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1.
Microb Pathog ; 188: 106537, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38211834

RESUMEN

Paracoccidioidomycosis (PCM) is a systemic mycosis caused by Paracoccidioides spp. The interaction mediated by the presence of adhesins on the fungal surface and receptors in the extracellular matrix of the host, as well as the biofilm formation, is essential in its pathogenesis. Adhesins such as gp43, enolase, GAPDH (glyceraldehyde-3-phosphate dehydrogenase), and 14-3-3 have been demonstrated in the Paracoccidioides brasiliensis (Pb18) strain and recognized as necessary in the fungus-host interaction. The Pb 18 strain silenced to 14-3-3 showed changes in morphology, virulence, and adhesion capacity. The study aimed to evaluate the role of adhesin 14-3-3 in P. brasiliensis biofilm formation and the differential expression of genes related to adhesins, comparing planktonic and biofilm forms. The presence of biofilm was also verified in sutures in vitro and in vivo. The silenced strain (Pb14-3-3 aRNA) was compared with the wild type Pb18, determining the differential metabolic activity between the strains by the XTT reduction assay; the biomass by violet crystal and the polysaccharides by safranin, even as morphological differences by microscopic techniques. Differential gene expression for adhesins was also analyzed, comparing the relative expression of these in planktonic and biofilm forms at different times. The results suggested that the silencing of 14-3-3 protein altered the ability to form biofilm and its metabolism. The quantity of biomass was similar in both strains; however, the formation of exopolymeric substances and polysaccharide material was lower in the silenced strain. Our results showed increased expression of enolase, GAPDH, and 14-3-3 genes in the first periods of biofilm formation in the Pb18 strain. In contrast, the silenced strain showed a lower expression of these genes, indicating that gene silencing can influence the expression of other genes and be involved in the biofilm formation of P. brasiliensis. In vitro and in vivo assays using sutures confirmed this yeast's ability to form biofilm and may be implicated in the pathogenesis of paracoccidioidomycosis.


Asunto(s)
Paracoccidioides , Paracoccidioidomicosis , Paracoccidioides/genética , Proteínas 14-3-3/genética , Proteínas 14-3-3/metabolismo , Gliceraldehído-3-Fosfato Deshidrogenasas , Biopelículas , Adhesinas Bacterianas/metabolismo , Fosfopiruvato Hidratasa/genética
2.
Med Mycol ; 62(5)2024 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-38684477

RESUMEN

The epidemiological dynamics of paracoccidioidomycosis (PCM) has been changing over the years. We analyzed secondary public data from the Hospital Information System of the Brazilian Unified Health System (SIH/SUS), focusing on PCM-related hospitalizations and in-hospital deaths. In the period between 2010 and 2019, 396 hospitalizations and 30 deaths were related to PCM among 7 073 334 hospitalizations registered in Rio de Janeiro. We highlight the rising rates, reflecting the increase in the number of acute forms previously reported. Urgent public health policies are essential to prevent poor outcomes related to this neglected mycosis.


Epidemiology of paracoccidioidomycosis has been changing in endemic areas. We analyzed secondary data on hospitalizations in Rio de Janeiro, an important endemic area. There is a trend on increasing rates of hospitalizations and in-hospital deaths mainly in the Metropolitan belt.


Asunto(s)
Mortalidad Hospitalaria , Hospitalización , Paracoccidioidomicosis , Brasil/epidemiología , Humanos , Paracoccidioidomicosis/epidemiología , Paracoccidioidomicosis/mortalidad , Hospitalización/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Femenino , Adulto , Anciano , Adolescente , Adulto Joven , Niño , Preescolar , Anciano de 80 o más Años
3.
Med Mycol ; 62(6)2024 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-38935909

