Hepatic Disease with Portal Hypertension and Acute Juvenile Paracoccidioidomycosis: A Report of Two Cases and Literature Review

Macedo, Priscila Marques de; Almeida‐Paes, Rodrigo; Freitas, Dayvison Francis Saraiva; Brito‐Santos, Fabio; Figueiredo-Carvalho, Maria Helena Galdino; Soares, João Carlos; Freitas, Andréa d’Avila; Zancopé‐Oliveira, Rosely Maria; Valle, Antônio Carlos Francesconi do

doi:10.1007/s11046-017-0152-6

Cited by 8 publications

(12 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This strain was isolated from a patient whose probable place of infection was the Rio de Janeiro state (Duque de Caxias municipality), although the major clinical presentation of this case, portal hypertension, was very similar to another case caused by a strain belonging to the large P . brasiliensis haplotype [23].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Clinical features and genetic background of the sympatric species Paracoccidioides brasiliensis and Paracoccidioides americana

Macedo¹,

Teixeira

Barker

et al. 2019

PLoS Negl Trop Dis

Self Cite

View full text Add to dashboard Cite

Introduction The agents of paracoccidioidomycosis, historically identified as Paracoccidioides brasiliensis , are in fact different phylogenetic species. This study aims to evaluate associations between Paracoccidioides phylogenetic species and corresponding clinical data. Methods Paracoccidioides strains from INI/Fiocruz patients (1998–2016) were recovered. Socio-demographic, epidemiological, clinical, serological, therapeutic and prognostic data of the patients were collected to evaluate possible associations of these variables with the fungal species identified through partial sequencing of the ADP-ribosylation factor ( arf ) and the 43-kDa-glycoprotein ( gp43 ) genes. Results Fifty-four fungal strains were recovered from 47 patients, most (72.3%) infected in Rio de Janeiro state, Brazil. Forty-one cases were caused by Paracoccidioides brasiliensis and six by Paracoccidioides americana (former PS2). P . brasiliensis was responsible for severe lymph abdominal forms, whereas patients infected with P . americana presented a high rate of adrenal involvement. However, no statistically significant associations were found for all variables studied. P . americana presented 100% reactivity to immunodiffusion, even when tested against antigens from other species, while negative results were observed in 9 (20%) cases caused by P . brasiliensis , despite being tested against a homologous antigen. Conclusions P . brasiliensis and P . americana are sympatric and share similar clinical features and habitat, where they may compete for similar hosts.

show abstract

Section: Resultsmentioning

confidence: 99%

“…It is well described that P . brasiliensis [8, 21, 23, 25] and P . lutzii [45] can be related to severe PCM cases.…”

Section: Resultsmentioning

confidence: 99%

Clinical features and genetic background of the sympatric species Paracoccidioides brasiliensis and Paracoccidioides americana

Macedo¹,

Teixeira

Barker

et al. 2019

PLoS Negl Trop Dis

Self Cite

View full text Add to dashboard Cite

show abstract

“…At present, it is believed that PCM is caused by fungi of the genus Paracoccidioides [39], which is composed of at least five species (P. brasiliensis, P. lutzii, P. americana, P. restrepiensis, and P. venezuelensis) [40]. Despite the great genetic variability among these species, there do not seem to be important differences in the clinical findings when comparing P. brasiliensis with P. americana [41] or P. lutzii [42], for instance. Currently, the genus Paracoccidioides is taxonomically classified as Eukaryota of the kingdom Fungi, phylum Ascomycota, subphylum Pezizomycotina, and family Ajellomycetaceae.…”

