Neuroblastomicose: registro de três casos

Wittig, Ehrenfried Othmar; Kasting, Gllda; Leal, Rui M.

doi:10.1590/s0004-282x1968000100011

Cited by 11 publications

(6 citation statements)

References 8 publications

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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%

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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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Section: The Involvement Of the Cnsmentioning

confidence: 99%

Section: Clinical Featuresmentioning

confidence: 99%

Central Nervous System Paracoccidioidomycosis: an overview

Almeida¹

2005

Braz J Infect Dis

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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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“…Flowchart describing the selection of autopsy and biopsy PCM and NPCM cases from the reports of the Medical Pathology Unit, HC ‐ UFPR , Brazil, between 1951 and 2014. * Three autopsy cases were previously described; ** One biopsy case was previously described; *** Possible NPCM defined as: cases without CNS biopsy but with CNS symptoms and/or neuroimaging, compatible with PCM in CNS after medical chart review and systemic PCM diagnosis confirmed by biopsies on other organs. Reports excluded: autopsies without CNS examination (six cases), it was not possible to locate the medical charts of these patients, all were from the 1960s.…”

Section: Resultsmentioning

confidence: 99%

Autopsy and biopsy study of paracoccidioidomycosis and neuroparacoccidioidomycosis with and without HIV co‐infection

Almeida

Roza

Salvador

et al. 2018

Mycoses

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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.

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Neuroblastomicose: registro de três casos

Cited by 11 publications

References 8 publications

Central Nervous System Paracoccidioidomycosis: an overview

Central Nervous System Paracoccidioidomycosis: an overview

Intramedullary spinal cord paracoccidioidomycosis: report of two cases

Autopsy and biopsy study of paracoccidioidomycosis and neuroparacoccidioidomycosis with and without HIV co‐infection

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