RESUMEN

The World Health Organization, in response to the growing burden of fungal disease, established a process to develop a fungal pathogen priority list. This systematic review aimed to evaluate the epidemiology and impact of infections caused by Talaromyces marneffei, Coccidioides species, and Paracoccidioides species. PubMed and Web of Sciences databases were searched to identify studies published between 1 January 2011 and 23 February 2021 reporting on mortality, complications and sequelae, antifungal susceptibility, preventability, annual incidence, and trends. Overall, 25, 17, and 6 articles were included for T. marneffei, Coccidioides spp. and Paracoccidioides spp., respectively. Mortality rates were high in those with invasive talaromycosis and paracoccidioidomycosis (up to 21% and 22.7%, respectively). Hospitalization was frequent in those with coccidioidomycosis (up to 84%), and while the duration was short (mean/median 3-7 days), readmission was common (38%). Reduced susceptibility to fluconazole and echinocandins was observed for T. marneffei and Coccidioides spp., whereas >88% of T. marneffei isolates had minimum inhibitory concentration values ≤0.015 µg/ml for itraconazole, posaconazole, and voriconazole. Risk factors for mortality in those with talaromycosis included low CD4 counts (odds ratio 2.90 when CD4 count <200 cells/µl compared with 24.26 when CD4 count <50 cells/µl). Outbreaks of coccidioidomycosis and paracoccidioidomycosis were associated with construction work (relative risk 4.4-210.6 and 5.7-times increase, respectively). In the United States of America, cases of coccidioidomycosis increased between 2014 and 2017 (from 8232 to 14 364/year). National and global surveillance as well as more detailed studies to better define sequelae, risk factors, outcomes, global distribution, and trends are required.


Asunto(s)
Antifúngicos , Coccidioides , Paracoccidioides , Talaromyces , Organización Mundial de la Salud , Talaromyces/aislamiento & purificación , Talaromyces/clasificación , Talaromyces/efectos de los fármacos , Humanos , Paracoccidioides/aislamiento & purificación , Paracoccidioides/efectos de los fármacos , Paracoccidioides/clasificación , Antifúngicos/farmacología , Antifúngicos/uso terapéutico , Coccidioides/aislamiento & purificación , Coccidioides/clasificación , Coccidioides/efectos de los fármacos , Micosis/epidemiología , Micosis/microbiología , Micosis/mortalidad , Paracoccidioidomicosis/epidemiología , Paracoccidioidomicosis/microbiología , Paracoccidioidomicosis/tratamiento farmacológico , Coccidioidomicosis/epidemiología , Coccidioidomicosis/microbiología , Pruebas de Sensibilidad Microbiana
4.
Photochem Photobiol Sci ; 23(7): 1295-1307, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38806861

RESUMEN

Paracoccidioidomycosis (PCM) is a systemic mycosis with serious clinical consequences in which the use of antifungal drugs requires long-term treatment. Therefore, we studied the effect of low-level LASER therapy (LLLT) to evaluate its prospects as a complementary treatment for PCM and improve the clinical response to the disease. OBJECTIVES: Our study focused on the resolution of lesions caused by fungal infection using a subcutaneous air pouch model of infection. METHODS: We evaluated cell profile and cytokines, fungi viability, and the presence of fibroblasts and fibrocytes at the site of infection. Inoculation of P. brasiliensis (Pb) was performed using a subcutaneous air pouch model and the LLLT irradiation was performed on alternate days on the rear paws of mice for 10 days, after which the cells from the air pouch were collected and analyzed. RESULTS: In animals irradiated with LLLT, the influx of cells to the air pouch was reduced, but they were more activated and produced pro-inflammatory (IL-12, IL-17 and TNF-α) and neutrophil (PMN) activating cytokines (IL-8, GM-CSF and γ-IFN). A better resolution of the infection, evidenced by the reduction in the number of viable fungi with preserved morphology in the air pouch, and an increase in the number of fibrocytes, indicating a healing profile were also observed. CONCLUSION: LLLT decreased the influx of PMN, but those presents were highly activated, with increased fungicidal activity. LLLT irradiation also resulted in earlier cicatrization at the site of infection, leading to a better outcome of the infection. These data are favorable to the use of LLLT as a complementary therapy in PCM.


Asunto(s)
Citocinas , Terapia por Luz de Baja Intensidad , Paracoccidioidomicosis , Células TH1 , Células Th2 , Animales , Ratones , Citocinas/metabolismo , Células TH1/inmunología , Células TH1/metabolismo , Paracoccidioidomicosis/radioterapia , Paracoccidioidomicosis/inmunología , Paracoccidioidomicosis/patología , Células Th2/inmunología , Células Th2/metabolismo , Paracoccidioides/inmunología , Ratones Endogámicos BALB C , Masculino
5.
Mycoses ; 67(1): e13662, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37837228

