissues. It has long been associated with defects of cellular immunity. We report a 28-year-old woman who presented with a chronic, ulcerated lesion with draining sinuses in the right malar region. Predisposing factors were HIV infection with poor immunological control, alcoholism, and a previous trauma to the right cheek. Several courses of antimicrobial therapy provided only partial and temporary remission. Complete clinical remission was only achieved 5 years later when a novel antiretroviral regimen composed of darunavir and raltegravir was initiated.
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Affiliation(s)
- Walter de Araujo Eyer-Silva
- Centro de Ciências Biológicas e da Saúde, Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro, RJ, Brasil
| | - Guilherme Almeida Rosa da Silva
- Centro de Ciências Biológicas e da Saúde, Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro, RJ, Brasil
| | - Fernando Raphael de Almeida Ferry
- Centro de Ciências Biológicas e da Saúde, Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro, RJ, Brasil
| | - Jorge Francisco da Cunha Pinto
- Centro de Ciências Biológicas e da Saúde, Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro, RJ, Brasil
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de Castro IJ, da Silva EBS, Dos Santos TR, de Freitas AB, de Castro IJ, Portela AS, de Magalhães MC, Pires KL, da Silva GAR, de Azevedo MCVM. T-Cell Lymphoma in a Patient with Neurofibromatosis Type 1 and AIDS. Case Rep Oncol 2017; 10:161-168. [PMID: 28413392 PMCID: PMC5346920 DOI: 10.1159/000456029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 01/12/2017] [Indexed: 11/19/2022] Open
Abstract
Neurofibromatosis type 1 (NF1) and AIDS are risk factors for the development of malignant neoplasms, including hematological malignancies, such as non-Hodgkin lymphoma. NF1 is an autosomal dominant disease that primarily manifests as café-au-lait spots, dermal neurofibromas, axillary and/or inguinal ephelides or freckles, plexiform neurofibromas, Lisch nodules, and bone deformities. In this report, we present a 38-year-old female patient with NF1 from childhood and AIDS who developed peripheral T-cell lymphoma with good response to chemotherapeutic treatment.
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Affiliation(s)
| | | | | | | | | | | | | | - Karina Lebeis Pires
- Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
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Eyer-Silva WDA, Pinto HDB, Silva GARD, Ferry FRDA. A case of chikungunya virus disease presenting with remarkable acute arthritis of a previously damaged finger joint. Rev Soc Bras Med Trop 2017; 49:790-792. [PMID: 28001232 DOI: 10.1590/0037-8682-0204-2016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 08/08/2016] [Indexed: 11/21/2022] Open
Abstract
Chikungunya virus (CHIKV) is a mosquito-borne arthritogenic alphavirus that has recently been introduced to Brazil. We report the case of a 36-year-old male patient from the City of Rio de Janeiro who developed molecularly-confirmed CHIKV disease and whose clinical picture was remarkable because of acute arthritis of an interphalangeal joint that had been damaged by trauma 8 years previously. This case illustrates that acute CHIKV disease may preferentially target previously damaged joints. Careful study of individual cases may provide valuable information on the presentation and management of this emerging zoonosis in Brazil.
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Affiliation(s)
- Walter de Araujo Eyer-Silva
- Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Guilherme Almeida Rosa da Silva
- Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernando Raphael de Almeida Ferry
- Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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Eyer-Silva WDA, Santana AC, Silva GARD, Azevedo MCVMD, Barreto JLTMS, Neumann MA, Castro IJD, Basílio-de-Oliveira RP, Araujo LFD, Ré NZ, Oliveira FMD, Simas CJDA, Sarvat MAD, Ferry FRDA. Laryngeal paracoccidioidomycosis presenting as solitary true vocal fold disease. IDCases 2017; 10:71-74. [PMID: 28966914 PMCID: PMC5608563 DOI: 10.1016/j.idcr.2017.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 09/10/2017] [Accepted: 09/12/2017] [Indexed: 11/13/2022] Open
Abstract
Paracoccidioidomycosis (PCM) is a systemic granulomatous disease caused by Paracoccidioides brasiliensis or P. lutzii. It is a neglected tropical infectious disease that poses a major public health burden in endemic areas of Latin America. Mucosae of the upper digestive and respiratory tracts are commonly involved and many patients have disease at multiple mucosal sites, with or without lung involvement. Mucosal PCM presenting as solitary true vocal fold disease is relatively rare. We present the case of a 67-year-old Brazilian forest guard who presented with a 6-month history of hoarseness and globus pharyngeus due to a solitary left true vocal fold infiltration and vegetation diagnosed as PCM. Silent pulmonary disease was also present. A laryngoscopy video is offered as supplemental material to this report. He completely remitted after surgical removal and amphotericin B deoxycholate treatment.