Section: Paracoccidioides Phylogeny and Ecologymentioning

confidence: 99%

Updates in Paracoccidioides Biology and Genetic Advances in Fungus Manipulation

Chaves

Navarro

Barros

et al. 2021

JoF

View full text Add to dashboard Cite

The dimorphic fungi of the Paracoccidioides genus are the causative agents of paracoccidioidomycosis (PCM). This disease is endemic in Latin America and primarily affects workers in rural areas. PCM is considered a neglected disease, despite being a disabling disease that has a notable impact on the public health system. Paracoccidioides spp. are thermally dimorphic fungi that present infective mycelia at 25 °C and differentiate into pathogenic yeast forms at 37 °C. This transition involves a series of morphological, structural, and metabolic changes which are essential for their survival inside hosts. As a pathogen, the fungus is subjected to several varieties of stress conditions, including the host immune response, which involves the production of reactive nitrogen and oxygen species, thermal stress due to temperature changes during the transition, pH alterations within phagolysosomes, and hypoxia inside granulomas. Over the years, studies focusing on understanding the establishment and development of PCM have been conducted with several limitations due to the low effectiveness of strategies for the genetic manipulation of Paracoccidioides spp. This review describes the most relevant biological features of Paracoccidioides spp., including aspects of the phylogeny, ecology, stress response, infection, and evasion mechanisms of the fungus. We also discuss the genetic aspects and difficulties of fungal manipulation, and, finally, describe the advances in molecular biology that may be employed in molecular research on this fungus in the future.

show abstract

“…Until now, there have been four reports on eight clinical cases with phylogenetic analyses of the etiological agent in this region. In one case, P. brasiliensis PS2 was reported ( de Macedo et al 2016a ) and in the remaining cases P. brasiliensis S1 was detected, all in non-HIV infected patients ( de Macedo et al 2016b , 2017a , b ). Together with this study, it appears that P. brasiliensis S1 is the most prevalent species in Rio de Janeiro, both in non-HIV and HIV groups.…”

Section: Discussionmentioning

confidence: 97%

Paracoccidioidomycosis due to Paracoccidioides brasiliensis S1 plus HIV co-infection

Macedo

Almeida‐Paes

Almeida

et al. 2018

Mem. Inst. Oswaldo Cruz

Self Cite

View full text Add to dashboard Cite

BACKGROUNDParacoccidioidomycosis (PCM) is one of the most important systemic mycoses in Latin America and the leading fungal cause of mortality in non-immunosuppressed individuals in Brazil. However, HIV/PCM co-infection can increase the clinical severity in these co-infected patients. This co-infection is rarely reported in the literature mainly because of the different epidemiological profiles of these infections. Furthermore, PCM is a neglected and non-notifiable disease, which may underestimate the real importance of this disease. The advent of molecular studies on the species of the genus Paracoccidioides has expanded the knowledge regarding the severity and the clinical spectrum in PCM. In this context, the development of studies to describe the association of the Paracoccidioides phylogenetic cryptic species in vulnerable populations, such as HIV-infected patients, appears relevant.OBJECTIVETo describe the clinical, epidemiological, therapeutic and prognostic aspects in HIV/PCM co-infected patients, along with the molecular identification of the Paracoccidioides species involved in these cases.METHODSThe investigators performed a molecular and clinical retrospective study involving HIV/PCM co-infected patients, from a reference centre for PCM care in the endemic area of Rio de Janeiro, Brazil, from 1998 to 2015. Molecular identification of the fungal strains was done by amplification of partial sequences of arf and gp43 genes.FINDINGSOf 89 patients diagnosed with PCM by fungal isolation in the culture, a viable isolate was recovered for molecular analysis from 44 patients. Of these 44 patients, 28 (63.6%) had their serum samples submitted for enzyme immunoassay tests for screening of HIV antibodies, and 5 (17.9%) had a positive result. All cases were considered severe, with a variable clinical presentation, including mixed, acute/subacute clinical forms and a high rate of complications, requiring combination therapy. Paracoccidioides brasiliensis S1 was the species identified in all cases.CONCLUSIONSHIV/PCM co-infection can change the natural history of this fungal disease. The authors reinforce the need to include HIV screening diagnostic tests routinely for patients with PCM.

show abstract

Hepatic Disease with Portal Hypertension and Acute Juvenile Paracoccidioidomycosis: A Report of Two Cases and Literature Review

Cited by 8 publications

References 21 publications

Clinical features and genetic background of the sympatric species Paracoccidioides brasiliensis and Paracoccidioides americana

Clinical features and genetic background of the sympatric species Paracoccidioides brasiliensis and Paracoccidioides americana

Updates in Paracoccidioides Biology and Genetic Advances in Fungus Manipulation

Paracoccidioidomycosis due to Paracoccidioides brasiliensis S1 plus HIV co-infection

Contact Info

Product

Resources

About