Paracoccidioidomycosis associated with acquired immunodificiency syndrome: report of seven cases

Marques, Sílvio Alencar; Conterno, Luciene de Oliveira; Sgarbi, Luciana P.; Villagra, Aurea Maria P.C.; Sabongi, Vania P.G.; Bagatin, Ediléia; Gonçalves, V.

doi:10.1590/s0036-46651995000300014

Cited by 29 publications

(24 citation statements)

References 11 publications

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“…In a series of coinfected patients in which a small number of patients were assessed with serological tests for anti-P. brasiliensis antibodies, false-negative results were obtained in 33% (Paniago et al 2005) and 66% (Marques et al 1995) of the serum samples. The use of CIEP or ELISA increased the rate of reactive sera; however, in both tests the low levels of anti-P. brasiliensis in some HIV-infected patients were insufficient for a safe serological diagnosis of paracoccidioidomycosis because of cross-reactions and specificity lower than 100% (de Camargo 2008).…”

Section: Discussionmentioning

confidence: 99%

Serological diagnosis of paracoccidioidomycosis in HIV-coinfected patients

Bellissimo-Rodrigues¹,

Vitali²,

Martínez

2010

Mem. Inst. Oswaldo Cruz

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Paracoccidioidomycosis should be differentiated from other opportunistic diseases in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients who live in Latin America. Laboratory investigation can begin with serological tests, which are rapid and efficient. In the present study, double immunodiffusion (DID), counterimmunoelectrophoresis (CIEP) and an enzyme linked immunosorbent assay (ELISA) tests were assessed for the detection of anti-Paracoccidioides brasiliensis antibodies in 40 patients coinfected with HIV. The results were compared to those obtained for 75 non-HIV-infected patients with endemic paracoccidioidomycosis. Anti-P. brasiliensis antibodies were detected in 65% (DID), 79% (CIEP) and 95% (ELISA) of the patients with HIV/AIDS, significantly lower rates than those detected in cases of endemic paracoccidioidomycosis, which were 89%, 99% and 100%, respectively. The reactive sera of HIV-infected patients also showed lower anti-P. brasiliensis antibody titres than those of non-HIV-infected patients. Despite the lower intensity of the specific humoral response, serological tests are useful for the diagnosis of opportunistic paracoccidioidomycosis in the HIV/AIDS population. We suggest optimization of the laboratory diagnosis by combining the ELISA test with CIEP or DID

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Section: Discussionmentioning

confidence: 99%

Serological diagnosis of paracoccidioidomycosis in HIV-coinfected patients

Bellissimo-Rodrigues¹,

Vitali²,

Martínez

2010

Mem. Inst. Oswaldo Cruz

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“…2,4,6 In the present case, despite the extremely low CD4+ cell count (4 cells/mm 3 ), the patient was able to control pathogen load and to form granulomas. Granuloma formation was supported by epithelial cells, giant cells, plasma cells and CD8+ T cells and the absence of CD4+ T cells, as shown by the immunohistochemical analysis.…”

Section: Discussionmentioning

confidence: 47%

“…In 2000, Bernard et al 2 published a comprehensive review of 73 cases of PCM and HIV/AIDS coinfection. According to these authors, 56 (77%) patients had the disseminated form of the disease and characteristics of the acute form, with adenomegaly, hepatomegaly, splenomegaly and osteoarticular and cutaneous (61%) lesions.…”

Section: Introductionmentioning

confidence: 99%

AIDS-associated paracoccidioidomycosis in a patient with a CD4+ T-cell count of 4 cells/mm³

Nogueira

Santos

Ferreira

et al. 2011

An. Bras. Dermatol.

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Abstract:We describe a case of a patient presenting with HIV and paracoccidioidomycosis co-infection. At the time of diagnosis total CD4+ T-cell count was 4 cells/mm3. Histopathology revealed tuberculoid granulomas, scarce CD4+ T cells, a moderate number of CD8+ cells and the absence of Foxp3+ cells. Most of the cutaneous lesions healed after two weeks of treatment with amphotericin B. After 14 months the patient is still under antiretroviral therapy and no clinical evidence of recurrence of the mycosis has been observed. Keywords: AIDS-related opportunistic infections; HIV; Paracoccidioidomycosis Resumo: Neste trabalho apresenta-se paciente com coinfecção paracoccidioidomicose/Aids. No momento do diagnóstico, a contagem de células T CD4 + era 4 células. No exame histopatológico, observou-se a presença de granulomas tuberculóides bem formados e na imunohistoquímica, ausência de células Foxp3, raros linfócitos T CD4+ e presença de células T CD8+ em moderada quantidade. Com duas semanas de uso da anfotericina B, verificou-se a regressão de grande parte das lesões cutâneas. Após 14 meses, o paciente encontra-se em uso de terapia antiretroviral e sem evidências de atividade da micose. Palavras-chave: HIV; Infecções oportunistas relacionadas com a AIDS; Paracoccidioidomicose Recebido em 18.11.2010. Aprovado pelo Conselho Consultivo e aceito para publicação em 14.12.2010.

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“…Entre esses, pode ser incluído o consumo de bebida alcoólica, tabagismo e imunocomprometimentos, como AIDS (17)(18)(19) , todos presentes em nossa casuística. A alta prevalência de tabagismo, em nossa casuística, merece menção, principalmente nos consumidores por mais de 20 anos, por apresentar maiores chances de desenvolver a PCM (14) .…”

Section: Discussionunclassified

Perfil clínico, laboratorial e epidemiológico de pacientes com paracoccidioidomicose em um serviço de referência no noroeste do estado do Paraná

Gomes¹,

Ferreira

Patussi

et al. 2008

Cienc. Cuid. Saúde

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RESUMOHá indicativos de que a paracoccidioidomicose (PCM) seja endêmica no Noroeste do Paraná, porém pouco ainda é documentado sobre essa doença na região. No presente estudo, são descritas as características clínico-laboratoriais e epidemiológicas de 45 indivíduos com PCM, atendidos em um serviço de referência, no Noroeste do Estado do Paraná, no período de março de 1996 a novembro de 2006. Observou-se que a manifestação clínica que motivou a procura por assistência foi lesões na orofaringe em 28 (62,2%) casos, seguida do comprometimento pulmonar em 9 (20,0%), sendo que 10 dos 45 pacientes (22,2%) foram encaminhados ao serviço por cirurgiões-dentistas. A proporção homem/mulher foi de 14:1, houve predomínio de maiores de 41 anos de idade; da forma crônica da doença e profissão vinculada à agricultura. Os hábitos de tabagismo e consumo de bebida alcoólica foram freqüentes. Como método de diagnóstico, o mais realizado foi o histopatológico, e a associação sulfametoxazol-trimetropim foi o tratamento farmacológico mais prescrito.Palavras-chave: Paracoccidioidomicose. Paracoccidioides. Epidemiologia. Investigação laboratorial.

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Paracoccidioidomycosis associated with acquired immunodificiency syndrome: report of seven cases

Cited by 29 publications

References 11 publications

Serological diagnosis of paracoccidioidomycosis in HIV-coinfected patients

Serological diagnosis of paracoccidioidomycosis in HIV-coinfected patients

AIDS-associated paracoccidioidomycosis in a patient with a CD4+ T-cell count of 4 cells/mm³

Perfil clínico, laboratorial e epidemiológico de pacientes com paracoccidioidomicose em um serviço de referência no noroeste do estado do Paraná

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