Clinical and Demographic Features of Paracoccidioidomycosis in Argentina: A Multicenter Study Analysis of 466 Cases

Abstract

Information on paracoccidioidomycosis (PCM) in Argentina is fragmented and has historically been based on estimates, supported only by a series of a few reported cases. Considering the lack of global information, a national multicentric study in order to carry out a more comprehensive analysis was warranted. We present a data analysis including demographic and clinical aspects of a historical series of 466 cases recorded over 10 years (2012–2021). Patients were aged from 1 to 89 years. The general male: female (M:F) ratio was 9.5:1 with significant variation according to the age group. Interestingly, the age range 21–30 shows an M:F ratio of 2:1. Most of the cases (86%) were registered in northeast Argentina (NEA), showing hyperendemic areas in Chaco province with more than 2 cases per 10,000 inhabitants. The chronic clinical form occurred in 85.6% of cases and the acute/subacute form occurred in 14.4% of cases, but most of these juvenile type cases occurred in northwestern Argentina (NWA). In NEA, the incidence of the chronic form was 90.6%; in NWA, the acute/subacute form exceeded 37%. Diagnosis by microscopy showed 96% positivity but antibody detection displays 17% of false negatives. Tuberculosis was the most frequent comorbidity, but a diverse spectrum of bacterial, fungal, viral, parasitic, and other non-infectious comorbidities was recorded. This national multicenter registry was launched in order to better understand the current status of PCM in Argentina and shows the two endemic zones with a highly diverse epidemiology.

Trends in the Epidemiological and Clinical Profile of Paracoccidioidomycosis in the Endemic Area of Rio de Janeiro, Brazil

“…In addition to an increase in the occurrence of acute forms, in the second period herein studied, changes were observed in the clinical and epidemiological characteristics of the disease in relation to what was observed in the first period and reported in the literature [ 1 , 2 , 3 , 7 , 16 ]. Between 2014 and 2019, there was a lower median age, lower percentages of patients with history of contact with rural activities or hunting, and of smokers diagnosed with PCM.…”

Impact of COVID‐19 on paracoccidioidomycosis. Which was the most influential: The pandemic or the virus?

“…Over the past decade, the incidence of PCM in Argentina has been estimated to range between 0.5 and 2 cases per 10,000 inhabitants, with an hyperendemic area exhibiting a higher rates exceeding three cases per 10,000 inhabitants. 5 Infection is acquired by inhalation of aerosolized conidia and/or mycelia from the saprobic phase of Paracoccidioides spp., resulting in a transient and benign primary pulmonary disease. 6,7 After multifactorial host-fungus interactions involving fungal virulence factors, adaptation, adhesion, and invasion depending on the host's immune status and its response, infection may progress acutely or, more commonly to the chronic form of the disease.…”

“…[11][12][13] During the last 10 years, the frequency of PCM cases in Argentina has shown a slight but constant annual increase. 5 Since World Health Organization (WHO) declared COVID-19 a global pandemic, PCM incidence in Argentina has been considerably influenced. Furthermore, starting in 2021, disseminated and severe cases have emerged.…”