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1.
Prensa méd. argent ; 105(10): 661-665, oct 2019. fig
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1025853

RESUMO

La paracoccidioidomicosis es una micosis sistemática, endémica de amplias regiones de América Latina, causada por un hongo termodimorfo, Paracoccidioides brasiliensis. Afecta de manera predominante a individuos de mediana edad y sexo masculino, en particular aquellos que cumplen tareas rurales. la infección se adquiere por vía inhalatoria, y puede diseminarse por vía hemática a diversos órganos y tejidos. La enfermedad puede evolucionar en forma aguda, subaguda o crónica. El diagnóstico presuntivo de la paracoccidioidomicosis se sustenta en los antecedentes epidemiológicos del paciente y en las manifestaciones clínicas. El diagnóstico etiológico clásico consiste en la visualización, el aislamiento y la identificación del agente causal, o bien el empleo de pruebas serológicas para determinar la presencia de anticuerpos específicos en sangre. Se presentan tres casos de paracoccidioidomicosis en pacientes varones, dos con formas agudas de la enfermedad y el restante con una forma crónica. En todos los casos, el diagnóstico se efectuó por los hallazgos de la microscopia, los cultivos y las pruebas serológicas


Paracoccidioidomycosis is a systemic mycosis, endemic to large regions of Latin America, caused by a thermodimorphic fungus, Paracoccidioides brasiliensis. It predominantly affects middle-aged and male individuals, particularly those who perform rural tasks. The infection is acquired by inhalation, and it can spread by blod to various organs and tissues. The disease can evolve in acute, subacute or chronic form. The presumptive diagnosis of paracoccidiodomycosis is based on the patient's epidemiological history and clinical manifestations. The classic etiological diagnosis consists of visualization, isolation and identification of the causative agent, or the use of serological tests to determine the presence of specific antibodies in the blood. There are threee cases of paracoccidioidomycosis in male patients, two with acute forms of the disease and the remaining with a chronic form. In all cases, the diagnosis was made by the findings of microscopy, cultures and serological tests


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Idoso , Paracoccidioidomicose/diagnóstico , Paracoccidioidomicose/transmissão , Paracoccidioidomicose/epidemiologia , Manifestações Cutâneas , Trabalhadores Rurais , Testes Sorológicos , Microscopia
2.
Am J Trop Med Hyg ; 101(5): 1100-1106, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31516118

RESUMO

Paracoccidioidomycosis (PCM) is an endemic systemic mycosis that is of great importance in Latin America. Its occurrence in solid organ transplantation (SOT) is rare, but with high mortality rate. In this report, we describe a case of PCM in a liver transplant recipient 19 months after transplantation. The patient presented with multiple skin abscesses, arthritis, osteolytic lesions, and pulmonary and adrenal involvement. Despite the presence of disseminated disease and the patient's immunosuppressed condition, the patient responded well to prolonged antifungal treatment with no sequelae, thus suggesting that early diagnosis and correct treatment may lead to favorable outcomes in SOT recipients with PCM.


Assuntos
Transplante de Fígado/efeitos adversos , Paracoccidioidomicose/diagnóstico , Paracoccidioidomicose/tratamento farmacológico , Transplantados , Anfotericina B/administração & dosagem , Anfotericina B/uso terapêutico , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Antifúngicos/uso terapêutico , Brasil/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Paracoccidioides , Paracoccidioidomicose/epidemiologia , Combinação Trimetoprima e Sulfametoxazol/administração & dosagem , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
3.
PLoS Negl Trop Dis ; 13(6): e0007437, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31163028

