Dados do Trabalho

Título

Case report of Crithidia fasciculata infection in a child with hepatosplenomegaly in the city of São Paulo.

Objetivos(s)

In this report, we recorded the infection by Crithidia fasciculata in a patient at a public hospital in São Paulo.

Relato do Caso

A trypanosomatid morphologically resembling Crithidia was isolated from the liver biopsy of a female patient aged 2 years and 11 months, from the municipality of Manoel Vitorino, Bahia, diagnosed with LAD-1. Patient with a history of recurrent bacterial infections and successive hospitalizations since the first year of life. Current clinical conditions began at 1 year and 6 months ago, with anemia, malnutrition, leukocytosis and hepatosplenomegaly.
Parasite isolation was obtained by culture from liver in tubes and microplates using biphasic BAB/BHI medium added with gentamicin and sterile human urine. From the first observation, after 48 hours, many colonies were noted in the solid phase of the medium with an exuberant multiplication of choanomastigote-like forms typical of Crithidia. RT- PCR reactions using DNA from liver biopsy and from cultures were always negative for Leishmania of Viannia and Leishmania subgenera.
The identification of the trypanosomatid present in liver tissue and cultures as Crithidia fasciculata was performed by DNA barcoding followed by phylogenetic analysis of DNA sequences.

Conclusão

New attempts on isolation of parasites and additional diagnostic assays are being carried out to confirm the absence of Leishmania, which until now was never detected in the patient.
The patient remains in hospital and new scientific communications about clinical conditions and treatment are currently in preparation.