RESUMEN

BACKGROUND: Paracoccidioidomycosis is the most prevalent systemic mycosis in Latin America, with a high incidence in Brazil, Colombia and Venezuela, and constitutes a serious public health problem, a frequent cause of morbidity and disability for work. Some mechanisms of cell death are described as important tools in infectious processes. When apoptosis is blocked, RIPK (Receptor-interacting protein kinase) 3 dependent, a caspase-independent form of cell death, can limit the replication and spread of pathogens. Some molecules that mediate necroptosis include RIPK3 and have been extensively studied due to their signalling mechanism and pathological function. RIPK3 activates NLRP1 and NLRP3-mediated inflammasome formation. Caspase-1 has an important role in processing the cytokines ILß and IL18 to their active form. Such molecules are part of the inflammasome characterization, whose caspase-1-dependent activation promotes the death of pyroptotic cells and the secretion of proinflammatory cytokines. Knowledge about the mechanisms of pathogen-mediated cell death can be useful for understanding of the pathogenesis of infections and inflammatory conditions. OBJECTIVE: The objective of this work was to identify the mechanisms of programmed cell death and inflammasome components in human oral mucosal lesions of paracoccidioidomycosis through immunohistochemical methods and identification of RIPK-3, IL1ß, IL18, NLRP-1 and caspase-1. Thirty specimens were included, and a histopathological analysis of the lesions was performed using haematoxylin-eosin staining. RESULTS: Our results on in situ expression of inflammasome elements and programmed cell death showed increased expression of IL-1ß, NLRP-1, caspase-1 and RIPK-3. We suggest that inflammasome complex participate in the immunopathogenesis in paracoccidioidomycosis oral lesions in an interplay with RIPK3.


Asunto(s)
Inflamasomas , Paracoccidioidomicosis , Humanos , Interleucina-18 , Apoptosis/fisiología , Caspasa 1/metabolismo , Citocinas
6.
Mycoses ; 67(7): e13761, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38946016

RESUMEN

The impact of COVID-19 on paracoccidioidomycosis (PCM) in Argentina and the consequences generated by the pandemic are discussed. From 2018 to 3 years after the pandemic declaration, 285 proven PCM patients were registered. No association between both diseases was documented. PCM frequency decreased to extremely low levels in 2020. Mandatory social isolation and the emotional and psychological effects generated under pandemic circumstances led to delays in diagnosis, severe disseminated cases, and other challenges for diagnosis in subsequent years. Probable underdiagnosis should be considered due to the overlap of clinical manifestations, the low index of suspicion and the lack of sensitive diagnostic tools.


Asunto(s)
COVID-19 , Paracoccidioidomicosis , Paracoccidioidomicosis/epidemiología , Paracoccidioidomicosis/diagnóstico , Paracoccidioidomicosis/complicaciones , Humanos , COVID-19/epidemiología , COVID-19/complicaciones , Argentina/epidemiología , Masculino , Adulto , Persona de Mediana Edad , Femenino , SARS-CoV-2 , Anciano , Adulto Joven , Pandemias , Adolescente , Diagnóstico Tardío
7.
Mikrochim Acta ; 191(5): 287, 2024 04 26.
Artículo en Inglés | MEDLINE | ID: mdl-38671236

RESUMEN

To overcome the limitations of current methods for diagnosing paracoccidioidomycosis (PCM), it is critical to develop novel diagnostic strategies that can be implemented in low-resource settings and dramatically improve turnaround times. This study focused on the development of a portable molecular test to screen for Paracoccidioides spp. The proposed approach integrated double-tagging polymerase chain reaction (PCR) and a paper-based lateral flow assay (LFA) for readout, using carbon nanoparticles as a signal generation system. Primers tagged with biotin and digoxigenin were employed to conduct the double-tagging PCR, which can be conveniently carried out on portable thermocyclers. This method can generate billions of tagged DNA copies from a single target molecule, which can be rapidly detected by the LFA platform, providing results within minutes. Avidin-modified carbon nanoparticles served as a signal generation system, enabling detection in the immunochromatographic assay. The LFA demonstrated the capability to detect double-tagged amplicons as low as 0.21 ng or 0.10 ng, depending on whether the results were assessed visually or with a smartphone equipped with an image processor. These findings suggest that the proposed approach holds great promise as a point-of-care diagnostic tool for the early and accurate detection of PCM in low-resource settings. The diagnostic test is rapid and inexpensive, requires minimal handling and can be easily introduced into the general practitioner's armoury for ambulatory screening of infection. This innovative approach has the potential to make a substantial contribution to PCM diagnosis, ultimately reducing morbidity and mortality associated with this disease.


