Localização nervosa da blastomicose sul-americana

Raphael, Açucena

doi:10.1590/s0004-282x1966000200001

Cited by 30 publications

(13 citation statements)

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“…However, it is very close to the 3.8% prevalence reported by a recent case series report 11 . Beyond that, it must be noted that NCPM prevalence is extremely variable in the literature, ranging from 0% to 36% [12][13][14][15] . Interestingly, the majority (75%) of the cases reported in this work were diagnosed after 1990, especially after the year 2000, and the adjusted prevalence to this period is raised to 7.7%.…”

Section: Discussionmentioning

confidence: 99%

Paracoccidioidomycosis case series with and without central nervous system involvement

Pedroso

Lyon

Araújo

et al. 2012

Rev. Soc. Bras. Med. Trop.

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Introduction: Paracoccidioidomycosis (PCM) is the most important systemic mycosis in South America. Central nervous system involvement is potentially fatal and can occur in 12.5% of cases. This paper aims to contribute to the literature describing eight cases of neuroparacoccidioidomycosis (NPMC) and compare their characteristics with patients without neurological involvement, to identify unique characteristics of NPCM. Methods: A cohort of 213 PCM cases was evaluated at the Infectious Diseases Clinic of the University Hospital, Federal University of Minas Gerais, Brazil, from October 1976 to August 2008. Epidemiological, clinical, laboratory, therapeutic and follow-up data were registered. Results: Eight patients presented NPCM. The observed NPCM prevalence was 3.8%. One patient presented the subacute form of PCM and the other seven presented the chronic form of the disease. The parenchymatous form of NPCM occurred in all patients. 60% of the patients who proceeded from the north/ northeast region of Minas Gerais State developed NPCM. The neurological involvement of a mother and her son was observed. NPCM patients exhibited demographical and clinical profiles similar to what is described in the literature. When NPCM cases were compared to PCM patients, there were differences in relation to origin and positive PCM family history. Conclusions: The results corroborate the clinical view that the neurological findings are extremely important in the evaluation of PCM patients. Despite the limitations of this study, the differences in relation to patient's origins and family history point to the need of further studies to determine the susceptibility factors involved in the neurological compromise.

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Section: Discussionmentioning

confidence: 99%

Paracoccidioidomycosis case series with and without central nervous system involvement

Pedroso

Lyon

Araújo

et al. 2012

Rev. Soc. Bras. Med. Trop.

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“…The frequency of CNS involvement in PCM is extremely variable, from 9.65% to 25.45% [1,[15][16][17][18][19]. There have been an increasing number of reports of NPCM, most of which involve neurosurgical or anatomopathological findings [1,16,17,[19][20][21][22][23][24][25][26].…”

Section: The Involvement Of the Cnsmentioning

confidence: 99%

“…The granulomatous form predominates in the CNS in 96% of cases, mainly in the brain hemispheres, although it can occur in any location of the CNS [16]. Clinical manifestations are not specific and depend on the CNS location of the lesion [15][16][17][18][19][20]23,25,26,[29][30][31]. The most frequent clinical manifestations are seizure in 33%, hemiparesis in 25%, cerebellar signs in 25%, headache in 21%, and hydrocephalus in 21%; less frequent symptoms include paresthesias in 13%, confusion in 13%, and bulbar signs in 8% [16].…”

Section: Clinical Featuresmentioning

confidence: 99%

Central Nervous System Paracoccidioidomycosis: an overview

Almeida¹

2005

Braz J Infect Dis

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Paracoccidioidomycosis (PCM) is an infectious disease, endemic to subtropical areas of Central and South America, caused by the dimorphic fungus Paracoccidioides brasiliensis. It is a chronic disease, mostly affecting adult males, with a mean patient age of 44 years. Central nervous system involvement (CNS PCM) has been found in 13% of the patients with systemic disease. We reviewed the clinical presentation, diagnosis techniques and treatments for CNS PCM.

