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1.
Mem. Inst. Oswaldo Cruz ; 116: e210203, 2021. tab, graf
Article in English | LILACS | ID: biblio-1346579

ABSTRACT

BACKGROUND Paracoccidioidomycosis (PCM) is a systemic mycosis endemic to Latin America. Etiological agents are Paracoccidioides species that diverge phylogenetically throughout South America. OBJECTIVES This study aimed to document the epidemiology of PCM in Venezuela. METHODS We have performed a retrospective cross-sectional descriptive study in 31,081 clinical records of patients from two reference centres during 65 years (1954-2019). FINDINGS PCM diagnosis was confirmed in 745 patients. Chronic PCM was the most prevalent form (90.06% cases); 80.67% were male and the most affected age range was 41-60. Farming and construction were the most prevalent occupation and Miranda State had a higher prevalence. Lung and skin were the most affected organs, followed by oral manifestations. Direct examination, culture and serology showed a high sensibility, and no statistical difference was observed among the diagnostic tools. Out of 17 Paracoccidioides isolates genotyped from Venezuela, one was typed as Paracoccidioides americana and 16 as Paracoccidioides venezuelensis. MAIN CONCLUSIONS Clinical manifestations observed, information about the epidemiology and molecular profile is essential not only for diagnosis but also for understanding therapeutic responses to mycotic drugs and prognosis. Therefore, it is necessary to sequence all positive isolated strains in order to confirm the dominance of P. venezuelensis in Venezuela.


Subject(s)
Humans , Male , Paracoccidioides/genetics , Paracoccidioidomycosis/genetics , Paracoccidioidomycosis/epidemiology , Venezuela/epidemiology , Cross-Sectional Studies , Retrospective Studies
2.
Rev. epidemiol. controle infecç ; 10(4): 1-11, out.-dez. 2020. ilus
Article in English | LILACS | ID: biblio-1253087

ABSTRACT

Background and Objectives: Paracoccidioidomycosis (PCM) is a systemic disease caused by the dimorphic fungus Paracoccidioides brasiliensis found in the tropical and subtropical regions of Latin America. This study aimed to perform a retrospective analysis of PCM cases from the northern region of Rio Grande do Sul, Brazil. Methods: A total of 200 records of PCM cases diagnosed at the local reference pathology laboratory from 1995 to 2015 were analyzed Results: Of the patients, 185 were male and 15 female. Patients ranged in age from 31 to 80 years, the largest pro portion ( being aged between 51 and 60 years and living or working in the countryside. Clinical samples were mostly obtained from the oral cavity, followed by the oropharynx, lungs, brain, skin, and prostate. Conclusion: PCM is endemic in the south o f Brazil, as the local economy is largely based on agricultural activities, favoring the contact of the population with P. brasiliensis . Due to the great similarity between PCM symptoms and other respiratory diseases, the differential diagnosis is essentia l for the correct treatment of the disease and to avoid its progression.(AU)


Justificativa e Objetivos: A paracoccidioidomicose (PCM) é uma doença sistêmica causada pelo fungo dimórfico Paracoccidioides brasiliensis , o qual é encontrado nas regiões tropicais e subtropicais da América Latina. Este estudo objetivou realizar uma análise retrospectiva dos casos de PCM na região nor te do Rio Grande do Sul, Brasil . Métodos: Foram anal isados 200 prontuários relativos aos casos de PCM de 1995 até 2015 diagnosticados pelo laboratório de patologia referência na região . Resultados: Destes pacientes, 185 eram homens e 15 mulheres. Os pacientes tinham idade variando de 31 a 80 anos, sendo que a maior proporção (35,5%) tinha entre 51 e 60 anos e viviam ou trabalhavam na zona rural Os materiais clínicos eram provenientes em sua maioria da cavidade oral, seguido da região orofaríngea, pulmão, cérebro, provenientes em sua maioria da cavidade oral, seguido da região orofaríngea, pulmão, cérebro, pele e próstata. pele e próstata. Conclusão: O sul do Brasil O sul do Brasil é região endêmica de PCM, devido a sua é região endêmica de PCM, devido a sua economia estar centrada na agricultura, o que propicia o contato do homem com o fungo. economia estar centrada na agricultura, o que propicia o contato do homem com o fungo. Devido à grande semelhança dos sintomas da PCM com outras doenças respiratórias, o Devido à grande semelhança dos sintomas da PCM com outras doenças respiratórias, o diagnóstico diferencial é relevante para que se diagnóstico diferencial é relevante para que seja realizado o tratamento correto da doença e ja realizado o tratamento correto da doença e para que seu avanço seja evitado. para que seu avanço seja evitado.(AU)


