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Mycopathologia Apr 2023Paracoccidioidomycosis (PCM) defines a broad spectrum of human and animal diseases caused by Paracoccidioides species (Onygenales). In the twenty-first century,... (Review)
Review
Paracoccidioidomycosis (PCM) defines a broad spectrum of human and animal diseases caused by Paracoccidioides species (Onygenales). In the twenty-first century, Paracoccidioides advanced from a monotypic taxon to a genus that harbors seven species, including P. brasiliensis sensu stricto, P. americana, P. restrepiensis, P. venezuelensis, P. lutzii, P. loboi, and P. cetii. Classic PCM, acquired upon inhalation of propagules from P. brasiliensis sensu stricto, P. americana, P. restrepiensis, P. venezuelensis, and P. lutzii, affects the human lungs and may progress to systemic granulomatous disease with tegumentary and visceral involvement. On the other hand, PCM loboi and PCM ceti caused by the unculturable P. loboi and P. cetii are subcutaneous mycoses, typically observed as keloid lesions in humans and dolphins. Such heterogeneity highlights the importance of recognizing species boundaries in Paracoccidioides to gain insights into the ecology, evolution, clinical features, and mitigation strategies to tackle the advance of PCM.
Topics: Animals; Humans; Dolphins; Genomics; Paracoccidioides; Paracoccidioidomycosis; Phylogeny
PubMed: 36633737
DOI: 10.1007/s11046-022-00704-y -
PLoS Neglected Tropical Diseases May 2023In 2020, we reported the first patient with concomitant COVID-19 and paracoccidioidomycosis (PCM). Since then, no other cases have been recorded in the literature. We... (Review)
Review
INTRODUCTION
In 2020, we reported the first patient with concomitant COVID-19 and paracoccidioidomycosis (PCM). Since then, no other cases have been recorded in the literature. We aim to update information on the occurrence of COVID-19 in patients with PCM followed at a reference center for infectious diseases at Rio de Janeiro, Brazil.
METHODS
We reviewed the medical records from patients diagnosed with PCM who presented with clinical symptoms, radiological findings, and/or laboratory diagnosis of COVID-19 at any time during their acute or follow-up care. The clinical profiles of these patients were described.
RESULTS
Between March 2020 and September 2022, we identified six individuals with COVID-19 among the 117 patients with PCM evaluated. The median age was 38 years and the male to female ratio 2:1. Most patients (n = 5) presented for evaluation due to acute PCM. The severity of COVID-19 ranged from mild to severe in acute PCM and only the single patient with chronic PCM died.
CONCLUSIONS
There is a range of disease severity in COVID-19 and PCM co-infection and concomitant disease may represent a severe association, especially in the chronic type of the mycosis with pulmonary involvement. As COVID-19 and chronic PCM share similar clinical aspects and PCM is neglected, it is probable that COVID-19 has been hampering simultaneous PCM diagnosis, which can explain the absence of new co-infection reports. With the continued persistence of COVID-19 globally, these findings further suggest that more attention by providers is necessary to identify co-infections with Paracoccidioides.
Topics: Humans; Male; Female; Adult; Paracoccidioidomycosis; Coinfection; Brazil; COVID-19; Paracoccidioides
PubMed: 37155708
DOI: 10.1371/journal.pntd.0011322 -
Biomedica : Revista Del Instituto... May 2020Primary adrenal insufficiency is a defect in glucocorticoid, mineralocorticoid and sexual androgens production. Patients with this disorder have low cortisol levels and...
Primary adrenal insufficiency is a defect in glucocorticoid, mineralocorticoid and sexual androgens production. Patients with this disorder have low cortisol levels and aldosterone deficiency with concomitant hyponatremia and hyperkalemia. The most common etiology of this disease is the production of antibodies against the enzyme 21 hydroxylase. Another common cause, particularly in low income countries, are infectious diseases. Several micro-organisms have been reported as a causal agent in adrenal insufficiency including Mycobacterium tuberculosis, Mycobacterium avium complex, Neisseria meningitidis, Pseudomonas aeruginosa, Haemophilus influenzae, cytomegalovirus, Pneumocystis jirovecii, Histoplasma capsulatum, Blastomyces dermatiditis, Cryptococcus neoformans, Cocciodiodes immitis, Nocardia spp. and Paracoccidioides brasiliensis. In this article, we present the computerized tomography and the adrenal biopsy of a patient with adrenal insufficiency. The final diagnosis was paracoccidioidomycosis.
Topics: Adrenal Gland Diseases; Adrenal Insufficiency; Humans; Male; Middle Aged; Paracoccidioidomycosis
PubMed: 32463603
DOI: 10.7705/biomedica.4844 -
Expert Review of Anti-infective Therapy Nov 2020The global frequency of endemic mycoses has considerably increased, mainly due to environmental changes, population growth in endemic areas, and the increase in... (Review)
Review
INTRODUCTION
The global frequency of endemic mycoses has considerably increased, mainly due to environmental changes, population growth in endemic areas, and the increase in HIV-related immunosuppressed status. Among the most frequent endemic mycoses are coccidioidomycosis in semi-desert climates, and paracoccidioidomycosis, and histoplasmosis in tropical climates. The inoculum can enter the host through the airway or directly through the skin. Lymphatic and hematogenous spread may involve the skin.
AREAS COVERED
In this article, we provide up-to-date epidemiological and diagnostic data on major (histoplasmosis, paracoccidioidomycosis, coccidioidomycosis, blastomycosis) and minor (talaromycosis, adiaspiromycosis, emergomycosis) endemic mycoses.
