Autor(es): Gaspar, Gilberto Gambero ; Cocio, Tiago Alexandre ; Guioti-Puga, Fernanda ; Nascimento, Erika ; Fabro, Alexandre Todorovic ; von Zeska Kress, Marcia Regina ; Bagagli, Eduardo [UNESP] ; Martinez, Roberto
Data: 2021
Identificador Persistente: http://hdl.handle.net/11449/209695
Origem: Oasisbr
Assunto(s): Paracoccidioidomycosis; Paracoccidioides lutzii; Pulmonary arterial hypertension
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Fundacao de Apoio ao Ensino, Pesquisa e Assistencia of the Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto - USP (FAEPA)
Paracoccidioidomycosis caused by Paracoccidioides lutzii is endemic in the Midwest of Brazil and its clinical spectrum is still little known due to the recent identification of this fungal species. A patient resident in Southeast Brazil, but who had lived for many years in the Midwest region, presented with skin injuries, chronic cough and bilateral adrenal involvement. Paracoccidioides spp. was isolated in culture from a skin lesion biopsy. This isolate was later identified as P. lutzii using gene sequencing. A favorable initial response to treatment with itraconazole was observed, but a few weeks later, the patient developed respiratory failure and worsening of lung lesions. Evaluation by computed tomography and echocardiography were suggestive of pulmonary arterial hypertension, and a bronchoscopic biopsy showed peribronchial remodeling. The patient completed the antifungal treatment but maintained the respiratory dysfunction. The reported case shows that P. lutzii can be isolated from patients in a geographic area far from the place of infection acquisition and that, as P. brasiliensis, it can cause adrenal injury and cardio-respiratory complications as a consequence of excessive necrosis and fibrosis.
Univ Sao Paulo, Fac Med Ribeirao Preto, Dept Clin Med, Av Bandeirantes 3900, BR-14049900 Ribeirao Preto, SP, Brazil
Univ Sao Paulo, Fac Med Ribeirao Preto, Dept Patol & Med Legal, Ribeirao Preto, SP, Brazil
Univ Sao Paulo, Fac Ciencias Farmaceut Ribeirao Preto, Dept Anal Clin Toxicol & Bromatol, Ribeirao Preto, SP, Brazil
Univ Estadual Paulista, Inst Biociencias, Dept Ciencias Quim & Biol, Botucatu, SP, Brazil
Univ Estadual Paulista, Inst Biociencias, Dept Ciencias Quim & Biol, Botucatu, SP, Brazil
CAPES: 001
CAPES: 88882.180015/2018-1
CAPES: 88882.317609/2019-1
