Liseloth Garrido - Academia.edu (original) (raw)
Papers by Liseloth Garrido
Dermatología Venezolana, 1995
International Journal of Dermatology, Jun 1, 1996
A 25-year-old woman apparently healthy until 1 year earlier when sbe started to present with coug... more A 25-year-old woman apparently healthy until 1 year earlier when sbe started to present with cough productive of mucus, dysphonia, dysphagia for solid foods, a weight loss of unknown magnitude, secondary amenorrhea for 8 months, and a vulvoperineal ulcer detected by the patient 2 months before hospitalization. She denies tuberculosis contacts and her family history was not relevant. Her obstetric background reveals tbree full-term pregnancies. Pbysical examination: height 1.48 m; weight 33 kg (ideal weight: 45 kg); a BCG scar on the left arm; and a granuiomatous plaque on tbe soft palate measuring 1x1 cm in diameter. Multiple small lympb nodes that were mobile, were palpable, not painful, and located in the laterocervical region bilaterally. On the genitalia, enlargement of the labia majora and an ulcer in the right perineal region, 5 x 5 cm in diameter, with excavated borders and sero-yellowish secretion on its surface (Fig. 1) were present. With a speculum, a polypoid vegetating "cauliflower" lesion on the cervix was visualized, but there were no lesions on the vagina. Upon palpation, the uterus appeared increased in size, but was not painful. The rest of the examination was normal. Hemoglobin, 10 g per dL, erythrocyte sedimentation rate 52 mm for the second hour (Westergren). Blood chemistry, VDRL, serologic assays for fungi and enzyme linked immunosorbent assay (ELISA) for HIV were negative. Culture specimens of the vulvoperineal ulcer, sputum, and urine in Lowenstein-Jensen medium were negative at 6 weeks. Bacterial culture of the vulvoperineal ulcer yielded Enterococcus spp., and of the cervix, Enterococcus spp. and Escherichia coli. Mantoux test (10 UT) gave 15 mm induration at 48 hours. Chest roentgenogram was normal. Pulmonary function tests showed severe mixed dysfunction with obstructive predominance and no response to bronchodilators. Bronchofibroscopy showed whitish nodules on the larynx obstructing 70% of tbe passage and limiting further exploration of the tracheobronchial airways. Histopathologic examination with hematoxylin and eosin stain of the vulvoperineal ulcer revealed pseudoepitheliomatous hyperplasia, a macrophagic mononuclear infiltrate with epithelioid infiltration and tuberculous granulomas with caseous necrosis, surrounded and invaded by lymphocytes and multinucleated Langhans-type giant cells (Fig. 2). A ZiehlNeelsen stain showed multiple acid-fast bacilli (Fig. 3). Histopathologic examination of the cervix, botb exocervix
Investigación clínica, 1997
Pulmonary Alveolar Proteinosis (PAP) is a rare and diffuse lung disease characterized by the abno... more Pulmonary Alveolar Proteinosis (PAP) is a rare and diffuse lung disease characterized by the abnormal deposition of PAS positive, lipoproteinaceous material in the alveolar spaces. It has been related, mainly, to alterations in the immune state and to secondary infections. We studied four cases of PAP diagnosed by light microscopy. In two cases we were able to demonstrate disseminated Histoplasmosis related to immunodeficiency states (AIDS and malnutrition), one case with Pneumocystis carinii infection and AIDS, and one case with no related pathology. Granular and electron dense material, concentric myelin figures, and variable-sized osmiophilic bodies were observed by electron microscopy. We found yeast-like structures, trophozoites and cysts in the alveolar spaces, in the Histoplasmosis and Pneumocystic carinii infection cases, respectively. In one of our cases, the circulating neutrophils showed crystalloid inclusions in the nucleus. PAP should be considered in the differential d...