EXPERT OPINION
Endemic mycoses include diseases with a localized endemic area, and a few of them converge. These mycoses all have in common the airway involvement and can cause pulmonary symptoms following initial asymptomatic infection. Among the risk groups to acquire these mycoses are travelers from endemic areas, archeologists, speleologists, and immigrants. Promising and useful diagnostic tools have been developed in endemic mycoses; however, most of them are not standardized or available in low-income countries.
Topics: Animals; Endemic Diseases; Fungi; Global Health; Humans; Immunocompromised Host; Mycoses; Risk Factors
PubMed: 32620065
DOI: 10.1080/14787210.2020.1792774 -
Revista Da Sociedade Brasileira de... 2022
Topics: Humans; Lung; Lung Diseases, Fungal; Paracoccidioidomycosis
PubMed: 36134863
DOI: 10.1590/0037-8682-0188-2022 -
Brazilian Journal of Microbiology :... Dec 2023This review is about Dr. Luiz Rodolpho Raja Gabaglia Travassos' scientific contributions to paracoccidioidomycosis as told by myself, Rosana Puccia, but co-written with... (Review)
Review
This review is about Dr. Luiz Rodolpho Raja Gabaglia Travassos' scientific contributions to paracoccidioidomycosis as told by myself, Rosana Puccia, but co-written with Dr. Carlos P. Taborda, my younger scientific brother, collaborator, and dear friend. Dr. Travassos' pioneer papers and scientific insights covering biochemistry, immunology, cell biology, and molecular biology in the paracoccidiodomycosis area are key contributions that we acknowledge here, with focus on the Paracoccidioides antigen gp43. Importantly, we tell some personal stories behind the scene. Dr. Travassos' contribution to science is available in a number of quality publications, while his influence to hundreds of people who gravitated around him will be kept alive inside each one of us forever.
Topics: Humans; Male; Antigens, Fungal; Paracoccidioidomycosis; Paracoccidioides; Fungal Proteins
PubMed: 37052751
DOI: 10.1007/s42770-023-00962-y -
The Open Microbiology Journal 2017This review article summarizes and updates the knowledge on paracoccidioidomycosis. and the cryptic species of and their geographical distribution in Latin America,... (Review)
Review
BACKGROUND
This review article summarizes and updates the knowledge on paracoccidioidomycosis. and the cryptic species of and their geographical distribution in Latin America, explaining the difficulties observed in the serological diagnosis.
OBJECTIVES
Emphasis has been placed on some genetic factors as predisposing condition for paracoccidioidomycosis. Veterinary aspects were focused, showing the wide distribution of infection among animals. The cell-mediated immunity was better characterized, incorporating the recent findings.
METHODS
Serological methods for diagnosis were also compared for their parameters of accuracy, including the analysis of relapse.
RESULTS
Clinical forms have been better classified in order to include the pictures less frequently observesiod.
CONCLUSION
Itraconazole and the trimethoprim-sulfamethoxazole combination was compared regarding efficacy, effectiveness and safety, demonstrating that azole should be the first choice in the treatment of paracoccidioidomycosis.
PubMed: 29204222
DOI: 10.2174/1874285801711010224 -
Revista Do Instituto de Medicina... Jul 2016A previously healthy, 52-year-old woman presented with a nine months history of low fever and weight loss (> 30 kg). Physical examination disclosed generalized...
A previously healthy, 52-year-old woman presented with a nine months history of low fever and weight loss (> 30 kg). Physical examination disclosed generalized lymphadenopathy, skin lesions, abdominal distension, mild tachypnea and a left breast mass. Laboratory tests showed anemia; (prerenal) kidney injury, low serum albumin level; and negative serology for HIV and viral hepatitis. Computed tomography (neck/chest/abdomen) showed generalized lymph node enlargement, splenomegaly, pleural effusion and ascites. We performed thoracocentesis and paracentesis, and the findings were consistent with chylothorax and chylous ascites (with no neoplastic cells). Biopsies of the breast mass, skin and lymph nodes were performed and all of them showed large round yeast cells with multiple narrow-based budding daughter cells, characteristic of Paracoccidioides brasiliensis. Consequently, paracoccidioidomycosis was diagnosed, and liposomal amphotericin B was prescribed, as well as a high protein and low fat diet (supplemented with medium chain triglycerides). Even so, her clinical status worsened, requiring renal replacement therapy. She evolved with pneumonia, septic shock and respiratory failure and subsequently died. To our knowledge, this is the first description of a case with chylothorax and breast mass due to paracoccidioidomycosis. Additionally, we discuss: 1- the importance of the inclusion of this mycosis in the differential diagnosis of chylothorax and breast mass (breast cancer), especially in endemic areas; and 2- the possible mechanism involved in the development of chylous effusions.
Topics: Chylothorax; Diagnosis, Differential; Fatal Outcome; Female; Humans; Middle Aged; Paracoccidioidomycosis
PubMed: 27410917
DOI: 10.1590/S1678-9946201658057 -
Revista Iberoamericana de Micologia 2022
Topics: Humans; Paracoccidioidomycosis; Lobomycosis
PubMed: 35283022
DOI: 10.1016/j.riam.2022.01.002 -
The American Journal of Tropical... Sep 2020
Topics: Adrenal Glands; Amphotericin B; Asthenia; Diarrhea; Fludrocortisone; Humans; Hydrocortisone; Itraconazole; Male; Middle Aged; Paracoccidioides; Paracoccidioidomycosis; Tomography, X-Ray Computed; Vomiting
PubMed: 32896237
DOI: 10.4269/ajtmh.20-0083