RESUMO

BACKGROUND: The fungus Paracoccidioides lutzii was recently included as a new causative species of paracoccidioidomycosis (PCM) and most cases have been reported from Brazil. According to available epidemiological information, P. lutzii is concentrated in the Middle-West region in Brazil, mainly in the state of Mato Grosso. However, clinical and laboratorial data available on patients infected with P. lutzii remain extremely limited. METHODOLOGY/MAIN FINDINGS: This work describes the clinical manifestations of 34 patients suffering from PCM caused by P. lutzii, treated along 5 years (2011-2017) at a reference service center for systemic mycoses in Mato Grosso, Brazil. Adult rural workers (men), aged between 28 and 67 predominated. All patients had the chronic form of the disease, and the oral mucosa (n = 19; 55.9%), lymph nodes (n = 23; 67.7%), skin (n = 16; 47.1%) and lung (n = 28; 82.4%) were the most affected sites. Alcohol intake (n = 19; 55.9%) and smoking (n = 29; 85.3%) were frequent habits among the patients. No patient suffered from any other life-threatening disease, such as tuberculosis, cancer or other inflammatory or infectious parasitic diseases. The positivity in culture examination (97.1%) was higher than that found for the direct mycological examination (88.2%). Particularly, one patient presented fungemia at diagnosis, which lead to his death. The time elapsed between the initial symptoms and the initiation of treatment of PCM caused by P. lutzii was 19.7 (31.5) months, with most patients diagnosed 7 months after the symptoms' onset. CONCLUSIONS/SIGNIFICANCE: Compared with the classical clinical-epidemiological profile of PCM caused by P. brasiliensis, the results of this descriptive study did not show significant clinical or epidemiological differences that could be attributed to the species P. lutzii. Future studies may confirm or refute the existence of clinical differences between the two fungal species.


Assuntos
Paracoccidioides/classificação , Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/epidemiologia , Paracoccidioidomicose/patologia , Adulto , Idoso , Brasil , Doença Crônica/epidemiologia , Feminino , Humanos , Pulmão/patologia , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/patologia , Paracoccidioidomicose/microbiologia
5.
Med Mycol ; 57(1): 30-37, 2019 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-29346653

RESUMO

Argentina has two endemic areas of paracoccidioidomycosis (PCM). Bordering Paraguay and Brazil, Northeast Argentina (NEA) comprises the area with the highest incidence where the chronic adult clinical form has historically been reported. Juvenile form in children and adolescents is rare in this area since only one case was reported in the last 10 years. Despite this, between 2010 and 2012, several cases of acute/subacute clinical forms in children aged 10 to 16 (median 12) were detected. In the last decade, the NEA region has been exposed to ecological variations as consequences of certain climatic and anthropogenic changes, including El Niño-Southern Oscillation phenomenon during 2009, and deforestation. The region has also suffered from the significant ecological effects of the construction of one of the biggest hydroelectric dams of South America. This study aims to describe clinical and epidemiological aspects of acute/subacute PCM cases detected in children from NEA and to discuss climatic and anthropogenic changes as possible contributing factors in the emergence of this disease in children. This acute/subacute PCM cluster was characterized by severe disseminated and aggressive presentations to localized form, with a high spectrum of clinical manifestations uncommonly observed. Due to the lack of experience in acute/subacute PCM in children in the studied area and the atypical clinical manifestations observed, the diagnosis was delayed. In order to avoid misdiagnosis, a higher level of suspicion is now required in NEA and countries bordering the southern part of the endemic area, which are affected by the changes discussed in this article.


Assuntos
Clima , Meio Ambiente , Paracoccidioidomicose/epidemiologia , Adolescente , Antifúngicos/uso terapêutico , Argentina/epidemiologia , Criança , Doenças Transmissíveis Emergentes/diagnóstico , Doenças Transmissíveis Emergentes/tratamento farmacológico , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/patologia , Feminino , Humanos , Incidência , Masculino , Paracoccidioides/efeitos dos fármacos , Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/diagnóstico , Paracoccidioidomicose/tratamento farmacológico , Paracoccidioidomicose/patologia , Estudos Retrospectivos , Testes Sorológicos , Resultado do Tratamento
6.
Rev Argent Microbiol ; 51(2): 144-147, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-30243524

