Disseminated paracoccidioidomycosis with peripleuritis in an AIDS patient

Abstract

SUMMARYParacoccidioidomycosis is one of the most frequent systemic and endemic mycoses of Latin America caused by a dimorphic fungus. In AIDS patients, paracoccidioidomycosis appears as a severe and disseminated disease with a wide spectrum of clinical findings. The CD4 counts are usually less than 200 cell/µL. We present a case of disseminated paracoccidioidomycosis with peripleuritis and subcutaneous abscesses on the chest wall as initial manifestation of AIDS. In endemic countries, paracoccidioidomycosis should be included as an opportunistic infection in AIDS.

Paracoccidioidomycosis in Patients Infected with and Not Infected with Human Immunodeficiency Virus: A Case-Control Study

“…18 In addition, many P. brasiliensis -HIV co-infected patients have lung lesions, sometimes showing atypical infiltrates, probably resulting from reactivation of the primary focus and from hematogenous dissemination. 25,27,28 This finding is in contrast to the pulmonary normality seen in the acute/subacute form of endemic paracoccidioidomycosis. 2 The multiple extrapulmonary fungal lesions caused by hematogenous dissemination, together with the frequent and occasionally more intense pulmonary involvement, characterize a unique form of opportunistic paracoccidioidomycosis in persons with AIDS-related immunosuppression.…”

Paracoccidioidomycosis in patients with human immunodeficiency virus: review of 12 cases observed in an endemic region in Brazil

“…4 Cutaneous lesions, observed in half of the cases, indicate a hematogeous dissemination of P. brasiliensis. Involvement of organs unusually involved in PCM, such as pleura 15 and bone was observed in one patient with a severe disseminated form.…”

Pulmonary Paracoccidioidomycosis and AIDS

“…1 In addition, it might be related to many patients with AIDS receiving trimethoprim-sulfamethoxazole and ketoconazole as a prophylaxis or treatment for Pneumocystis carinni pneumonia and oropharyngeal candidiasis, and both drugs are active against PCM infection. 1,2,13,14 Finally, it should be considered that AIDS is a predominantly urban disease in contrast with the rural prevalence of PCM. 14 Despite the epidemiological importance of PCM in Latin America, only a few studies have assessed the chest HRCT manifestations of this infection.…”

“…1,2,13,14 Finally, it should be considered that AIDS is a predominantly urban disease in contrast with the rural prevalence of PCM. 14 Despite the epidemiological importance of PCM in Latin America, only a few studies have assessed the chest HRCT manifestations of this infection. 5,6,9 Funari et al 5 reviewed the HRCT findings of 38 patients with pulmonary PCM.…”