<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2176-6223</journal-id>
<journal-title><![CDATA[Revista Pan-Amazônica de Saúde]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Pan-Amaz Saude]]></abbrev-journal-title>
<issn>2176-6223</issn>
<publisher>
<publisher-name><![CDATA[Instituto Evandro Chagas. Secretaria de Vigilância em Saúde e Ambiente. Ministério da Saúde]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2176-62232016000200075</article-id>
<article-id pub-id-type="doi">10.5123/S2176-62232016000200009</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Presença de Mycobacterium leprae em escarro de paciente sintomático respiratório com hanseníase multibacilar]]></article-title>
<article-title xml:lang="en"><![CDATA[The presence of Mycobacterium leprae in sputum of respiratory symptomatic patient with multibacillary leprosy]]></article-title>
<article-title xml:lang="es"><![CDATA[Presencia de Mycobacterium leprae en esputo de paciente sintomático respiratorio con lepra multibacilar]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lima]]></surname>
<given-names><![CDATA[Luana Nepomuceno Gondim Costa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lopes]]></surname>
<given-names><![CDATA[Maria Luíza]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silvestre]]></surname>
<given-names><![CDATA[Maria do Perpétuo Socorro Amador]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramos]]></surname>
<given-names><![CDATA[Francisco Lúzio de Paula]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Matos]]></surname>
<given-names><![CDATA[Haroldo José de]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Evandro Chagas/SVS/MS  ]]></institution>
<addr-line><![CDATA[Ananindeua Pará]]></addr-line>
<country>Brazil</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2016</year>
</pub-date>
<volume>7</volume>
<numero>2</numero>
<fpage>75</fpage>
<lpage>78</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iec.gov.br/scielo.php?script=sci_arttext&amp;pid=S2176-62232016000200075&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iec.gov.br/scielo.php?script=sci_abstract&amp;pid=S2176-62232016000200075&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iec.gov.br/scielo.php?script=sci_pdf&amp;pid=S2176-62232016000200075&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO Paciente com queixa principal de tosse produtiva crônica com três meses de duração e expectoração de muco purulento, perda de peso, falta de apetite, dispneia, dor na região torácica e cansaço, sendo ainda observados sintomas clínicos de hanseníase, índice baciloscópico da linfa de 4,25 e títulos de IgM anti-PGL-I positivos. Do escarro, pelo método de Ziehl-Neelsen, foram observados bacilos isolados e globias, com ausência de crescimento em Löwenstein-Jensen. Foi demonstrada amplificação do DNA de Mycobacterium leprae nas amostras de escarro e secreção nasal. Assim, ilustramos um caso sintomático de tuberculose e hanseníase, mas somente com hanseníase multibacilar, podendo ter ocorrido disseminação do M. leprae para os pulmões por contiguidade, uma vez que o bacilo é encontrado rotineiramente na nasofaringe.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT Patient with main complaints of chronic productive cough lasted three months and expectoration of purulent sputum, weight loss, loss of appetite, dyspnea, pain in the thoracic region and tiredness, clinical symptoms of leprosy, lymph index of 4.25 and positive IgM anti-PGL-I titers. Of the sputum, by using the Ziehl-Neelsen method, isolated bacilli and in groups with lack of growth in Löwenstein-Jensen were observed. It was shown DNA amplification of Mycobacterium leprae in the sputum samples and nasal secretion. It is demonstrated a symptomatic case of tuberculosis and leprosy, but only in multibacillary leprosy, so the dissemination by contiguity of M. leprae to the lungs can occur, once bacillus is frequently found in the nasopharynx.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN Paciente con queja principal de tos productiva crónica con tres meses de duración y expectoración de muco purulento, pérdida de peso, falta de apetito, disnea, dolor en la región torácica y cansancio, se observaron síntomas clínicos de lepra, índice baciloscópico de linfa de 4,25 y títulos de IgM anti-PGL-I positivos. Del esputo, por el método de Ziehl-Neelsen, se observaron bacilos aislados y globias, con ausencia de crecimiento en Löwenstein-Jensen. Se demostró una amplificación del ADN de Mycobacterium leprae en las muestras de esputo y secreción nasal. Así, ilustramos un caso sintomático de tuberculosis y lepra, solamente con lepra multibacilar, aunque puede haber habido diseminación de M. leprae para los pulmones por contigüidad, una vez que el bacilo se encuentra, normalmente, en la nasofaringe.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Hanseníase]]></kwd>