RESUMO

In order to describe the clinical and epidemiological characteristics of paracoccidioidomycosis, a descriptive study of all the cases diagnosed by the Clinical Microbiology Service at Dr. Julio C. Perrando hospital in the city of Resistencia (Chaco Province, Argentina) was conducted. Between 2011 and 2014, 46 cases were detected. In the period 2013-2014, an almost 4-fold increase in the incidence rate was detected. The chronic form of the disease was predominant with an average age of 53 years. Serological tests in 39 out of 46 patients were performed. In 15 of 39 patients, serological tests were the only diagnostic tool while in 4 patients with a microbiological diagnosis serological tests were non-reactive. In patients from endemic areas with non-specific infectious syndrome it is important to include paracoccidioidomycosis in the differential diagnosis and to apply all available diagnostic tools to reach a timely diagnosis and to reduce the long-term sequelae and their socio-economic impact.


Assuntos
Paracoccidioidomicose/diagnóstico , Paracoccidioidomicose/epidemiologia , Adulto , Idoso , Argentina/epidemiologia , Feminino , Hospitais , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
7.
PLoS One ; 13(11): e0208208, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30475920

RESUMO

Mucocutaneous leishmaniasis and paracoccidioidomycosis are infectious diseases with similar epidemiological and clinical aspects. Cases of both diseases may manifest similar lesions in the mucosa. Therefore, the determination of distinguishing characteristics for the purpose of differential diagnosis is critical for better management of the diseases. The present study evaluated factors that assist in the differentiation of mucosal lesions between these diseases. This cross-sectional study included data from medical records of 122 cases of mucocutaneous leishmaniasis and 83 cases of paracoccidioidomycosis attended at the university hospital Cassiano Antonio Moraes, located in Vitória, Espírito Santo State, Brazil. Comparison between the diseases included the following variables: sex, age, time of disease evolution, location of the lesion and symptoms. Adults and males were affected by both diseases at higher rates. Lesions in the nasal region (95.1%; p-value = 0.000) and the pharynx (20.5%; p-value = 0.009) and nasal obstruction (34.4%; p-value = 0.000) were associated with leishmaniasis. Paracoccidioidomycosis was associated with lesions in the oral region (90.4%; p-value = 0.000), oral pain (16.9%; p-value = 0.000), and hoarseness (14.5%; p-value = 0.008). In leishmaniasis, lesions in oral regions were not associated with oral pain and were frequently located close to the nasal area. The manifestations cited above could improve the differential diagnosis of leishmaniasis and paracoccidioidomycosis, and thereby potentially aid in the choice of appropriate confirmatory diagnostic testing.


Assuntos
Leishmaniose Mucocutânea/diagnóstico , Leishmaniose Mucocutânea/patologia , Paracoccidioidomicose/diagnóstico , Paracoccidioidomicose/patologia , Adulto , Fatores Etários , Idoso , Brasil/epidemiologia , Estudos Transversais , Diagnóstico Diferencial , Feminino , Humanos , Leishmaniose Mucocutânea/epidemiologia , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/patologia , Mucosa Nasal/patologia , Paracoccidioidomicose/epidemiologia , Faringe/patologia , Fatores Sexuais , Língua/patologia
8.
Curr Top Med Chem ; 18(15): 1333-1348, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30277157

RESUMO

The thermally-dimorphic systemic fungal group includes several important human pathogens: Blastomyces dermatitides, Coccidioides immitis and C. posadasii, Histoplasma capsulatum, Paracoccidioides brasiliensis, P. lutzii, and Talaromyces (Penicillium) marneffei. They usually are geographically restricted and have natural habitats in soil or in plants, and when fungal propagules invade mammalian host by inhalation, they initiate an inflammatory reaction that can result in self-resolution of the infection or cause an acute or chronic disease. In the setting of the AIDS pandemic and the developments in modern medicine, such as immunosuppressive therapy in cancer surgery patients and in transplantation and autoimmune diseases, the incidence of endemic mycoses has progressively increased. Another important factor of the increased incidence of systemic mycoses in certain regions is the progressive devastation of tropical and subtropical forests. In this review, we focus on two of the most important systemic mycoses: paracoccidioidomycosis and histoplasmosis, and their major characteristics in epidemiology, clinical aspects and laboratorial diagnosis.


