A Rare Paracoccidioidomycosis Diagnosis in a Kidney Transplant Receptor: Case Report

Pontes, A.M.; Borborema, J.; Correia, Cátia; Almeida, Wagner Leite de; Maciel, Rafael Fábio

doi:10.1016/j.transproceed.2015.03.006

Cited by 15 publications

(20 citation statements)

References 5 publications

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“…Chest X-rays revealed that these patients had bilateral nodules 18 , pulmonary cavitation 71,72 , or bronchopneumonic infiltrate 73 . Lymphatic impairment was uncommon 74 . In these cases, microbiological diagnosis should be preferential because serological tests generally show low titers of anti-Paracoccidioides spp.…”

Section: Organ Transplantation and Immunosuppressive Therapymentioning

confidence: 99%

“…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.

325

590

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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: 99%

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.

325

590

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“…73 É incomum o predomínio de comprometimento linfático. 74 Deve ser priorizado o diagnóstico microbiológico, pois os testes sorológicos em geral mostram títulos baixos de anticorpos anti-Paracoccidioides spp. 73,75 Como em outros pacientes imunossuprimidos, as expressões clínica e sorológica não usuais podem confundir e retardar o diagnóstico da PCM.…”

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 is a relatively common fungus found in Latin America; approximately 80% of cases occur in Brazil, where the incidence is 1-3 cases per 100,000 inhabitants 4 . P. brasiliensis is a thermally dimorphic fungus that typically infects healthy adults.…”

Section: Discussionmentioning

confidence: 99%

Paracoccidioidomycosis in a liver transplant recipient

Lima

Bezerra

Siqueira

et al. 2017

Rev. Soc. Bras. Med. Trop.

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Paracoccidioidomycosis is a granulomatous systemic mycosis that is endemic in Latin America; it is an extremely rare infection following solid organ transplantation. In this study, we describe the first report of disseminated paracoccidioidomycosis in a 3-year-old girl who underwent liver transplantation 2 years previously. The radiologic diagnosis and patient follow-up are described. In addition, we review the clinical evolution and treatment regimens for this infection.

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A Rare Paracoccidioidomycosis Diagnosis in a Kidney Transplant Receptor: Case Report

Cited by 15 publications

References 5 publications

Brazilian guidelines for the clinical management of paracoccidioidomycosis

Brazilian guidelines for the clinical management of paracoccidioidomycosis

II Consenso Brasileiro em Paracoccidioidomicose - 2017*

Paracoccidioidomycosis in a liver transplant recipient

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