Paracoccidioidomycosis in an immunocompetent adult South of Minas Gerais: Case report
DOI:
https://doi.org/10.33448/rsd-v11i12.34421Keywords:
Paracoccidioidomycosis; Prostate; Diagnosis; Central nervous system fungal infections.Abstract
Paracoccidioidomycosis (PCM) is an infection that develops after inhalation of fungal parts dispersed in the atmosphere. It affects mainly males living in rural areas and since there is a higher incidence of the fungus in this environment. It presents several clinical manifestations, thus making the outcome of the diagnosis difficult. In this report, we describe the case of a 59-year-old man with a history of syncope followed by several generalized tonic-clonic seizures. After hospitalization and several complementary exams, the investigation culminated in the anatomopathological analysis of the transrectal resection of the prostate, investigating the presence of fungus, which resulted positive by PAS and Gragott staining for Paracoccidioides brasiliensis. The patient underwent treatment with Sulfamethoxazole 400 mg +Trimethoprim 80 mg, for two years, until clinical improvement and the results of requested complementary exams were obtained. The patient is under monitoring and has had no recurrences of the disease so far.
References
Benard, G. (2021). Pathogenesis and classification of paracocidioidomycosis: new insights from old good stuff. Open forum infectious diseases. 8(3), ofaa624). US: Oxford University Press. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7944344/.
Da Silva, L. B. R. et al. (2020). Advances in Fungal Peptide Vaccines. Journal of fungi. 6(3), 119.doi:10.3390/jof6030119. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7558412/.
Boniche, C., Rossi, S. A., Kischkel, B., Barbalho, F. V., Moura, Á., Nosanchuk, J. D., Travassos, L. R., & Taborda, C. P. (2020). Immunotherapy against Systemic Fungal Infections Based on Monoclonal Antibodies. Journal of fungi (Basel, Switzerland), 6(1), 31. https://doi.org/10.3390/jof6010031. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151209/
Burger, E. (2021). Paracoccidioidomycosis Protective Immunity. Journal of fungi (Basel, Switzerland), 7(2), 137. https://doi.org/10.3390/jof7020137. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918802/
Eyer-Silva, W. A., Santana, A. C., Silva, G., Azevedo, M., Barreto, J., Neumann, M. A., Castro, I. J., Basílio-de-Oliveira, R. P., Araujo, L. F., Ré, N. Z., Oliveira, F. M., Simas, C., Sarvat, M. A., & Ferry, F. (2017). Laryngeal paracoccidioidomycosis presenting as solitary true vocal fold disease. IDCases, 10, 71–74. https://doi.org/10.1016/j.idcr.2017.09.003. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5608563/
Gonçalves, S. P., Gonçalves, J., & Marques, C. G. (2021). Manual de investigação qualitativa. Lisboa, Portugal. https://static.fnac-static.com/multimedia/PT/pdf/9789896931148.pdf
Junior, S. R. D. S., Da Silva, F. K. L., Dias, L. S., Souza, A. C. O., De Araujo, M. V., Da Silva, L. B. R., Travassos, L. R., Amaral, A. C. & Taborda, C. P. (2020). Intranasal Vaccine Using P10 Peptide Complexed within Chitosan Polymeric Nanoparticles as Experimental Therapy for Paracoccidioidomycosis in Murine Model. Journal of fungi (Basel, Switzerland), 6(3), 160. https://doi.org/10.3390/jof6030160. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7560165/
Kischkel, B., Rossi, S. A., Santos, S. R., Nosanchuk, J. D., Travassos, L. R., & Taborda, C. P. (2020). Therapies and Vaccines Based on Nanoparticles for the Treatment of Systemic Fungal Infections. Frontiers in cellular and infection microbiology, 10, 463. https://doi.org/10.3389/fcimb.2020.00463. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7502903/
Lenhard-Vidal, A., Bender, F. R., Assolini, J. P., Maruo, A., Vieira, L. T., Pereira, E. C., Ono, M. A., Sano, A., & Itano, E. N. (2021). IgG reactivity profile to Paracoccidioides spp. antigens in people with asymptomatic Paracoccidioidomycosis. Journal of medical microbiology, 70(1), 10.1099/jmm.0.001279. https://doi.org/10.1099/jmm.0.001279. https://pubmed.ncbi.nlm.nih.gov/33258768/
Lopes, D. L., Araújo, S., Santos, J. P., Lyon, A. C., Dantas, D. V., Reis, B. S., de Góes, A. M., & Pedroso, E. R. (2009). Prostatic paracoccidioidomycosis: differential diagnosis of prostate cancer. Memorias do Instituto Oswaldo Cruz, 104(1), 33–36. https://doi.org/10.1590/s0074-02762009000100005. Prostatic paracoccidioidomycosis: differential diagnosis of prostate cancer - PubMed (nih.gov)
