Pathogenesis of Paracoccidioidomycosis: A model based on the study of 46 patients

Abstract

Forty-six Paracoccidioidomycosis patients were studied with emphasis on lung pathology. It was found that the greatest clinical involvement of the reticuloendothelial system occurred in younger individuals. On the other hand, the frequency of tegumentary lesions was low in young patients and increased with age. Lung involvement was nearly always demonstrated when searched for and showed no relationship to the patient's age. In the young patients the disease was acute while in the older individuals its course was chronic. The findings from this study permitted formulation of a model for the pathogenesis of paracoccidioidomycosis in which the respiratory tract is accepted as the primary site of infection. Based on this model, a classification of the various forms of the entity is proposed.

Localization of eosinophil granule major basic protein in paracoccidioidomycosis lesions.

“…It presents as either a systemic disease with a rapid course or as a chronic localized mycosis, depending on several factors including the host's immunocompetence, strain of the parasite, and the environment. 4 Current data point to the lungs as the portal of entry. [5][6][7] Eosinophils are considered to be effector cells, which in the presence of antibody or complement, are able to kill parasites.…”

Paracoccidioidomicosis juvenil diseminada diagnosticada en una niña en área urbana

“…En el país, la enfermedad tiene un acentuado predominio por el sexo masculino: hasta 45 casos en hombres por cada dos en mujeres (6). La prevalencia está alrededor de 2,6 por 100.000 habitantes (3), siendo un poco mayor en departamentos como Valle y Antioquia, donde se alcanzan prevalencias de 4,6 a 4,8 por 100.000 habitantes.…”

“…La intensidad del compromiso cutáneo depende de la gravedad del compromiso sistémico (6). Las lesiones orales y de la mucosa nasal consisten en lesiones papulosas, erosivas y, en ocasiones, sangrantes.…”

“…El compromiso de mucosas se calcula hasta en 50 % de todas las formas de presentación, siendo la cavidad oral el sitio más afectado (17). Menos común (25 %) es la afección en piel (6). También puede existir compromiso de los ganglios linfáticos, el sistema nervioso central y las glándulas suprarrenales (18,19).…”

Paracoccidioidomicose subaguda progressiva: tratamento de um doente com anfotericina B e nutrição parenteral

“…A Paracoccidioidomicose da criança e do adolescente manifesta-se com freqüência pela forma denominada juvenil da doença 6 , que evolui com acometimento ganglionar predominante. A poliadenopatia aguda ou subaguda com localização preferencial nas cadeias linfáticas: cervical, sub-mandibular, axilar e mesentérica é comum na primeira e segunda décadas da vida.…”