Justificación y objetivos: L a paracoccidioidomicosis (PCM) es una enfermedad sistémica c ausada por el hongo dimorfo Paracoccidioides brasiliensis , que se encuentra en las regiones tropicales y subtropicales de América Latina. Este estudio tuvo como objetivo realizar un análisis retrospectivo de casos de PCM en la región nor te de Rio Grande do Sul, Brasil . Métodos: se analizaron 200 registros médicos relacionados con casos de PCM de 1995 a 2015 diagnosticado s por el laboratorio de patología de referencia en la región . Resultados: De estos pacientes, 185 eran hombres y 15 mujeres. Los pacientes tenían edades comprendidas entre 31 y 80 años, con la mayor proporción (35.5%) entre 51 y 60 años y viviendo o trabajando en el campo. Los materiales clínicos provenían principalmente de la cavidad oral, seguidos de la región orofaríngea, pulmón, cerebro, piel y próstata. Conclusión: El sur de Brasil es una región endémica de PCM, debido a que su economía se centra en la agricultura, que proporciona el contacto del hombre con el hongo. Debido a la gran similitud de los síntomas de PCM con otras enfermedade s respiratorias, el diagnóstico diferencial es relevante para el tratamiento correcto de la enferm edad y para evitar su progreso.(AU)


Subject(s)
Humans , Paracoccidioidomycosis/epidemiology , Mycoses
3.
Prensa méd. argent ; 105(10): 661-665, oct 2019. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1025853

ABSTRACT

La paracoccidioidomicosis es una micosis sistemática, endémica de amplias regiones de América Latina, causada por un hongo termodimorfo, Paracoccidioides brasiliensis. Afecta de manera predominante a individuos de mediana edad y sexo masculino, en particular aquellos que cumplen tareas rurales. la infección se adquiere por vía inhalatoria, y puede diseminarse por vía hemática a diversos órganos y tejidos. La enfermedad puede evolucionar en forma aguda, subaguda o crónica. El diagnóstico presuntivo de la paracoccidioidomicosis se sustenta en los antecedentes epidemiológicos del paciente y en las manifestaciones clínicas. El diagnóstico etiológico clásico consiste en la visualización, el aislamiento y la identificación del agente causal, o bien el empleo de pruebas serológicas para determinar la presencia de anticuerpos específicos en sangre. Se presentan tres casos de paracoccidioidomicosis en pacientes varones, dos con formas agudas de la enfermedad y el restante con una forma crónica. En todos los casos, el diagnóstico se efectuó por los hallazgos de la microscopia, los cultivos y las pruebas serológicas


Paracoccidioidomycosis is a systemic mycosis, endemic to large regions of Latin America, caused by a thermodimorphic fungus, Paracoccidioides brasiliensis. It predominantly affects middle-aged and male individuals, particularly those who perform rural tasks. The infection is acquired by inhalation, and it can spread by blod to various organs and tissues. The disease can evolve in acute, subacute or chronic form. The presumptive diagnosis of paracoccidiodomycosis is based on the patient's epidemiological history and clinical manifestations. The classic etiological diagnosis consists of visualization, isolation and identification of the causative agent, or the use of serological tests to determine the presence of specific antibodies in the blood. There are threee cases of paracoccidioidomycosis in male patients, two with acute forms of the disease and the remaining with a chronic form. In all cases, the diagnosis was made by the findings of microscopy, cultures and serological tests


