RAPHAEL ABEGAO DE CAMARGO
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bookPart Leishmaniose tegumentar(2013) AMATO, Valdir Sabbaga; CAMARGO, Raphael Abegão de; TUON, Felipe Francisco- Case Report: Reactivation of Mucosal and Cutaneous Leishmaniasis in a Renal Transplanted Patient(2014) TUON, Felipe F.; BOMBONATTO, Giovana Marina; BATTAGLIN, Eveline Roesler; SAKUMOTO, Marcus Henrique; AMATO, Valdir Sabbaga; CAMARGO, Raphael Abegao de; NICODEMO, Antonio CarlosMucosal leishmaniasis (ML) is a chronic form of tegumentary leishmaniasis, which causes destructive lesions of nasal, pharyngeal, and laryngeal mucosa. We describe a case of leishmaniasis reactivation with simultaneous cutaneous and mucosal forms in a renal transplanted patient with no history of prior leishmaniasis. Reactivation after renal transplantation was not reported in Brazil. A 67-year-old woman receiving prednisone 20 mg/day, tacrolimus 1 mg/day, and mycophenolic acid 360 mg/day presented with nose edema with erythema and cutaneous lesions. Amastigotes were identified on biopsies and the polymerase chain reaction confirmed Leishmania (Viannia) braziliensis. The patient was treated with liposomal amphotericin B but died 3 weeks after as a result of bacterial septic shock. In conclusion, tegumentary leishmaniasis can reactivate with simultaneous cutaneous and mucosal forms in a renal transplanted patient during the immunosuppressant therapy.
- Facial Structure Alterations and Abnormalities of the Paranasal Sinuses on Multidetector Computed Tomography Scans of Patients with Treated Mucosal Leishmaniasis(2014) CAMARGO, Raphael Abegao de; NICODEMO, Antonio C.; SUMI, Daniel Vaccaro; GEBRIM, Eloisa Maria Mello Santiago; TUON, Felipe Francisco; CAMARGO, Lazaro Manoel de; IMAMURA, Rui; AMATO, Valdir SabbagaBackground/Objectives: Mucosal leishmaniasis (ML) is a progressive disease that affects cartilage and bone structures of the nose and other upper respiratory tract structures. Complications associated with ML have been described, but there is a lack of studies that evaluate the structural changes of the nose and paranasal sinuses in ML using radiological methods. In this study, we aimed to assess the opacification of the paranasal sinuses in patients with treated ML and any anatomical changes in the face associated with ML using multidetector computed tomography scans (MDCT) of the sinuses. We compared the findings with a control group. Methodology/Principal Findings: We evaluated 54 patients with treated ML who underwent CT scans of the sinuses and compared them with a control group of 40 patients who underwent orbital CT scans. The degree of sinus disease was assessed according to the Lund-Mackay criteria. Forty of the 54 patients with a history of ML (74.1%) had a tomographic score compatible with chronic sinusitis (Lund-Mackay >= 4). CT scans in the leishmaniasis and control groups demonstrated significant differences in terms of facial structure alterations. Patients from the ML group showed more severe levels of partial opacification and pansinus mucosal thickening (42.6%) and a greater severity of total opacification. Patients from the ML group with a Lund-Mackay score >= 4 presented longer durations of disease before treatment and more severe presentations of the disease at diagnosis. Conclusion/Significance: CT scans of the sinuses of patients with ML presented several structural alterations, revealing a prominent destructive feature of the disease. The higher prevalence in this study of chronic rhinosinusitis observed in CT scans of patients with treated ML than in those of the control group suggests that ML can be considered a risk factor for chronic rhinosinusitis in this population (p<0.05).
conferenceObject 18F-FDG PET/CT Findings vs. Histology of Surgically Resected Cardiac Valves in Patients With Infective Endocarditis.(2018) CAMARGO, Raphael A.; CASTELLI, Jussara B.; BITTENCOURT, Marcio S.; AYABE, Daniel; PAIXAO, Milena R.; FELICIO, Marilia F.; SOEIRO, Alexandre M.; GONCALVES, Luis Fernando T.; V, Tania Strabelli; SOARES JR., Jose; BUCHPIGUEL, Carlos A.; MANSUR, Alfredo J.; TARASOUTCHI, Flavio; OLIVEIRA JR., Mucio T.; MENEGHETTI, Claudio; GUALANDRO, Daniele M.; POCEBON, Lucas; BLANKSTEIN, Ron; ALAVI, Abass; SICILIANO, Rinaldo F.- Pacemaker-related infection detected by F-18-fluorodeoxyglucose positron emission tomography-computed tomography(2014) PEIXOTO, Giselle de Lima; SICILIANO, Rinaldo Focaccia; CAMARGO, Raphael Abegao; BUENO, Fabiana Lucas; SOARES JUNIOR, Jose; COSTA, Roberto; STRABELLI, Tania Mara Varejao; MARTINELLI FILHO, MartinoLead endocarditis (LE) is one of the most feared complications and remains a challenging diagnosis in cardiology due to the possibility of an obscure clinical course and symptoms, leading to a delayed diagnosis, or even no diagnosis. F-18-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) appears to be a valuable imaging technique and has been shown to have advantages in the diagnosis of patients with fever of unknown origin. We present the case of a 52-year-old man with a 3-year history of intermittent fever, chills, anemia, and weight loss (13 kg). He was submitted to an extensive investigation to clarify his symptoms and all results were negative. LE was finally diagnosed by FDG PET/CT. This examination could become a useful noninvasive method for the detection of LE at an earlier stage, thus avoiding repeated tests and reducing the length of hospital stay.
