Pulmonary Paracoccidioidomycosis

Abstract

Paracoccidioidomycosis (formerly known as South American blastomycosis) is produced by the thermally dimorphic fungus Paracoccidioides brasiliensis. Most often this mycosis runs a chronic progressive course affecting preferentially the lungs followed by the skin, mucous membranes, adrenals, and reticuloendothelial organs. Acute-subacute presentations can be observed in children and immunosuppressed patients. Occasionally, self-limited infections have been documented. Two types of clinical presentations are described, the acute-subacute (juvenile) and the chronic (adult) forms of the disease. Paracoccidioidomycosis predominates in adult males (13:1); this gender difference is not observed in children or adolescents. The mycosis is limited geographically to various Latin American countries, with the greatest number of cases originating in Brazil, The fungus's natural habitat has not been precisely defined, although it is supposed to be a soil-inhabiting microorganism. No outbreaks have been reported. P. brasiliensis is capable of entering into prolonged periods of latency as is demonstrated by its diagnosis in patients who have moved outside the recognized endemic areas. This review updates clinicians and laboratory workers on the characteristics of a mycosis seldom reported outside of the Latin American countries.

Identification of Paracoccidioides brasiliensis in adrenal glands biopsies of two patients with paracoccidioidomycosis and adrenal insufficiency

“…Approximately 10% of proven paracoccidioidomycosis patients do not present reactive tests; the real reason is not known but could be attributed to the sensitivity of the techniques used as none of them is capable of detecting 100% of the cases; additionally, low fungal burdens, or restricted infectious foci could also be incriminated 6,10 .…”

Dendritic cell interactions withHistoplasmaandParacoccidioides

“…87 Colombia, Venezuela, Ecuador, and Argentina account for the majority of other endemic cases. 88,89 The infection is acquired through inhalation of the conidia produced by the fungus in its mycelial form. 90 The clinical presentation of the infection ranges from a localized and benign disease to a progressive and potentially fatal systemic infection.…”

Human neutrophils produce extracellular traps against Paracoccidioides brasiliensis

“…Infection is caused after inhalation of P. brasiliensis conidia, small propagules produced by the mycelia being able to reach the lungs. In 90 % of clinically active cases, PCM produces a chronic systemic and progressive disease, which progresses slowly and can take months or even years to develop, while the remaining 10 % of patients develop an acute form (Londero & Melo, 1983;Brummer et al, 1993;Restrepo et al, 2008;Marques, 2013;Restrepo & Tobon, 2010).…”