Asunto(s)
Carbono , ADN de Hongos , Nanopartículas , Paracoccidioides , Paracoccidioides/genética , Paracoccidioides/aislamiento & purificación , Carbono/química , Nanopartículas/química , ADN de Hongos/genética , ADN de Hongos/análisis , Paracoccidioidomicosis/diagnóstico , Paracoccidioidomicosis/microbiología , Humanos , Reacción en Cadena de la Polimerasa/métodos , Límite de Detección
8.
Clin Microbiol Rev ; 35(4): e0023321, 2022 12 21.
Artículo en Inglés | MEDLINE | ID: mdl-36074014

RESUMEN

Paracoccidioidomycosis (PCM), initially reported in 1908 in the city of São Paulo, Brazil, by Adolpho Lutz, is primarily a systemic and neglected tropical mycosis that may affect individuals with certain risk factors around Latin America, especially Brazil. Paracoccidioides brasiliensis sensu stricto, a classical thermodimorphic fungus associated with PCM, was long considered to represent a monotypic taxon. However, advances in molecular taxonomy revealed several cryptic species, including Paracoccidioides americana, P. restrepiensis, P. venezuelensis, and P. lutzii, that show a preference for skin and mucous membranes, lymph nodes, and respiratory organs but can also affect many other organs. The classical diagnosis of PCM benefits from direct microscopy culture-based, biochemical, and immunological assays in a general microbiology laboratory practice providing a generic identification of the agents. However, molecular assays should be employed to identify Paracoccidioides isolates to the species level, data that would be complemented by epidemiological investigations. From a clinical perspective, all probable and confirmed cases should be treated. The choice of treatment and its duration must be considered, along with the affected organs, process severity, history of previous treatment failure, possibility of administering oral medication, associated diseases, pregnancy, and patient compliance with the proposed treatment regimen. Nevertheless, even after appropriate treatment, there may be relapses, which generally occur 5 years after the apparent cure following treatment, and also, the mycosis may be confused with other diseases. This review provides a comprehensive and critical overview of the immunopathology, laboratory diagnosis, clinical aspects, and current treatment of PCM, highlighting current issues in the identification, treatment, and patient follow-up in light of recent Paracoccidioides species taxonomic developments.


Asunto(s)
Paracoccidioides , Paracoccidioidomicosis , Humanos , Paracoccidioidomicosis/diagnóstico , Paracoccidioidomicosis/tratamiento farmacológico , Paracoccidioidomicosis/epidemiología , Brasil , Piel
9.
J Assoc Physicians India ; 72(6): 99-102, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38881144

RESUMEN

Paracoccidioidomycosis (PCM) is caused by a dimorphic fungus Paracoccidioides Brasiliensis and is endemic to subtropical areas of Central and South America. CNS involvement of PCM is extremely variable. NeuroPCM is found in 9.65% to 27.18% of PCM cases .Most neuro PCM patients presents with simultaneous involvement of other organ but isolated or initial CNS involvement may be a feature in 21%. Here we report a case of CNS PCM and this appears to be first reported case of PCM and CNS PCM in India.


Asunto(s)
Paracoccidioidomicosis , Humanos , Paracoccidioidomicosis/diagnóstico , Paracoccidioidomicosis/tratamiento farmacológico , Masculino , Antifúngicos/uso terapéutico , Infecciones Fúngicas del Sistema Nervioso Central/diagnóstico , Infecciones Fúngicas del Sistema Nervioso Central/microbiología , Adulto , Imagen por Resonancia Magnética
10.
Med Oral Patol Oral Cir Bucal ; 29(4): e533-e536, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38615259

