Rhinoscleroma is a chronic, infectious and granulomatous disease of the respiratory tract. There is often a delay in diagnosis due to unfamiliarity with the disease and also because culture is not always positive. We report a case in a 26-year-old woman with granular mass obstructing bilateral nasal cavities and causing breathing difficulty. Histopathological examination showed characteristic Mikulicz histiocytes containing numerous Gram-negative intracellular rod-shaped bacilli consistent with the diagnosis of rhinoscleroma. The patient was treated with gemifloxacin and tetracycline and remains asymptomatic over a year follow-up period. It is important to consider rhinoscleroma in cases of chronic nasal obstruction. As culture is not always positive, histopathological examination may be crucial to the diagnosis.

Os autores descrevem um caso de entomoftoromicose em paciente previamente saudável, que apresentou abscesso em nádega direita, evoluindo, após drenagem cirúrgica, para tumoração retroperitoneal. Após ressecção da massa, o paciente obteve melhora clínica, em uso de cetoconazol. A análise histopatológica evidenciou fenômeno de Splendore-Hoeppli, sugerindo infecção por Basidiobolus ranarum, uma zigomicose geralmente restrita ao tecido subcutâneo, com raro comprometimento gastrintestinal.

The authors describe a case of entomophthoromycosis in a previously healthy patient, who presented with an abscess in the right buttock. After surgical drainage it evolved into a retroperitoneal tumor. The patient improved clinically after resection of the mass and ketoconazole treatment. The histopathological analysis showed the Splendore-Hoeppli phenomenon, suggesting Basidiobolus ranarum infection, a zygomycosis generally restricted to the subcutaneous tissue, with rare gastrointestinal involvement.

Um novo inquérito para oncocercose, realizado em 1984, entre índios Yanomami da parte média dos rios Mucajaí e Catrimâni (Território de Roraima), mostrou que, decorridos vários anos das primeiras investigações - uma década no caso do rio Mucajaí - os índices de prevalência, nesses dois locais da periferia do foco brasileiro, não haviam sofrido alteração significativa. Levando-se em conta apenas os residentes nas aldeias ou malocas abrangidas pelo inquérito, a prevalência atingiu 3,1% nos índios do rio Mucajaí, enquanto ficou em zero nos do rio Catrimâni. Dada a presença contínua, nas referidas aldeias, de índios visitantes, altamente infectados, oriundos da parte central e mais elevada do território indígena - onde cerca de 90% doa adultos têm oncocercose - seria de esperar o achado de valores bem maiores (acima pelo menos daqueles encontrados anteriormente), caso um vetor apropiado estivesse presente na região. Simulium oyapockense s.1. é a única espécie antropofílica de simulídeo, em toda zona inferior da área ocupada pelos Yanomami (altitude ao redor de 200 metros), abundante o suficiente para constituir-se em transmissor da oncocercose. Sem dúvida, no entanto, trata-se de um mau vetor (como aliás já foi demonstrado experimentalmente para Mansonella ozzardi) ou, até mesmo, de espécie não vetora de Onchocerca volvulus, pois, de outra forma, os índices de prevalência na parte média dos rios Mucajaí e Catrimâni já teriam crescido durante o período assinalado. Para explicar as altas taxas alcançadas pela endemia na porção central e cheia de acidentes (altitude superior a 900 metros) do território Yanomami, há que se admitir a presença aí de um outro vetor, muito eficiente, cujos hábitos estariam ligados à região montanhosa da fronteira entre o Brasil e a Venezuela.