<kwd lng="pt"><![CDATA[Escarro]]></kwd>
<kwd lng="pt"><![CDATA[Tuberculose]]></kwd>
<kwd lng="en"><![CDATA[Leprosy]]></kwd>
<kwd lng="en"><![CDATA[Sputum]]></kwd>
<kwd lng="en"><![CDATA[Tuberculosis]]></kwd>
<kwd lng="es"><![CDATA[Lepra]]></kwd>
<kwd lng="es"><![CDATA[Esputo]]></kwd>
<kwd lng="es"><![CDATA[Tuberculosis]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="book">
<collab>Ministério da Saúde (BR). Departamento de Informática do SUS</collab>
<source><![CDATA[Datasus]]></source>
<year>2014</year>
<publisher-loc><![CDATA[Brasília ]]></publisher-loc>
<publisher-name><![CDATA[Ministério da Saúde]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Respiratory system involvement in leprosy]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kaur]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Malik]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
<name>
<surname><![CDATA[Kumar]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Singh]]></surname>
<given-names><![CDATA[MP]]></given-names>
</name>
<name>
<surname><![CDATA[Chakravarty]]></surname>
<given-names><![CDATA[RN]]></given-names>
</name>
</person-group>
<source><![CDATA[Int J Lepr Other Mycobact Dis]]></source>
<year>1979</year>
<volume>47</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>18-25</page-range></nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[A clinical study of the nose in lepromatous leprosy]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Barton]]></surname>
<given-names><![CDATA[RPE]]></given-names>
</name>
</person-group>
<source><![CDATA[Lepr Rev]]></source>
<year>1974</year>
<volume>45</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>135-44</page-range></nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Visceral lesions caused by M. leprae: a histopathological study]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Desikan]]></surname>
<given-names><![CDATA[KV]]></given-names>
</name>
<name>
<surname><![CDATA[Job]]></surname>
<given-names><![CDATA[CK]]></given-names>
</name>
</person-group>
<source><![CDATA[Indian J Pathol Bacteriol]]></source>
<year>1970</year>
<volume>13</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>100-8</page-range></nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Tracheitis and bronchitis leprosa]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lie]]></surname>
<given-names><![CDATA[HP]]></given-names>
</name>
</person-group>
<source><![CDATA[Int J Lepr]]></source>
<year>1936</year>
<volume>4</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>281-8</page-range></nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rozen]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Skaletsky]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Primer3 on the WWW for general users and for biologist programmers]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Misener]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Krawetz]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
</person-group>
<source><![CDATA[Bioinformatics methods and protocols]]></source>
<year>1999</year>
<page-range>365-86</page-range><publisher-loc><![CDATA[Totowa ]]></publisher-loc>
<publisher-name><![CDATA[Humana Press]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Concomitant active pulmonary tuberculosis and lepromatous leprosy with type-II lepra reaction in same patient]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Waghray]]></surname>
<given-names><![CDATA[DP]]></given-names>
</name>
<name>
<surname><![CDATA[Tummuru]]></surname>
<given-names><![CDATA[VR]]></given-names>
</name>
<name>
<surname><![CDATA[Rao]]></surname>
<given-names><![CDATA[AK]]></given-names>
</name>
<name>
<surname><![CDATA[Reddy]]></surname>
<given-names><![CDATA[VV]]></given-names>
</name>
</person-group>
<source><![CDATA[J Evol Med Dent Sci]]></source>
<year>2013</year>
<volume>2</volume>
<numero>36</numero>
<issue>36</issue>
<page-range>6880-5</page-range></nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Leprosy of the lungs]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Muir]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[Lepr India]]></source>
<year>1933</year>
<volume>5</volume>
<page-range>72</page-range></nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Co-infection of Mycobacterium tuberculosis and Mycobacterium leprae in human archaeological samples: a possible explanation for the historical decline of leprosy]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Donoghue]]></surname>
<given-names><![CDATA[HD]]></given-names>
</name>
<name>
<surname><![CDATA[Marcsik]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Matheson]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Vernon]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Nuorala]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Molto]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
</person-group>