Se presenta un caso de tuberculosis cutis periorificialis en una joven mujer manifestándos... more Se presenta un caso de tuberculosis cutis periorificialis en una joven mujer manifestándose como úlcera vulvo-perineal extensa cuyo foco primario fue una tuberculosis genital.This is a case of periorificial cutis tuberculosis in a young woman. It was manifested by extensive vulvoperineal ulcer, whose primary focus was genital tuberculosis
Neumol. pediátr, 2013
The Sarcomas Ewing/PNET is highly aggressive and both tumors present/display he himself phantom o... more The Sarcomas Ewing/PNET is highly aggressive and both tumors present/display he himself phantom of genetic anomalies reason for which the term of "Tumors of the family of sarcoma of Ewing is used (TFSE)" that includes to a group of tumors with a phantom of neuroectodérmic differentiation. Case of feminine adolescent of eleven years, that referred sharp pain, in hemitorax appears left, in Rx of the thorax heterogenous dense image of diffuse edges projected on third basal means in left pulmonary field received antibiotics, remained asymptomatic up to eight months later when chest pain reappeared, made Rx of the thorax where demonstrate at level of the eighth costal arc bony erosion, in addition to the image previously described to greater size. Normal physical examinations. normal examinations of laboratory, computerized axial Tomography of the chest demonstrate bony erosion, and commitment of the local pleura biopsy of the injury reported: "Malignant Tumor of round cells, extensive necrosis". Bony scintygraphy indicated osteoblástic activity altered in D8, suggestive of secondary bony infiltration. Made resection of tumor like injury in chest wall with reconstruction, positioning of prosthesis and central catheter biopsy of bony Marrow: refusal. The morphologic and inmunohistochemical findings with positivity for compatible FLy and CD99 with tumor of the family of sarcoma of Ewing/primtive neuroectodérmic tumor. At the moment in treatment programmed with standard chemotherapy every 21 days X-ray in week 12.
Tribuna del Investigador, Apr 3, 2020
Se recopilan evidencias con respecto a la epidemiología de la histoplasmosis, obtenida... more Se recopilan evidencias con respecto a la epidemiología de la histoplasmosis, obtenidas durante los últimos 70 años en Venezuela, extraídas de los diferentes estudios realizados en el país, en los cuales se demuestra la existencia de esta micosis en nuestro medio. El objetivo fue estimular el interés entre nuestros médicos, por la búsqueda de esta micosis. 
Archivos Venezolanos de Puericultura y Pediatría, Jan 12, 2016
La histoplasmosis es una infección sistémica causada por un hongo dimorfo, Histoplasma capsulatum... more La histoplasmosis es una infección sistémica causada por un hongo dimorfo, Histoplasma capsulatum. Crece en suelos que contienen grandes cantidades de excretas tanto de aves como de murciélagos, en las proximidades del suelo de los gallineros y alrededor de árboles que albergan aves y murciélagos, en el interior o alrededor de las cuevas. La aerosolización de las microconidias residentes en estos suelos es la causante de las manifestaciones de la enfermedad Objetivo: Dar a conocer un brote de esta enfermedad relacionado con una actividad de remoción de suelos en espacio abierto. Método: Estudio observacional descriptivo de reporte de serie de casos que se inició con la identificación del caso índice. Se realizaron tomas de muestras tanto a los niños del colegio como al personal docente, así como de las fuentes de contagio común. Resultados: Se identificaron 7 niños, edad promedio de 11 años, predominantemente del sexo femenino y sin enfermedad predisponente condicionante. El diagnóstico de la enfermedad se realizó por estudio de material clínico (esputo, médula ósea, tejido pulmonar) con coloraciones especiales. Se aisló Histoplasma capsulatum del suelo donde estos niños residen y donde se desarrolló la actividad de remoción y rastrillo. Se estimó una tasa de ataque del 58 % % con una letalidad del 14 %. Conclusión: Se ha realizado el primer reporte para el país de un brote de histoplasmosis en espacio abierto relacionado con remoción y rastrillo de suelo, reconociendo un área de endemicidad previamente no determinada. Palabras clave: Histoplasmosis, brote, terapia, prevención y control. Outbreak of acute histoplasmosis in schoolchildren from El Mayar,
Investigacion Clinica, 1997
La Proteinosis Alveolar Pulmonar (PAP) es una enfermedad pulmonar difusa, poco frecuente, caracte... more La Proteinosis Alveolar Pulmonar (PAP) es una enfermedad pulmonar difusa, poco frecuente, caracterizada por el deposito anormal de material lipoproteinaceo PAS positivo en los alveolos. Se ha asociado, principalmente, a alteraciones del estado inmunologico y a infecciones secundarias. Se estudiaron cuatro casos con diagnostico histologico de PAP. En dos casos se demostro infeccion sistemica por Histoplasma capsulatum y asociacion a estados de inmunodeficiencia (SIDA y desnutricion), un caso con Pneumocystis carinii y SIDA, y un caso sin patologia asociada. El estudio ultraestructural mostro material granular electron denso, figuras de mielina concentricas y cuerpos osmiofilicos de tamano variable. Se observaron estructuras levaduriformes trofozoitos y quistes en la luz alveolar, en los casos de Histoplasmosis e infeccion por Pneumocystis carinii, respectivamente. En uno de los casos, los neutrofilos circulantes mostraron inclusiones cristaloides intranucleares. Enfatizamos la necesi...
