Detalhes bibliográficos
| Ano de defesa: |
2013 |
| Autor(a) principal: |
Silva, Thaísa Cristina
 |
| Orientador(a): |
Souza, Lúcia Kioko Hasimoto e
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| Banca de defesa: |
Souza, Lúcia Kioko Hasimoto e,
Faganello, Josiane,
Silva, Maria do Rosário Rodrigues |
| Tipo de documento: |
Dissertação
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| Tipo de acesso: |
Acesso aberto |
| Idioma: |
por |
| Instituição de defesa: |
Universidade Federal de Goiás
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| Programa de Pós-Graduação: |
Programa de Pós-graduação em Medicina Tropical e Saúde Pública (IPTSP)
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| Departamento: |
Instituto de Patologia Tropical e Saúde Pública - IPTSP (RG)
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| País: |
Brasil
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| Palavras-chave em Português: |
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| Palavras-chave em Inglês: |
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| Área do conhecimento CNPq: |
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| Link de acesso: |
http://repositorio.bc.ufg.br/tede/handle/tede/3728
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Resumo: |
Histoplasmosis is a systemic mycosis considered an important public health problem, especially in patients with the human immunodeficiency virus (HIV), in which the disease is associated with poor prognosis and high mortality. It has worldwide distribution with higher prevalence in tropical and temperate zones, and in Brazil has been reported more frequently in the South and Southeast. Objectives: Conduct a descriptive sociodemographic, clinical, laboratory and treatment analysis of patients with histoplasmosis and aids treated between January 2000 and June 2012, at the Hospital for Tropical Diseases - Dr. Anuar Auad (HDT). Methodology: It is a descriptive, observational, cross-sectional and retrospective study, with secondary data analysis of records filed in Sector Statistics Division and Medical File (DEAM) of HDT. All confirmed cases of disseminated histoplasmosis (HD) were sample through laboratory testing. Results: This study found a prevalence of 4.2%, which corresponds to 279 cases of AIDS associated HD. Most patients were young adult males, unmarried and with low education, and most from the interior of Goiás and urban area residents. The main occupations/professions exercised by patients were related to construction activities, home activities and rural. Regarding the signs and symptoms the most frequent were: fever (84.2%), cough (63.4%), weight loss (63.1%), dyspnea (56.3%) and asthenia (53.8 %). The diagnosis was made by blood culture (59.5%) and direct examination of peripheral blood (24.8%). Oral candidiasis, cryptococcosis and pneumocystosis were opportunistic infections associated with histoplasmosis found in these patients. Prevalent laboratory findings were hemoglobin < 10 g/dL (61.2%), platelets > 100,000 cells/mm3 (60.6%), creatinine < 1.5 mg/dL (75.9%), aspartate aminotransferase (AST) ≥ 45 UI/L (76.2%), lactate dehydrogenase (LDH) ≥ 480 UI/L (79.1%) and CD4 cell count below 150 cells/mm3 in 85.9% of patients. After diagnosis, 86.7% of patients were treated with amphotericin B, and 70.3% died and the fatality rate presented was 6.45%. When analyzed risk factors associated with death from HD no variable was significant. Conclusion: Histoplasmosis showed high prevalence and lethality in AIDS patients in Goiânia, showing the need to adopt actions to facilitate early diagnosis, proper treatment and thus improved prognosis. |
