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Postgrad Med J. Focaccia R coord. Hepatites Virais.
In: Veronesi R, Focaccia R. Tratado de Infectologia. Differential diagnosis of acute liver failure in India. Ann Hepatol. Clin Infect Dis. Prognostic factors of death in leptospirosis: a prospective cohort study in Khon Kaen, Thailand.
Int J Infect Dis. Risk factors for mortality in patients with leptospirosis during an epidemic in northern Kerala. Natl Med J India. Tantitanawat S, Tanjatham S. Prognostic factors associated with severe leptospirosis. Currently, surgical removal is the therapeutic procedure of choice in initial cases.
Despite the existing data and studies to date, the active immune mechanisms in this infection and its involvement in the control or development of lacaziosis have not been fully clarified.
In recent years, little progress has been made in the appraisal of the epidemiologic aspects of the disease. So far, we have neither a population-based study nor any evaluation directed to the forest workers. Keywords: infection, Lacazia loboi, lobomycosis, lacaziosis, mycosis Introduction Lobomycosis is a fungal infection caused by Lacazia loboi. This disease affects primarily the subcutaneous tissue manifested by a chronic granulomatous reaction, full of parasites, in the dermis.
Keloid-like lesions are the most common clinical presentation. This new context expands the possibility of lobomycosis to every coastal region in which those cetaceans are found, raising the need for clinicians to recognize this emerging fungal infection.
Etiology The first case report of lobomycosis was done in by the Brazilian dermatologist Jorge Lobo. This report was about a year-old man who lived in the site region and who presented with sacral lesions resembling keloid. Lobomycosis is the correct name for this disease. Reproduction with simple gemmulation, without exporulation, forms the blastoconidia and leads to the typical rosary bead figures. Trauma is considered the pivotal event. It is believed that La. This cytokine is expressed in histiocytes and multinucleated giant cells and diffuses in the inflammatory infiltrate of patients with lobomycosis.
It is possible that CD8 T lymphocytes or natural killer cells exert a cytotoxic effect by lysing macrophages infected with the fungus through a mechanism dependent on exocytosis of granules containing perforin and granzyme, similar to what occurs in other infectious diseases.
Nowadays it is not possible to identify sub-clinical lobomycosis due to lack of a specific and reliable antigen. Lobina, once used for this purpose, lacks specificity and may present cross reaction with other agents such as P.
Because there is no way to correctly identify cases of lobomycosis infection, at this time it is not possible to know the exact number of infected people or the percentage of them that present with the disease. Reports of regional lymph node enlargement and lymphatic spread of the disease have both been described, and supports this hypothesis.
It is not known, however, how many patients evolve with lymphatic disease. Repetitive traumatism cannot be discarded in many cases because the patient is still under the epidemiologic risk of being infected. There is only one reported case of systemic lesion caused by possible L. Human transmission has never occurred, although experimental autoinoculation and accidental inoculation both have been reported.
Those climatic characteristics are found in the tropical region of the site basin, where most of the cases have been described. Until that time, it mainly affected male forest workers. By , only 3 of human cases had been published outside the site basin. The identification of the disease in dolphins was first made in the bottlenose dolphin Tursiops truncatus from the Atlantic coast of the United States at the Gulf of Mexico; 55 it is also endemic in Florida coastal estuaries.
The disease also affects the Guyana dolphin Sotalia guianensis from the Suriname River. Identification of Leptospira species in the pathogenesis of uveitis and determination of clinical ocular characteristics in South India. Sporadic anicteric leptospirosis in South Vietnam.
Ann Intern Med ; Leptospirosis in the United States. Analysis of cases in man, , N Engl J Med ; Haemorrhagic pneumonitis: a rare presentation of leptospirosis.
J Postgrad Med ; Pulmonary manifestations of leptospirosis.
Rev Infect Dis ; 9. Clinical spectrum of pulmonary involvement in leptospirosis in a region of endemicity, with quantification of leptospiral burden. Leptospirosis in pregnancy and its effect on the fetus: case report and review.
Detection of leptospiras in urine by PCR for early diagnosis of leptospirosis. J Clin Microbiol ; Detection of Leptospira DNA by polymerase chain reaction in aqueous humor of a patient with unilateral uveitis. Placebo-controlled trial of intravenous penicillin for severe and late leptospirosis. Lancet Feb 27; 1 : Ceftriaxone compared with sodium penicillin G for treatment of severe leptospirosis.
An open, randomized, controlled trial of penicillin, doxycycline, and cefotaxime for patients with severe leptospirosis. Clinical observation and treatment of leptospirosis. J Infect Chemother ; 7: The Jarisch-Herxheimer reaction in leptospirosis: possible pathogenesis and review.
Rev Infect Dis ; Leptospirosis complicated by a Jarisch-Herxheimer reaction and adult respiratory distress syndrome: Case Report. Antibiotics for treating leptospirosis. No: CD DOI: