Paracoccidioidomicose cutânea disseminada e pulmonar em paciente portador de neoplasia maligna visceral

Abstract

Paracoccidioidomycosis is a systemic mycosis caused by the fungus Paracoccidioides brasiliensis that is characterized by polymorphous clinical manifestations principally affecting the skin, mucous membranes, lungs, lymph nodes, adrenal glands and the central nervous system. Depending on the site of inoculation and the individual's immunological status, the disease may take various different forms, affecting the skin, lymph nodes, viscera or a combination of these. The present report describes a patient with extensive cutaneous and pulmonary paracoccidioidomycosis, with disseminated papules and pustules, fever and pulmonary symptoms, probably related to immunosuppression caused by a renal carcinoma. Keywords: Carcinoma; Immunocompromised host; Kidney neoplasms; Paracoccidioidomycosis Resumo: Paracoccidioidomicose é doença causada pelo fungo Paracoccidioides brasiliensis, caracterizada por quadro polimórfico e acometimento preferencial de pele, mucosas, pulmões, linfonodos, adrenais e sistema nervoso. De acordo com o local de inoculação e o estado imunológico do indivíduo, ocorrem as diversas formas da doença: tegumentar, linfonodular, visceral e mista. Relatamos caso de paciente com quadro de paracoccidioidomicose mista (tegumentar e pulmonar), com lesões cutâneas caracterizadas por pápulas e pústulas disseminadas e sintomas sistêmicos, possivelmente associada a imunossupressão causada por neoplasia maligna visceral.

Paracoccidioidomycosis in Immunocompromised Patients: A Literature Review

“…Most of the solid cancers are carcinomas (>80%) from the respiratory or digestive tract [42], and are related to the chronic form of PCM and its risk factors, such as male sex, rural workers with a history of smoking and alcohol intake [1,42]. Likewise, among the 36 cases that fulfilled the inclusion criteria (31 from two case series [42,43] and five from isolated case reports [44,45,46,47,48]), 26 (72%) were related to carcinomas of the upper and lower respiratory ( n = 16, 44%) and digestive tracts, mainly the oropharynx and esophagus ( n = 7, 19%). Carcinoma was diagnosed at the same anatomical site of the fungal lesion in twenty-one cases (58%).…”

Paracoccidioidomycosis and cryptococcosis with localized skin manifestations: report of two cases in the elderly

“…In immunocompetent individuals lesions are localized, there is formation of granulomas with few fungi and low serum titles, as in case 1. 1 - 4 …”