Pesquisa Brasileira em Odontopediatria e Clínica Integrada, 2020
To determine the prevalence of nasal septum perforation associated to Histoplasma sp. Material an... more To determine the prevalence of nasal septum perforation associated to Histoplasma sp. Material and Methods: A retrospective descriptive study was conducted with patients who developed nasal septum perforation associated to histoplasmosis. The diagnosis was made based on clinical manifestations and confirmed with mycological direct examination with Giemsa stain, culture, serologic tests (immunodiffusion method), and histopathology with hematoxylin-eosin, Grocott methenamine (GMS) and Periodic Acid-Schiff stain (PAS). Results: Out of 1654 medical records reviewed with diagnosis of histoplasmosis in the study period, we found 22 cases with nasal septum perforation. Autoimmune disease was present in 6 patients; all six were on immunosuppressive treatment. Two patients had HIV/AIDS, one of them had also paracoccidiodomycoses and the remaining had no apparent underlying disease or conditions. Conclusion: Physicians of endemic areas such as Venezuela, must consider this entity in the differential diagnosis with other diseases.
Neumología Pediátrica, 2021
Los Sarcomas Ewing/PNET son altamente agresivos y ambos tumores presentan el mismo espectro de an... more Los Sarcomas Ewing/PNET son altamente agresivos y ambos tumores presentan el mismo espectro de anomalías genéticas razón por la que se usa el término de “Tumores de la familia del sarcoma de Ewing (TFSE)” que abarca a un grupo de tumores con un espectro de diferenciación neuroectodérmica. Se presenta caso de adolescente femenina de once años, quien refirió dolor punzante, en hemitorax izquierdo, en Rx del tórax imagen densa heterogénea de bordes difusos proyectada sobre tercio medio basal en campo pulmonar izquierdo. Recibió antibióticos, permaneció asintomática hasta ocho meses después cuando reapareció dolor torácico, y en Rx del tórax se evidencio a nivel del octavo arco costal erosión ósea, además de la imagen anteriormente descrita de mayor tamaño. Examen físico y de laboratorios fueron normales, en Tomografía axial computarizada del tórax se evidencio erosión ósea, y compromiso de la pleura local. Biopsia de la lesión reportó: “Tumor maligno de células redondas, extensa necros...
Se revisa la experiencia sobre Tuberculosis cutanea (TBCc) en Venezuela durante el quinquenio 198... more Se revisa la experiencia sobre Tuberculosis cutanea (TBCc) en Venezuela durante el quinquenio 1989-1993. Para ello se practico revision de 3.335 fichas de notificacion (Denuncia) de TBC extrapulmonar provenientes del Departamento de Tuberculosis del MSAS con sede en el Hospital Jose Ignacio Baldo. De ellas se seleccionaron solo las notificaciones como TBC ganglionar (debido a que las escrofulas son reportadas mayormente asi) y TBCc que reunieron los criterios de Wilkinson (modificados) mundialmente aceptados como diagnosticos para TBC, los cuales fueron 243 casos. En una segunda etapa, se revisaron las historias clinicas de los casos vistos en nuestro hospital durante ese lapso y algunas de oros centros hospitalarios y dispensarios del area metropolitana. La incidencia global fue de 0,24%, cifra que sigue estando dentro, del rango observado a nivel nacional, da la impresion desde el punto de vista clinico que la TBCc estuviera aumentando, sin embargo los parametros estadisticos no l...
Pesquisa Brasileira em Odontopediatria e Clínica Integrada
To determine the prevalence of nasal septum perforation associated to Histoplasma sp. Material an... more To determine the prevalence of nasal septum perforation associated to Histoplasma sp. Material and Methods: A retrospective descriptive study was conducted with patients who developed nasal septum perforation associated to histoplasmosis. The diagnosis was made based on clinical manifestations and confirmed with mycological direct examination with Giemsa stain, culture, serologic tests (immunodiffusion method), and histopathology with hematoxylin-eosin, Grocott methenamine (GMS) and Periodic Acid-Schiff stain (PAS). Results: Out of 1654 medical records reviewed with diagnosis of histoplasmosis in the study period, we found 22 cases with nasal septum perforation. Autoimmune disease was present in 6 patients; all six were on immunosuppressive treatment. Two patients had HIV/AIDS, one of them had also paracoccidiodomycoses and the remaining had no apparent underlying disease or conditions. Conclusion: Physicians of endemic areas such as Venezuela, must consider this entity in the differential diagnosis with other diseases.
