Acute-subacute paracoccidioidomycosis: A paediatric cohort of 141 patients, exploring clinical characteristics, laboratorial analysis and developing a non-survival predictor.
Mycoses
; 62(11): 999-1005, 2019 Nov.
Article
em En
| MEDLINE
| ID: mdl-31408548
ABSTRACT
The acute-subacute form of paracoccidioidomycosis (PCM) is a severe systemic mycosis that affects children and adolescents from endemic regions, leading to generalised lymphadenopathy, fever, weight loss, anaemia, eosinophilia, hypoalbuminemia and hypergammaglobulinemia. The objective of this study is to describe the clinical and laboratorial characteristics of acute-subacute PCM, to determine a mortality risk factor and to propose a test for non-survival hazard related to the disease. Children and adolescents diagnosed with PCM, under 15 years were included in the study. Their epidemiological, clinical and laboratorial data were obtained from the hospital records. Descriptive analysis, comparison of means, univariate logistic regression, multivariate logistic regression and a ROC curve were performed in order to identify significant information (P < .05). Through a period of 38 years, 141 children and adolescents were diagnosed with acute-subacute PCM. The main antifungal agent used for the treatment was sulfamethoxazole-trimethoprim (SMX-TMP). The complication rate was 17%, the relapse rate was 7.8% and the mortality rate was 5.7%. A low albumin dosage was identified as a predictor factor for mortality. The cut-off for serum albumin was 2.18 g/dL, above which, the survival rate is 99.1%. Thus, simple clinical and laboratorial examinations may lead to the diagnosis of acute-subacute PCM, and the beginning of the treatment is encouraged even before the isolation of the fungus in biological samples, preventing unfavourable outcomes. Patients with an albumin dosage ≤ 2.18g/dL must receive special attention, preferably hospitalised, during the first four weeks of treatment for presenting an elevated mortality hazard.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Aperfeicoar_gestao_SUS
Base de dados:
MEDLINE
Assunto principal:
Paracoccidioidomicose
Tipo de estudo:
Etiology_studies
/
Observational_studies
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Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limite:
Adolescent
/
Child
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Child, preschool
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Female
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Humans
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Infant
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Male
/
Newborn
País/Região como assunto:
America do sul
/
Brasil
Idioma:
En
Revista:
Mycoses
Ano de publicação:
2019
Tipo de documento:
Article