Fatal Fungemia due to Paracoccidioides lutzii

Hahn, Rosane Christine; Rodrigues, Anderson Messias; Fontes, Cor Jésus Fernandes; Nery, Andréia Ferreira; Tadano, Tomoko; Júnior, Luiz de Pádua Queiroz; Camargo, Zoilo Pires de

doi:10.4269/ajtmh.13-0482

Cited by 34 publications

(34 citation statements)

References 36 publications

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“…Por sua vez, P. lutzii abriga uma única espécie, predominantemente distribuída no Centro-Oeste e na Amazônia (Brasil e Equador). 1,5,6,7,8 A incidência real de cada espécie filogenética e sua implicação na prática clínica é difícil de se estabelecer, devido à falta de estudos comparando as formas PCM e as manifestações clínicas com o perfil genético dessas entidades. 8 A imunodifusão radial contra os exoantígenos comumente usados, contendo uma glicoproteína de 43-kDa (gp43), sugere que esses fungos apresentam uma grande variabilidade antigênica.…”

Section: Etiologiaunclassified

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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Section: Etiologiaunclassified

II Consenso Brasileiro em Paracoccidioidomicose - 2017*

Shikanai-Yasuda¹,

Mendes²,

Colombo³

et al. 2018

Epidemiologia e Serviços de Saúde

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“…According to recent studies, P. lutzii has its epicentre in the central‐west region of Brazil, unlike P. brasiliensis , which was also described in the south and southeast regions of the country . However, P. lutzii was reported in the Amazon region .…”

Section: Discussionmentioning

confidence: 99%

Paracoccidioidomycosis infection in domestic and wild mammals by Paracoccidioides lutzii

Mendes

Klafke

Albano

et al. 2017

Mycoses

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Paracoccidioidomycosis (PCM) is a systemic mycosis that occurs in several Latin American countries, especially in Brazil. It is caused by the thermo-dimorphic fungus Paracoccidioides spp. Serological studies to detect animal infection represent an excellent strategy for data on the agent's ecology. Although the state of Rio Grande do Sul (RS) is an endemic area for PCM in humans, there is scarce information available on the ecology of the agent in the region. This study aimed to investigate the infection by Paracoccidioides lutzii in animals living in RS, Brazil. A total of 85 wild mammals, 200 horses and 196 domestic dogs, previously tested for infection by P. brasiliensis, were included in this study. Serum samples from the animals were tested by ELISA to detect anti- P. lutzii antibodies. From the 481 animals tested, 105 (21.8%) were seropositive for IgG anti-P. lutzii. Of these, 54 were also positive for P. brasiliensis. A total of 11 horses (10.5%), 30 dogs (28.8%) and 10 wild mammals (9.5%) were positive only for P. lutzii (n=51). The detection of anti-P. lutzii antibodies in animals of RS suggests that the fungus can be found in southern Brazil, despite being described mainly in the midwest and southeast of the country.

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“…These range from chronic PCM (adult type), accounting for 80-90% of cases that are mostly among male farm workers and usually affecting the lungs and oral mucosa, to acute/subacute PCM (juvenile type) in young susceptible patients presenting a more severe clinical condition because of intense reticuloendothelial system involvement 1 . Although it has been hypothesized that Paracoccidioides lutzii is associated with severe clinical forms, P. brasiliensis has also been recently reported to cause serious and unusual clinical pictures 2,3 .…”

Section: Introductionmentioning

confidence: 99%

Fatal septic shock caused by Paracoccidioides brasiliensis phylogenetic species S1 in a young immunocompetent patient: a case report

Macedo

Almeida‐Paes

Almeida

et al. 2018

Rev. Soc. Bras. Med. Trop.

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The authors report the first case of fatal septic shock, a rare clinical presentation of paracoccidioidomycosis (PCM) caused by Paracoccidioides brasiliensis S1. We also provide an immunological evaluation of the patient. Severe clinical signs such as organ dysfunction and digital gangrene occurred in this case. The patient presented a remarkable cell activation profile and diminished percentage of peripheral blood T regulatory cells. A decrease in anti-inflammatory IL-1RA plasma level showed the potential for endothelium damage, probably contributing to a vasculitis process. Together with P. lutzii, P. brasiliensis appears to be involved in severe cases of PCM.

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Fatal Fungemia due to Paracoccidioides lutzii

Cited by 34 publications

References 36 publications

II Consenso Brasileiro em Paracoccidioidomicose - 2017*

II Consenso Brasileiro em Paracoccidioidomicose - 2017*

Paracoccidioidomycosis infection in domestic and wild mammals by Paracoccidioides lutzii

Fatal septic shock caused by Paracoccidioides brasiliensis phylogenetic species S1 in a young immunocompetent patient: a case report

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