Unifocal Bone Paracoccidioidomycosis, Brazil

Abstract

Abstract. We report a 47 year-old man from the State of Mato Grosso do Sul, Brazil, with unifocal tibial paracoccidioidomycosis. A radiograph showed an osteolytic lesion on the tibial middle third diaphysis. The diagnosis was confirmed by histopathologic analysis, and treatment with sulfamethoxazole and trimethoprim was started. After three months, the patient showed significant clinical improvement. Ten months after treatment, the patient showed lesion bone healing. This case describes the rare occurrence of an osteolytic lesion caused by endemic Paracoccidioides brasiliensis in Latin America.

Important aspects of oral paracoccidioidomycosis–a literature review

“…The lungs are the major target of paracoccidioidomycosis, where they are affected in 50–100% of cases 30 . On examination, pulmonary involvement typically appears as bilateral, symmetrical, perihilar, interstitial thickening, 31 and chest radiography can display some non‐specific alterations 30 such as linear reticular opacities, nodules of various sizes, patchy ill‐defined opacities, airspace consolidation and cavitation 30,32 . The finding known as the butterfly wing pattern, reflecting the bilateral and symmetric opacities in the middle zone of the lungs with associated emphysema in the lung bases, is suggestive of the disease 30 .…”

“…The finding known as the butterfly wing pattern, reflecting the bilateral and symmetric opacities in the middle zone of the lungs with associated emphysema in the lung bases, is suggestive of the disease 30 . Nevertheless, chest tomography can identify lesions that are imperceptible in plain radiography 31 . Therefore, because of its higher sensitivity, CT should be the first‐choice examination to evaluate pulmonary compromise in paracoccidioidomycosis 30,32 .…”

Chronic osteomyelitis to Paracoccidioides braziliensis

“…La afectación ósea en la paracoccidioidomicosis es generalmente asintomática, pero puede mostrar el dolor, edema y sensación de calor en el área de la lesión En general, la afectación osteoarticular ocurre por progación linfo -hematógena desde un foco primario pulmonar 9 Los huesos más afectados son los de la pared torácica (costillas, esternón, escápula y acromion) 10 . Actualmente, se recomienda itraconazol para el tratamiento.…”

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

“…17 In this study, the patient presented the clinical and epidemiological characteristics of the disease, which included: male gender, farm laborer in an endemic area and age over 40 years. [6][7][8][9][10][11][12][13][17][18][19] The patient needed to have become infected during his second decade of life, when he worked in the fields for 10 years in an After 36 months, the patient was seen to be clinically asymptomatic, and his blood inflammatory markers were within the normal range. These parameters are considered to be the most important healing criteria.…”

“…This is generally associated with lung infection that spreads to bones through lympho-hematogenous dissemination. 4,7,[10][11][12][13] Chest wall bones are the ones most affected by the disease, including ribs, sternum, scapula and acromion. 13 Spinal involvement is rare.…”