Subject(s)
Humans , Male , Adult , Middle Aged , Aged , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/transmission , Paracoccidioidomycosis/epidemiology , Skin Manifestations , Rural Workers , Serologic Tests , Microscopy
4.
Rev. argent. microbiol ; 51(2): 144-147, jun. 2019. map, tab
Article in Spanish | LILACS | ID: biblio-1013364

ABSTRACT

Con el objetivo de describir las características clínico-epidemiológicas de la paracoccidioidomicosis, se realizó un estudio descriptivo de los casos diagnosticados por el Servicio de Microbiología Clínica del hospital de adultos Dr. Julio C. Perrando, de la ciudad de Resistencia (Chaco, Argentina). Entre 2011 y 2014 se detectaron 46 casos. En 2013 y 2014 se constató un incremento de la tasa de incidencia de alrededor de 4 veces con respecto a los anos anteriores. La forma crónica fue la predominante, con una media de edad de los pacientes de 53 anos. Del total de ellos, a 39 se les realizaron pruebas serológicas. En 15 de 39 casos, las pruebas serológicas fueron la única herramienta diagnóstica, mientras que en 4 de estos casos con diagnóstico microbiológico, la prueba resultó no reactiva. La inclusión de la paracoccidioidomicosis en el diagnóstico diferencial de pacientes de áreas endémicas que presentan un síndrome infeccioso inespecífico y la aplicación de las herramientas diagnósticas disponibles contribuyen al diagnóstico oportuno, así como a disminuir las secuelas de esta afección y su impacto socioeconómico.


In order to describe the clinical and epidemiological characteristics of paracoccidioidomycosis, a descriptive study of all the cases diagnosed by the Clinical Microbiology Service at Dr. Julio C. Perrando hospital in the city of Resistencia (Chaco Province, Argentina) was conducted. Between 2011 and 2014, 46 cases were detected. In the period 2013-2014, an almost 4-fold increase in the incidence rate was detected. The chronic form of the disease was predominant with an average age of 53 years. Serological tests in 39 out of 46 patients were performed. In 15 of 39 patients, serological tests were the only diagnostic tool while in 4 patients with a microbiological diagnosis serological tests were non-reactive. In patients from endemic areas with non-specific infectious syndrome it is important to include paracoccidioidomycosis in the differential diagnosis and to apply all available diagnostic tools to reach a timely diagnosis and to reduce the long-term sequelae and their socio-economic impact.


Subject(s)
Paracoccidioidomycosis/epidemiology , Serologic Tests/methods , Paracoccidioidomycosis/diagnosis , Incidence , Endemic Diseases/statistics & numerical data
5.
Araçatuba; s.n; 2017. 52 p. tab, ilus.
Thesis in Portuguese | LILACS, BBO | ID: biblio-915569