Pesquisa Brasileira em Odontopediatria e Clínica Integrada
Objective: To determine the frequency and clinical forms of oral manifestations associated to Par... more Objective: To determine the frequency and clinical forms of oral manifestations associated to Paracoccidioidomycosis (PCM) and Histoplasmosis. Material and Methods: 481 medical records of outpatients referred to the Medical Mycology Department were reviewed since 2009 to 2016. Data were analyzed using descriptive statistical methods. Results: 47 (9.77%) cases had oral manifestations, 29 (61.70%) were associated to PCM and 18 (38.29%) to histoplasmosis. For PCM, male-female ratio was 8:1 and 1:1 for histoplasmosis. The average age for PCM was 48 years old and 53 for histoplasmosis. All the PCM patients had more than 1 oral structure affected: 44.82% were gingival lesions and 27.58% palate. In patients with histoplasmosis, 6 (33.33%) were lesions affecting palate and 6 (33.33%) involving tongue. For both entities, painful ulcers and granulomatous-like lesions were the most prevalent clinical forms; however, we observed a wide range of other oral manifestations. Regarding PCM patient's comorbidities, 3 (10.34%) cases had HIV/AIDS, 8 (27.58%) histoplasmosis and 2 (6.89%) carcinomas. Whereas the comorbidities of patients with histoplasmosis, 2 (11.11%) had HIV/AIDS and 1 (5.55%) had carcinoma. Conclusion: In endemic countries for both mycoses, dentists must be aware of patients with mouth lesions, take advantage of epidemiologic clues that suggest risk factors and be acquainted with all the current diagnostic tests in order to make a quick diagnosis and treatment in highly suspicious cases.
Antecedentes: Los hallazgos histopatologicos y ultraestructurales (HU) descritos en la fase croni... more Antecedentes: Los hallazgos histopatologicos y ultraestructurales (HU) descritos en la fase cronica de la neumonitis por hipersensibilidad (NH) son caracteristicos; por lo cual, podrian ayudar a diferenciarla de otras enfermedades pulmonares intersticiales difusas (EPID), identificando los casos de dificil diagnostico clinico-imagenologico en pacientes venezolanos. El objetivo del presente estudio fue investigar, por primera vez, las caracteristicas HU de biopsias pulmonares a cielo abierto de pacientes venezolanos con NH en fase cronica. Material y metodos: Se estudiaron fragmentos de biopsias de pulmon a cielo abierto que fueron procesados para microscopia optica y electronica de transmision, con consentimiento de los pacientes. Resultados: Todos los casos presentaron neumonitis intersticial cronica en parches, alveolitis linfocitica, tapones fibrosos intrabronquiolares e intraalveolares, fibrosis intersticial, enfisema centrolobulillar y neumonia obstructiva. Ultraestructuralment...
Dermatologia Venezolana, 1995
Medicine, 2008
Histoplasmosis, a granulomatous disease caused by Histoplasma capsulatum, is endemic in Venezuela... more Histoplasmosis, a granulomatous disease caused by Histoplasma capsulatum, is endemic in Venezuela. We conducted the current study to appraise retrospectively the demographic data, clinical features, diagnostic methods, and treatment of patients with histoplasmosis from January 2000 to December 2005. We reviewed the medical records of outpatient cases with a diagnosis of histoplasmosis and considered clinical samples processed at our laboratory. We collected demographic, epidemiologic, and clinical data from each case as available, including results of any mycologic examinations performed. Treatment and outcome data were available for some patients. We assessed 158 cases of histoplasmosis: 103 (65.2%) patients came from the Caracas metropolitan area; 53 were associated with acquired immunodeficiency syndrome (AIDS), 14 with tuberculosis, and 8 with paracoccidioidomycosis. Six pediatric patients were malnourished. Epidemiologic data suggested histoplasmosis in most cases. Patients received treatment with itraconazole and/or amphotericin B. Our results may reflect changes in the epidemiology occurring in Venezuela, perhaps due to environmental changes and the presence of AIDS. Several mycologic exams are necessary to ensure a proper diagnosis. More reliable data and statistics on this infection are necessary to monitor outbreaks closely and to establish if there is an epidemic pattern.
