Consenso em paracoccidioidomicose

Shikanai-Yasuda, Maria Aparecida; Filho, Flávio de Queiroz Telles; Mendes, Rinaldo Pôncio; Colombo, Arnaldo Lopes; Moretti, Maria Luíza

doi:10.1590/s0037-86822006000300017

Cited by 351 publications

(383 citation statements)

References 35 publications

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“…The treatment of PCM is lengthy, starting with an aggressive dosage of antifungal agents, to which a maintenance treatment follows for months or years [5]. Sulfonamides (either sulfamethoxazole or Fig.…”

Section: Experimental Antifungalsmentioning

confidence: 99%

“…This binding disrupts osmotic integrity of the fungal membrane, compromising its barrier function in such a way that leakage of intracellular potassium, magnesium, sugars, metabolites and cellular death proceed. This drug is only to be administered intravenously, under strictly regulated conditions, and with a continuous surveillance of eventual renal impairment in the patient, because of its serious side effects as a nephrotoxic agent [5]. Over the years, P. brasiliensis isolates have continued to be sensitive to amphotericin B, thereby being the drug of choice when treatment with other antifungal agents becomes ineffective because of resistance.…”

Section: Experimental Antifungalsmentioning

confidence: 99%

“…Notable among these important pathogens are Candida albicans or some species of Aspergillus, whose morphogenetic processes are the subject of intense studies [1,2]. Another fungal species among this group of pathogens is Paracoccidioides brasiliensis, a dimorphic fungus, the causative agent of paracoccidioidomycosis (PCM), one of the most frequent systemic mycoses affecting the rural population of Latin America, the only geographic region in which PCM is found [3][4][5]. Its dimorphic transition is dependent on temperature, a yeastlike (Y) form being observed at 37°C and a mycelial (M) one at 23°C [3].…”

Section: Introductionmentioning

confidence: 99%

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Paracoccidioides brasiliensis: chemical and molecular tools for research on cell walls, antifungals, diagnosis, taxonomy

San-Blas

Niño-Vega

2008

Mycopathologia

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Paracoccidioides brasiliensis is a dimorphic fungus, a causative agent of paracoccidioidomycosis, one of the most frequent systemic mycoses that affect the rural population in Latin America, only geographical region in which this fungus is to be found. In this work, we discuss matters related to (a) cell wall studies based on the cloning and analysis of genes involved in the synthesis of cell wall components, and their possible roles in virulence and dimorphism in P. brasiliensis, (b) molecular taxonomy and the molecular classification of P. brasiliensis as an Ascomycete belonging in the Order Onygenales, (c) phylogeny of P. brasiliensis and the possible existence of cryptic species within the genus Paracoccidioides, and (d) new experimental antifungal drugs such as azasterols or sterol hydrazones, compounds that affect the activity of D 24(28) sterol methyl reductase (SMR) and/or D (24) -sterol methyl transferase (SMT), and (e) specific primers for the molecular detection of P. brasiliensis in vitro and in clinical samples.

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Section: Experimental Antifungalsmentioning

confidence: 99%

Section: Experimental Antifungalsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Paracoccidioides brasiliensis: chemical and molecular tools for research on cell walls, antifungals, diagnosis, taxonomy

San-Blas

Niño-Vega

2008

Mycopathologia

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“…A paracoccidioidomicose é uma micose sistêmica e qualquer sítio anatômico pode ser acometido 19 . Apesar de o pulmão ser a porta de entrada do fungo, com a formação do complexo pulmonar primário, são as lesões extrapulmonares, em especial as lesões na orofaringe, que habitualmente motivam a primeira consulta 1 22 .…”

Section: Discussionunclassified

“…Se não adequadamente tratada, a paracoccidioidomicose é agravada em decorrência do declínio da função pulmonar até o ponto de incapacitar o indivíduo ao trabalho e limitar suas atividades de vida diária 19 . Mesmo no doente tratado com antifúngicos, o quadro de insuficiência pulmonar é irreversível.…”

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Dissociação clínico-radiológica nas manifestações pulmonares da paracoccidioidomicose

Gomes

Wingeter²,

Svidzinski

2008

Rev. Soc. Bras. Med. Trop.

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A paracoccidioidomicose é uma micose sistêmica de natureza granulomatosa causada pelo fungo dimórfico Paracoccidioides brasiliensis 6 16 .A via inalatória é considerada a principal porta de entrada do agente e as alterações observadas nos vários sítios anatômicos ocorrem como conseqüência da disseminação do fungo. Uma vez inalados, os propágulos ambientais dão origem a sua forma parasitária encontrada nos tecidos do hospedeiro 18 . ABSTRACTLungs are among the main sites affected by paracoccidioidomycosis. However, the alterations are not always easy to differentiate from other respiratory disorders. The objectives of the present study were to investigate the frequency of lung impairment in paracoccidioidomycosis cases and to investigate whether any clinical-radiological association exists. A retrospective study was carried out from March 1996 to November 2006, among patients with paracoccidioidomycosis at the Regional University Hospital of Maringá, Paraná, brazil. Over this period, 45 cases were confirmed, of which 79.5% presented radiological abnormalities on chest X-rays, and four of them also presented pulmonary tuberculosis. Out of the total of 40 patients with paracoccidioidomycosis alone, 57.5% presented respiratory clinical manifestations, whereas 77.5% presented radiological abnormalities, thus demonstrating clinical-radiological dissociation. On the other hand, 80.6% of the patients who presented radiological abnormalities said that they smoked. We concluded that although morphological abnormalities in the lungs are frequent, they do not always correspond to respiratory signs and symptoms and cannot easily be attributed exclusively to paracoccidioidomycosis. Key-words:Paracoccidioidomycosis. Lung impairment. Radiological appearance. Smoking.A paracoccidioidomicose apresenta extensa gama de sinais e sintomas, que são agrupados em dois padrões principais: a forma aguda tipo juvenil, que ocorre em indivíduos com idade inferior a 30 anos, é de curso rápido e grave, comprometendo preferencialmente o sistema monocítico fagocitário e manifestandose clinicamente de forma disseminada. A outra forma é a crônica ou tipo adulto, mais freqüente que a aguda, se manifesta entre a terceira e quinta década de vida, com uma evolução lenta e

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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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Consenso em paracoccidioidomicose

Cited by 351 publications

References 35 publications

Paracoccidioides brasiliensis: chemical and molecular tools for research on cell walls, antifungals, diagnosis, taxonomy

Paracoccidioides brasiliensis: chemical and molecular tools for research on cell walls, antifungals, diagnosis, taxonomy

Dissociação clínico-radiológica nas manifestações pulmonares da paracoccidioidomicose

Fundamentals of paracoccidioidomycosis treatment

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