RESUMEN

BACKGROUND: Paracoccidioidomycosis (PCM) is the leading cause of death among systemic mycoses in Brazil. On the other hand, oral squamous cell carcinoma (OSCC) is the most prevalent malignant neoplasm of the mouth. Both lesions rarely affect the tongue dorsum and may share similar clinical characteristics. This study aimed to retrieve cases of single oral ulcers diagnosed as PCM or OSCC. MATERIAL AND METHODS: A cross-sectional retrospective study was conducted. All patients who had a single ulcer on dorsum of the tongue and confirmed diagnosis of PCM or OSCC were evaluated. RESULTS: A total of 9 patients (5 women and 4 men) were evaluated, 5 patients had OSCCs (mean age = 69,8 years old), and 4 patients PCM (mean age = 51 years old). Most of the lesions were infiltrated and indurated in the palpation exam. Duration ranged from 1 to 12 months (mean time of 5.2 months and 4.7 months for OSCC and PCM, respectively). OSCC was the main clinical diagnosis hypothesis. CONCLUSIONS: Although uncommon, PCM and OSCC should be considered as a diferential diagnosis hypothesis in infiltrated ulcers on the tongue dorsum. Iincisional biopsy is mandatory to confirm the diagnosis and indicate the appropriate treatment.


Asunto(s)
Carcinoma de Células Escamosas , Paracoccidioidomicosis , Neoplasias de la Lengua , Humanos , Masculino , Estudios Retrospectivos , Femenino , Persona de Mediana Edad , Estudios Transversales , Paracoccidioidomicosis/diagnóstico , Anciano , Carcinoma de Células Escamosas/diagnóstico , Diagnóstico Diferencial , Neoplasias de la Lengua/diagnóstico , Úlceras Bucales/diagnóstico , Úlceras Bucales/microbiología , Úlceras Bucales/etiología , Enfermedades de la Lengua/diagnóstico , Enfermedades de la Lengua/microbiología , Adulto , Anciano de 80 o más Años
11.
Med Oral Patol Oral Cir Bucal ; 29(4): e509-e516, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38615253

RESUMEN

BACKGROUND: Paracoccidioidomycosis (PCM) is the leading cause of death among systemic mycoses in Brazil. On the other hand, oral squamous cell carcinoma (OSCC) is the most prevalent malignant neoplasm of the mouth. Both lesions rarely affect the tongue dorsum and may share similar clinical characteristics. This study aimed to retrieve cases of single oral ulcers diagnosed as PCM or OSCC. MATERIAL AND METHODS: A cross-sectional retrospective study was conducted. All patients who had a single ulcer on dorsum of the tongue and confirmed diagnosis of PCM or OSCC were evaluated. RESULTS: A total of 9 patients (5 women and 4 men) were evaluated, 5 patients had OSCCs (mean age = 69,8 years old), and 4 patients PCM (mean age = 51 years old). Most of the lesions were infiltrated and indurated in the palpation exam. Duration ranged from 1 to 12 months (mean time of 5.2 months and 4.7 months for OSCC and PCM, respectively). OSCC was the main clinical diagnosis hypothesis. CONCLUSIONS: Although uncommon, PCM and OSCC should be considered as a differential diagnosis hypothesis in infiltrated ulcers on the tongue dorsum. Incisional biopsy is mandatory to confirm the diagnosis and indicate the appropriate treatment.


Asunto(s)
Ameloblastoma , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ameloblastoma/genética , Ameloblastoma/epidemiología , Estudios Transversales , América Latina , Paracoccidioidomicosis/epidemiología , Estudios Retrospectivos , Neoplasias de la Lengua/patología , Neoplasias de la Lengua/genética
12.
Trop Med Int Health ; 28(9): 771-779, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37559424

RESUMEN

OBJECTIVE: To analyse the records of male hospitalisation for fungal infections, including their spatial distribution and the main invasive epidemiological and sociodemographic characteristics in the State of Paraná, Brazil. METHODS: Spatial analysis based on data from male admission records for invasive fungal infections (IFIs) in the State of Paraná, from 2015 to 2019. Data were taken from the hospital records obtained in the Hospital Information System of the Unified Health System, being collected, georeferenced and analysed to infer the existence of autocorrelation with the hospitalisation rates in the state. RESULTS: From 2015 to 2019, there were 385 cases of IFIs in men, being more prevalent in white individuals aged 61-70 years. We observed that the metropolitan, southeast, central-eastern, north-central, northwestern and western regions formed high-high clusters, with regions with a high number of registered cases. In the regression, there was an association with socioeconomic and demographic factors that showed a correlation with the rates of hospitalisation for IFIs. CONCLUSION: The study draws attention to Paraná as an endemic region for paracoccidioidomycosis, in addition to presenting high rates of nosocomial fungal infections. We also emphasise the importance of compulsory notification in the state and in the country to gain greater control over the incidence and prevalence of cases and to incentivise the creation of public policies for the prevention of IFIs.


