It has been more than 30 years since AIDS was introduced in people's daily life, and it is a milestone that causes taboos, myths and prejudices. At that time, a patient told me his feelings, and he was very convincing:“I am horrified of living and afraid of dying.”Three decades later, AIDS infection is not a death sentence anymore. First, doctors could make that infected patients did not die from the disease;then, that the medication which kept them alive was not so toxic. And finally, that the treatments were more comfortable. And once at this point, the possibility that the virus may disappear from the body is a more realistic goal than ever. The story of AIDS has changed and, for the first time, we can foresee in the short term the beginning of the end of the pandemic. Now it is not about whether the cure is possible or not, but about when we will have it. This current mo-mentum, so hard to get, should be maintained. We have never been so close to achieving this goal. Although the end of the pandemic is close, this is not enough. It is worrying that some world leaders have absolved themselves of responsibility for not stopping or at least having understood the explosion of the pandemic as if it was a natural disaster. “Zero tolerance for HIV”requires a profound understanding of the stigma and discrimination of the infected people to finally get rid of the epidemic of fear and the devastation that the pandemic caused.

Objective: To facilitate the recognition of intracellular yeasts of Histoplasma capsulatum and differentiate it from Leishmania amastigotes and other parasites, using the combination of then Giemsa) to previously fixed peripheral blood smears. Microscopy was performed with 400ístudy. Methods: The combination of both stains was applied consecutively (first Grocott and Giemsa and a rapid modification of Grocott stains to peripheral blood smears in a hematological and 1000í, the latter using immersion oil. Results: The yeasts of Histoplasma capsulatum were observed into the cytoplasm of leukocytes as brownish oval elements, with 3-4 μm in diameter. Conclusions: The combination of both techniques is a simple and fast method to facilitate recognition of intracellular yeasts and it is different from intracellular parasitic elements. Moreover, it allows distinguishing the cell elements that are in the microscopic preparations. It may be very helpful in those cases in which the presumptive diagnosis of histoplasmosis has not been established yet and where other more sophisticated methods are not available.

Objective: To communicate the presence of adult females, rabditoid larvae and eggs of Strongyloides stercoralis (S. stercoralis) in the respiratory secretions obtained by tracheal aspirate from a HIV-negative patient who was suffering from polymyositis, and treated with corticoids and amethopterin and assisted by pneumonia. Methods: The respiratory secretions submitted to the Parasitology Laboratory of the Mu?iz Hospital were made more concentrated by centrifugation (1 500 r/min for 15 seconds). Wet mount microscopy was performed with the pellet. Results: It revealed adult females, rabditoid larvae and eggs of S. stercoralis. Further parasitological studies performed after the start of the treatment with ivermectin on fresh fecal samples, gastric lavages and tracheal aspirates showed scanty mobile filariform and rabditoid larvae of the same parasite. Conclusions: The presence of adult female S. stercoralis which has never been observed before in the clinical samples submitted to our Laboratory for investigation can be considered as an indirect marker of the severe immunosupression of the patient.

The Aedes aegypti mosquito which transmits Zika virus (as well as dengue, chikungunya and yellow fever) represents a high risk for global transmission. This virus comes from Africa, the Zika forest in Uganda, where it was discovered in 1947 in a rhesus monkey. In May 2015, the first local cases were recorded in Brazil, surpassing 1.5 million cases in December of the same year. By March 2016, local transmission of Zika was recognized in 34 countries. Its clinical condition is similar to dengue febrile illness, although milder. The final geographical distribution area is constantly expanding. Recently, it has been associated with cases of Guillain-Barré syndrome in Brazil, Colombia, El Salvador, Venezuela and Suriname. Microcephaly was documented in Brazil. This article discusses some factors that contributed to the spread of Zika virus in South America. Climate change associated with the events of the phenomenon of "El Niño" is also analyzed. The biggest concern is how quickly Zika is spreading around the world and that it could be far more dangerous than previously thought. Zika virus infection, by its explosive potential, has every chance of becoming a global pandemic.

It has been more than 30 years since AIDS was introduced in people's daily life, and it is a milestone that causes taboos, myths and prejudices. At that time, a patient told me his feelings, and he was very convincing: "I am horrified of living and afraid of dying." Three decades later, AIDS infection is not a death sentence anymore. First, doctors could make that infected patients did not die from the disease; then, that the medication which kept them alive was not so toxic. And finally, that the treatments were more comfortable. And once at this point, the possibility that the virus may disappear from the body is a more realistic goal than ever. The story of AIDS has changed and, for the first time, we can foresee in the short term the beginning of the end of the pandemic. Now it is not about whether the cure is possible or not, but about when we will have it. This current momentum, so hard to get, should be maintained. We have never been so close to achieving this goal. Although the end of the pandemic is close, this is not enough. It is worrying that some world leaders have absolved themselves of responsibility for not stopping or at least having understood the explosion of the pandemic as if it was a natural disaster. "Zero tolerance for HIV" requires a profound understanding of the stigma and discrimination of the infected people to finally get rid of the epidemic of fear and the devastation that the pandemic caused.

