Um caso de difteria ocorreu, em 1999, em mulher de 32 anos de idade. A paciente iniciou episódio de dor de garganta imediatamente após participação em reunião com profissionais europeus durante cinco dias consecutivos, no Rio de Janeiro. Ela declarou ter sido submetida ao esquema completo de imunização contra difteria (DTP-tríplice bacteriana) na infância e a doses de reforço (dT-dupla adulto) há dois anos. O diagnóstico clínico da doença só foi firmado após o laboratório de microbiologia ter confirmado a capacidade de produção de toxina pela amostra isolada de Corynebacterium diphtheriae var. gravis, biotipo não fermentador de sacarose comumente encontrado em diversos países europeus e responsável pela atual epidemia na região correspondente a antiga União Soviética. Na era da vacinação antidiftérica, indivíduos adultos de nossa comunidade podem apresentar-se potencialmente susceptíveis a difteria.

In 1999, a case of diphtheria in a 32-year-old woman was reported. The patient developed a sore throat immediately after participating of a five-day meeting with European workers in Rio de Janeiro. Her history included complete pediatric immunization (DTP) and three doses of adult formulation tetanus and diphtheria toxoid (dT) two years earlier. Clinical diagnosis of diphtheria was not made until microbiologic examination of specimens confirmed toxigenicity of Corynebacterium diphtheriae var. gravis, a biotype currently found circulating within Europe where diphtheria remains epidemic. This case reinforces the potential susceptibility of Brazilian adults to epidemic diphtheria in the vaccine era.

Pulmonary infection on cystic fibrosis (CF) patients are associated with a limited qualitative number of microorganisms. During the colonization process, Staphylococcus aureus usually preceedes Pseudomonas aeruginosa. This latter is at first non-mucoid, being replaced or associated to a mucoid morphotype which is rare in other diseases. In 1980, Pseudomonas cepacia appeared as an important agent in CF pulmonary infections with a mean frequency of about 6.1% isolations in different parts of the world. The primus colonization mainly occurs in the presence of pre-existent tissue lesions and the clinical progress of the disease is variable. In some patients it can be fulminant; in others it can cause a gradual and slow decrease in their pulmonary functions. The concern with this germ isolation is justified by its antibiotic multiple resistence and the possibility of direct transmission from a colonized patient to a non-colonized one. We reported the first case of P. cepacia infection in a CF patient in our area. The microbiological attendance to this patient had been made from 1986 to 1991 and the first positive culture appeared in 1988. The sensitivity profile showed that the primus colonization strain was sensitive to 9 of 17 tested antibiotics, however in the last culture the strain was resistent to all antibiotics. These data corroborate the need for monitoring the bacterial flora on CF patients respiratory system.