Paracoccidioidal Infection in HIV Patients at an Endemic Area of Paracoccidioidomycosis in Brazil

Sarti, Elaine Cristina Fernandes Baez; Oliveira, Sandra Maria do Valle Leone de; Santos, Liara Ferreira dos; Camargo, Zoilo Pires de; Paniago, Anamaria Mello Miranda

doi:10.1007/s11046-011-9495-6

Cited by 17 publications

(16 citation statements)

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“…Although there are some reports of PCM in immunocompromised patients [12][13][14][15][16][17][18], this mycosis has not been properly characterized as an opportunistic infection. Furthermore, in many of these immunocompromised patients, PCM also precedes diagnosis of malignancy [8].…”

Section: Discussionmentioning

confidence: 99%

Paracoccidioidomycosis in Patients with Lymphoma and Review of Published Literature

et al. 2014

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This paper describes four new cases of lymphomas, two Hodgkin lymphomas and two non-Hodgkin lymphomas in patients with paracoccidioidomycosis. All had mycosis diagnosed before lymphomas with Paracoccidioides brasiliensis demonstrated in several lymph nodes, as seen in the disseminated form of the disease. When lymphoma was diagnosed, one patient was under regular paracoccidioidomycosis treatment and in clinic-serological remission for this disease, another was under regular treatment but with clinic-serological mycosis activity, one had abandoned paracoccidioidomycosis treatment 6 years earlier, and the other had not yet received any kind of antifungal drugs. Three patients received treatment for lymphomas with one remaining in remission until now, one achieving tumor remission which relapsed years later, and one having only residual lymphoma in bone marrow for a decade but clinically well. All three experienced paracoccidioidomycosis clinical remission, however, serology became negative just in one. Similar previously described cases were reviewed: five Hodgkin lymphomas, three non-Hodgkin lymphomas, and one described only as "lymphoma" without specifying type; a summary of their findings is presented. Finally, there is also a brief discussion on the possible pathophysiological mechanisms involved in the concomitance of these two disorders.

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Section: Discussionmentioning

confidence: 99%

Paracoccidioidomycosis in Patients with Lymphoma and Review of Published Literature

et al. 2014

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“…In regard to patients with AIDS, the association between both diseases may represent 5 % of all PCM cases [29,30,60,61]. Although the mycosis develops mainly in patients with low CD4 + lymphocyte counts (< 200 cells/μl), response to antifungal therapy is, in general, similar to that observed in non-immunocompromised patients with PCM [12,29,57]. Additionally, in severe cases, corticosteroids appear beneficial [71].…”

Section: Disease In Immunocompromised Patientsmentioning

confidence: 97%

“…A direct relation to underlying immunosuppressive conditions, including HIV disease, has not been clearly demonstrated. Sarti et al found that in a cohort of over 1000 HIV-infected patients, PCM accounted for only 3.3 % of the deaths (in contrast with histoplasmosis which caused 38 % of fatalities) [29]. Morejon et al estimated that in HIV patients the prevalence of P. brasiliensis coinfection was low, 1.4 % [30].…”

Section: Epidemiologymentioning

confidence: 99%

“…On the basis of gallium image studies, it is presently accepted that the various manifestations of PCM entail multiple organ involvement, thus negating the former division of the disease into a unifocal or a multifocal process [48]. With the increase in the number of immunocompromised individuals, particularly those with AIDS, the mycosis is being recognized more frequently [25,26,29,30,57]. In such patients, the corresponding clinical presentation does not allow to categorize the process as chronic or acute but rather as a mixed (opportunistic) form [58][59][60][61][62].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…In patients having an impaired immune system, the pulmonary findings corresponding to those of the chronic adult-type disease which are frequently associated with signs of lymphohematogenous dissemination, such as lymph node enlargement, hepatomegaly and/or splenomegaly, and skin lesions, features of the acute type disease [49,50]. In regard to patients with AIDS, the association between both diseases may represent 5 % of all PCM cases [29,30,60,61]. Although the mycosis develops mainly in patients with low CD4 + lymphocyte counts (< 200 cells/μl), response to antifungal therapy is, in general, similar to that observed in non-immunocompromised patients with PCM [12,29,57].…”

Section: Disease In Immunocompromised Patientsmentioning

confidence: 99%

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