Asunto(s)
Infecciones Fúngicas Invasoras , Micosis , Paracoccidioidomicosis , Humanos , Masculino , Brasil/epidemiología , Micosis/epidemiología , Infecciones Fúngicas Invasoras/epidemiología , Paracoccidioidomicosis/epidemiología , Análisis Espacial
13.
Med Mycol ; 61(11)2023 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-37960963

RESUMEN

Germline-encoded pattern recognition receptors, particularly C-type lectin receptors (CLRs), are essential for phagocytes to sense invading fungal cells. Among CLRs, Dectin-2 (encoded by Clec4n) plays a critical role in the antifungal immune response as it recognizes high-mannose polysaccharides on the fungal cell wall, triggering phagocyte functional activities and ultimately determining adaptive responses. Here, we assessed the role of Dectin-2 on the course of primary Paracoccidioides brasiliensis systemic infection in mice with Dectin-2-targeted deletion. Paracoccidioides brasiliensis constitutes the principal etiologic agent of paracoccidioidomycosis, the most prominent invasive mycosis in Latin American countries. The deficiency of Dectin-2 resulted in shortened survival rates, high lung fungal burden, and increased lung pathology in mice infected with P. brasiliensis. Consistently, dendritic cells (DCs) from mice lacking Dectin-2 infected ex vivo with P. brasiliensis showed impaired secretion of several proinflammatory and regulatory cytokines, including TNF-α, IL-1ß, IL-6, and IL-10. Additionally, when cocultured with splenic lymphocytes, DCs were less efficient in promoting a type 1 cytokine pattern secretion (i.e., IFN-γ). In macrophages, Dectin-2-mediated signaling was required to ensure phagocytosis and fungicidal activity associated with nitric oxide production. Overall, Dectin-2-mediated signaling is critical to promote host protection against P. brasiliensis infection, and its exploitation might lead to the development of new vaccines and immunotherapeutic approaches.


We report a critical role of the innate immune receptor Dectin-2 during Paracoccidioides brasiliensis infection. Fungal sensing by Dectin-2 improved the survival of mice and lowered fungal burden. Further, Dectin-2 was required for cytokine production, phagocytosis, and fungal killing by phagocytes.


Asunto(s)
Paracoccidioides , Paracoccidioidomicosis , Ratones , Animales , Fagocitos/patología , Lectinas Tipo C/metabolismo , Macrófagos , Paracoccidioidomicosis/veterinaria
14.
Mycoses ; 66(2): 168-175, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36062632

RESUMEN

BACKGROUND: Advanced neuroimaging demonstrated that neurological involvement occurs in up to 30% of paracoccidioidomycosis (PCM) cases. Current knowledge of neuroparacoccidioidomycosis (NPCM) is based on a 2009 systematic review. However, in the last decade, several new cases have been published, with modern neuroimaging techniques. OBJECTIVES: We believe a new systematic review is needed to summarise these advances. METHODS: We searched PubMed/MEDLINE, Embase and LILACS for studies from January 2010 to May 2022. Case series and case reports of NPCM were included. We performed a metaproportion to estimate a summary proportion with 95% confidence intervals (CI). RESULTS: Thirty-four studies including 104 patients were evaluated. We combined our data with the results from the previous review that included 257 cases, totalling 361 patients. We found no new important demographic, clinical or laboratory characteristics. On magnetic resonance imaging (MRI), we found that 72% (95%CI: 38-91) had hyperintensity on T1-weighted image; 84% (95%CI: 71%-92%) had hypointensity on T2-weighted image; 80% (95%CI: 66-89) had contrast enhancement with the classical ring-enhancing pattern. All 8 patients undergoing spectroscopy presented lipid peaks. We found a 16% mortality, lower than in the previous review (44%). CONCLUSION: NPCM presents a characteristic pattern on MRI that may help to differentiate it from other causes of single or multiple brain lesions. Albeit there is a frequent pattern, it is not specific, as other granulomatous diseases may show similar findings. Advances in neuroimaging with early diagnosis and appropriate management of the disease may have contributed to reducing its mortality.


