Paracoccidioidomycosis in southern Rio Grande do Sul: a retrospective study of histopathologically diagnosed cases

Abstract

Paracoccidioidomycosis (PCM) is a systemic mycosis caused by the fungus Paracoccidioides brasiliensis and is endemic to Brazil. The aim of this study was to perform a retrospective analysis of the PCM cases in the countryside south of Rio Grande do Sul, Brazil. The files from four histopathology laboratories located in the city of Pelotas were obtained, and all of the epidemiological and clinical data from the PCM diagnosed cases were collected for analysis. A total of 123 PCM cases diagnosed between 1966 and 2009 were selected. Of these patients, 104 (84.5%) were male, and 17 were female. The patients ranged from 02 to 92 years of age. Fifty-two cases (41.9%) were obtained from the oral pathology laboratory, and the remaining 71 cases (58.1%) were obtained from the three general pathology laboratories. Of all of the patients studied, 65.2% lived in rural zones and worked in agriculture or other related fields. Data on the evolution of this disease was available for 43 cases, and the time frame ranged from 20 to 2920 days (mean = 572.3 days). An accurate diagnosis performed in less than 30 days only occurred in 21% of the cases. PCM is endemic to the countryside of Rio Grande do Sul. Therefore, it is recommended that PCM be included as a differential diagnosis, mainly for individuals between 30 and 60 years of age, living in rural zones and who have respiratory signs and associated-oropharyngeal lesions.

Oral paracoccidioidomycosis: Retrospective analysis of 55 Brazilian patients

“…All the cases in question were diagnosed by histopathological examination of biopsied specimens of oral lesions. The incisional biopsy was the most used technique (85.45% of cases) for diagnosis, and shown to be effective in the diagnosis of oral lesions as demonstrated in other studies . Some differential diagnosis should be included to such injuries, especially squamous cell carcinoma, tuberculosis, sarcoidosis and Wegener's granulomatosis …”

“…reported that 45.5% of 422 patients were rural workers, Bicalho et al . found this association in 53% of patients and Souza et al . found that 65.2% lived in rural areas or working with agriculture.…”

“…et al4 reported that 45.5% of 422 patients were rural workers, Bicalho et al1 found this association in 53% of patients and Souza et al20 …”

Different DNA methylation profile is demonstrated in paracoccidioidomycosis patients without oral lesions

“…About 30% to 50% of the chronic PCM patients exhibit oral manifestations, characterised by erythematous granular ulcers with haemorrhagic dots that is called moriform stomatitis involving mainly hard and soft palate, buccal, labial and gingival mucosa, or severe periodontal bone loss . Oral PCM manifestations favour the recognition of the disease and make possible the diagnosis through incisional biopsy …”

Paracoccidioidomycosis: level of pulmonary sequelae in high resolution computed tomography images from patients of two endemic regions of Brazil

“…The majority of the PCM cases (around 80%) are reported in Brazil (7,8), which is the first one cause of death among systemic mycoses disease in the country (1,9). Different distribution in endemic areas and the difficult to notify the Original Article Paracoccidioidomycosis: level of pulmonary sequelae in high resolution computed tomography images from patients of two endemic regions of Brazil disease are facts, which contributes negatively to establish incidence and prevalence of PCM (10,11).…”