- F-18-FDG PET/CT in the Follow-Up of Mucosal Leishmaniasis(2018) CAMARGO, Raphael A.; CAMARGO, Lazaro M.; SAPIENZA, Marcelo T.; BUCHPIGUEL, Carlos A.; AMATO, Valdir S.; TUON, Felipe Francisco
- Liposomal formulation of amphotericin B for the treatment of mucosal leishmaniasis in HIV-negative patients(2014) ROCIO, Carolina; AMATO, Valdir Sabbaga; CAMARGO, Raphael A.; TUON, Felipe F.; NICODEMO, Antonio CarlosBackground: Studies assessing the efficacy of liposomal amphotericin B (LAB) in the treatment of patients with mucosal leishmaniasis (ML) are very scarce in the literature and an optimal dose regimen has not yet been defined. Methods: We performed a retrospective and descriptive analysis from records of 16 patients with ML treated with LAB. The mean daily dose of LAB was 2.5 mg/kg/day. Results: Healing of the lesion was observed in 14 (88%) of the 16 patients. The mean cumulative doses, excluding the two treatment failures, were 2265 mg and 33 mg/kg. Conclusion: Liposomal amphotericin B in the cumulative dose of 30 to 35 mg/kg was able to achieve 100% effectiveness.
- Short Report: Can We Use a Lower Dose of Liposomal Amphotericin B for the Treatment of Mucosal American Leishmaniasis?(2011) AMATO, Valdir S.; TUON, Felipe F.; CAMARGO, Raphael A.; SOUZA, Regina M.; SANTOS, Carolina R.; NICODEMO, Antonio C.Liposomal amphotericin B has been used as an alternative treatment of mucosal leishmaniasis, but the optimal dose is not established. We retrospectively reviewed the clinical outcome of eight patients with mucosal leishmaniasis treated with liposomal amphotericin B. The mean total dose was 35 mg/kg (range 24-50 mg/kg), which resulted in the healing of all the lesions in all patients and no recurrences were observed during the follow-up period (mean 25 months; range 7-40 months).
- The Role of F-18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Diagnosis of Left-sided Endocarditis: Native vs Prosthetic Valves Endocarditis(2020) CAMARGO, Raphael Abegao de; BITENCOURT, Marcio Sommer; MENEGHETTI, Jose Claudio; JR, Jose Soares; GONCALVES, Luis Fernando Tonello; BUCHPIGUEL, Carlos Alberto; PAIXAO, Milena Ribeiro; FELICIO, Marilia Francesconi; SOEIRO, Alexandre de Matos; STRABELLI, Tania Mara Varejao; MANSUR, Alfredo Jose; TARASOUTCHI, Flavio; JR, Mucio Tavares de Oliveira; CASTELLI, Jussara Bianchi; GUALANDRO, Danielle Menosi; POCEBON, Lucas Zoboli; BLANKSTEIN, Ron; ALAVI, Abass; MOORE, John Edmund; MILLAR, Beverley Cherie; SICILIANO, Rinaldo FocacciaBackground: F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG-PET/CT) has emerged as a useful diagnostic tool for suspected infective endocarditis (IE) in patients with prosthetic valves or implantable devices. However, there is limited evidence regarding use of F-18-FDG-PET/CT for the diagnosis of native valve endocarditis (NVE). Methods: Between 2014 and 2017, 303 episodes of left-sided suspected IE (188 prosthetic valves/ascending aortic prosthesis and 115 native valves) were studied. F-18-FDG-PET/CT accuracy was determined in the subgroups of patients with NVE and prosthetic valve endocarditis (PVE)/ascending aortic prosthesis infection (AAPI). Associations between inflammatory infiltrate patterns and F-18-FDG-PET/CT uptake were investigated in an exploratory ad hoc histological analysis. Results: Among 188 patients with PVE/AAPI, the sensitivity, specificity, and positive and negative predictive values of F-18-FDG-PET/CT focal uptake were 93%, 90%, 89%, and 94%, respectively, while among 115 patients with NVE, the corresponding values were 22%, 100%, 100%, and 66%. The inclusion of abnormal F-18-FDG cardiac uptake as a major criterion at admission enabled a recategorization of 76% (47/62) of PVE/AAPI cases initially classified as ""possible"" to ""definite"" IE. In the histopathological analysis, a predominance of polymorphonuclear cell inflammatory infiltrate and a reduced extent of fibrosis were observed in the PVE group only. Conclusions: Use of F-18-FDG-PET/CT at the initial presentation of patients with suspected PVE increases the diagnostic capability of the modified Duke criteria. In patients who present with suspected NVE, the use of F-18-FDG-PET/CT is less accurate and could only be considered a complementary diagnostic tool for a specific population of patients with NVE.
bookPart Leishmanaiose Visceral(2016) AMATO, Valdir Sabbaga; SOUZA, Regina Maia de; BRAZ, Lucia Maria Almeida; CAMARGO, Raphael Abegão de; TUON, Felipe Francisco Bondan; NICODEMO, Elisabeth Lima