Dermatología Venezolana, 1995
International Journal of Dermatology, Jun 1, 1996
A 25-year-old woman apparently healthy until 1 year earlier when sbe started to present with coug... more A 25-year-old woman apparently healthy until 1 year earlier when sbe started to present with cough productive of mucus, dysphonia, dysphagia for solid foods, a weight loss of unknown magnitude, secondary amenorrhea for 8 months, and a vulvoperineal ulcer detected by the patient 2 months before hospitalization. She denies tuberculosis contacts and her family history was not relevant. Her obstetric background reveals tbree full-term pregnancies. Pbysical examination: height 1.48 m; weight 33 kg (ideal weight: 45 kg); a BCG scar on the left arm; and a granuiomatous plaque on tbe soft palate measuring 1x1 cm in diameter. Multiple small lympb nodes that were mobile, were palpable, not painful, and located in the laterocervical region bilaterally. On the genitalia, enlargement of the labia majora and an ulcer in the right perineal region, 5 x 5 cm in diameter, with excavated borders and sero-yellowish secretion on its surface (Fig. 1) were present. With a speculum, a polypoid vegetating "cauliflower" lesion on the cervix was visualized, but there were no lesions on the vagina. Upon palpation, the uterus appeared increased in size, but was not painful. The rest of the examination was normal. Hemoglobin, 10 g per dL, erythrocyte sedimentation rate 52 mm for the second hour (Westergren). Blood chemistry, VDRL, serologic assays for fungi and enzyme linked immunosorbent assay (ELISA) for HIV were negative. Culture specimens of the vulvoperineal ulcer, sputum, and urine in Lowenstein-Jensen medium were negative at 6 weeks. Bacterial culture of the vulvoperineal ulcer yielded Enterococcus spp., and of the cervix, Enterococcus spp. and Escherichia coli. Mantoux test (10 UT) gave 15 mm induration at 48 hours. Chest roentgenogram was normal. Pulmonary function tests showed severe mixed dysfunction with obstructive predominance and no response to bronchodilators. Bronchofibroscopy showed whitish nodules on the larynx obstructing 70% of tbe passage and limiting further exploration of the tracheobronchial airways. Histopathologic examination with hematoxylin and eosin stain of the vulvoperineal ulcer revealed pseudoepitheliomatous hyperplasia, a macrophagic mononuclear infiltrate with epithelioid infiltration and tuberculous granulomas with caseous necrosis, surrounded and invaded by lymphocytes and multinucleated Langhans-type giant cells (Fig. 2). A ZiehlNeelsen stain showed multiple acid-fast bacilli (Fig. 3). Histopathologic examination of the cervix, botb exocervix
Investigación clínica, 1997
Pulmonary Alveolar Proteinosis (PAP) is a rare and diffuse lung disease characterized by the abno... more Pulmonary Alveolar Proteinosis (PAP) is a rare and diffuse lung disease characterized by the abnormal deposition of PAS positive, lipoproteinaceous material in the alveolar spaces. It has been related, mainly, to alterations in the immune state and to secondary infections. We studied four cases of PAP diagnosed by light microscopy. In two cases we were able to demonstrate disseminated Histoplasmosis related to immunodeficiency states (AIDS and malnutrition), one case with Pneumocystis carinii infection and AIDS, and one case with no related pathology. Granular and electron dense material, concentric myelin figures, and variable-sized osmiophilic bodies were observed by electron microscopy. We found yeast-like structures, trophozoites and cysts in the alveolar spaces, in the Histoplasmosis and Pneumocystic carinii infection cases, respectively. In one of our cases, the circulating neutrophils showed crystalloid inclusions in the nucleus. PAP should be considered in the differential d...
