Intestinal Paracoccidioidomycosis: Case report and systematic review

Cruz, Eduarda Renz da; Forno, Amanda Dal; Pacheco, Suelen Apratto; Bigarella, Lucas Goldmann; Ballotin, Vinícius Remus; Salgado, Karina; Freisbelen, Diogo; Michelin, Lessandra; Soldera, Jonathan

doi:10.1016/j.bjid.2021.101605

Cited by 9 publications

(8 citation statements)

References 37 publications

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“…The large intestine was most frequently affected (78.2%), followed by the small intestine (52.1%). Noteworthy, a CD clinical behavior was described in 10 among the 46 cases (21.7%) while the presence of both PCM and inflammatory bowel disease (IBD) occurred in only one case [ 5 ]. In the case herein reported, although we observed the most frequently reported gastrointestinal clinical signs, other findings such as cutaneous lesions and generalized lymphadenopathy occurred after initiation of immunosuppressive drugs to treat CD.…”

Section: Case Discussionmentioning

confidence: 99%

“…The colonoscopy findings of PCM may include ulcers clinically similar to CD [ 6 – 8 ] and the histopathological study of these lesions may be unspecific or difficult to differentiate if yeast-like fungal structures of Paracoccidioides spp. are not visualized since granulomatous inflammation can be observed in both diseases [ 5 , 9 ]. In the present case, clinical and endoscopic features led to a misdiagnosis of CD.…”

Section: Case Discussionmentioning

confidence: 99%

“…PCM mimicking CD has been scarcely reported in the literature and in most reported cases the diagnosis came after several months of symptoms [5][6][7][8]. The wrong diagnosis led to immunosuppressive therapy leading to worsening of symptoms in some cases [6][7][8].…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

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Acute paracoccidioidomycosis worsened by immunosuppressive therapy due to a misdiagnosis of Crohn’s disease

Falcão¹,

Medeiros

Freitas

et al. 2023

PLoS Negl Trop Dis

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Paracoccidioidomycosis (PCM) is a systemic mycosis endemic in Latin America, mostly in Brazil. The involvement of the gastrointestinal tract is uncommon and usually associated with the acute form. Recently, a cluster of acute PCM cases has been described in Rio de Janeiro, Brazil. We report a 42-year-old male, resident of Rio de Janeiro, presenting chronic diarrhea and abdominal pain in the past 3 years, previously diagnosed as Chron´s disease. When immunosuppressive therapy was prescribed, the patient evolved with worsening of the previous symptoms in addition to odynophagia, 20 kg-weight loss, disseminated skin lesions, diffuse lymphadenopathy and adrenal insufficiency. Histopathological and mycological examination of a skin lesion were compatible with PCM. Itraconazole was prescribed in high doses (400 mg/day). After seven months of treatment, the patient presented with acute abdominal pain which led to an emergent appendectomy, revealing the presence of the fungus. After 24 months, the patient reached clinical cure and recovered from adrenal insufficiency. We emphasize the importance of PCM as a differential diagnosis in patients with chronic diarrhea. The risk of fungal infections should be considered prior to initiating immunosupressive therapies, particularly in endemic areas.

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Section: Case Discussionmentioning

confidence: 99%

Section: Case Discussionmentioning

confidence: 99%

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Acute paracoccidioidomycosis worsened by immunosuppressive therapy due to a misdiagnosis of Crohn’s disease

Falcão¹,

Medeiros

Freitas

et al. 2023

PLoS Negl Trop Dis

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“…Concluindo que a paciente apresentava paracoccidioidomicose, conforme sugerido pela detecção de anticorpos, e PCR da FFPE. Cruz, et al, (2021), expuseram na sua revisão relatos de casos de pacientes afetados pela paracoccidioidomicose com envolvimento do trato gastrointestinal onde pode afetar qualquer parte do sistema digestivo, sendo a localização mais comum da doença o cólon, seguido do intestino delgado e boca. Os sintomas mais comuns encontrados são dores abdominais, perda de peso e diarreia, (sintomatologia encontrada em pacientes com diagnóstico de doença inflamatória intestinal).…”

Section: Discussionunclassified

Avanços e desafios no diagnóstico de paracoccidioidomicose causada pelo complexo de espécies da paracoccidioides: revisão integrativa

Trindade¹,

Diniz²,

Alves³

et al. 2022

RSD

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O artigo a seguir apresenta o diagnóstico clássico e alguns avanços da paracoccidioidomicose, doença infecciosa com espectro de evolução aguda, subaguda ou crônica causada pelo fungo Paracoccidioides spp., a doença é contraída através da inalação de partículas fúngicas transportadas pelo ar, tendo como principais sintomas a tosse, falta de ar, emagrecimento e lesões na pele ou mucosas. Os sintomas clínicos dificultam um diagnóstico correto, em vista da semelhança com outras doenças, como, por exemplo, a tuberculose e a sarcoidose, além de que em algumas situações pode haver um extenso período de tempo entre a exposição do indivíduo ao fungo e a manifestação dos sintomas. Levando isso em consideração, o objetivo do trabalho é avaliar e discorrer dos métodos de diagnósticos, bem como, identificar os novos avanços realizados pelos métodos moleculares, sorológicos, micológicos e histopatológicos para essa micose. Para esta finalidade, foram realizados uma leitura sobre estudos de casos, ensaio experimental e uma revisão sistemática.

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“…Our patient showed abdominal pain and diarrhea in the early stages of the disease, which are the most frequent symptoms of gastrointestinal tract involvement. However, other manifestations have also been described, such as hematochezia, mucus in the stool, vomiting and, less frequently, regurgitation, intestinal motility, hiccups, and palpable abdominal mass [12][13][14][15] . A recent review reported that the most common location of the disease was the colon, followed by the small intestine and mouth, with the most significant involvement in segments of the gastrointestinal tract rich in lymphoid tissue such as the ileum, cecum, appendix, and ascending colon 14 .…”

Section: Discussionmentioning

confidence: 99%

Paracoccidioidomycosis with digestive manifestations in a pediatric patient

Ormeño-Julca¹,

Córdova²,

Tragodara³

et al. 2022

BMHIM

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Background: Paracoccidioidomycosis is a systemic infection caused by the fungus Paracoccidioides. It may present in two forms: an acute/subacute form, whose most frequent manifestations include weight loss, fever, anemia, and adenopathy, and a chronic condition with mainly respiratory symptoms. Digestive symptoms, although they may occur, are not frequently reported. Paracoccidioidomycosis usually affects adult male agricultural workers; thus, its presentation in children is rare. Case report: We describe the case of a 9-year-old male patient diagnosed with paracoccidioidomycosis, who showed abdominal pain and diarrhea as initial manifestations of the disease. Conclusions: This case is reported not only because of the age of presentation but also due to the existence of digestive symptoms from the onset of the disease, both infrequently reported in the literature.

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Intestinal Paracoccidioidomycosis: Case report and systematic review

Cited by 9 publications

References 37 publications

Acute paracoccidioidomycosis worsened by immunosuppressive therapy due to a misdiagnosis of Crohn’s disease

Acute paracoccidioidomycosis worsened by immunosuppressive therapy due to a misdiagnosis of Crohn’s disease

Avanços e desafios no diagnóstico de paracoccidioidomicose causada pelo complexo de espécies da paracoccidioides: revisão integrativa

Paracoccidioidomycosis with digestive manifestations in a pediatric patient

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