Paracoccidioidomycosis

Abstract

Paracoccidioidomycosis is a systemic fungal infection caused by Paracoccidoides brasiliensis. The infection is endemic in subtropical areas of Latin America and has a high prevalence in Brazil. The disease is acquired by airborne inhalation of conidia and is frequently observed in adult male rural workers. The juvenile type of this mycosis is less prevalent (5-10% of clinical cases) and attacks both sexes. This clinical form occurs in children and adolescents and has a subacute course with fever, toxemia, loss of weight, adenopathy, hepatoesplenomegaly, anaemia and eosinophilia. Radiologic abnormalities in the lung fields may be seen. Mucous membrane lesions occasionally occur. The clinical presentation resembles severe tuberculosis, leukaemia or lymphoma. The diagnosis is confirmed by finding yeast-like elements of P. brasiliensis in microscopic examinations of wet preparations of specimens submitted for mycologic studies. The fungus grows slowly (20-30 days) and its isolation is difficult. Histologic and serologic studies may also assist in the diagnosis of this mycosis. Sulfonamides, ketoconazole, itraconazole, fluconazole and amphotericin B have been successfully used in the treatment of paracoccidioidomycosis. Itraconazole is the treatment of choice, being effective in more than 95% of cases. Co-trimoxazole is still frequently used especially in chronic progressive disease and as maintenance after a course of amphotericin B in severe cases of this mycosis.

Antifungal and antioxidant activity of fatty acid methyl esters from vegetable oils

“…The main disadvantage of SMX-THT is the need for long-term treatment (more than 12 months) in moderate and severe cases which can lead patients to abandon treatment (Brummer et al 1993, Paniago et al 2003, Travassos et al 2008. Amphotericin B therapy is the best choice for severe cases of PCM, but toxicity, mainly nephrotoxicity, is related to this drug which will sometimes require discontinuation of this therapy (de Oliveira et al 2015, Ferreira 2009, ShikanaiYasuda 2015. Relapses, a common event in PCM patients, associated with toxicity represent an unresolved problem in the conventional therapeutic approach (Travassos et al 2008, Travassos andTaborda 2012).…”

Paracoccidioidomycosis in the spine: case report and review of the literature

“…It is primarily acquired during the first two decades of life, with peak incidence between the ages of 10 and 20 years. 4,5,7 Individuals who become infected may develop two main clinical forms: the acute or subacute form (juvenile type), with severe involvement of internal organs and mononuclear phagocyte system; or the chronic form (adult type), which represents 90% of the cases, with insidious evolution and involvement of the lungs that can leave residual damage (latent foci) with fungus that remains viable for years. In the unifocal presentation, the mycosis is restricted to one organ, which is rare.…”

Influence of Different Media, Incubation Times, and Temperatures for Determining the MICs of Seven Antifungal Agents against Paracoccidioides brasiliensis by Microdilution

“…Sulfa drugs were the first to be employed for the treatment of this mycosis and continue to be active medications against this fungal infection, including the severe juvenile forms, although in vitro and clinical resistances have been reported (5)(6)(7). The sulfamethoxazole-trimethoprim combination is the most frequently employed treatment for these patients, in both its oral and intravenous formulations, and it is used for severe acute cases and for the neurological form of the disease.…”