Se presenta un caso de tuberculosis cutis periorificialis en una joven mujer manifestándos... more Se presenta un caso de tuberculosis cutis periorificialis en una joven mujer manifestándose como úlcera vulvo-perineal extensa cuyo foco primario fue una tuberculosis genital.This is a case of periorificial cutis tuberculosis in a young woman. It was manifested by extensive vulvoperineal ulcer, whose primary focus was genital tuberculosis
Neumol. pediátr, 2013
The Sarcomas Ewing/PNET is highly aggressive and both tumors present/display he himself phantom o... more The Sarcomas Ewing/PNET is highly aggressive and both tumors present/display he himself phantom of genetic anomalies reason for which the term of "Tumors of the family of sarcoma of Ewing is used (TFSE)" that includes to a group of tumors with a phantom of neuroectodérmic differentiation. Case of feminine adolescent of eleven years, that referred sharp pain, in hemitorax appears left, in Rx of the thorax heterogenous dense image of diffuse edges projected on third basal means in left pulmonary field received antibiotics, remained asymptomatic up to eight months later when chest pain reappeared, made Rx of the thorax where demonstrate at level of the eighth costal arc bony erosion, in addition to the image previously described to greater size. Normal physical examinations. normal examinations of laboratory, computerized axial Tomography of the chest demonstrate bony erosion, and commitment of the local pleura biopsy of the injury reported: "Malignant Tumor of round cells, extensive necrosis". Bony scintygraphy indicated osteoblástic activity altered in D8, suggestive of secondary bony infiltration. Made resection of tumor like injury in chest wall with reconstruction, positioning of prosthesis and central catheter biopsy of bony Marrow: refusal. The morphologic and inmunohistochemical findings with positivity for compatible FLy and CD99 with tumor of the family of sarcoma of Ewing/primtive neuroectodérmic tumor. At the moment in treatment programmed with standard chemotherapy every 21 days X-ray in week 12.
Tribuna del Investigador, Apr 3, 2020
Se recopilan evidencias con respecto a la epidemiología de la histoplasmosis, obtenida... more Se recopilan evidencias con respecto a la epidemiología de la histoplasmosis, obtenidas durante los últimos 70 años en Venezuela, extraídas de los diferentes estudios realizados en el país, en los cuales se demuestra la existencia de esta micosis en nuestro medio. El objetivo fue estimular el interés entre nuestros médicos, por la búsqueda de esta micosis. 
Archivos Venezolanos de Puericultura y Pediatría, Jan 12, 2016
La histoplasmosis es una infección sistémica causada por un hongo dimorfo, Histoplasma capsulatum... more La histoplasmosis es una infección sistémica causada por un hongo dimorfo, Histoplasma capsulatum. Crece en suelos que contienen grandes cantidades de excretas tanto de aves como de murciélagos, en las proximidades del suelo de los gallineros y alrededor de árboles que albergan aves y murciélagos, en el interior o alrededor de las cuevas. La aerosolización de las microconidias residentes en estos suelos es la causante de las manifestaciones de la enfermedad Objetivo: Dar a conocer un brote de esta enfermedad relacionado con una actividad de remoción de suelos en espacio abierto. Método: Estudio observacional descriptivo de reporte de serie de casos que se inició con la identificación del caso índice. Se realizaron tomas de muestras tanto a los niños del colegio como al personal docente, así como de las fuentes de contagio común. Resultados: Se identificaron 7 niños, edad promedio de 11 años, predominantemente del sexo femenino y sin enfermedad predisponente condicionante. El diagnóstico de la enfermedad se realizó por estudio de material clínico (esputo, médula ósea, tejido pulmonar) con coloraciones especiales. Se aisló Histoplasma capsulatum del suelo donde estos niños residen y donde se desarrolló la actividad de remoción y rastrillo. Se estimó una tasa de ataque del 58 % % con una letalidad del 14 %. Conclusión: Se ha realizado el primer reporte para el país de un brote de histoplasmosis en espacio abierto relacionado con remoción y rastrillo de suelo, reconociendo un área de endemicidad previamente no determinada. Palabras clave: Histoplasmosis, brote, terapia, prevención y control. Outbreak of acute histoplasmosis in schoolchildren from El Mayar,
Investigacion Clinica, 1997
La Proteinosis Alveolar Pulmonar (PAP) es una enfermedad pulmonar difusa, poco frecuente, caracte... more La Proteinosis Alveolar Pulmonar (PAP) es una enfermedad pulmonar difusa, poco frecuente, caracterizada por el deposito anormal de material lipoproteinaceo PAS positivo en los alveolos. Se ha asociado, principalmente, a alteraciones del estado inmunologico y a infecciones secundarias. Se estudiaron cuatro casos con diagnostico histologico de PAP. En dos casos se demostro infeccion sistemica por Histoplasma capsulatum y asociacion a estados de inmunodeficiencia (SIDA y desnutricion), un caso con Pneumocystis carinii y SIDA, y un caso sin patologia asociada. El estudio ultraestructural mostro material granular electron denso, figuras de mielina concentricas y cuerpos osmiofilicos de tamano variable. Se observaron estructuras levaduriformes trofozoitos y quistes en la luz alveolar, en los casos de Histoplasmosis e infeccion por Pneumocystis carinii, respectivamente. En uno de los casos, los neutrofilos circulantes mostraron inclusiones cristaloides intranucleares. Enfatizamos la necesi...