Assuntos
Antifúngicos/farmacologia , Histoplasma/efeitos dos fármacos , Histoplasmose/diagnóstico , Histoplasmose/tratamento farmacológico , Paracoccidioides/efeitos dos fármacos , Paracoccidioidomicose/diagnóstico , Paracoccidioidomicose/tratamento farmacológico , Antifúngicos/química , Histoplasma/isolamento & purificação , Histoplasmose/epidemiologia , Humanos , Testes de Sensibilidade Microbiana , Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/epidemiologia
9.
Epidemiol Serv Saude ; 27(spe): e0500001, 2018 08 16.
Artigo em Português | MEDLINE | ID: mdl-30133688

RESUMO

Paracoccidioidomycosis is a systemic fungal disease associated with agricultural activities. Its incidence and prevalence are underestimated because of the lack of reporting in several Brazilian states. If paracoccidiodomycosis is not diagnosed and treated early and adequately, endemic fungal infection may result in serious sequelae. In addition to the Paracoccidioides brasiliensis (P. brasiliensis) complex, the appearance of a new species, Paracoccidioides lutzii (P. lutzii), in Rondônia state, where the disease has reached epidemic levels, and in the country's Midwest region and Pará state, are challenges to diagnosis and to the urgent availability of antigens that are reactive with patients' sera. These guidelines aim to update the first Brazilian consensus on paracoccidioidomycosis by providing evidence-based recommendations for bedside patient management. The guidelines provide data on etiology, epidemiology, immunopathogenesis, diagnosis, treatment and sequelae, with emphasis on diagnosis and treatment, as well as current recommendations and challenges in this field of knowledge.


Assuntos
Antígenos de Fungos/imunologia , Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/terapia , Brasil/epidemiologia , Humanos , Incidência , Paracoccidioidomicose/diagnóstico , Paracoccidioidomicose/epidemiologia , Prevalência
11.
J Travel Med ; 25(1)2018 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-30085265

RESUMO

Background: International travel has increased in the past few decades, placing more travellers at risk of acquiring systemic endemic mycoses. There are limited published data on systemic endemic mycoses among international travellers. We report epidemiological characteristics of non-migrant, international travellers who acquired systemic endemic mycoses during travel. Methods: We analysed records of non-migrant international travellers with a confirmed diagnosis of histoplasmosis, coccidioidomycosis, paracoccidioidomycosis, blastomycosis or talaromycosis reported from 1997 through 2017 to GeoSentinel, a global surveillance network now consisting of 70 travel or tropical medicine centres in 31 countries. Results: Sixty-nine records met the inclusion criteria. Histoplasmosis was most frequently reported; the 51 travellers with histoplasmosis had the lowest median age (30 years; range: 8-85) and shortest median duration of travel (12 days; range: 5-154). Coccidioidomycosis was reported in 14 travellers; travellers with coccidioidomycosis were older (median 62 years; range: 22-78) and had the longest median number of days between return from travel and presentation to a GeoSentinel site (55 days; range: 17-273). Almost all travellers with coccidioidomycosis were exposed in the USA. Other systemic endemic mycoses were less frequently reported, including blastomycosis (three travellers) and talaromycosis (one traveller). Conclusions: Although relatively rare, systemic endemic mycoses should be considered as potential travel-related infections in non-migrant international travellers. Epidemiological exposures should be used to guide diagnostic evaluations and treatment.