Asunto(s)
Infecciones Fúngicas del Sistema Nervioso Central , Paracoccidioidomicosis , Humanos , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Infecciones Fúngicas del Sistema Nervioso Central/diagnóstico por imagen , Infecciones Fúngicas del Sistema Nervioso Central/patología , Imagen por Resonancia Magnética , Neuroimagen , Paracoccidioidomicosis/diagnóstico por imagen , Paracoccidioidomicosis/patología
15.
Mycopathologia ; 188(1-2): 129-133, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36633737

RESUMEN

Paracoccidioidomycosis (PCM) defines a broad spectrum of human and animal diseases caused by Paracoccidioides species (Onygenales). In the twenty-first century, Paracoccidioides advanced from a monotypic taxon to a genus that harbors seven species, including P. brasiliensis sensu stricto, P. americana, P. restrepiensis, P. venezuelensis, P. lutzii, P. loboi, and P. cetii. Classic PCM, acquired upon inhalation of propagules from P. brasiliensis sensu stricto, P. americana, P. restrepiensis, P. venezuelensis, and P. lutzii, affects the human lungs and may progress to systemic granulomatous disease with tegumentary and visceral involvement. On the other hand, PCM loboi and PCM ceti caused by the unculturable P. loboi and P. cetii are subcutaneous mycoses, typically observed as keloid lesions in humans and dolphins. Such heterogeneity highlights the importance of recognizing species boundaries in Paracoccidioides to gain insights into the ecology, evolution, clinical features, and mitigation strategies to tackle the advance of PCM.


Asunto(s)
Paracoccidioides , Paracoccidioidomicosis , Animales , Humanos , Delfines/microbiología , Genómica , Paracoccidioides/clasificación , Paracoccidioides/genética , Paracoccidioides/aislamiento & purificación , Paracoccidioidomicosis/diagnóstico , Paracoccidioidomicosis/epidemiología , Paracoccidioidomicosis/inmunología , Paracoccidioidomicosis/microbiología , Filogenia
16.
Mycopathologia ; 188(4): 307-334, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37294504

RESUMEN

Endemic systemic mycoses such as blastomycosis, coccidioidomycosis, histoplasmosis, talaromycosis, paracoccidioidomycosis are emerging as an important cause of morbidity and mortality worldwide. We conducted a systematic review on endemic systemic mycoses reported in Italy from 1914 to nowadays. We found out: 105 cases of histoplasmosis, 15 of paracoccidioidomycosis, 10 of coccidioidomycosis, 10 of blastomycosis and 3 of talaromycosis. Most cases have been reported in returning travelers and expatriates or immigrants. Thirtytwo patients did not have a story of traveling to an endemic area. Fortysix subjects had HIV/AIDS. Immunosuppression was the major risk factor for getting these infections and for severe outcomes. We provided an overview on microbiological characteristics and clinical management principles of systemic endemic mycoses with a focus on the cases reported in Italy.


Asunto(s)
Blastomicosis , Coccidioidomicosis , Histoplasmosis , Micosis , Paracoccidioidomicosis , Humanos , Histoplasmosis/diagnóstico , Histoplasmosis/tratamiento farmacológico , Histoplasmosis/epidemiología , Coccidioidomicosis/epidemiología , Blastomicosis/epidemiología , Paracoccidioidomicosis/diagnóstico , Paracoccidioidomicosis/tratamiento farmacológico , Paracoccidioidomicosis/epidemiología , Micosis/tratamiento farmacológico , Micosis/epidemiología
17.
Med Oral Patol Oral Cir Bucal ; 28(2): e131-e139, 2023 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-36806021