<source><![CDATA[Proc Biol Sci]]></source>
<year>2005</year>
<volume>272</volume>
<numero>1561</numero>
<issue>1561</issue>
<page-range>389-94</page-range></nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Co-infection with M. tuberculosis and M. leprae-case report and systematic review]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rajagopala]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Devaraj]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[D'Souza]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Aithal]]></surname>
<given-names><![CDATA[VV]]></given-names>
</name>
</person-group>
<source><![CDATA[J Mycobac Dis]]></source>
<year>2012</year>
<volume>2</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>1-5</page-range></nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Tuberculose et lepre, maladies antagoniques: eviction de la lepre par la tuberculose]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chaussinand]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<source><![CDATA[Int J Lepr]]></source>
<year>1948</year>
<volume>16</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>431-8</page-range></nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Rapid differentiation of Mycobacterium tuberculosis and Mycobacterium leprae from sputum by polymerase chain reaction]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sapkota]]></surname>
<given-names><![CDATA[BR]]></given-names>
</name>
<name>
<surname><![CDATA[Ranjit]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Macdonald]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Nepal Med Coll J]]></source>
<year>2007</year>
<volume>9</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>12-6</page-range></nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Detection of Mycobacterium leprae by PCR testing of sputa from a patient with pulmonary cryptococcus coinfection in Northern Australia]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Edwards]]></surname>
<given-names><![CDATA[LJ]]></given-names>
</name>
<name>
<surname><![CDATA[Price]]></surname>
<given-names><![CDATA[RN]]></given-names>
</name>
<name>
<surname><![CDATA[Krause]]></surname>
<given-names><![CDATA[VL]]></given-names>
</name>
<name>
<surname><![CDATA[Huffam]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
<name>
<surname><![CDATA[Globan]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Fyfe]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[J Clin Microbiol]]></source>
<year>2014</year>
<volume>52</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>3811-2</page-range></nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[PCR-based techniques for leprosy diagnosis: from the laboratory to the clinic]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martinez]]></surname>
<given-names><![CDATA[AN]]></given-names>
</name>
<name>
<surname><![CDATA[Talhari]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Moraes]]></surname>
<given-names><![CDATA[MO]]></given-names>
</name>
<name>
<surname><![CDATA[Talhari]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[PLoS Negl Trop Dis]]></source>
<year>2014</year>
<volume>8</volume>
<numero>4</numero>
<issue>4</issue>
</nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Cytokine polymorphisms and susceptibility to leprosy]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lima]]></surname>
<given-names><![CDATA[LNGC]]></given-names>
</name>
<name>
<surname><![CDATA[Frota]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
<name>
<surname><![CDATA[Freitas]]></surname>
<given-names><![CDATA[MVC]]></given-names>
</name>
<name>
<surname><![CDATA[Câmara]]></surname>
<given-names><![CDATA[LMC]]></given-names>
</name>
<name>
<surname><![CDATA[Rodrigues]]></surname>
<given-names><![CDATA[LC]]></given-names>
</name>
<name>
<surname><![CDATA[Barreto]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
</person-group>
<source><![CDATA[Rev Bras Med]]></source>
<year>2013</year>
<volume>70</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>1-6</page-range></nlm-citation>
</ref>
<ref id="B16">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Role of HLA, KIR, MICA, and cytokines genes in leprosy]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jarduli]]></surname>
<given-names><![CDATA[LR]]></given-names>
</name>
<name>
<surname><![CDATA[Sell]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Reis]]></surname>
<given-names><![CDATA[PG]]></given-names>
</name>
<name>
<surname><![CDATA[Sippert]]></surname>
<given-names><![CDATA[EA]]></given-names>
</name>
<name>
<surname><![CDATA[Ayo]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Mazini]]></surname>
<given-names><![CDATA[PS]]></given-names>
</name>
</person-group>
<source><![CDATA[Biomed Res Int]]></source>
<year>2013</year>
<volume>2013</volume>
<page-range>1-17</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
