RESUMO
We probably describe the first report of esophageal rupture in a patient with autoimmune polyendocrinopathy - candidiasis - ectodermal dystrophy (APECED, OMIM # 240300), who had candida esophagitis as the main feature for decades. Strong evidence shows that this rupture may have been caused directly and indirectly by chronic candidiasis. In this way, we demonstrate how severe and harmful the persistent esophageal candidiasis can cause in the esophagus, especially in immunodeficient patients.
Assuntos
Candidíase Mucocutânea Crônica , Candidíase , Poliendocrinopatias Autoimunes , Candidíase/complicações , Candidíase/diagnóstico , Candidíase Mucocutânea Crônica/complicações , Candidíase Mucocutânea Crônica/diagnóstico , Humanos , Poliendocrinopatias Autoimunes/complicações , Poliendocrinopatias Autoimunes/diagnósticoRESUMO
We describe the first report of a patient with chronic mucocutaneous candidiasis associated with disseminated and recurrent paracoccidioidomycosis. The investigation demonstrated that the patient had a mannose receptor deficiency, which would explain the patient's susceptibility to chronic infection by Candida spp. and systemic infection by paracoccidioidomycosis. Mannose receptors are responsible for an important link between macrophages and fungal cells during phagocytosis. Deficiency of this receptor could explain the susceptibility to both fungal species, suggesting the impediment of the phagocytosis of these fungi in our patient.
Assuntos
Candidíase Mucocutânea Crônica , Paracoccidioidomicose , Candidíase Mucocutânea Crônica/complicações , Candidíase Mucocutânea Crônica/genética , Humanos , Lectinas Tipo C , Receptor de Manose , Lectinas de Ligação a Manose , Paracoccidioidomicose/complicações , Paracoccidioidomicose/diagnóstico , Receptores de Superfície CelularRESUMO
Here, we describe a case of hepatosplenic schistosomiasis that progressed to widespread persistent dermatophytosis. Significant T and B lymphocytopenia was confirmed. T-cell deficit is associated with increased susceptibility to fungal infections of skin and mucous membranes. The accumulation of a large amount of blood cells in the spleen could have played a crucial role in the development of lymphocytopenia in the present case. Alternatively, the schistosomiasis-induced increase in prostaglandin E2 levels could have inhibited the production of interferon-γ, a cytokine fundamental to fungal resistance. This case shows the potential of hepatosplenic schistosomiasis to impair the immune response.
Assuntos
Infecções Oportunistas/microbiologia , Esquistossomose mansoni/imunologia , Tinha/imunologia , Adulto , Doença Crônica , Humanos , Hospedeiro Imunocomprometido , Masculino , Esquistossomose mansoni/complicações , Esplenopatias/complicações , Esplenopatias/imunologia , Tinha/etiologiaRESUMO
Myeloperoxidase (MOP) is present in monocyte and neutrophil lysosomes, catalyzing hydrogen peroxide and chloride ion conversion to hypochlorous acid. MOP seems to destroy pathogens during phagocytosis by neutrophils and is considered an important defense against innumerous bacteria. We present a patient who had MOP deficiency, who presented with a subacute form of paracoccidioidomycosis and later with peritoneal tuberculosis. MOP deficiency leads to the diminished destruction of phagocytized pathogens. This case gives important evidence of an association between MOP deficiency and increased susceptibility to infection by Paracoccidioides brasiliensis and Mycobacterium tuberculosis.
Assuntos
Erros Inatos do Metabolismo/microbiologia , Paracoccidioidomicose/complicações , Peritonite Tuberculosa/complicações , Feminino , Humanos , Erros Inatos do Metabolismo/diagnóstico , Paracoccidioidomicose/diagnóstico , Peritonite Tuberculosa/diagnóstico , Adulto JovemRESUMO
Abstract We describe the first report of a patient with chronic mucocutaneous candidiasis associated with disseminated and recurrent paracoccidioidomycosis. The investigation demonstrated that the patient had a mannose receptor deficiency, which would explain the patient's susceptibility to chronic infection by Candida spp. and systemic infection by paracoccidioidomycosis. Mannose receptors are responsible for an important link between macrophages and fungal cells during phagocytosis. Deficiency of this receptor could explain the susceptibility to both fungal species, suggesting the impediment of the phagocytosis of these fungi in our patient.
Assuntos
Humanos , Paracoccidioidomicose/complicações , Paracoccidioidomicose/diagnóstico , Candidíase Mucocutânea Crônica/complicações , Candidíase Mucocutânea Crônica/genética , Receptores de Superfície Celular , Lectinas Tipo C , Lectinas de Ligação a ManoseRESUMO
Abstract Myeloperoxidase (MOP) is present in monocyte and neutrophil lysosomes, catalyzing hydrogen peroxide and chloride ion conversion to hypochlorous acid. MOP seems to destroy pathogens during phagocytosis by neutrophils and is considered an important defense against innumerous bacteria. We present a patient who had MOP deficiency, who presented with a subacute form of paracoccidioidomycosis and later with peritoneal tuberculosis. MOP deficiency leads to the diminished destruction of phagocytized pathogens. This case gives important evidence of an association between MOP deficiency and increased susceptibility to infection by Paracoccidioides brasiliensis and Mycobacterium tuberculosis.
Assuntos
Humanos , Feminino , Adulto Jovem , Paracoccidioidomicose/complicações , Peritonite Tuberculosa/complicações , Erros Inatos do Metabolismo/microbiologia , Paracoccidioidomicose/diagnóstico , Peritonite Tuberculosa/diagnóstico , Erros Inatos do Metabolismo/diagnósticoRESUMO
Abstract: Here, we describe a case of hepatosplenic schistosomiasis that progressed to widespread persistent dermatophytosis. Significant T and B lymphocytopenia was confirmed. T-cell deficit is associated with increased susceptibility to fungal infections of skin and mucous membranes. The accumulation of a large amount of blood cells in the spleen could have played a crucial role in the development of lymphocytopenia in the present case. Alternatively, the schistosomiasis-induced increase in prostaglandin E2 levels could have inhibited the production of interferon-γ, a cytokine fundamental to fungal resistance. This case shows the potential of hepatosplenic schistosomiasis to impair the immune response.
Assuntos
Humanos , Masculino , Adulto , Tinha/imunologia , Esquistossomose mansoni/imunologia , Infecções Oportunistas/microbiologia , Esplenopatias/complicações , Esplenopatias/imunologia , Tinha/etiologia , Esquistossomose mansoni/complicações , Doença Crônica , Hospedeiro ImunocomprometidoRESUMO
Trabalho de revisäo, no qual säo relatados os principais achados clínico nos acometidos pela síndrome de Down, com destaque maior para as alteraçöes do sistema imunitário, doenças caradiovasculares e leucemia, que säo as principais causadoras da morbidade e mortalidade nestes indivíduos. As curvas de mortalidade e sobrevida, ao mesmo tempo que mostram uma menor expectativa de vida em relaçäo a outros deficientes mentais e à populaçäo geral, ressaltam o aumento da longevidade, fato importante para a melhor compreensäo desta síndrome também em pacientes mais velhos.