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“…The disease is acquired by the inhalatory route and habitually manifests as lesions in the oral mucosa and skin, possibly also involving the lungs, lymph nodes, liver, bones and the adrenal glands in a combined or separated manner, although any organ may be involved. Involvement of the nervous system is not infrequent, ranging from 9.6 to 12.5%, with predominance in the brain and meninges 2 -5 ' 6 " 131617,25 " 28,3032,34 . Lesions of the nervous system may manifest as granulomas, meningitis or as a mixed form.…”

Section: Granuloma Paracoccidioidomicótico Intramedular: Relato De Domentioning

confidence: 99%

Intramedullary spinal cord paracoccidioidomycosis: report of two cases

Colli

Assirati

Machado

et al. 1996

Arq. Neuro-Psiquiatr.

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-Two cases of intramedullary paracoccidioidomycosis are reported. Paracoccidioidomycosis is a systemic disease that involves the buccopharyngeal mucosa, lungs, lymph nodes and viscera and infrequently the central nervous system. Localization in the spinal cord is rare. Case 1: a 55-year old male admitted with crural pararesis, tactile/painful hypesthesia and sphincter disturbances of 15 days duration. Cutaneous-pulmonary blastomycosis was diagnosed 17 years ago. Myelotomography showed a blockade of T3-T4 (intramedullary lesion). The lesion surgically removed was a Paracoccidioides brasiliensis granuloma. Treatment with sulfadiazine was started after the surgery. Follow-up of 15 month showed an improvement of the clinical signs. Case 2: a 57-year old male was admitted elsewhere 6 months ago and, with a radiologic diagnosis of pulmonary paracoccidioidomycosis, was treated with amphotericin B. He progressively developed paresthesia and tactile/ pain anaesthesia on the left side, sphincter disturbances and tetraparesis with bilateral extensor plantar response and clonus of the feet. Myelotomography showed a blockade of C4-C6 (intramedullary lesion). The lesion was not found during surgical exploration and the patient deteriorated and died. Post-mortem examination revealed an intramedullary tumor above the site of the mielotomy (Paracoccidioides brasiliensis granuloma). The preoperative diagnosis of intramedullary paracoccidioidomycotic granulomas is difficult because the clinical and radiologic manifestations are uncharacteristic. Clinical suspicion was possible in our cases based on the history of previous systemic disease. Contrary to intracranial localizations, paracoccidioidomycotic granulomas causing progressive spinal cord compression may require early surgery because response to clinical treatment is slow and the reversibility of neurological deficits depends on the promptness of the decompression.KEY WORDS: intramedullary paracoccidioidomycosis, granuloma intramedullar blastomycotic, spinal cord compression, surgical treatment, medical treatment. Granuloma paracoccidioidomicótico intramedular: relato de dois casosRESUMO -São relatados dois casos de granuloma blastomicótico intramedular. A paracoccidioidomicose é micose sistêmica que atinge predominantemente a mucosa bucofaríngea, pulmões, linfonodos e vísceras e infrequentemente o sistema nervoso. A localização medular é rara. Caso 1: paciente masculino, de 55 anos, admitido com parestesias, hipoestesia táctil/dolorosa, paraparesia crural e distúbios esfincterianos. Tinha diagnóstico de blastomicose cutâneo-pulmonar há 17 anos. A mielotomografia mostrou bloqueio em T3-T4 (lesão intramedular). A lesão removida cirurgicamente revelou-se um granuloma blastomiótico. Após a cirurgia foi tratado com sulfadiazina. Durante o seguimento (15 meses) apresentou melhora do quadro clínico. Caso 2: paciente masculino, de 57 anos, internado em outro hospital há 6 meses por blastomicose pulmonar e tratado com anfotericina B. Desenvolveu parestesias, hipoestesia táct...

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Localização nervosa da blastomicose sul-americana

Cited by 30 publications

References 0 publications

Paracoccidioidomycosis case series with and without central nervous system involvement

Paracoccidioidomycosis case series with and without central nervous system involvement

Central Nervous System Paracoccidioidomycosis: an overview

Intramedullary spinal cord paracoccidioidomycosis: report of two cases

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