Mattos, K., Cocio, T. A., Chaves, E., Borges, C. L., Venturini, J., de Carvalho, L. R., Mendes, R. P., Paniago, A., & Weber, S. S. (2021). An update on the occurrence of Paracoccidioides species in the Midwest region, Brazil: Molecular epidemiology, clinical aspects and serological profile of patients from Mato Grosso do Sul State. PLoS neglected tropical diseases, 15(4), e0009317. https://doi.org/10.1371/journal.pntd.0009317. https://pubmed.ncbi.nlm.nih.gov/33826630/
Morais, E. A., Martins, E. M., Boelone, J. N., Gomes, D. A., & Goes, A. M. (2015). Immunization with recombinant Pb27 protein reduces the levels of pulmonary fibrosis caused by the inflammatory response against Paracoccidioides brasiliensis. Mycopathologia, 179(1-2), 31–43. https://doi.org/10.1007/s11046-014-9815-8. https://pubmed.ncbi.nlm.nih.gov/25487973/
Nunes, T. F., Ribeiro, S. M., Carvalho, L. R., Maldonado, B. M., Mendes, R. P., & Paniago, A. (2020). Comparison of clinico-epidemiological and radiological features in paracoccidioidomycosis patients regarding serological classification using antigens from Paracoccidioides brasiliensis complex and Paracoccidioides lutzii. PLoS neglected tropical diseases, 14(8), e0008485. https://doi.org/10.1371/journal.pntd.0008485
Pereira, E. F., Gegembauer, G., Chang, M. R., Camargo, Z. P. D., Nunes, T. F., Ribeiro, S. M., ... & Paniago, A. M. (2020). Comparison of clinico-epidemiological and radiological features in paracoccidioidomycosis patients regarding serological classification using antigens from Paracoccidioides brasiliensis complex and Paracoccidioides lutzii. PLoS neglected tropical diseases, 14(8), e0008485. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7447013/
Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da pesquisa científica. Santa Maria (RS). Brasil. https://www.ufsm.br/app/uploads/sites/358/2019/02/Metodologia-da-Pesquisa-Cientifica_final.pdf
Pinheiro, B. G., Pôssa, A. P., Della Terra, P. P., de Carvalho, J. A., Ricci, G., Nishikaku, A. S., Hahn, R. C., Camargo, Z. P., & Rodrigues, A. M. (2021). A New Duplex PCR-Assay for the Detection and Identification of Paracoccidioides Species. Journal of fungi (Basel, Switzerland), 7(3), 169. https://doi.org/10.3390/jof7030169. https://pubmed.ncbi.nlm.nih.gov/33652623/
Plá, M. P., Hartung, C., Mendoza, P., Stukanoff, A., & Moreno, M. J. (1994). Neuroparacoccidioidomycosis: case reports and review. Mycopathologia, 127(3), 139–144. https://doi.org/10.1007/BF01102913. https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0038-1641578
Poplin, V., Smith, C., Milsap, D., Zabel, L., & Bahr, N. C. (2021). Diagnosis of Pulmonary Infections Due to Endemic Fungi. Diagnostics (Basel, Switzerland), 11(5), 856. https://doi.org/10.3390/diagnostics11050856. https://pubmed.ncbi.nlm.nih.gov/34068825/
Rodrigues, A. M., Kubitschek-Barreira, P. H., Pinheiro, B. G., Teixeira-Ferreira, A., Hahn, R. C., & de Camargo, Z. P. (2020). Immunoproteomic Analysis Reveals Novel Candidate Antigens for the Diagnosis of Paracoccidioidomycosis Due to Paracoccidioides lutzii. Journal of fungi (Basel, Switzerland), 6(4), 357. https://doi.org/10.3390/jof6040357. https://pubmed.ncbi.nlm.nih.gov/33322269/
Silva, L., Taira, C. L., Cleare, L. G., Martins, M., Junqueira, M., Nosanchuk, J. D., & Taborda, C. P. (2021). Identification of Potentially Therapeutic Immunogenic Peptides From Paracoccidioides lutzii Species. Frontiers in immunology, 12, 670992. https://doi.org/10.3389/fimmu.2021.670992. https://pubmed.ncbi.nlm.nih.gov/34046037/
Shikanai-Yasuda, M. A., Mendes, R. P., Colombo, A. L., Telles, F. D. Q., Kono, A., Paniago, A. M. M., ... & Martinez, R. (2018). II consenso brasileiro em paracoccidioidomicose-2017. Epidemiologia e Serviços de Saúde, 27. https://doi.org/10.5123/S1679-49742018000500001 https://www.scielo.br/j/ress/a/FzK9ZYXzYzk5bW7PCcrKH3t/abstract/?lang=pt
Shikanai-Yasuda, M. A., Mendes, R. P., Colombo, A. L., Queiroz-Telles, F. D., Kono, A. S. G., Paniago, A. M., ... & Martinez, R. (2017). Brazilian guidelines for the clinical management of paracoccidioidomycosis. Revista da Sociedade Brasileira de Medicina Tropical, 50, 715-740. II Consenso Brasileiro em Paracoccidioidomicose - 2017 (iec.gov.br)
Taborda, C., Urán, M. E., Nosanchuk, J. D., & Travassos, L. R. (2015). Paracoccidioidomycosis: challenges in the development of a vaccine against an endemic mycosis in the Americas. Revista do Instituto de Medicina Tropical de São Paulo, 57, 21-24.https://www.scielo.br/j/rimtsp/a/WpkhGvLYpVbQx8cpmYHwmWS/?lang=em
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Ana Paula de Araújo Raimundo; Beatriz Gianini de Oliveira Burza Maia; Jaqueline Brandão Guerreiro Marotti
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.