Assuntos
Coccidioidomicose/epidemiologia , Histoplasmose/epidemiologia , Paracoccidioidomicose/epidemiologia , Doença Relacionada a Viagens , Viagem/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Coccidioidomicose/diagnóstico , Feminino , Saúde Global , Histoplasmose/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Micoses/epidemiologia , Paracoccidioidomicose/diagnóstico , Fatores de Risco , Adulto Jovem
12.
Epidemiol. serv. saúde ; 27(spe): 0500001, Aug. 2018. ilus, tab
Artigo em Português | Sec. Est. Saúde SP, SESSP-IIERPROD, Sec. Est. Saúde SP | ID: biblio-1021810

RESUMO

A paracoccidioidomicose (PCM) é uma micose sistêmica, relacionada às atividades agrícolas, com incidência e prevalência subestimadas, pela ausência de notificação em várias Unidades da Federação (UFs). A evolução insidiosa do quadro clínico pode ter como consequência sequelas graves se o diagnóstico e o tratamento não forem instituídos precoce e adequadamente. Ao lado do complexo Paracoccidioides brasiliensis (P. brasiliensis), a descrição de nova espécie, Paracoccidioides lutzii (P. lutzii), em Rondônia, onde a doença alcançou níveis epidêmicos, bem como na região Centro-Oeste e no Pará, constituem-se em desafios para a instituição do diagnóstico e a urgente disponibilização de antígenos que tenham reatividade com os soros dos pacientes. Este consenso visa atualizar o primeiro consenso brasileiro em PCM, estabelecendo recomendações para o manejo clínico do paciente, com base nas evidências conhecidas. São apresentados dados de etiologia, epidemiologia, imunopatogenia, diagnóstico, terapêutica e sequelas, enfatizando-se o diagnóstico e a terapêutica, bem como recomendações e desafios atuais nessa área do conhecimento


Paracoccidioidomycosis is a systemic fungal disease associated with agricultural activities. Its incidence and prevalence are underestimated because of the lack of reporting in several Brazilian states. If paracoccidiodomycosis is not diagnosed and treated early and adequately, endemic fungal infection may result in serious sequelae. In addition to the Paracoccidioides brasiliensis (P. brasiliensis) complex, the appearance of a new species, Paracoccidioides lutzii (P. lutzii), in Rondônia state, where the disease has reached epidemic levels, and in the country's Midwest region and Pará state, are challenges to diagnosis and to the urgent availability of antigens that are reactive with patients' sera. These guidelines aim to update the first Brazilian consensus on paracoccidioidomycosis by providing evidence-based recommendations for bedside patient management. The guidelines provide data on etiology, epidemiology, immunopathogenesis, diagnosis, treatment and sequelae, with emphasis on diagnosis and treatment, as well as current recommendations and challenges in this field of knowledge


La paracoccidioidomicosis es una micosis sistémica, relacionada con las actividades agrícolas, con incidencia y prevalencia subestimadas por la ausencia de notificación en varios estados. La evolución insidiosa del cuadro clínico puede tener como consecuencia secuelas graves si el diagnóstico y el tratamiento no se establecen precoz y adecuadamente. Al lado del complejo Paracoccidioides brasiliensis (P. brasiliensis), la descripción de nueva especie, Paracoccidioides lutzii (P. lutzii) en Rondonia, donde la enfermedad alcanzó niveles epidémicos, y en la región Centro Oeste y en Pará, se constituyen en desafíos para la institución del diagnóstico y la urgente puesta a disposición de antígenos que tengan reactividad con los sueros de los pacientes. El presente consenso tiene por objeto actualizar el primer consenso brasileño en paracoccidioidomicosis, estableciendo recomendaciones para el manejo del paciente al borde del lecho, con base en las evidencias conocidas. Se presentan datos de etiología, epidemiología, inmunopatogenia, diagnóstico, terapéutica y secuelas, enfatizando el diagnóstico y terapéutica, así como recomendaciones desafíos y actuales en esta área del conocimiento


Assuntos
Humanos , Masculino , Feminino , Criança , Adulto , Paracoccidioidomicose/diagnóstico , Paracoccidioidomicose/tratamento farmacológico , Paracoccidioidomicose/epidemiologia
13.
Oral Dis ; 24(8): 1492-1502, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29949225

