Paracoccidioimycosis and white individuals: Susceptibility and biogeographic aspects in an important endemic area in Brazil

Abstract

Paracoccidioidomycosis (PCM) is a neglected mycosis most commonly occurring in Latin America. The etiologic agents are thermo dimorphic fungi of the genus Paracoccidioides, and cause an important granulomatous response in affected tissues. The Botucatu Medical School, from São Paulo State University (UNESP), is a PCM study pole, located in São Paulo State Midwest region, which is classified as a hyperendemic area in the Southeast region in Brazil. This study aimed to perform a retrospective epidemiological, geographical, and clinical analysis by the information available in medical records. It was listed as socio-demographic data along with clinical characteristics from patients diagnosed and treated during a 10-year period in Botucatu, totaling 177 patients with Paracoccidioidomycosis confirmed by the histopathological test. It was observed that the main clinical presentation was the chronic type (76,3%), most commonly identified in white male individuals over the age of 29 years old, smokers, males and alcoholics, providing evidences for the first time that white individuals were more affected by the disease, in comparison to non-white individuals that may be more resistant to infection. This data opens new avenues for study within ancestry, resistance and susceptibility in paracoccidioidomycosis.

Molecular Phylogenetic Analysis of Paracoccidioides Species Complex Present in Paracoccidioidomycosis Patient Tissue Samples

“…This illness has a profound socioeconomic impact since it affects mostly rural male workers, 30–50 years old, who are the main providers, hindering their ability to work [ 34 ]. Our clinical and socio-demographic data corroborate with the known literature regarding PCM [ 4 , 32 ], showing that chronic form was more frequently presented in males, white individuals, smokers, and alcoholics, with a median of age superior to 50 years old, as already described; while acute form affects both genders, white individuals, non-alcoholics, non-smokers, and of younger age [ 32 , 35 , 36 ].…”

“…It was identified that most of our patients are residents of the São Paulo State with a few cases from Paraná. The analysis of the area showed that where the patients lived, the place where they came from at the moment of the PCM diagnosis and treatment start, was predominantly concentrated in municipalities at São Paulo State central west region, around the city of Botucatu, corroborating the data published in 2021 [ 32 ].…”

The risk of infections for multiple sclerosis and neuromyelitis optica spectrum disorder disease-modifying treatments: Eighth European Committee for Treatment and Research in Multiple Sclerosis Focused Workshop Review. April 2021

“…Other opportunistic infections should also be checked when treating patients with DMTs in Latin America, such as paracoccidioidomycosis, caused by Paracoccidioides brasiliensis, an endemic fungus in Latin America, which mainly affects the lungs. 143,144 Its treatment, which usually includes itraconazole, has been described in detail. 145 In summary, post-marketing data and real-world evidence available in the Latin American population do not differ from results of international clinical trials.…”