Paracoccidioidomycosis in a Renal Transplant Recipient

Góes, Heliana Freitas de Oliveira; Durães, Sandra Maria Barbosa; Lima, Caren dos Santos; Souza, Mariana Boechat de; Vilar, Enoí Aparecida Guedes; Dalston, Marcos Olivier

doi:10.1590/s1678-9946201658012

Cited by 11 publications

(10 citation statements)

References 7 publications

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“…In a small number of cases, PCM manifested a few days to 14 years after kidney transplantation, which enabled the evaluation of PCM's clinical and laboratory characteristics under these conditions. Chest X-rays revealed that these patients had bilateral nodules 18 , pulmonary cavitation 71,72 , or bronchopneumonic infiltrate 73 . Lymphatic impairment was uncommon 74 .…”

Section: Organ Transplantation and Immunosuppressive Therapymentioning

confidence: 98%

“…As in other immunosuppressed patients, unusual clinical and serological expressions may confuse and delay the diagnosis of PCM. In addition, the response to therapy in renal transplant patients may be slow, especially with the administration of oral antifungal agents [72][73][74] . In half of these cases, death was reported.…”

Section: Organ Transplantation and Immunosuppressive Therapymentioning

confidence: 99%

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Brazilian guidelines for the clinical management of paracoccidioidomycosis

Shikanai-Yasuda

Mendes

Colombo

et al. 2017

Rev. Soc. Bras. Med. Trop.

289

514

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Paracoccidioidomycosis is a systemic fungal disease occurring in Latin America that is associated with rural environments and agricultural activities. However, the incidence and prevalence of paracoccidiodomycosis is underestimated because of the lack of compulsory notification. If paracoccidiodomycosis is not diagnosed and treated early and adequately, the endemic fungal infection could result in serious sequelae. While the Paracoccidioides brasiliensis (P. brasiliensis) complex has been known to be the causal agent of paracoccidiodomycosis, a new species, Paracoccidioides lutzii (P. lutzii), has been reported in Rondônia, where the disease has reached epidemic levels, and in the Central West and Pará. Accurate diagnoses and availability of antigens that are reactive with the patients' sera remain significant challenges. Therefore, the present guidelines aims to update the first Brazilian consensus on paracoccidioidomycosis by providing evidence-based recommendations for bedside patient management. This consensus summarizes etiological, ecoepidemiological, molecular epidemiological, and immunopathological data, with emphasis on clinical, microbiological, and serological diagnosis and management of clinical forms and sequelae, as well as in patients with comorbidities and immunosuppression. The consensus also includes discussion of outpatient treatments, severe disease forms, disease prevalence among special populations and resource-poor settings, a brief review of prevention and control measures, current challenges and recommendations.

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Section: Organ Transplantation and Immunosuppressive Therapymentioning

confidence: 98%

Section: Organ Transplantation and Immunosuppressive Therapymentioning

confidence: 99%

Brazilian guidelines for the clinical management of paracoccidioidomycosis

Shikanai-Yasuda

Mendes

Colombo

et al. 2017

Rev. Soc. Bras. Med. Trop.

289

514

View full text Add to dashboard Cite

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“…35,[48][49][50] There are only 11 cases reported in solid organ transplantation, but as organ transplantation becomes more available in endemic areas of PCM, awareness of PCM pre-and posttransplant is important, as is investigation of PCM in cases of chronic granulomatous disease. [51][52][53][54][55][56][57][58] In the same way, the use of immunobiological therapy has been growing, and cases of PCM during its use have been reported. 59,60 Case series and isolated case reports suggest that cancer occurs in 0.6 to 11% of patients with PCM, mainly carcinomas of the respiratory and digestive tract, which share the same risk factors as PCM, that is, smoking and alcoholism.…”

Section: Eco Epidemiologymentioning

confidence: 99%

New Insights on Pulmonary Paracoccidioidomycosis

Queiroz-Telles

Peçanha-Pietrobom

Júnior

et al. 2020

Semin Respir Crit Care Med

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Paracoccidioidomycosis (PCM) is one of the most relevant systemic endemic mycoses in Latin American countries, especially in South American countries, with endemic and hyperendemic areas. The real burden of PCM may be underestimated because of a lack of compulsory case notification. Recent phylogenetic data revealed that Paracoccidioides brasiliensis comprises several cryptic species including P. brasiliensis and P. lutzii. However, the genetic biodiversity of Paracoccidioides does not affect the clinical manifestations or therapeutic response to therapy. Lung involvement is a common finding, especially in patients experiencing the chronic form of the disease, and, because of its similarities with tuberculosis, clinicians must be alert to the possibility of PCM in patients with chronic respiratory manifestations and epidemiological risk factors for this fungal disease.

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“…20 Um pequeno número de casos, que ocorreu desde poucos dias a 14 anos após o transplante de rim, possibilitou verificar, nesta condição, alterações significativas das características clínico-laboratoriais da PCM. Na radiografia do tórax, os pacientes apresentaram nódulos bilaterais, 18 cavitação pulmonar 71,72 ou infiltrado broncopneumônico. 73 É incomum o predomínio de comprometimento linfático.…”

Section: Transplante De óRgãos E Imunossupressão Medicamentosaunclassified

“…73,75 Como em outros pacientes imunossuprimidos, as expressões clínica e sorológica não usuais podem confundir e retardar o diagnóstico da PCM. Adicionalmente, a resposta à terapêutica em pacientes com transplante renal pode ser lenta, particularmente com os antifúngicos usados por via oral, 72,73,74 tendo-se observado evolução para óbito em metade dos casos relatados. Recomenda-se, portanto, o uso de antifúngicos eficazes e por via endovenosa, além de monitoramento rigoroso de pacientes imunossuprimidos em geral, que tenham tido exposição em áreas endêmicas de PCM.…”

Section: Transplante De óRgãos E Imunossupressão Medicamentosaunclassified

II Consenso Brasileiro em Paracoccidioidomicose - 2017*

Shikanai-Yasuda¹,

Mendes²,

Colombo³

et al. 2018

Epidemiologia e Serviços de Saúde

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Paracoccidioidomycosis is a systemic fungal disease associated with agricultural activities. Its incidence and prevalence are underestimated because of the lack of reporting in several Brazilian states. If paracoccidiodomycosis is not diagnosed and treated early and adequately, endemic fungal infection may result in serious sequelae. In addition to the Paracoccidioides brasiliensis (P. brasiliensis) complex, the appearance of a new species, Paracoccidioides lutzii (P. lutzii), in Rondônia state, where the disease has reached epidemic levels, and in the country's Midwest region and Pará state, are challenges to diagnosis and to the urgent availability of antigens that are reactive with patients' sera. These guidelines aim to update the first Brazilian consensus on paracoccidioidomycosis by providing evidence-based recommendations for bedside patient management. The guidelines provide data on etiology, epidemiology, immunopathogenesis, diagnosis, treatment and sequelae, with emphasis on diagnosis and treatment, as well as current recommendations and challenges in this field of knowledge.

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Paracoccidioidomycosis in a Renal Transplant Recipient

Cited by 11 publications

References 7 publications

Brazilian guidelines for the clinical management of paracoccidioidomycosis

Brazilian guidelines for the clinical management of paracoccidioidomycosis

New Insights on Pulmonary Paracoccidioidomycosis

II Consenso Brasileiro em Paracoccidioidomicose - 2017*

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