Paracoccidioidomycosis: an unusual presentation with a rapid progression

Deps, Patrícia Duarte; Neves, Marisa Barros das; Neto, Lauro F.S. Pinto

doi:10.1590/s0037-86822004000500014

Cited by 7 publications

(1 citation statement)

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“…However, according to survey data, the combination sulfamethoxazole-trimethoprim has been the most used for treating patients with PCM, achieving great success in healing (Table 1). In severe forms of the disease, the treatment regimen involves administration of an IV solution of Cotrimazole (sulfamethoxazole 400 mg/ trimethoprim 80 mg), 2 ampoules/8 hr until clinical improvement of the patient followed by administration of oral antifungal drugs [Deps et al, 2004;Lopes et al, 2009;Ministé rio da Saú de, 2009a]. In less severe forms of the disease, the latter should be administered for a period of 2 years, resulting in high dropout rates during treatment (Table 2).…”

Section: Treatment Of Paracoccidioidomycosismentioning

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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Section: Treatment Of Paracoccidioidomycosismentioning

confidence: 99%