West Nile Virus in the State of Ceará, Northeast Brazil.

In June 2019, a horse with neurological disorder was diagnosed with West Nile virus (WNV) in Boa Viagem, a municipality in the state of Ceará, northeast Brazil. A multi-institutional task force coordinated by the Brazilian Ministry of Health was deployed to the area for case investigation. A total of 513 biological samples from 78 humans, 157 domestic animals and 278 free-ranging wild birds, as well as 853 adult mosquitoes of 22 species were tested for WNV by highly specific serological and/or molecular tests.

West Nile Virus in Brazil.

West Nile virus (WNV) was first sequenced in Brazil in 2019, when it was isolated from a horse in the Espírito Santo state. Despite multiple studies reporting serological evidence suggestive of past circulation since 2004, WNV remains a low priority for surveillance and public health, such that much is still unknown about its genomic diversity, evolution, and transmission in the country. A combination of diagnostic assays, nanopore sequencing, phylogenetic inference, and epidemiological modeling are here used to provide a holistic overview of what is known about WNV in Brazil.

Sequential serological surveys in the early stages of the coronavirus disease epidemic: limitations and perspectives.

Introduction: Estimates of the number of individuals infected by severe acute respiratory syndrome coronavirus 2 are important for health planning and establishment of expectations regarding herd immunity.

Methods: Seven testing rounds of a serological survey were conducted at 1-week intervals between April 19 and May 31, 2020 in Teresina municipality. RESULTS Over the 7 weeks, serological positivity increased from 0.

Potential role of dengue virus, chikungunya virus and Zika virus in neurological diseases.

This study showed that laboratory markers of recent infection by dengue, Zika or chikungunya arboviruses were detected in the biological samples of approximately one-third of patients with encephalitis, myelitis, encephalomyelitis or Guillain-Barré syndrome, in a surveillance programme in Piauí state, Brazil, between 2015-2016. Fever and myalgia had been associated with these cases. Since in non-tropical countries most infections or parainfectious diseases associated with the nervous system are attributed to herpesviruses, enteroviruses, and Campylobacter jejuni, the present findings indicate that in tropical countries, arboviruses may now play a more important role and reinforce the need for their surveillance and systematic investigation in the tropics.

Proposal for a simplified approach to suspected meningitis case diagnosis: experience report of a reference service in the state of Piauí, Brazil, 2007-2016.

Objective: to describe a simplified protocol to diagnose suspected cases of meningitis.

Methods: this is an experience report on the approach to diagnosing meningitis at the Tropical Diseases Reference Service in the state of Piauí, Brazil, between 2007 and 2016; information was extracted from the Notifiable Diseases Information System (SINAN) and the laboratory record book; the chi-square test was used to compare epidemiological surveillance indicators based on final meningitis case classification; the Phi coefficient was used to verify the correlation between presumed diagnosis and laboratory-confirmed diagnosis.

Results: considering the 4,096 cases of meningitis investigated, there was a reduction in the generic classification of meningitis cases from 72% to 47% (p<0.

Encephalitis associated with Zika virus infection and reactivation of the varicella-zoster virus in a Brazilian child.

We report a case of encephalitis associated with Zika virus infection and reactivation of varicella-zoster virus in the central nervous system of a Brazilian child. This case raises the possibility that reactivation of the latent varicella-zoster virus may be a mechanism of neurological impairment induced by acquired Zika virus infection.

Microcephaly in Piauí, Brazil: descriptive study during the Zika virus epidemic, 2015-2016.

Objective: to describe the occurrence and characteristics of microcephaly cases in Piauí, Brazil, during an epidemic of Zika virus infection in 2015-2016.

Methods: descriptive study using data of live births from January/2015 to January/2016, obtained from the Information System on Live Births (Sinasc), the Public Health Events Registry (RESP) and the active search for medical records; mothers and live births were tested for dengue, chikungunya, and Zika, besides syphilis, toxoplasmosis, rubella, cytomegalovirus, and herpes (STORCH).

Results: of the 75 microcephaly cases, 34 were related to congenital infectious process; microcephaly prevalence was of 13.

Soap bubble appearance in brain magnetic resonance imaging: cryptococcal meningoencephalitis.

Although cryptococcal infections begin in the lungs, meningoencephalitis is the most frequently encountered manifestation of cryptococcosis among individuals with advanced immunosuppression. As the infection progresses along the Virchow-Robin spaces, these structures may become dilated with mucoid material produced by the capsule of the organism. We report a case of a 24-year-old man with cryptococcal meningoencephalitis in which magnetic resonance imaging showed clusters of gelatinous pseudocysts in the periventricular white matter, basal ganglia, mammillary bodies, midbrain peduncles and nucleus dentatus with a soap bubble appearance.

Spinal cord injury: epidemiological study of 386 cases with emphasis on those patients admitted more than four hours after the trauma.

We studied 386 cases of spinal cord injury to analyze the follow up of the patients admitted most of the time more than four hours, the majority of the injuries happening far from the attending health service and first specialized care received long after the accident. This is a clinical study based on data collected during hospitalization of the patients, operated or not, in a Brazilian public health service. The lesion mainly seen was fracture and dislocation, isolated or on multiple levels, and the most important clinical complications were due to respiratory failure and hypotension, especially because 73.

[Paracoccidioidomycosis in cerebral hemisphere and brainstem: case report].

We report on a 36 years-old man that had been at the Amazon forest four years before. Six months before the admission he had developed a progressive quadriparesis, gait ataxia, dysphagia, dysarthria, difficulty in breathing and hiccup. The gadolinium-enhanced T1-weighted MRI showed a lesion into the right parietoccipital area and another into the medulla, that was the largest.

[Schwannoma of brachial plexus: report of two cases].

Schwannomas, neurinomas or neurilemmomas are benign peripheral nerve tumors. The literature report some cases associated with neurofibromatosis 2. We report two cases of cervical schwannoma originating from the brachial plexus unassociated with neurofibromatosis.

[Eosinophilic granuloma of the cervical spine: case report].

Eosinophilic granuloma (EG) is a benign condition of histocytes proliferation localized or multifocal. It is presents in the cervical spine in 1.5%-20% of the cases of EG.