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ABSTRACT Brazilian spotted fever, a zoonotic disease transmitted by ticks, is caused by Rickettsia rickettsii. We report a fulminant case of this zoonosis in a healthy 46-year-old military man in the urban region of Rio de Janeiro city, in October, 2021. Ticks and capybaras (Amblyomma sculptum, Hydrochoerus hydrochaeris, respectively) were identified in the military fields, pointing to the participation of this large synanthropic rodent, recognized as an efficient amplifier host of Rickettsia rickettsii in Brazil. As the military population is considered a risk group for spotted fever, it is necessary to alert health professionals to the importance of the early detection of the disease and its adequate management, mainly in populations that are particularly at risk of exposure to ticks, in order to avoid fatal outcomes.

BACKGROUND American tegumentary leishmaniasis (ATL) is a non-lethal parasitic disease that presents with cutaneous (CL) and mucosal (ML) clinical forms. ATL treatment aims at healing the lesions and preventing the development of the late mucosal form. Systemic meglumine antimoniate (MA) therapy with 10-20 mg Sb5+/kg/day is the first choice of treatment. However, alternative therapies using 5 mg Sb5+/kg/day or intralesional (IL) MA are the usual regimens at the National Institute of Infectious Diseases (NIID), Rio de Janeiro, Brazil. OBJECTIVES To evaluate lethality and the incidence of relapse and development of late ML in CL patients treated at NIID from 2001 until 2013. METHODS Data were recovered from records of all ATL patients diagnosed during that period. FINDINGS Out of 777 patients, 753 were treated with MA (96.9%). Of those, 89.1% received alternative therapy of 9.9% IL and 79.2% systemic 5 mg Sb5+/kg/day. Some patients required 1-3 additional courses of treatment, thus making a total of 997 courses; 85.2% of them were subjected to alternative therapies. Lethality was 0.1%, relapse incidence 5.8%, and late ML incidence 0.25%. As a final outcome for the 777 patients, 95.9% were cured, 0.1% died and 4.0% were not able to follow-up. MAIN CONCLUSIONS Alternative MA schedules resulted in low lethality without increase of relapse or late ML incidence.

Phlebotomine sand flies (Diptera, Psychodidae) from Rio de Janeiro State, Brazil: Species distribution and potential vectors of leishmaniases. Rio de Janeiro State, in Brazil, has endemic areas of both cutaneous and visceral leishmaniases. In these areas, entomologic surveillance actions are highly recommended by Brazil's Ministry of Health. The present work describes the results of sand fly captures performed by the Health Department of Rio de Janeiro State between 2009 and 2011 in several municipalities. An updated species list and distribution of phlebotomine sand flies in the state are provided based on an extensive literature review. Currently, the sand fly fauna of Rio de Janeiro State has 65 species, belonging to the genera Brumptomyia (8 spp.) and Lutzomyia (57 spp.). Distribution maps of potential leishmaniases vector species Lutzomyia (Nyssomyia) intermedia, L. migonei, L. (N.) whitmani, L. (N.) flaviscutellata and L. (Lutzomyia) longipalpis are provided and their epidemiological importance is discussed.

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