RESUMO

OBJECTIVES: To investigate the frequency of oral paracoccidioidomycosis from representative geographical regions of Brazil and to compare the data with a literature review. MATERIALS AND METHODS: A retrospective study was conducted on 108,304 biopsies obtained from 1953 to 2016 at six Brazilian oral and maxillofacial pathology services. Demographic data and clinical and histopathological diagnosis of oral paracoccidioidomycosis were evaluated. A literature review of oral paracoccidioidomycosis studies published in three electronic databases was carried out. Data were analysed descriptively. RESULTS: A total of 320 cases of oral paracoccidioidomycosis were surveyed (0.3% of the oral lesions at the centres studied). The lesions were more frequent among male patients. The gingiva/alveolar ridge was the most affected site. Mean age of affected individuals was 51.3 years (±11.7). The literature review showed a higher incidence of oral paracoccidioidomycosis in the south-east and south regions of Brazil. Male individuals and individuals between 50 and 59 years were most affected. CONCLUSIONS: Oral paracoccidioidomycosis is an uncommon lesion observed in oral biopsy samples. The differences in the relative frequency of oral paracoccidioidomycosis are related to geographical variations. Men between 50 and 59 years are more affected. This study provides helpful information for clinicians in the diagnosis of oral paracoccidioidomycosis.


Assuntos
Doenças da Boca/epidemiologia , Paracoccidioidomicose/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Criança , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Doenças da Boca/microbiologia , Paracoccidioidomicose/complicações , Estudos Retrospectivos , Fatores Sexuais , Adulto Jovem
14.
Mycopathologia ; 183(5): 847-852, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29737451

RESUMO

We discuss the sarcoid-like clinical presentation, a rare type of infiltrative paracoccidioidomycosis (PCM) that is almost exclusively cutaneous, involves the face and histologically has a tuberculoid granulomatous pattern with few fungi. It is often misdiagnosed. In endemic regions of Brazil, PCM is more common among men from rural areas, while women of a reproductive age appear to be protected. We report the sarcoid-like PCM in a female urban dweller and highlight the main findings of a literature review.


Assuntos
Paracoccidioidomicose/diagnóstico , Paracoccidioidomicose/patologia , Adulto , Brasil/epidemiologia , Diagnóstico Diferencial , Feminino , Histocitoquímica , Humanos , Microscopia , Paracoccidioidomicose/epidemiologia , Fatores Sexuais
15.
Microb Pathog ; 121: 359-362, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29803846

RESUMO

Paracoccidioidomycosis (PCM) is a chronic mycosis caused by the saprobic and dimorphic species Paracoccidioides brasiliensis and P. lutzii. This disease is prevalent in Latin American countries. PCM appears as a relevant concern and challenge for the mycologists, since until now there is no a methodology suitable for an efficient and safe diagnosis and species identification. Thus, the present study aimed to validate a methodology for PCM´s diagnosis, using quantitative Polymerase Chain Reaction (qPCR) through target amplification of the gene encoding the recombinant protein Pb27, a common protein to the both species Paracoccidioides brasiliensis and P. lutzii. The experiments were performed in vitro to determine the specificity, efficiency and detection limit of qPCR assay, using specific primers and probe, which sequences were subject to a patent deposited in Brazilian CTIT, under the registration number: BR1020160078830. According to the results the technique showed sensitivity of 94% and specificity of 100%, demonstrating that it will be possible to develop a new fast and safe diagnostic PCM and can be standardized in order to present a low cost, accessible to the patient served by the public health system in Brazil and Latin America.