Pesquisa Brasileira em Odontopediatria e Clínica Integrada, 2020
To determine the prevalence of nasal septum perforation associated to Histoplasma sp. Material an... more To determine the prevalence of nasal septum perforation associated to Histoplasma sp. Material and Methods: A retrospective descriptive study was conducted with patients who developed nasal septum perforation associated to histoplasmosis. The diagnosis was made based on clinical manifestations and confirmed with mycological direct examination with Giemsa stain, culture, serologic tests (immunodiffusion method), and histopathology with hematoxylin-eosin, Grocott methenamine (GMS) and Periodic Acid-Schiff stain (PAS). Results: Out of 1654 medical records reviewed with diagnosis of histoplasmosis in the study period, we found 22 cases with nasal septum perforation. Autoimmune disease was present in 6 patients; all six were on immunosuppressive treatment. Two patients had HIV/AIDS, one of them had also paracoccidiodomycoses and the remaining had no apparent underlying disease or conditions. Conclusion: Physicians of endemic areas such as Venezuela, must consider this entity in the differential diagnosis with other diseases.
Neumología Pediátrica, 2021
Los Sarcomas Ewing/PNET son altamente agresivos y ambos tumores presentan el mismo espectro de an... more Los Sarcomas Ewing/PNET son altamente agresivos y ambos tumores presentan el mismo espectro de anomalías genéticas razón por la que se usa el término de “Tumores de la familia del sarcoma de Ewing (TFSE)” que abarca a un grupo de tumores con un espectro de diferenciación neuroectodérmica. Se presenta caso de adolescente femenina de once años, quien refirió dolor punzante, en hemitorax izquierdo, en Rx del tórax imagen densa heterogénea de bordes difusos proyectada sobre tercio medio basal en campo pulmonar izquierdo. Recibió antibióticos, permaneció asintomática hasta ocho meses después cuando reapareció dolor torácico, y en Rx del tórax se evidencio a nivel del octavo arco costal erosión ósea, además de la imagen anteriormente descrita de mayor tamaño. Examen físico y de laboratorios fueron normales, en Tomografía axial computarizada del tórax se evidencio erosión ósea, y compromiso de la pleura local. Biopsia de la lesión reportó: “Tumor maligno de células redondas, extensa necros...
Se revisa la experiencia sobre Tuberculosis cutanea (TBCc) en Venezuela durante el quinquenio 198... more Se revisa la experiencia sobre Tuberculosis cutanea (TBCc) en Venezuela durante el quinquenio 1989-1993. Para ello se practico revision de 3.335 fichas de notificacion (Denuncia) de TBC extrapulmonar provenientes del Departamento de Tuberculosis del MSAS con sede en el Hospital Jose Ignacio Baldo. De ellas se seleccionaron solo las notificaciones como TBC ganglionar (debido a que las escrofulas son reportadas mayormente asi) y TBCc que reunieron los criterios de Wilkinson (modificados) mundialmente aceptados como diagnosticos para TBC, los cuales fueron 243 casos. En una segunda etapa, se revisaron las historias clinicas de los casos vistos en nuestro hospital durante ese lapso y algunas de oros centros hospitalarios y dispensarios del area metropolitana. La incidencia global fue de 0,24%, cifra que sigue estando dentro, del rango observado a nivel nacional, da la impresion desde el punto de vista clinico que la TBCc estuviera aumentando, sin embargo los parametros estadisticos no l...
Pesquisa Brasileira em Odontopediatria e Clínica Integrada
To determine the prevalence of nasal septum perforation associated to Histoplasma sp. Material an... more To determine the prevalence of nasal septum perforation associated to Histoplasma sp. Material and Methods: A retrospective descriptive study was conducted with patients who developed nasal septum perforation associated to histoplasmosis. The diagnosis was made based on clinical manifestations and confirmed with mycological direct examination with Giemsa stain, culture, serologic tests (immunodiffusion method), and histopathology with hematoxylin-eosin, Grocott methenamine (GMS) and Periodic Acid-Schiff stain (PAS). Results: Out of 1654 medical records reviewed with diagnosis of histoplasmosis in the study period, we found 22 cases with nasal septum perforation. Autoimmune disease was present in 6 patients; all six were on immunosuppressive treatment. Two patients had HIV/AIDS, one of them had also paracoccidiodomycoses and the remaining had no apparent underlying disease or conditions. Conclusion: Physicians of endemic areas such as Venezuela, must consider this entity in the differential diagnosis with other diseases.
