Magnetic resonance imaging findings of paracoccidioidomycosis in the musculoskeletal system

Savarese, Leonor Garbin; Monsignore, Lucas Moretti; Hernandes, Mateus de Andrade; Martínez, Roberto; Nogueira-Barbosa, Marcello Henrique

doi:10.1111/tmi.12552

Cited by 12 publications

(7 citation statements)

References 24 publications

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“…Isolated involvement of the osteoarticular system is rare and, when present, is part of a multisystem process. Osteolytic lesions with cortical destruction are generally observed, especially in the metaphyses and epiphyses of long bones, without periosteal reactions [ 135 ].…”

Section: Diagnostic Imagingmentioning

confidence: 99%

Paracoccidioidomycosis: What We Know and What Is New in Epidemiology, Diagnosis, and Treatment

Peçanha

Peçanha-Pietrobom

Velloso

et al. 2022

JoF

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Paracoccidioidomycosis (PCM) is a systemic mycosis endemic to Latin America caused by thermodimorphic fungi of the genus Paracoccidioides. In the last two decades, enhanced understanding of the phylogenetic species concept and molecular variations has led to changes in this genus’ taxonomic classification. Although the impact of the new species on clinical presentation and treatment remains unclear, they can influence diagnosis when serological methods are employed. Further, although the infection is usually acquired in rural areas, the symptoms may manifest years or decades later when the patient might be living in the city or even in another country outside the endemic region. Brazil accounts for 80% of PCM cases worldwide, and its incidence is rising in the northern part of the country (Amazon region), owing to new settlements and deforestation, whereas it is decreasing in the south, owing to agriculture mechanization and urbanization. Clusters of the acute/subacute form are also emerging in areas with major human intervention and climate change. Advances in diagnostic methods (molecular and immunological techniques and biomarkers) remain scarce, and even the reference center’s diagnostics are based mainly on direct microscopic examination. Classical imaging findings in the lungs include interstitial bilateral infiltrates, and eventually, enlargement or calcification of adrenals and intraparenchymal central nervous system lesions are also present. Besides itraconazole, cotrimoxazole, and amphotericin B, new azoles may be an alternative when the previous ones are not tolerated, although few studies have investigated their use in treating PCM.

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Section: Diagnostic Imagingmentioning

confidence: 99%

Paracoccidioidomycosis: What We Know and What Is New in Epidemiology, Diagnosis, and Treatment

Peçanha

Peçanha-Pietrobom

Velloso

et al. 2022

JoF

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“…Gas can be seen more commonly in pyogenic abscesses. Diabetic versus non-diabetic abscesses, as well as tubercular and fungal abscesses show similar appearances and underlying clinical picture is paramount to arrive at such diagnoses [ 41 , 42 ]. Other terms used in this domain include tissue necrosis or pyomyositis [ 43 , 44 ].…”

Section: Soft Tissuementioning

confidence: 99%

MRI nomenclature for musculoskeletal infection

et al. 2021

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The Society of Skeletal Radiology (SSR) Practice Guidelines and Technical Standards Committee identified musculoskeletal infection as a White Paper topic, and selected a Committee, tasked with developing a consensus on nomenclature for MRI of musculoskeletal infection outside the spine. The objective of the White Paper was to critically assess the literature and propose standardized terminology for imaging findings of infection on MRI, in order to improve both communication with clinical colleagues and patient care.A definition was proposed for each term; debate followed, and the committee reached consensus. Potential controversies were raised, with formulated recommendations. The committee arrived at consensus definitions for cellulitis, soft tissue abscess, and necrotizing infection, while discouraging the nonspecific term phlegmon. For bone infection, the term osteitis is not useful; the panel recommends using terms that describe the likelihood of osteomyelitis in cases where definitive signal changes are lacking. The work was presented virtually to SSR members, who had the opportunity for review and modification prior to submission for publication.

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“…In this study, infection severity was higher on day 45 compared to day 15, as evidenced by pannus formation, increased synovial membrane edema, severe synovitis, severe neovascularization, periosteal granuloma, necrosis, and periarticular dissemination. Similarly, a clinical study using magnetic resonance imaging also found soft tissue reactive edema and synovial infl ammation in PCM patients with joint involvement 13 .…”

Section: Figurementioning

confidence: 87%

Natural history of experimental arthritis induced by Paracoccidioides brasiliensis in wistar rats

Loth

Cecatto

Genske

et al. 2019

Rev. Soc. Bras. Med. Trop.

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Introduction: Paracoccidioidomycosis (PCM) is the most prevalent systemic mycosis in Latin America. This study aimed to evaluate the natural history of Paracoccidioides brasiliensis-induced experimental arthritis of the knee joints in Wistar rats. Methods: Rats were randomly allocated to either an absolute control group, or 15-day, 45-day, or 90-day experimental (fungusinoculated) groups. Results: Experimental groups developed classic signs of articular PCM. Titers of anti-gp43 were observed to increase during the interval from 15 to 45 days post-inoculation. Conclusions: Articular arthritic lesions were induced and progressed during the study period in all experimental groups.

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Magnetic resonance imaging findings of paracoccidioidomycosis in the musculoskeletal system

Cited by 12 publications

References 24 publications

Paracoccidioidomycosis: What We Know and What Is New in Epidemiology, Diagnosis, and Treatment

Paracoccidioidomycosis: What We Know and What Is New in Epidemiology, Diagnosis, and Treatment

MRI nomenclature for musculoskeletal infection

Natural history of experimental arthritis induced by Paracoccidioides brasiliensis in wistar rats

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