Assuntos
DNA Fúngico/isolamento & purificação , Paracoccidioides/genética , Paracoccidioidomicose/diagnóstico , Paracoccidioidomicose/epidemiologia , Brasil , Líquido da Lavagem Broncoalveolar/microbiologia , Feminino , Humanos , América Latina/epidemiologia , Masculino , Paracoccidioides/isolamento & purificação , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
16.
Mycoses ; 61(8): 587-593, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29663530

RESUMO

Paracoccidioidomycosis (PCM) is the most prevalent systemic mycosis among immunocompetent patients in Latin America. This study aimed to describe the expansion over time and the geographical distribution of confirmed Neuroparacoccidioidomycosis (NPCM) and PCM cases, and relate it to environmental characteristics such as climate, soil types and coffee crops. This was a retrospective study of autopsy and biopsy reports between 1951 and 2014 from the Medical Pathology Section of the Hospital de Clinicas, Universidade Federal do Paraná (UFPR), Curitiba, Southern Brazil. PCM was predominant in male agricultural workers. PCM cases predominated in areas with subtropical climate with hot summers in North West Parana state. NPCM cases were distributed statewide more frequent in rural than metropolitan area. There was no association with climate, soil type, or coffee crop culture. Most of the PCM cases were in the metropolitan area of the capital, chiefly due to migration fluxes. Even though the history is predominantly agricultural, PCM cases were distributed mainly in the metropolitan area of the state capital, there was no association with climate and soil. NPCM cases were numerically more frequent in rural than metropolitan area.


Assuntos
Infecções Fúngicas do Sistema Nervoso Central/epidemiologia , Paracoccidioidomicose/epidemiologia , Topografia Médica , Adulto , Brasil/epidemiologia , Clima , Exposição Ambiental , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional , Prevalência , Estudos Retrospectivos , População Urbana
17.
PLoS Negl Trop Dis ; 12(2): e0006245, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29447170

RESUMO

Endemic mycoses are systemic fungal infections. Histoplasmosis is endemic in all temperate areas of the world; coccidioidomycosis and paracoccidioidomycosis are only present in the American continent. These pathogens are not present in Spain, but in the last years there has been an increase of reported cases due to migration and temporary movements. We obtained from the Spanish hospitals records clinical and demographic data of all hospitalized cases between 1997 and 2014. There were 286 cases of histoplasmosis, 94 of Coccidioidomycosis and 25 of paracoccidioidomycosis. Overall, histoplasmosis was strongly related to HIV infection, as well as with greater morbidity and mortality. For the other mycoses, we did not find any immunosuppressive condition in most of the cases. Although we were not able to obtain data about clinical presentation of all the cases, the most frequently found was pulmonary involvement. We also found a temporal correlation between the Spanish population born in endemic countries and the number of hospitalized cases along this period. This study reflects the importance of imported diseases in non-endemic countries due to migratory movements.


Assuntos
Doenças Transmissíveis Importadas/epidemiologia , Emigração e Imigração , Doenças Endêmicas , Hospitalização , Micoses/epidemiologia , Micoses/transmissão , Adulto , Coccidioidomicose/epidemiologia , Coccidioidomicose/microbiologia , Coccidioidomicose/transmissão , Doenças Transmissíveis Importadas/microbiologia , Feminino , Histoplasmose/epidemiologia , Histoplasmose/microbiologia , Histoplasmose/transmissão , Humanos , Pneumopatias Fúngicas/epidemiologia , Pneumopatias Fúngicas/microbiologia , Masculino , Registros Médicos , Pessoa de Meia-Idade , Micoses/microbiologia , Paracoccidioidomicose/epidemiologia , Paracoccidioidomicose/microbiologia , Paracoccidioidomicose/transmissão , Estudos Retrospectivos , Espanha
18.
Mycoses ; 61(4): 237-244, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29274088

