Paracoccidioidomicose e infecção pelo virus da imunodeficiência humana

Abstract

We present two cases of paracoccidioidomycosis, one occurring in an AIDS patient and the other in an HIV infected man. This is the first report of such association. The first patient, which was already followed for HIV infection (group IV-A) presented with high fever and hepatosplenomegaly. Plain X-ray, ultrasound and CT-scan of the abdomen showed solid nodules in the spleen, some of them with calcification. Both the direct smear and the culture of a bone marrow aspiration revealed Paracoccidioides brasiliensis. The patient died of acute disseminated Paracoccidioidomycosis. The second patient, a man anti-HIV seropositive presented with a mass on the right lower abdomen and inguinal region. A biopsy of the mass showed the association of Hodgkin's disease of the mixed cellularity type and paracoccidioidomycosis. With the expanding AIDS epidemic we believe this report emphasizes the need to consider Paracoccidioidomycosis in HIV infected persons in countries where this mycosis is endemic. We also suggest the inclusion of Paracoccidioidomycosis as a potential opportunistic infection in these areas.

Neoplasia and paracoccidioidomycosis

“…Other 23 single reports or series reports, one from Mexico, one from Argentina, and the others from Brazil, only described cases presenting malignancy and mycosis without references to the total number of patients observed in these cohorts of paracoccidioidomycosis [28][29][30][31][32][33][34][35][36][37][38]. One case of lung carcinoma, one of them in a patient receiving chemotherapy (oat cell carcinoma) and presenting Strongyloides stercoralis in the sputum, whose pulmonary biopsy showed oat cell carcinoma and the necropsy, large necrotic areas and bizarre forms of the fungi [28].…”

Paracoccidioidomycosis: an update

“…The greatest incidence of HIV-positive and AIDS cases occurs in areas where P. brasiliensis is endemic in the population centers of southern Brazil (Rio de Janeiro and Sao Paulo). However, in spite of the 4,000 cases of full-blown AIDS and the 300,000 HIV-positive individuals in Brazil (129), the reported number of AIDS patients with paracoccidioidomycosis is minimal (only seven) (15,22,128,129,133,227). An analysis of seven of the published cases (Table 8) reveals that all of these patients came from Brazil, all but one were males, and the mean patient age was 34 years.…”

Disseminated paracoccidioidomycosis with peripleuritis in an AIDS patient

“…The first cases of this mycosis in AIDS patients were reported in 1989 and, until 1995, 31 cases of this association had been reported 3,11,26 . in Brazil, the estimated incidence of PCM in HIV-1 seropositive patients in 1995 was 0.09% 18 .…”