Neglected tropical diseases (NTDs) are remediable injustices of our times. Poverty is the starting point, and the ultimate outcome, of NTD. Ebola is just one of many NTDs that badly need attention. Ebola exacerbates West Africa's poverty crisis. The virus spreading in Guinea, Liberia and Sierra Leone has led to food shortages and neglect of other devastating tropical illnesses. A health crisis that was ignored for months until it was out of control is now beginning to get the attention required, if not the resources. So far, the world's nations have contributed far less than the $ 1 billion. The U.N. estimates would need to control the epidemic before it becomes endemic. Past outbreaks of Ebola have flared up in remote, forested communities, disconnected from much of the outside world. But the outbreak in West Africa has not slowed yet, and it worsens there the chances of it spreading to other countries. Ebola draws attention to NTD. Ebola is not only a health emergency, but also it's a poverty crisis. The current Global Ebola crisis presents a multitude of challenges in terms of our capacity to respond; the future is even less predictable. Ebola outbreak represents inequity in health as the occurrence of health differences considered unnecessary, avoidable, unfair, and unjust, thus adding a moral and ethical dimension to health inequalities. Health equity does not refer only to the fairness in the distribution of health or the provision of health care; rather, it is linked with the larger issues of fairness and justice in social arrangements.

HIV Infections ; Human Rights ; Humans ; Travel

We communicate the diagnosis by microscopy of a pulmonary coinfection produced by Cryptococcus neoformans and Pneumocystis jiroveci, from a respiratory secretion obtained by bronchoalveolar lavage of an AIDS patient. Our review of literature identified this coinfection as unusual presentation. Opportunistic infections associated with HIV infection are increasingly recognized. It may occur at an early stage of HIV-infection. Whereas concurrent opportunistic infections may occur, coexisting Pneumocystis jiroveci pneumonia (PCP) and disseminated cryptococcosis with cryptococcal pneumonia is uncommon. The lungs of individuals infected with HIV are often affected by opportunistic infections and tumours and over two-thirds of patients have at least one respiratory episode during the course of their disease. Pneumonia is the leading HIV-associated infection. We present the case of a man who presented dual Pneumocystis jiroveci and cryptococcal pneumonia in a patient with HIV. Definitive diagnosis of PCP and Cryptococcus requires demonstration of these organisms in pulmonary tissues or fluid. In patients with < 200/microliter CD4-lymphocytes, a bronchoalveolar lavage should be performed. This patient was successfully treated with amphotericin B and trimethoprim sulfamethoxazole. After 1 week the patient showed clinical and radiologic improvement and was discharged 3 weeks later.
Acquired Immunodeficiency Syndrome ; complications ; Adult ; Amphotericin B ; therapeutic use ; Antifungal Agents ; therapeutic use ; Bronchoalveolar Lavage Fluid ; microbiology ; Coinfection ; diagnosis ; pathology ; Cryptococcosis ; complications ; diagnosis ; pathology ; Cryptococcus neoformans ; isolation & purification ; Humans ; Male ; Microscopy ; Pneumocystis carinii ; isolation & purification ; Pneumonia, Pneumocystis ; complications ; diagnosis ; pathology ; Treatment Outcome ; Trimethoprim, Sulfamethoxazole Drug Combination ; therapeutic use

Objective:To study anemia in AIDS patients and its relation with socioeconomic, employment status and educational levels. Methods:A total number of 442 patients who visited the Infectious Diseases University Hospital in Buenos Aires, Argentina were included in the study. Patients were dividied into two groups, i.e. one with anemia and the other without anemia. Anemia epidemiology and its relationship with educational level, housing, job situation, monthly income, total daily caloric intake and weekly intake of meat were evaluated. Results: Anemia was found in 228 patients (54%). Comparing patients with or without anemia, a statistically significant difference was found (P<0.000 1) in those whose highest educational level reached was primary school, who lived in a precarious home, who had no stable job or were unable to work, whose income was less than 30 dollars per month, whose meat consumption was less than twice a week or received less than 8 000 calories per day. Conclusions:The high prevalence of anemia found in poor patients with AIDS suggests that poverty increases the risk to suffer from this hematological complication. The relationship between economic development policies and AIDS is complex. Our results seem to point to the fact that AIDS epidemic may affect economic development and in turn be affected by it. If we consider that AIDS affects the economically active adult population, despite recent medical progress it usually brings about fatal consequences, especially within the poorest sectors of society where the disease reduces the average life expectancy, increases health care demand and tends to exacerbate poverty and iniquity.

Cutaneous larva migrans (CLM) represents the most common tropically acquired dermatosis. CLM is caused by infection with hookworm larvae in tropical and sub-tropical areas, and people who have a history of foreign travel and of walking barefoot on sandy soil or beaches are at a high risk of getting infected with it. The diagnosis is usually made on the basis of the typical appearance of the lesion, intense itching and history of foreign travel. CLM is a common parasitic skin disease that can be easily prevented by wearing 'protective' footwear. A case of CLM is described in this article.
Adult ; Albendazole ; therapeutic use ; Antinematodal Agents ; therapeutic use ; Argentina ; Brazil ; Female ; Humans ; Larva Migrans ; Travel