ABSTRACT

Introdução: a paracoccidioidomicose (PCM) é uma micose sistêmica endêmica cuja incidência vem aumentando de forma significativa na região norte do Brasil. Duas espécies, Paracoccidioides brasiliensis e Paracoccidioides lutzii podem causar a doença. A última aparenta ter maior importância em Rondônia, estado com as maiores taxas de incidência e mortalidade por PCM do Brasil. Objetivo: descrever as características clínicas, epidemiológicas e laboratoriais de pacientes portadores de PCM e estabelecer correlação com lesões orais. Material e Métodos: estudo retrospectivo de pacientes atendidos no Centro de Referência em Medicina Tropical de Rondônia durante o período de janeiro de 2013 a dezembro de 2016. Resultados: foram diagnosticados 107 pacientes com média de idade de 53,8 anos, sendo 100 homens e 07 mulheres. Observou-se que 77% mantinham contato ou relataram experiência anterior com lavoura. A maioria (98,1%) apresentou a forma crônica da doença. O diagnóstico foi confirmado em 74,7%, e baseado em achados clínicos e/ou epidemiológicos no restante. O diagnóstico sorológico não esteve disponível no período. O tempo médio entre o início dos sintomas e a realização do diagnóstico foi de 7,3 meses. Os principais locais acometidos foram os pulmões (95,3%), seguidos da cavidade oral (55,1%) e dos gânglios (28%). Na cavidade oral, a faringe/laringe predominou (33%), seguida da mucosa jugal (17,8%) e palato mole (13,1%). Houve 58,3% de associação com tabagismo. O medicamento mais utilizado para o tratamento foi o Itraconazol, fornecido pelo governo. Conclusão: não houve diferença entre os grupos com ou sem comprometimento da cavidade oral. A presença de lesões orais em mais da metade dos casos, com diagnóstico mais acessível, sugere que se pode diminuir o tempo entre o início dos sintomas e o início do tratamento, e contribuir para uma menor proporção de sequelas. Sugere-se ainda que o P. lutzii pode manifestar doença com características clínicas, epidemiológicas e laboratoriais semelhantes ao P. brasiliensis, exceto pela menor proporção de formas agudas de PCM. Mas novos estudos são necessários(AU)


Background: Paracoccidioidomycosis (PCM) is an endemic systemic mycosis whose incidence has been increasing significantly in the northern region of Brazil. Two species, Paracoccidioides brasiliensis and Paracoccidioides lutzii can cause the disease. The latter appears to be more important in Rondônia, the state with the highest incidence and mortality rates by PCM in Brazil. Objective: To describe the clinical, epidemiological and laboratory characteristics of PCM patients and to establish correlation with oral lesions. Material and Methods: a retrospective study of patients attended at the Reference Center in Tropical Medicine of Rondônia during the period from January 2013 to December 2016. Results: A total of 107 patients were diagnosed, with mean age of 53.8 years, 100 men and 7 women. It was observed that 77% maintained contact or reported previous experience with rural areas. The majority (98.1%) presented the chronic form of the disease. The diagnosis was confirmed by the finding of the fungus in clinical specimens in 74.7%, and based on clinical and/or epidemiological findings in the rest. The serological diagnosis was not available in the period. The mean time between onset of symptoms and the diagnosis was 7.3 months. The main sites were the lungs (95.3%), followed by the oral cavity (55.1%) and the ganglia (28%). In the oral cavity, the pharynx/larynx predominated (33%), followed by jugal mucosa (17.8%) and soft palate (13.1%). There was an 58,3% association with smoking. The most commonly used drug was Itraconazole in 93.5% of patients. Conclusion: There was no difference between groups with or without oral cavity involvement. The presence of oral lesions in more than half of the cases, with a more accessible diagnosis, suggests that the time between onset of symptoms and the beginning of treatment can be shortened and contribute to a lower proportion of sequelae. It is also suggested that P. lutzii can manifest disease with clinical, epidemiological and laboratory characteristics similar to P. brasiliensis, except for the smaller proportion of acute forms of PCM. But new studies are needed(AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Mouth/injuries , Paracoccidioides , Paracoccidioidomycosis , Larynx/injuries , Mouth Mucosa/injuries , Palate, Soft/injuries , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/epidemiology , Pharynx/injuries
6.
Rev. Nac. (Itauguá) ; 8(2): 62-71, dic 2016.
Article in Spanish | LILACS, BDNPAR | ID: biblio-884758

