Computed tomography findings of paracoccidiodomycosis in musculoskeletal system

Abstract

ObjectiveTo evaluate musculoskeletal involvement in paracoccidioidomycosis at computed tomography.Materials and MethodsDevelopment of a retrospective study based on a review of radiologic and pathologic reports in the institution database. Patients with histopathologically confirmed musculoskeletal paracoccidioidomycosis and submitted to computed tomography were included in the present study. The imaging findings were consensually described by two radiologists. In order to avoid bias in the analysis, one patient with uncountable bone lesions was excluded from the study.ResultsA total of seven patients were included in the present study. A total of 18 bone lesions were counted. The study group consisted of 7 patients. A total number of 18 bone lesions were counted. Osteoarticular lesions were the first manifestation of the disease in four patients (57.14%). Bone lesions were multiple in 42.85% of patients. Appendicular and axial skeleton were affected in 85.71% and 42.85% of cases, respectively. Bone involvement was characterized by well-demarcated osteolytic lesions. Marginal osteosclerosis was identified in 72.22% of the lesions, while lamellar periosteal reaction and soft tissue component were present in 5.55% of them. One patient showed multiple small lesions with bone sequestra.ConclusionParacoccidioidomycosis can be included in the differential diagnosis of either single or multiple osteolytic lesions in young patients even in the absence of a previous diagnosis of pulmonary or visceral paracoccidioidomycosis

Bone involvement in paracoccidioidomycosis

“…Fernanda Lopes Franco [1] , Bruno Niemeyer [1], [2], [3] and Edson Marchiori [3] [1]. Departamento de Radiologia, Hospital Casa de Portugal, Rio de Janeiro, RJ, Brasil.…”

“…Departamento de Radiologia, Hospital Casa de Portugal, Rio de Janeiro, RJ, Brasil. [2]. Departamento de Radiologia, Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, RJ, Brasil.…”

“…Osteoarticular involvement by paracoccidioidomycosis results from lymphohematogenous dissemination, with a primary focus in the lungs, predominantly in men aged 20-40 years [1][2][3] . Clinically, most cases are asymptomatic, but patients may present with pain, edema, and heat sensation in the lesion area.…”

Magnetic resonance imaging findings of paracoccidioidomycosis in the musculoskeletal system

“…A previous study of our institution Monsignore et al [22] published the biggest case series of proven PCM osteoarticular involvement in the English literature, but described only conventional radiographic findings. A previous study of our institution Lima J unior et al [23] published seven cases of proven PCM osteoarticular involvement describing computed tomography findings, of which four cases had isolated osteoarticular involvement.…”

“…The published data about musculoskeletal PCM originate mainly from case reports [6][7][8][9][14][15][16][17][18][19][20]. There are only three series of cases of osteoarticular involvement in PCM [21][22][23]. Amstalden et al [21] published nine cases of PCM in which the locomotor system was the main clinical manifestation of the disease, but only two of these cases, one involving the femur and one the elbow, showed no lesion in another organ.…”