Bone Marrow Involvement in a Patient with Paracoccidioidomycosis: A Rare Presentation of Juvenile Form

Abstract

Paracoccidioides brasiliensis rarely shows bone marrow involvement and its response to treatment with itraconazole in children needs further assessment. We describe here a child with a juvenile disseminated form of paracoccidioidomycosis, which showed reticuloendothelial system involvement and the presence of Paracoccidioides brasiliensis in the bone marrow. The patient showed an effective and rapid response to itraconazole therapy.

Paracoccidioidomycosis: acute-subacute clinical form, juvenile type

“…Acute/ subacute paracoccidioidomycosis, juvenile type, classically occurs in young patients of both sexes and is characterized by tropism of the fungus to the monocyte-phagocyte system. 1 - 4 …”

Paracoccidioidomycosis: Latin America’s Own Fungal Disorder

“…In adult patients, hypertrophied lymph nodes may also be detected albeit not as frequently as in the juvenile form; they are located preferentially in the neck region; if in the abdomen, enlarged nodes may coalesce forming large masses that simulate a tumor [1-4, 5•, 78-80]. Adrenal gland involvement is also a classic sign with Addison syndrome being detected in ≥ 10 % of patients; at autopsy, a much higher (85 %) number reveal adrenal gland involvement [79,86,87].…”

Osteomielite de punho em paciente com paracoccidioidomicose disseminada: uma rara apresentação

“…As the disease progresses, the patient presents severe involvement of several organs such as skin, mucosas, lungs and bones. Such an infection may progress with dissemination, but the disseminated presentation occurs in only 3-5% of cases (3) .…”