ABSTRACT

RESUMEN Introducción: la paracoccidioidomicosis (PCM) es una micosis sistémica endémica del Paraguay que produce un gran impacto social. Objetivo: describir datos demográficos y clínicos de pacientes con PCM detectados durante el período 2004-2013 en el Laboratorio Central de Salud Pública, Asunción. Material y métodos: estudio retrospectivo de los pacientes diagnosticados en el período 2004-2013. Los métodos utilizados para el diagnóstico fueron: examen directo con KOH, cultivo y serología por inmunodifusión radial. Resultados: fueron diagnosticados 131 casos de PCM, con edades comprendidas entre 22 a 70 años, siendo 127 (97%) varones y 4 mujeres. La actividad rural fue preponderante en estos pacientes (80%). La infección fue diagnosticada predominantemente en muestras de esputo (35,8%). Los sitios principales de diseminación fueron la mucosa oral (32,8%) y nódulos linfáticos (6,8%). Los principales Departamentos de origen fueron Central, Caaguazú, San Pedro, Cordillera y Paraguarí. Conclusión: la PCM afectó predominantemente a varones adultos del área rural, siendo aislado preferentemente de secreciones respiratorias y lesiones bucofaríngeas.


ABSTRACT Introduction: paracoccidioidomycosis (PCM) is a systemic mycosis endemic to Paraguay that produces a great social impact. Objective: to describe demographic and clinical data of patients with PCM detected during the period 2004-2013 at the Central Laboratory of Public Health, Asunción. Material and methods: retrospective study of patients diagnosed in the period 2004-2013. The methods used for the diagnosis were: direct examination with KOH, culture and serology by radial immunodiffusion. Results: 131 cases of PCM were diagnosed, ranging from 22 to 70 years, with 127 (97%) males and 4 females. Rural activity was preponderant in these patients (80%). The infection was predominantly diagnosed in sputum samples (35.8%). The main sites of dissemination were oral mucosa (32.8%) and lymph nodes (6.8%). The main geographical areas were Central, Caaguazú, San Pedro, Cordillera and Paraguarí. Conclusion: PCM predominantly affected adult males in rural areas, being preferentially isolated from respiratory secretions and buccopharyngeal lesions.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Paracoccidioidomycosis/epidemiology , Paracoccidioidomycosis/diagnosis , Paraguay/epidemiology , Rural Population , Retrospective Studies
7.
Rev. Inst. Med. Trop. Säo Paulo ; 57(supl.19): 11-20, Sept. 2015. tab
Article in English | LILACS | ID: lil-762049

ABSTRACT

SUMMARYThe epidemiological characteristics of paracoccidioidomycosis were reviewed and updated. The new endemic areas in Brazil were discussed in the section regarding the geographic distribution of the mycosis. Subclinical infection with Paracoccidioides brasiliensis was discussed on the basis of skin test surveys with antigens of the fungus, seroepidemiological studies, and disease cases outside Latin America. Large case series permitted a comparison of the prevalence of the mycosis in different regions, its estimated incidence and risk factors for the development of the disease. Aspects modulating the expression of the clinical forms of paracoccidioidomycosis are also presented. This review also deals with diseases associated with the mycosis, opportunistic paracoccidioidomycosis, lethality, mortality and infection and disease in animals.


RESUMOAs características epidemiológicas da paracoccidioidomicose foram revistas e atualizadas. Novas áreas endêmicas brasileiras foram discutidas na seção de distribuição geográfica da micose. A infecção subclínica por Paracoccidioides brasiliensis foi discutida com base em pesquisas realizadas com testes cutâneos com antígenos do fungo, estudos soroepidemiológicos e em casos de doença, fora da América Latina. Grandes séries de casos permitiram a comparação da prevalência da micose em diferentes regiões, sua incidência estimada e fatores de risco para o desenvolvimento da doença. Aspectos modulando a expressão de formas subclínicas da paracoccidioidomicose foram igualmente apresentados. Esta revisão também trata de doenças associadas à micose, paracoccidioidomicose oportunista, letalidade, mortalidade e infecção e doença em animais.


