Acute disseminated paracoccidioidomycosis in a 3 year-old child

Abstract

Clinical cases involving paracoccidioidomycosis in children, diagnosed in Mato Grosso State, in the central western region of Brazil, are rare despite the state being classified with a moderate to high incidence. We describe a clinical case of infant acute disseminated Paracoccidioidomycosis in Mato Grosso State, Brazil, highlighting the importance of early differential diagnosis from other severe pathologies, thus contributing to the survival of compromised patients. A 3 year-old male child, weighing 12.8 Kg, originating from Vila Rica, MT, Brazil. The patient presented intermittent 40 masculineC fever evolving over 40 days, dry cough and painless bilateral cervical adenomegaly, showing no signs of inflammation. This was associated with diarrhea, distension and important abdominal pain and weight loss. Diagnosis was achieved by visualization of Paracoccidioides brasiliensis yeasts in a direct mycological exam and posterior fungus isolation in culture medium. The patient evolved presenting good clinical response to antifungal treatment and progressive reduction of abdominal and cervical ganglions. To improve the prognosis of compromised patients it is essential that professionals realize a full clinical-laboratorial evaluation, including differential diagnoses for other severe pathologies, as early as possible. The degree and intensity of paracoccidioidomycosis compromise are determining factors for defining the most efficient treatment.

Functional and phenotypic evaluation of eosinophils from patients with the acute form of paracoccidioidomycosis

“…In previous work, we demonstrated that lack of reactivity in immunodiffusion test could be associated with production of low affinity IgG2 class antibodies against carbohydrate epitopes [38]. In accordance with previous reports, all patients presented with mononuclear phagocytic system involvement (lymphadenomegaly and hepasplenomegaly), in addition to bones and skin lesions [39–41]. …”

Paracoccidioidomycosis: epidemiological, clinical, diagnostic and treatment up-dating

“…However, it is important to remember that the most affected age group is that between 30 and 50 years old and that the oldest patient recorded to date was 103 years old. 17,18 Studies on the specific mortality due to systemic mycoses began to be published in 2002. That year, the pioneer study of Coutinho et al .…”

Tropical Skin Diseases in Children: A Review— Part I

“…It is endemic to Mexico and South America, but most cases come from Brazil (incidence 1 to 10 in 100,000 per year) , Colombia, and Venezuela. It is more common in males, although both sexes are equally exposed to the fungus . It occurs frequently in adults, although in a large series, up to 18.5% of patients were children, with 9.7% younger than 4 years of age .…”