Paracoccidioidomycosis: intralesional therapy

Teixeira, Manoel Jacobsen; Fonoff, Erich Talamoni; Machado, Luı́s dos Ramos; Nobrega, J. P. S.; Sterman-Neto, Hugo; Amorim, Robson Luís Oliveira de

doi:10.1590/s0004-282x2010000300024

Cited by 5 publications

(8 citation statements)

References 13 publications

(17 reference statements)

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“…We also found one case not indexed in the two databases, the first case being of medullary infection by Paracoccidioides brasiliensis described in the literature, and one case of extradural spinal cord compression. 2,4,[6][7][8][9][10][12][13][14][15][16][17] Of the nineteen cases described, the majority underwent laminectomy and approach to the expanding lesion. The medical treatment used anfotericin B in three cases, anfotericin plus sulfadiazine in one case, only sulfadiazin in two cases, sulfamethoxazole plus trimethoprim in two cases, sulfamethoxazole plus trimethoprim plus fluconazole in one case, only fluconazole in one case, and cetaconazole in one case.…”

Section: Discussionmentioning

confidence: 99%

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Medullary Paracoccidioidomycosis Treated Successfully with Oral Itraconazole

et al. 2016

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Paracoccidioidomycosis is the most prevalent endemic mycosis in Latin America, with a great incidence in Brazil. Although a common disease, its medullary form is rare. We present a case report of medullary paracoccidioidomycosis presenting with subacute, progressive, spinal cord symptoms, and with multiple expansive lesions into the cervical and thoracic spinal cord. The patient was treated with itraconazole and showed good clinical and radiologic recovery upon six months of follow-up.

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Section: Discussionmentioning

confidence: 99%

“…The latter is present in more than 10% of cases, ranging from 1 to 27.7% in the Brazilian series. 5,6 It was first described by Pereira and Jacobs in 1919. In turn, the medullary form was described by Braga and Okamura in 1973.…”

Section: Introductionmentioning

confidence: 99%

Medullary Paracoccidioidomycosis Treated Successfully with Oral Itraconazole

et al. 2016

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“…Most contaminated patients have been engaged in agricultural activities during the first two decades of life and exposed persistently to endogenous latent foci, since plants and soil can be a natural source of Paracoccidioides brasiliensis [2, 4, 10–12]. Several cases of systemic paracoccidioidomycosis have also been reported outside endemic areas among travelers, aid workers and immigrants [3, 13–15].…”

Section: Discussionmentioning

confidence: 99%

“…Pulmonary involvement occurs in 70 to 90% of cases, but other organs can be affected such as skin/mucosa, adrenal glands, lymph nodes, gastrointestinal tract, musculoskeletal system and central nervous system [1–4]. Eye involvement of PCM is very rare and usually affects the eyelid and conjunctiva.…”

Section: Introductionmentioning

confidence: 99%

Retinal involvement of Paracoccioidomycosis: A Case Report

et al. 2012

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Purpose: to describe the clinicopathologic features and treatment of a rare case of systemic paracoccidioidomycosis with choroidal and retinal involvement. Design: retrospective interventional case report. Participant: A 36-year-old young man with visual impairment in left eye with anterior uveitis and presence of whitish perimacular choroidal nodule, multiple underlying whitish spots and mid-periphery exudative retinal detachment. A primary extensive work-up for systemic infectious, autoimmune, neoplasic or inflammatory conditions was performed and high-resolution computer tomography scan demonstrated asymmetric parietal thickening of the trachea and bilateral diffuse multiple lobular opacities. Pulmonary bronchoscopy/biopsy of larynx, trachea and bronchial tube were also performed. Histopathological evaluation showed characteristic of Paracoccidioidomycosis. Intervention: Patient was treated with oral sulphadiazine (1.5 g/day). Main Outcome Measures: Anterior uveitis, retinal examination, histopathological evaluation and primary clinical outcome were observed during systemic treatment. Results: After 3 months of irregular treatment, choroidal lesions decreased in size forming atrophic scars and fibrotic spots; however visual acuity did not show any improvement. Conclusion: We report a rare case of systemic paracoccidioidomycosis with choroidal and retinal involvement treated with oral sulphadiazine.

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“…A case of cerebral PCM was treated with repeated stereotaxic intra-lesion instillation of daily injections of AmB into the cyst for 4 weeks, resulting in neurological improvement of the patient and cure of the abscess. The patient was then treated with sulfonamides for 6 months [Teixeira et al, 2010].…”

Section: Treatment Of Neuroparacoccidioidomycosismentioning

confidence: 99%

Fundamentals of paracoccidioidomycosis treatment

Fróes

Caligiorne

2011

Drug Development Research

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Paracoccidioidomycosis (PCM) is the most important mycosis in Latin America. The etiological agent is the fungus, Paracoccidioides brasiliensis. Approximately 1 million people are infected with the fungus, 10% of whom will show symptoms of the disease. However, clinical and laboratorial studies addressing the diagnosis for this disease are both scarce and diverse in terms of definition. Nevertheless, two main advances were included in the portfolio of available diagnostic methods for paracoccidioidomycosis during the last decades: the detection of antibodies against P. brasiliensis antigens by serological methods, and the detection of the fungi DNA in peripheral blood and fragments of lesions using the polymerase chain reaction (PCR) assay and species-specific primers. Normally, the treatment of PCM is quite prolonged because of the immunosuppressed profile of the patients and the ability of P. brasiliensis to survive in the tissues even after long-term treatment. Case reports indicate that azoles and sulfa compounds can produce positive results in less severe cases of PCM. However, for acute cases of the disease in immunocompromised patients or in cases of neuroparacoccidioidomycosis, there is no standard treatment. Thus, there is a need to establish a standard treatment protocol within the context of the patient clinical profile. Moreover, drug availability to public institutions is an important issue, since new drugs, e.g., second-generation azoles, the echinocandines and immunomodulatory drugs, are not yet available in public hospitals and clinics. Drug Dev Res 72:528-537, 2011.

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Paracoccidioidomycosis: intralesional therapy

Cited by 5 publications

References 13 publications

Medullary Paracoccidioidomycosis Treated Successfully with Oral Itraconazole

Medullary Paracoccidioidomycosis Treated Successfully with Oral Itraconazole

Retinal involvement of Paracoccioidomycosis: A Case Report

Fundamentals of paracoccidioidomycosis treatment

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