Subject(s)
Humans , Animals , Paracoccidioidomycosis/epidemiology , Incidence , Latin America/epidemiology , Paracoccidioidomycosis/veterinary , Prevalence , Risk Factors
8.
Mem. Inst. Oswaldo Cruz ; 110(6): 781-785, Sept. 2015. tab, graf
Article in English | LILACS | ID: lil-763092

ABSTRACT

Paracoccidioidomycosis (PCM) is caused by dimorphic fungi from theParacoccidioides brasiliensis complex. Previous studies have demonstrated that the severity of disease is associated with a T-helper 2 immune response characterised by high interleukin (IL)-4 production. In the present study we analysed two polymorphisms in the IL-4gene (-590 C/T and intron-3 microsatellite) in 76 patients with PCM and 73 control subjects from an endemic area. The production of IL-4 by peripheral blood mononuclear cells after antigen or phytohaemagglutinin stimulation was determined by ELISA. A significant correlation was observed between the RP2/RP2 intron-3 genotype and infection with Paracoccidioides sp.(p = 0.011), whereas the RP1/RP1 genotype was correlated with resistance. No significant correlation was observed for the IL-4promoter polymorphism. Furthermore, the low IL-4 expression observed in the control group compared with patients was associated with the RP1/RP1 genotype. These results suggest that IL-4polymorphisms might be associated with the ability of the host to control Paracoccidioides sp.infection. The relevance of this polymorphism is supported by the observation that patients with disease produce high levels of IL-4 following mitogen or antigen stimulation. The IL-4gene is located in the cytokine cluster region of chromosome 5 where other polymorphisms have also been described.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Endemic Diseases , Genetic Predisposition to Disease , /genetics , /metabolism , Paracoccidioidomycosis/immunology , Polymorphism, Genetic/immunology , Enzyme-Linked Immunosorbent Assay , Leukocytes, Mononuclear/immunology , Leukocytes, Mononuclear/metabolism , Microsatellite Repeats , Paracoccidioidomycosis/epidemiology , Promoter Regions, Genetic/genetics , Statistics, Nonparametric
9.
Braz. j. microbiol ; 46(2): 513-517, Apr-Jun/2015. tab, graf
Article in English | LILACS | ID: lil-749731

ABSTRACT

Paracoccidioides brasiliensis is the etiological agent of the major systemic mycosis in Brazil, called paracoccidioidomycosis. Although the Rio Grande do Sul is considered an endemic area of the disease, there are few studies on the ecology of P. brasiliensis in the state. Therefore, this study aimed to evaluate the infection of P. brasiliensis in horses from the mesoregion of Southwest Riograndense, using these animals as sentinels. Serological techniques, such as double immunodiffusion in agar gel (AGID) and indirect ELISA, were performed to detect the anti-gp43 P. brasiliensis antibody in horses from five different farms in the region of Bagé, RS, Brazil. Serology was performed in 200 Pure Blood English horses up to two years of age that were born and raised exclusively at the farms. Of these horses, 12% had anti-gp43 antibodies according to the ELISA results, with rates ranging from 0 to 30% according to the farm of origin (p < 0.001). Based on the immunodiffusion results, all equine serum samples were negative. These results indicate the presence of the fungus P. brasiliensis in the middle region of the southwestern state of Rio Grande do Sul, Brazil.


Subject(s)
Animals , Antibodies, Fungal/blood , Horse Diseases/epidemiology , Paracoccidioides/immunology , Paracoccidioidomycosis/veterinary , Brazil/epidemiology , Enzyme-Linked Immunosorbent Assay , Horses , Horse Diseases/microbiology , Paracoccidioidomycosis/epidemiology , Paracoccidioidomycosis/microbiology , Seroepidemiologic Studies
10.
Rev. Inst. Med. Trop. Säo Paulo ; 56(4): 281-285, Jul-Aug/2014. tab
Article in English | LILACS | ID: lil-716428

