South American Blastomycosis: Ophthalmic and Oculomotor Nerve Lesions

Dantas, Amanda Maria Menezes; Yamane, Rina; Camara, A. G.

doi:10.4269/ajtmh.1990.43.386

Cited by 14 publications

(3 citation statements)

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“…Reported to cause lesions of eyelids (46,353), cornea (353), and bulbar conjunctiva (353); anterior uveitis (353); and granulomatous uveitis (75). Diagnosis by histopathological examination or direct microscopy of lesions (353); no photomicrographic evidence.…”

Section: Coccidioides Immitismentioning

confidence: 99%

Current Perspectives on Ophthalmic Mycoses

2003

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Fungi may infect the cornea, orbit and other ocular structures. Species of Fusarium, Aspergillus, Candida, dematiaceous fungi, and Scedosporium predominate. Diagnosis is aided by recognition of typical clinical features and by direct microscopic detection of fungi in scrapes, biopsy specimens, and other samples. Culture confirms the diagnosis. Histopathological, immunohistochemical, or DNA-based tests may also be needed. Pathogenesis involves agent (invasiveness, toxigenicity) and host factors. Specific antifungal therapy is instituted as soon as the diagnosis is made. Amphotericin B by various routes is the mainstay of treatment for life-threatening and severe ophthalmic mycoses. Topical natamycin is usually the first choice for filamentous fungal keratitis, and topical amphotericin B is the first choice for yeast keratitis. Increasingly, the triazoles itraconazole and fluconazole are being evaluated as therapeutic options in ophthalmic mycoses. Medical therapy alone does not usually suffice for invasive fungal orbital infections, scleritis, and keratitis due to Fusarium spp., Lasiodiplodia theobromae, and Pythium insidiosum. Surgical debridement is essential in orbital infections, while various surgical procedures may be required for other infections not responding to medical therapy. Corticosteroids are contraindicated in most ophthalmic mycoses; therefore, other methods are being sought to control inflammatory tissue damage. Fungal infections following ophthalmic surgical procedures, in patients with AIDS, and due to use of various ocular biomaterials are unique subsets of ophthalmic mycoses. Future research needs to focus on the development of rapid, species-specific diagnostic aids, broad-spectrum fungicidal compounds that are active by various routes, and therapeutic modalities which curtail the harmful effects of fungus- and host tissue-derived factors

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Section: Coccidioides Immitismentioning

confidence: 99%

Current Perspectives on Ophthalmic Mycoses

2003

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“…As manifestações neurológicas dependem da localização da(s) lesão(ões), destacando-se os sinais de hipertensão intracraniana (vômitos, cefaléia, papiledema), hemiplegia ou hemiparesia 4 , paralisia de nervos cranianos 18 , convulsões e distúrbios da consciência e humor 3,5 . A possibilidade de envolvimento assintomático é real 4 e sustentado por estudos de necrópsias que demonstram prevalência de 10 a 36% 5 .…”

Section: Discussionunclassified

Paracoccidioidomicose do sistema nervoso central: relato de caso

Silva

Cordeiro²,

Gollner

et al. 2000

Arq. Neuro-Psiquiatr.

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RESUMO -O envolvimento do sistema nervoso central na paracoccidioidomicose vem ganhando importância dentro do espectro de manifestações clínicas da doença. O primeiro registro na literatura de que o Paracoccidioides brasiliensis seria também capaz de comprometer órgãos do sistema nervoso central foi descrito em 1919 por Pereira & Jacobs; desde então muitos outros estudos têm demonstrado esta forma de apresentação clínica, sendo que em alguns sua frequência atinge os 27,27%. Descrevemos o caso de uma paciente de 34 anos, residente em Juiz de Fora-MG, admitida com quadro clínico compatível com pneumonia e que durante a internação iniciou sintomatologia cerebelar (náuseas, vômitos, ataxia de marcha e dismetria). A tomografia computadorizada de crânio revelou lesão cerebelar sugestiva de abscesso. O tratamento proposto baseou-se na exerese cirúrgica da lesão e, como a anátomo-patologia mostrasse presença de leveduras em gemulação múltipla ("roda de leme de navio"), diagnóstico de neuroparacoccidioidomicose pôde ser firmado, e o tratamento complementado pela associação de sulfametoxazol-trimetoprim. A paciente evoluiu bem, persistindo discreta paresia e hipoestesia em membro superior direito. PALAVRAS-CHAVE: paracoccidioidomicose, sistema nervoso central, neuroinfecção. Paracoccidioidomycosis of the central nervous system: case reportABSTRACT -The involvement of the central nervous system in paracoccidioidomycosis is more frequent than previously thought. The first reference to the possibility that Paracoccidioides brasiliensis could affect the central nervous system was by Pereira & Jacobs in 1919. Since then, a great number of other studies has showed this form of clinical behavior and, in some of them, the frequency has ranged 27.27%. We report a clinical case of a 34-year-old white Brazilian woman admitted because of bacterial pneumonia. In the sixth day of admission, the patient developed cerebellar symptomatology with nausea, vomiting, dysmetria and gait disturbance. Central nervous system computer tomographic scanning disclosed a hypodense lesion in the right cerebellar hemisphere. The patient was submitted to surgery with total excision of the lesion. Histopathological examination confirmed the diagnosis of neuroparacoccidioidomycosis. Coadjuvant treatment with sulfamethoxazole-trimetoprim was introduced. The patient had a good outcome and was discharge 30 days after surgery.KEY WORDS: paracoccidioidomycosis, central nervous system, neuroinfection.A paracoccidioidomicose é doença sistêmica causada por um fungo dimórfico: o Paracoccidioides brasiliensis. Embora alguns casos isolados tenham sido relatados na América do Norte e Europa , a infecção predomina na América do Sul. No Brasil, onde sua prevalência é maior 1 , observa-se maior incidência nos estados de São Paulo e Minas Gerais 2 . A micose é adquirida através da inalação de conídeos e manifesta-se, principalmente, pelo acometimento mucocutâneo e pulmonar,

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“…Besides other ophthalmologic syndromes like chorioretinitis 2 , anterior uveitis 30 , choroidal lesions 10,30 , blepharitis 30 , oculomotor nerve lesions 20 and conjunctivitis 6,11,14,20,30 , P. brasiliensis can cause typical Parinaud's oculoglandular syndrome.…”

Section: Silva Et Al In 1988mentioning

confidence: 99%

Parinaud's oculoglandular syndrome associated with paracoccidioidomycosis

Costa

Hollanda²,

Assis³

et al. 2002

Rev. Inst. Med. trop. S. Paulo

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SUMMARYThe authors report one case of Parinaud's oculoglandular syndrome associated with Paracoccidioides brasiliensis infection. No other medical report of this condition was found in the medical literature available at Index Medicus and Medline.The eye involvement has been rather uncommon in paracoccidioidomycosis and this report emphasizes the possibility of this kind of presentation making it also necessary to include paracoccidioidomycosis among the several known causes of Parinaud's oculoglandular syndrome.

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South American Blastomycosis: Ophthalmic and Oculomotor Nerve Lesions

Cited by 14 publications

References 0 publications

Current Perspectives on Ophthalmic Mycoses

Current Perspectives on Ophthalmic Mycoses

Paracoccidioidomicose do sistema nervoso central: relato de caso

Parinaud's oculoglandular syndrome associated with paracoccidioidomycosis

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