RESUMEN

BACKGROUND: The ecoepidemiological panorama of paracoccidioidomycosis (PCM) is dynamic and still ongoing in Brazil. In particular, data about the oral lesions of PCM are barely explored. The aim of this study was to report the clinicopathological features of individuals diagnosed with oral PCM lesions at an oral and maxillofacial pathology service in Rio de Janeiro, Brazil, in the light of a literature review. MATERIAL AND METHODS: A retrospective study was conducted on oral biopsies obtained from 1958 to 2021. Additionally, electronic searches were conducted in PubMed, Embase, Scopus, Web of Science, Latin American and Caribbean Center on Health Sciences Information, and Brazilian Library of Dentistry to gather information from large case series of oral PCM. RESULTS: Ninety-five cases of oral PCM were surveyed. The manifestations were more frequent among males (n=86/90.5%), middle-aged/older adults (n=54/58.7%), and white individuals (n=40/51.9%). The most commonly affected sites were the gingiva/alveolar ridge (n=40/23.4%) and lip/labial commissure (n=33/19.3%); however, one (n=40/42.1%) or multiple sites (n=55/57.9%) could also be affected. In 90 (94.7%) patients, "mulberry-like" ulcerations/moriform appearance were observed. Data from 21 studies (1,333 cases), mostly Brazilian (90.5%), revealed that men (92.4%; male/female: 11.8:1) and individuals in the fifth and sixth decades of life were the most affected (range: 7-89 years), with the gingiva/alveolar ridge, palate, and lips/labial commissure being the sites most frequently affected. CONCLUSIONS: The features of oral PCM lesions are similar to those reported in previous studies from Latin America. Clinicians should be aware of the oral manifestations of PCM, with emphasis on the clinicodemographic aspects and differential diagnoses, especially considering the phenomenon of the emergence of reported cases in rural and/or urban areas of Brazil.


Asunto(s)
Paracoccidioidomicosis , Persona de Mediana Edad , Humanos , Masculino , Femenino , Anciano , Paracoccidioidomicosis/diagnóstico , Paracoccidioidomicosis/patología , Estudios Retrospectivos , Brasil , Encía , Hueso Paladar/patología
18.
N Engl J Med ; 390(4): 357, 2024 Jan 25.
Artículo en Inglés | MEDLINE | ID: mdl-38265647
19.
Curr Top Microbiol Immunol ; 432: 19-33, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34972875

RESUMEN

Species of the Paracoccidioides brasiliensis complex and P. lutzii cause human paracoccidioidomycosis (PCM). Early interest in Paracoccidioides extracellular vesicles (EVs) resulted in a series of publications that unraveled the EVs protein, carbohydrate, lipid, and RNA cargo from isolates of different phylogenetic groups and distinct virulence degrees. EV and cell wall components were compared. These works are discussed in parallel with more recent data on the role of Paracoccidioides EVs in immunomodulation.


Asunto(s)
Vesículas Extracelulares , Paracoccidioides , Paracoccidioidomicosis , Humanos , Paracoccidioides/genética , Filogenia , Virulencia
20.
Med Mycol ; 60(2)2022 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-35076076

RESUMEN

Paracoccidioidomycosis (PCM) is a systemic mycosis caused by fungi of the Paracoccidioides genus, being endemic in Latin America and with the highest number of cases in Brazil. Paracoccidioides spp. release a wide range of molecules, such as enzymes, which may be important for PCM establishment. Here, we identified the 85- and 90-kDa proteins from the supernatants of P. brasiliensis cultures as being an α-mannosidase. Because the expected mass of this α-mannosidase is 124.2-kDa, we suggest that the proteins were cleavage products. Indeed, we found an α-mannosidase activity in the culture supernatants among the excreted/secreted antigens (ESAg). Moreover, we determined that the enzyme activity was optimal in buffer at pH 5.6, at the temperature of 45ºC, and with a concentration of 3 mM of the substrate p-NP-α-D-Man. Remarkably, we showed that the gene expression of this α-mannosidase was higher in yeasts than hyphae in three P. brasiliensis isolates with different virulence degrees that were grown in Ham's F12 synthetic medium for 15 days. But in complex media YPD and Fava Netto, the significantly higher gene expression in yeasts than in hyphae was seen only for the virulent isolate Pb18, but not for intermediate virulence Pb339 and low virulence Pb265 isolates. These results about the high expression of the α-mannosidase gene in the pathogenic yeast form of P. brasiliensis open perspectives for studying this α-mannosidase concerning the virulence of P. brasiliensis isolates. LAY SUMMARY: Paracoccidioides brasiliensis causes deep mycosis, paracoccidioidomycosis. We determined for the first time the biochemical properties of an α-mannosidase released by this fungus. We suggest that the enzyme gene expression in the fungus is associated with fungal morphology, stress, and virulence.


Asunto(s)
Paracoccidioides , Paracoccidioidomicosis , Animales , Expresión Génica , Paracoccidioides/genética , Paracoccidioidomicosis/veterinaria , Virulencia , alfa-Manosidasa/genética
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