A recent survey for onchocerciasis conducted among the Yanomami Indians living on the middle reaches of the Mucajaí and Catrimâni Rivers (Territory of Roraima) has failed to show any alteration in the local pattern of the disease. Infact, after a decade from the first surveys in these areas located at the periphery of the Yanomami focus, the prevalence and the intensity of infection have not experienced a significant change. Considering only the residents in the villages inside the surveyed areas, the prevalence varied from zero in the neighbourhood of the Catrimâni mission to 3.1 per cent near the Mucajai mission. Had there been a competent vector of Onchocerca volvulus in the region higher rates might be expected due to the Yanomami custom of periodic visits among the groups of the tribe. In some of these visits, numbers of highly infected Indians from the central and mountainous part of the Yanomami territory - where more than 90 per cent of the adults have onchocerciasis - come to the villages in the lowland area, attracted by the facilities offered by the mission posts. As the visitors stay in the host villages for several days or weeks, the residents could become exposed to the disease. Simulium oyapockense s.l., a man-biting species of black fly, widely distributed in Northern Brazil, is the only possible vector of O. volvulus in the investigated areas, on the grounds of its local abundance. However, it must be a poor vector (as has already been demonstrated for Mansonella ozzardi), since the prevalence rates in the lower part of the Yanomami territory have not changed for the past ten years, in spite of the constant presence of infected Indians visiting the villages. In order to explain the much higher prevalence in the central part of the Indian territory, we have to admit the presence there of another vector, extremely efficient, whose habits would be linked to the montainous region of the border between Brazil and Venezuela.

Resumo Do solo de uma gruta, localizada no Km 130 da Estrada Manaus-Caracaraí. isolou-se o dermatófito Microsporum amazonicum, que até então havia sido encontrado apenas no pêlo de animais silvestres. Em 3 coletas feitas, com intervalos de alguns meses, durante o ano de 1974, recolheram-se 96 amostras de terra do chão da gruta, das quais 12, ou seja, 12,5% foram positivas para o fungo. São discutidas no trabalho as razões que tornam difícil o isolamento de M. amazonicum do solo, apesar de ser ele, aparentemente, um fungo ceratinofílico próprio da região amazônica.

Summary The dermatophyte Microsporum amazonicum was first isolated by Moraes, et al. (1967), from the hair of a wild rat (Oryzomys sp.) trapped near the city of Manaus, State of Amazonas, Brasil. Since that time, it has been recovered several times from other wild rodents of the Amazon region, but not from the soil. In this paper, the Authors report the isolation of M. amazonicum from the soil of a cave on the Manaus-Caracarav Highway, about 130 Kms. from Manaus. This is the first time that this dermathophyte has been obtained directly from the soil. Of 96 soil samples, colleted in the cave, 12 were found to be positive for Microsporum amazonicum. Rarely found in the soil, this fungo appears to be restricted to the Amazon region. Reasons for its limited distribution are discussed.

Sinopse De 696 casos de micoses superficiais, encontrados em Manaus — Estado do Amazonas, durante um período de 7 anos (1961 - 1968), isolaram-se 515 amostras de fungos, das quais 440 pertenciam a espécies do grupo dos dermatófitos. O fungo predominante foi Trichophyton tonsurans, responsável por 282 das 440 amostras, ou seja, 64% do total de dermatófitos. Contribuiu para este percentual, bastante elevado, o fato de ser T. tonsurans quase que o único agente causador de tinha da cabeça nas crianças de Manaus: em 242 casos de tinha tonsurante apareceu ele 234 vezes, e em 30 casos de quério, 23 vezes. Nas pessoas maiores de 15 anos, todavia, o dermatófito mais encontrado foi T. mentagrophytes; apareceu ele 106 vezes, contra apenas 16 de T. tonsurans, em 145 amostras de dermatófitos isolados deste grupo.

Summary From 696 cases of superficial mycoses diagnosed in Manaus — State of Amazonas, within a seven-year period (1961 - 1968), the author obtained 515 strains of fungi, including 440 strains which belonged to the dermatophyte group. Trichophyton tonsurans was the predominant species; in fact, it is the most common dermatophyte isolated from human cases in the States of Northern Brazil, as has been shown by other investigators. In the present work, T. tonsurans was the etiological agent in 64% of the 440 cases of dermatophytoses. This high percentage was due mainly to the fact that T. tonsurans is almost solely responsible for tinea among the children of Manaus. Of 242 cases of ringworm of the scalp and of 30 cases of Kerion, T. tonsurans was isolated from 234 and 23 cases respectively. In adults, however, Thichophyton mentagrophytes was the most common agent of tinea; of 145 strains of dermatophytes isolated from adults 106 were T. mentagrophytes and 16 were T. tonsurans.