RESUMO

Paracoccidioidomycosis (PCM) is a systemic mycosis prevalent among immunocompetent patients in Latin America. This study aimed to describe the frequency, demographics and clinical characteristics of central nervous system PCM (NPCM) and PCM in an endemic region, and the impact of human immunosuppression virus (HIV) co-infection. This was a retrospective study of autopsy and biopsy reports from the Medical Pathology Section of the Hospital de Clinicas, UFPR, Curitiba, Southern Brazil, between 1951 and 2014. PCM was present in 0.1% of 378,323 cases examined, with 5.7% being NPCM. Infection was prevalent in working-age men, agricultural workers and rural residents. Numbers of HIV autopsy cases increased over time, while those of PCM cases decreased. Prevalence of co-infection of HIV/PCM and HIV/NPCM was 1.6%, and 0.4%, respectively. Adrenals were affected more frequently in the NPCM group compared with the PCM group. Mortality was higher on NPCM group. The clinical course of PCM in HIV patients resembles an acute/sub-acute infection. Association of NPCM and HIV is rare, while diagnosis of NPCM is difficult, it should be considered a differential diagnosis in HIV patients who live in, or have visited, endemic areas and present with neurological symptoms.


Assuntos
Infecções Fúngicas do Sistema Nervoso Central/patologia , Coinfecção/patologia , Infecções por HIV/complicações , Paracoccidioidomicose/patologia , Adulto , Autopsia , Biópsia , Brasil/epidemiologia , Infecções Fúngicas do Sistema Nervoso Central/epidemiologia , Infecções Fúngicas do Sistema Nervoso Central/mortalidade , Coinfecção/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional , Paracoccidioidomicose/epidemiologia , Paracoccidioidomicose/mortalidade , Prevalência , Estudos Retrospectivos , Análise de Sobrevida
19.
J Infect Public Health ; 11(4): 530-533, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29153538

RESUMO

BACKGROUND: Paracoccidioidomycosis (PCM) is the most prevalent endemic systemic fungal infection in Latin America. In Brazil, it stands out as the eighth-highest cause of mortality among chronic or recurrent infections and has the highest mortality rate among systemic mycoses. Oral mucosal lesions may be the first visible physical manifestation of the disease. This study traced the epidemiological and clinical profiles of patients with oral lesions treated at the University Hospital Cassiano Antonio Moraes, Federal University of Espirito Santo. METHODS: A retrospective cross-sectional analysis of patient medical records was performed. RESULTS: Among the 161 patients identified with a confirmed diagnosis of PCM, 97 (60.24%) presented with oral lesions. The male:female ratio was 15:1, the mean age was 50.5 years, and the chronic form of paracoccidioidomycosis was predominant. Most of the patients had smoking habits and were rural workers. The most common oral lesions present in various anatomical sites were mulberry-like ulcers, more frequently observed in the gingiva, with regression within one to three months. Patients completed the treatment in one to two years (32.99%), and 47.42% of cases discontinued treatment. CONCLUSIONS: In addition to the characteristics of the oral lesions, information from the clinical profiles of patients with oral PCM is a central tool for dentists for early diagnosis. Earlier diagnosis may result in fewer consequences, especially respiratory ones that may cause an inability to work and poor quality of life.


Assuntos
Antifúngicos/uso terapêutico , Boca/microbiologia , Paracoccidioidomicose/tratamento farmacológico , Paracoccidioidomicose/epidemiologia , Adulto , Idoso , Brasil/epidemiologia , Doença Crônica/epidemiologia , Estudos Transversais , Feminino , Gengiva/microbiologia , Gengiva/patologia , Humanos , Masculino , Registros Médicos , Pessoa de Meia-Idade , Boca/patologia , Paracoccidioidomicose/patologia , Prevalência , Qualidade de Vida , Estudos Retrospectivos , População Rural , Fumar/efeitos adversos , Úlcera/microbiologia , Úlcera/patologia
20.
Emerg Infect Dis ; 23(11): 1917-1919, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-29048286

RESUMO

Transmission of Paracoccidioides spp. fungi to humans is usually related to manipulation of soil. Rural workers are the most affected group. We report an outbreak of paracoccidioidomycosis after deforestation and massive earth removal during construction of a highway in Rio de Janeiro, Brazil. Extensive environmental disturbances might be involved in fungal transmission.


Assuntos
Surtos de Doenças , Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Criança , Feminino , Humanos , Incidência , Masculino , Paracoccidioidomicose/microbiologia , Adulto Jovem
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