Pesquisa Brasileira em Odontopediatria e Clínica Integrada
Objective: To determine the frequency and clinical forms of oral manifestations associated to Par... more Objective: To determine the frequency and clinical forms of oral manifestations associated to Paracoccidioidomycosis (PCM) and Histoplasmosis. Material and Methods: 481 medical records of outpatients referred to the Medical Mycology Department were reviewed since 2009 to 2016. Data were analyzed using descriptive statistical methods. Results: 47 (9.77%) cases had oral manifestations, 29 (61.70%) were associated to PCM and 18 (38.29%) to histoplasmosis. For PCM, male-female ratio was 8:1 and 1:1 for histoplasmosis. The average age for PCM was 48 years old and 53 for histoplasmosis. All the PCM patients had more than 1 oral structure affected: 44.82% were gingival lesions and 27.58% palate. In patients with histoplasmosis, 6 (33.33%) were lesions affecting palate and 6 (33.33%) involving tongue. For both entities, painful ulcers and granulomatous-like lesions were the most prevalent clinical forms; however, we observed a wide range of other oral manifestations. Regarding PCM patient's comorbidities, 3 (10.34%) cases had HIV/AIDS, 8 (27.58%) histoplasmosis and 2 (6.89%) carcinomas. Whereas the comorbidities of patients with histoplasmosis, 2 (11.11%) had HIV/AIDS and 1 (5.55%) had carcinoma. Conclusion: In endemic countries for both mycoses, dentists must be aware of patients with mouth lesions, take advantage of epidemiologic clues that suggest risk factors and be acquainted with all the current diagnostic tests in order to make a quick diagnosis and treatment in highly suspicious cases.
Antecedentes: Los hallazgos histopatologicos y ultraestructurales (HU) descritos en la fase croni... more Antecedentes: Los hallazgos histopatologicos y ultraestructurales (HU) descritos en la fase cronica de la neumonitis por hipersensibilidad (NH) son caracteristicos; por lo cual, podrian ayudar a diferenciarla de otras enfermedades pulmonares intersticiales difusas (EPID), identificando los casos de dificil diagnostico clinico-imagenologico en pacientes venezolanos. El objetivo del presente estudio fue investigar, por primera vez, las caracteristicas HU de biopsias pulmonares a cielo abierto de pacientes venezolanos con NH en fase cronica. Material y metodos: Se estudiaron fragmentos de biopsias de pulmon a cielo abierto que fueron procesados para microscopia optica y electronica de transmision, con consentimiento de los pacientes. Resultados: Todos los casos presentaron neumonitis intersticial cronica en parches, alveolitis linfocitica, tapones fibrosos intrabronquiolares e intraalveolares, fibrosis intersticial, enfisema centrolobulillar y neumonia obstructiva. Ultraestructuralment...
Dermatologia Venezolana, 1995
Medicine, 2008
Histoplasmosis, a granulomatous disease caused by Histoplasma capsulatum, is endemic in Venezuela... more Histoplasmosis, a granulomatous disease caused by Histoplasma capsulatum, is endemic in Venezuela. We conducted the current study to appraise retrospectively the demographic data, clinical features, diagnostic methods, and treatment of patients with histoplasmosis from January 2000 to December 2005. We reviewed the medical records of outpatient cases with a diagnosis of histoplasmosis and considered clinical samples processed at our laboratory. We collected demographic, epidemiologic, and clinical data from each case as available, including results of any mycologic examinations performed. Treatment and outcome data were available for some patients. We assessed 158 cases of histoplasmosis: 103 (65.2%) patients came from the Caracas metropolitan area; 53 were associated with acquired immunodeficiency syndrome (AIDS), 14 with tuberculosis, and 8 with paracoccidioidomycosis. Six pediatric patients were malnourished. Epidemiologic data suggested histoplasmosis in most cases. Patients received treatment with itraconazole and/or amphotericin B. Our results may reflect changes in the epidemiology occurring in Venezuela, perhaps due to environmental changes and the presence of AIDS. Several mycologic exams are necessary to ensure a proper diagnosis. More reliable data and statistics on this infection are necessary to monitor outbreaks closely and to establish if there is an epidemic pattern.