Análise de parâmetros laboratoriais em fase aguda e pós-aguda de doenças infecto-parasitárias em centro de referência da Amazônia

Abstract

The population of the brazilian Amazon is the target of parasitic infectious diseases, especially: viruses, bacteria, protozoa and fungi, mainly due to the economic-social and epidemiological scenario. The most requested test in several possible clinical pictures is the blood count, in addition, as a way to evaluate inflammation response, it is possible to use the evaluation of erythrocyte sedimentation rate (ESR) and, finally, as an acute phase marker, c-reactive protein (CRP) is evaluated. To compare the quantitative values of neutrophils, lymphocytes, ESR and CRP among individuals infected with bacterial, parasitic and viral infections in acute and acute post-acute phase. The sample consisted of 107 participants, obtained through a database of 1064 participants, completed at SOAMU/IEC from February 2018 to January 2020. Patients with febrile syndrome and afebrile and healthy patients were selected, composing the control group, with 213 participants. The collection was performed in two moments, in an acute phase (called "T0") and later in the reassessment (called "T1"). Bacterial infections (n=33 30.8%), viral (n=38; 35.5%) and parasitic infections (n=36; 33.7%) were identified, affecting mainly the age group of young adults. In relation to neutrophils, the values were significantly higher in bacterial infections in T0 compared to the other patients, and also showed a significant increase in T0 when compared to T1. As for lymphocytes, in parasitic infections there was significant lymphocytosis in relation to control, in addition, in viral infections there was a significant increase in T1, when compared to T0. In relation to ESR, in all infections, both in T0 and T1, the increase was significantly higher in relation to the control, in addition, in the time T0, in bacterial infections, the increase was significant in relation to viral infections, moreover, the ESR was higher in T0 in relation to T1 in the groups with bacterial and viral infections. Finally, CRP was significantly higher in the three infections in relation to control in the acute phase and, in the post-acute phase, only in viral infections there was no difference in the values found in the controls, in addition, in relation to T0, CRP was also higher in bacterial infections in relation to viral infections and, moreover, CRP was higher in T0 in relation to T1 in all infections. Bacterial conditions present neutrophilia, increased CRP and ESR compared to the other groups. Viral diseases demonstrate acute lymphocytopenia. Parasitic diseases show lymphocytosis. The union of results with clinical findings is essential for medical practice.