Paracoccidioidomycosis Epidemiological Features of a 1,000-Cases Series from a Hyperendemic Area on the Southeast of Brazil

Bellissimo-Rodrigues, Fernando; Machado, Alcyone Artioli; Martínez, Roberto

doi:10.4269/ajtmh.2011.11-0084

Cited by 101 publications

(117 citation statements)

References 21 publications

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“…Compared to the 95 cases of active disease, 1,219 cases of paracoccidioidomycosis affecting immunocompetent individuals occurred in the same geographic area over an approximately equal period of time 16 . This result suggests that the incidence of histoplasmosis-disease is approximately 13 times lower than that of paracoccidioidomycosis, whose mean incidence in the Ribeirão Preto region has been estimated at 2.7 cases/100,000 inhabitants/ year 17 . However, this ratio needs careful interpretation because the patients with chronic pulmonary and chronic disseminated histoplasmosis did not know the places or times of the fungal infections.…”

Section: Discussionmentioning

confidence: 91%

Histoplasmosis in immunocompetent individuals living in an endemic area in the Brazilian Southeast

Faiolla

Coelho

Santana

et al. 2013

Rev. Soc. Bras. Med. Trop.

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Introduction:The distribution of infection by Histoplasma capsulatum in Brazil is heterogeneous, and the number of cases affecting immunocompetent individuals is relatively small. This study reports the epidemiological and clinical data regarding histoplasmosis in non-immunosuppressed individuals. Methods: The study included only the immunocompetent patients with histoplasmosis who were diagnosed between 1970 and 2012 at a university hospital located in Ribeirão Preto, State of São Paulo, Brazil. Clinical and epidemiological data were collected retrospectively from the patient records. Results: Of the 123 patients analyzed, 95 had an active disease that manifested in the different clinical forms of histoplasmosis. Men were the predominant gender, and most patients resided in the Northeast of the State of São Paulo and in the nearby municipalities of the State of Minas Gerais. The risk factors for acquiring histoplasmosis and prolonged contact in a rural environment were recorded in 43.9% and 82.9% of cases, respectively. Smoking, alcoholism, and comorbidity rates were high among the patients with the chronic pulmonary and subacute/chronic disseminated forms of histoplasmosis. Many patients achieved clinical cure spontaneously, but 58.9% required antifungals; the disease lethality rate was 5.3%. Conclusions: Immunocompetent individuals manifested the diverse clinical forms of histoplasmosis over a period of 4 decades, revealing an additional endemic area of this fungal disease in the Brazilian Southeast.

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Section: Discussionmentioning

confidence: 91%

Histoplasmosis in immunocompetent individuals living in an endemic area in the Brazilian Southeast

Faiolla

Coelho

Santana

et al. 2013

Rev. Soc. Bras. Med. Trop.

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“…(Bellissimo- Rodrigues et al, 2011;Paniago et al, 2003;Shankar et al, 2011). Clinically manifested PCM occurs, consequently, more often (>80%) in adult patients 30-60 years old with the fourth decade of life presenting the largest number of cases (Colombo et al, 2011;Nucci et al, 2009;Paniago et al, 2003).…”

Section: General Concepts On Epidemiology 221 Distribution By Agementioning

confidence: 99%

“…The predominance of adult patients is reflected in higher mortality rates for those within this age group (Bittencourt et al, 2005;Coutinho et al, 2002;Prado et al, 2009;Santo, 2008). Although co-existence of the mycosis with HIV infection is relatively uncommon, 4%-5% according to data in the two largest series of cases published in Brazil (Belissimo- Rodrigues et al, 2011;Morejon et al, 2009), this dual infection has introduced a significant change in age distribution as these patients are younger (mean, 34 years of age) than the PCM non-AIDS cases (mean, 45 years of age).…”

Section: General Concepts On Epidemiology 221 Distribution By Agementioning

confidence: 99%

“…Santo (2008) reviewed 1,950 PCM death certificates finding that the largest number of deaths had occurred in men in the older age groups and among rural workers. The largest series of cases ever published (Bellissimo- Rodrigues et al, 2011) analyzed 1,000 Brazilian PCM patients and indicated that in the 1980-1999 period, the incidence rates for the Riberão Preto district in São Paulo State were equivalent to a mean of 2.70 cases per 100,000 inhabitants. Colombian estimates show a much lower incidence rate, with the highest being 0.24 per 100,000 inhabitants.…”

Section: Incidence and Prevalencementioning

confidence: 99%

“…Colombian estimates show a much lower incidence rate, with the highest being 0.24 per 100,000 inhabitants. Since these were annual mean mortality rates calculated on the basis of 7,482 deaths reported to be caused by PCM, the figures varied from 1.45 to 3.48 per one million inhabitants (Bellissimo- Rodrigues et al, 2011). The importance of this mycosis can be inferred by the high burden of deaths occurring among the working population in individuals aged 30-60 years, mostly men engaged in agriculture (Bellissimo-Rodrigues et al, 2011).…”

Section: Incidence and Prevalencementioning

confidence: 99%

See 2 more Smart Citations

Pulmonary Paracoccidioidomycosis: Clinical, Immunological and Histopathological Aspects

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et al. 2012

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Paracoccidioidomycosis

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Fungal Infection

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RESUMENLa paracoccidioidomicosis es una de las micosis profundas más prevalentes en América Latina, causada por el hongo dimófico Paracoccidioides brasiliensis. La enfermedad presenta gran variabilidad clínica y se divide en dos formas de presentación. La forma aguda, que es la menos frecuente (3%-5% de los casos). Y la crónica, la más frecuente (>90% de los casos), que afecta principalmente a hombres mayores de 20-30 años. El diagnóstico se basa en la clínica, visualización microscópica de elementos fúngicos sugestivos de P. brasiliensis, cultivo del hongo de especímenes clínicos, pruebas serológicas, y otros exámenes como rayos X/tomografía axial computarizada (TAC) de acuerdo con la forma y presentación clínica. Cuando se confirma el diagnóstico, todos los pacientes deben recibir tratamiento. Los más usados son el itraconazol y el trimetropim/sulfametoxazol (TMP/ SMX). La anfotericina B se reserva para casos más severos. Las tasas de recaídas son poco frecuentes en aquellos pacientes que reciben un tratamiento completo y adecuado. Sin embargo, estas aumentan si se trata de pacientes inmunocomprometidos o aquellos que suspenden el tratamiento antes de cumplir con los criterios de curación. Es importante realizar un diagnóstico oportuno para evitar las secuelas producidas por la enfermedad, las cuales son más comunes en los pacientes con paracoccidioidomicosis crónica. Palabras clave: micosis; paracoccidioidomicosis; diagnóstico diferencial.

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Paracoccidioidomycosis Epidemiological Features of a 1,000-Cases Series from a Hyperendemic Area on the Southeast of Brazil

Cited by 101 publications

References 21 publications

Histoplasmosis in immunocompetent individuals living in an endemic area in the Brazilian Southeast

Histoplasmosis in immunocompetent individuals living in an endemic area in the Brazilian Southeast

Pulmonary Paracoccidioidomycosis: Clinical, Immunological and Histopathological Aspects

Paracoccidioidomycosis

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