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Silva GARD, Eyer-Silva WDA, Magalhães MCD, Ferry FRDA, Pinto JFDC, Azevedo MCVMD, Neves-Motta R, Athayde CCD, Jordão P, Basílio-de-Oliveira RP, Lyra MR, Fagundes A, Pimentel MI, Pacheco RDS, Madeira MDF, Marzochi MCDA. A novel case of human visceral leishmaniasis from the urban area of the city of Rio de Janeiro: autochthonous or imported from Spain ? Rev Inst Med Trop Sao Paulo 2017; 59:e11. [PMID: 28380112 PMCID: PMC5441152 DOI: 10.1590/s1678-9946201759011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 01/20/2017] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | - Pablo Jordão
- Universidade Federal do Estado do Rio de Janeiro, Brazil
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Eyer-Silva WDA, Silva GARD, Neves-Motta R. Two cases of lepidopterism caused by indoor exposure to moths. Rev Soc Bras Med Trop 2016; 49:393. [DOI: 10.1590/0037-8682-0345-2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 11/23/2015] [Indexed: 11/21/2022] Open
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Silva GARD, Neto JSP. [Whipple's disease manifested as difficult-to-diagnose polyarthralgia: a case report and literature review]. Rev Bras Reumatol 2015; 57:S0482-5004(15)00059-5. [PMID: 26066295 DOI: 10.1016/j.rbr.2014.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 09/14/2014] [Accepted: 12/07/2014] [Indexed: 11/27/2022] Open
Abstract
Whipple's disease is a rare and multisystemic bacterial disease caused by the Gram-positive bacillus Tropheryma whipplei. Since it is a rare disease with a varied clinical presentation, its diagnosis is often delayed. The joint manifestations may precede the typical syndrome in decades, being a challenge for specialists and internists. We report a case of Whipple's disease in a man with polyarthralgia whose diagnosis was established after extensive clinical deterioration over five years.
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Silva GARD, Andrade MCT, Sugui DDAS, Nunes RF, Pinto JFDC, Eyer Silva WDA, Ferry FRDA, Azevedo MCVMD, Motta RN. Association between antiretrovirals and thyroid diseases: a cross-sectional study. Arch Endocrinol Metab 2015; 59:116-22. [PMID: 25993673 DOI: 10.1590/2359-3997000000023] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 12/12/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study aims to estimate the prevalence of thyroid diseases and anti-TPO status. We searched for an association among presence of immune reconstitution and use of stavudine, didanosine and protease inhibitors with thyroid diseases. MATERIALS AND METHODS A cross-sectional study was performed to analyze the records of 117 HIV-infected patients who had their CD4+ cell count, viral load, anti-TPO, TSH and free T4 levels collected on the same day. Immune reconstitution was considered in those whose T CD4+ count was below 200 cells/mm3, but these values increased above 200 cells/mm3 after the use of antiretrovirals. The odds ratio obtained by a 2x2 contingency table and a chi-square test were used to measure the association between categorical variables. RESULTS The prevalence of thyroid disease was 34.18%; of these, 4.34% were positive for anti-TPO. There was an association of risk between stavudine use and subclinical hypothyroidism (OR = 4.19, 95% CI: 1.29 to 13.59, X2 = 6.37, p = 0.01). Immune reconstitution achieved protection associated with thyroid disease that was near statistical significance OR = 0.45, 95% CI: 0.19 to 1.04, X2 = 3.55, p = 0.059. CONCLUSION The prevalence of thyroid disease in the sample studied was higher than what had been found in the literature, with a low positive anti-TPO frequency. The historical use of stavudine has an association of risk for the presence of subclinical hypothyroidism, and immune reconstitution has trends towards protection for the presence of thyroid diseases.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Rogerio Neves Motta
- Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Silva GARD, Boechat TDO, Ferry FRDA, Pinto JFDC, Azevedo MCVMD, Carvalho RDS, Motta RN, Veras MF. First case of autochthonous human visceral leishmaniasis in the urban center of Rio de Janeiro: case report. Rev Inst Med Trop Sao Paulo 2014; 56:81-4. [PMID: 24553614 PMCID: PMC4085831 DOI: 10.1590/s0036-46652014000100013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 05/23/2013] [Indexed: 11/22/2022] Open
Abstract
Visceral leishmaniasis is an anthropozoonosis that is caused by protozoa
of the genus Leishmania, especially Leishmania
(Leishmania) infantum, and is transmitted to
humans by the bite of sandflies of the genus Lutzomyia, such as
Lutzomyia longipalpis. There are many reservoirs, including
Canis familiaris. It is a chronic infectious disease with
systemic involvement that is characterized by three phases: the initial period, the
state period and the final period. The main symptoms are fever, malnutrition,
hepatosplenomegaly, and pancytopenia. This article reports a case of a patient
diagnosed with visceral leishmaniasis in the final period following autochthonous
transmission in the urban area of Rio de Janeiro. The case reported here is
considered by the Municipal Civil Defense and Health Surveillance of Rio de Janeiro
to be the first instance of autochthonous visceral leishmaniasis in humans in the
urban area of this city. The patient was discharged and is undergoing a follow-up at
the outpatient clinic, demonstrating clinical improvement.
