Coccidioidomycosis: first cases reported in Pernambuco, Brazil

Abstract

Coccidioidomycosis is a fungal infection caused by Coccidioides immitis or Coccidioides posadasii. These fungi are known to thrive in desert climate. Fungi produce infectious arthroconidia in soil, they are aerosolized in the air and when inhaled by humans, usually cause infections such as pneumonia. The first cases of coccidioidomycosis in Brazil were reported in 1978. Since then, there have been other reports mainly from desert regions of Northeastern Brazil. The present report describes three cases of coccidioidomycosis on male farmers from Serra Talhada county, Pernambuco State, who developed pneumonia and were subsequently diagnosed with pulmonary coccidioidomycosis. These three farmers were successfully treated with oral fluconazole. They reported having hunted armadillos in a rural and arid area of Pernambuco State. Armadillos are known to be carriers of Coccidioides. This is the first report of infection caused by Coccidioides in Pernambuco State, Brazil.

Climate drivers of hospitalizations for mycoses in Brazil

“…Recently, Araújo et al . 30 reported cases of coccidioidomycosis in Pernambuco (Brazil), a region for which the disease had never been reported previously, and their possible association with the recent drought that occurred in the region. As with other systemic mycoses, temporal fluctuations in the incidence of disseminated histoplasmosis can also be explained by climatic variations 31 .…”

Coccidioidomycosis in Brazil: Historical Challenges of a Neglected Disease

“…In 1998, Brazil was included in the international list of countries with endemic areas of the disease [ 58 ], with zones limited to the semi-arid areas of the States of Maranhão, Piauí, and Bahia. The most recent area of occurrence of CM in Brazil is the city of Serra Talhada, in Pernambuco State (7°59′09″ S–38°17′45″ W), where four individuals presented acute pneumonia after armadillo hunting [ 58 , 59 , 60 ] ( Figure 1 ).…”

“…In Brazil, CM occurs exclusively in the northeast region, where approximately 136 cases of the disease have been reported since 1978: 94 cases in the state of Piauí [ 61 ]; six cases in the state of Maranhão [ 18 , 61 , 62 ]; 30 cases in the state of Ceará [ 63 , 64 , 65 , 66 , 67 , 68 ]; two cases in the state of Bahia [ 55 , 68 ]; four cases in the state of Pernambuco [ 59 , 60 ] ( Figure 2 ).…”

“…Since then, armadillos have been determined to figure as sentinels for CM in Brazil. As mentioned above, the majority of CM cases in Brazil have been linked to armadillo hunting [ 18 , 57 , 59 , 64 , 65 , 66 , 67 ], a cultural practice performed exclusively by men. Armadillos are mammals with terrestrial habits and can dig deep burrows, which makes them vulnerable to arthroconidia exposure and infection.…”

Coccidioidomycosis in a reference center in Northeast Brazil: clinical/epidemiological profile and most common radiological findings

“…In 1999, a report described eleven confirmed and three possibly autochthonous cases of coccidioidomycosis in four Northeast Brazilian states: Bahia, Ceará, Piauí, and Maranhão 5 . Between 1995 and 2007, 19 cases were reported in Ceará State in Northeast Brazil [6][7][8] . Since then, data have not been added adequately, which makes it difficult to understand the clinical and epidemiological aspects of coccidioidomycosis in this population.…”