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Affiliation(s)
| | - Thiago de Oliveira Boechat
- HEMORIO, Rio de JaneiroRJ, Brazil, HEMORIO, Resident physician, Hematology, Rio de Janeiro, RJ, Brazil. E-mail:
| | | | - Jorge Francisco da Cunha Pinto
- UNIRIO, Rio de JaneiroRJ, Brazil, UNIRIO, Professor of Internal Medicine, Rio de Janeiro, RJ, Brazil. E-mails: ; ; ; ; ;
| | | | - Ricardo de Souza Carvalho
- UNIRIO, Rio de JaneiroRJ, Brazil, UNIRIO, Professor of Internal Medicine, Rio de Janeiro, RJ, Brazil. E-mails: ; ; ; ; ;
| | - Rogerio Neves Motta
- UNIRIO, Rio de JaneiroRJ, Brazil, UNIRIO, Professor of Internal Medicine, Rio de Janeiro, RJ, Brazil. E-mails: ; ; ; ; ;
| | - Mariana Ferreira Veras
- UNIRIO, Rio de JaneiroRJ, Brazil, UNIRIO, Student of Medicine, Rio de Janeiro, RJ, Brazil. E-mail:
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Silva GARD, Pires KL, Soares DCDS, Ferreira MR, Ferry FRDA, Motta RN, Azevedo MCVMD. RRH: envenoming syndrome due to 200 stings from Africanized honeybees. Rev Inst Med Trop Sao Paulo 2013; 55:61-4. [PMID: 23328728 DOI: 10.1590/s0036-46652013000100011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 08/06/2012] [Indexed: 11/22/2022] Open
Abstract
Envenoming syndrome from Africanized bee stings is a toxic syndrome caused by the inoculation of large amounts of venom from multiple bee stings, generally more than five hundred. The incidence of severe toxicity from Africanized bee stings is rare but deadly. This report reveals that because of the small volume of distribution, having fewer stings does not exempt a patient from experiencing an unfavorable outcome, particularly in children, elderly people or underweight people.
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Affiliation(s)
- Guilherme Almeida Rosa da Silva
- Nacional School of Medicine and Surgery, Federal University of Rio de Janeiro State//Gaffrée e Guinle Universitary Hospital, Rua Mariz e Barros 775, Tijuca, 20270-004 Rio de Janeiro, RJ, Brazil.
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27
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Silva GARD, Motta RN, Carvalho RDS, Lupi O, Azevedo MCVMD, Ferry FRDA. Cutaneous tuberculous gummas in a patient with polymyositis. An Bras Dermatol 2013; 88:98-101. [PMID: 23539011 PMCID: PMC3699946 DOI: 10.1590/s0365-05962013000100013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Accepted: 01/15/2012] [Indexed: 11/29/2022] Open
Abstract
Metastatic tuberculous abscesses or cutaneous tuberculous gummas occur mostly by reactivation of ancient cutaneous foci and is triggered mainly by pharmacological immunosuppression, diabetes mellitus, alcoholism or acquired immunodeficiency syndrome. The present case report refers to a 33-year-old male patient with polymyositis and a previous diagnosis of treated pulmonary tuberculosis. He presented cutaneous abscesses and fever months after the tuberculosis regimen. The patient was diagnosed as metastatic tuberculous abscesses associated with immunosuppression as result of polymyositis treatment.
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Affiliation(s)
- Guilherme Almeida Rosa da Silva
- Teaching Hospital, Federal University of Rio de Janeiro (Hospital Universitário Gaffrée e Guinle. Universidade Federal do Estado do Rio de Janeiro - HUGG-UNIRIO), Rio de Janeiro, RJ, Brazil
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