ABSTRACT

This study aimed to estimate the prevalence of paracoccidioidal infection by intradermal reaction (Delayed-Type Hypersensitivity, DTH) to Paracoccidioides brasiliensis in rural areas in Alfenas, Southern Minas Gerais (MG) State, Brazil, and to assess risk factors (gender, occupation, age, alcohol intake and smoking) associated with infection. We conducted a population-based cross-sectional study using intradermal tests with gp 43 paracoccidioidin in 542 participants, who were previously contacted by local health agents and so spontaneously attended the test. Participants underwent an interview by filling out a registration form with epidemiological data and were tested with an intradermal administration of 0.1 mL of paracoccidioidin in the left forearm. The test was read 48 hours after injection and was considered positive if induration was greater than or equal to 5 mm. Out of 542 participants, 46.67% were positive to the skin test. Prevalence increased in accordance with an increase of age. There was statistical significance only for males. Occupation, alcohol intake and smoking habits were not significantly associated with the risk of paracoccidioidomycosis infection. There is relevance of paracoccidioidomycosis infection in such rural areas, which suggests that further epidemiological and clinical studies on this mycosis should be done in the southern part of Minas Gerais State.


Este estudo teve como objetivo estimar a prevalência de sensibilização da pele pelo Paracoccidioides brasiliensis em áreas rurais em Alfenas, MG, Brasil, e avaliar os fatores de risco associados à infecção. Foi realizado um estudo transversal de base populacional utilizando testes intradérmicos com paracoccidioidina em 542 indivíduos selecionados por demanda espontânea. Os participantes foram submetidos a uma entrevista através do preenchimento de um formulário de inscrição com os dados epidemiológicos e os testes com a administração intradérmica de 0,1 mL de paracoccidioidina no antebraço esquerdo. O teste foi lido 48 h após a injeção e foi considerado positivo se enduramento era maior ou igual a 5 mm. De 542, 46,67% participantes foram positivos ao teste de pele. Prevalência aumentou de acordo com o aumento da idade. Houve significância estatística apenas para o sexo masculino. Profissão, alcoolismo e tabagismo não foram significativamente associados com o risco de infecção paracoccidioidomicose. Há relevância da infecção paracoccidioidomicose em áreas rurais, o que sugere mais estudos epidemiológicos e clínicos sobre esta micose no sul do estado de Minas Gerais.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Young Adult , Antigens, Fungal/immunology , Paracoccidioides/immunology , Paracoccidioidomycosis/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Fungal Proteins , Intradermal Tests , Prevalence , Paracoccidioidomycosis/diagnosis , Rural Population
11.
Rev. peru. med. exp. salud publica ; 31(2): 352-357, abr.-jun. 2014.
Article in Spanish | LIPECS, LILACS, LIPECS | ID: lil-719514

ABSTRACT

El panorama epidemiológico de la esporotricosis y la paracoccidioidomicosis en Perú y Latinoamérica es esporádico, fragmentario, y geográficamente limitado, debido principalmente a la falta de notificación obligatoria y a la escasa cobertura diagnóstica. Sin embargo, los aportes de investigaciones relacionados a entender la interacción de estos hongos, la respuesta del huésped y el ambiente, como el uso de un análisis espacial que relacione la distribución de estas micosis, la densidad poblacional y el clima, contribuyen o están encaminadas, al diseño de medidas de prevención y control de estas micosis y propone el manejo de mapas de riesgo epidemiológicos, a partir del hábitat del hongo, por los médicos, los turistas y las personas que viven en zonas rurales, donde estas micosis son endémicas. El objetivo del artículo es presentar una revisión del tema mediante resultados de investigaciones que contribuyen a la prevención y control de estas micosis.


The epidemiological picture of sporotrichosis and paracoccidioidomycosis in Peru and Latin America is sporadic, fragmented, and geographically limited, mainly due to lack of mandatory reporting and limited diagnostic coverage. However, research contributions related to understanding the interaction of these fungi, the response of the host and the environment, the use of spatial analysis that relates the distribution of these mycoses, population density and climate, contributes to the design of prevention and control strategies of these mycosis and suggest epidemiological risk maps management, based on the habitat of the fungus. This information will be used by doctors, tourists and people living in rural areas where mycoses are endemic. The aim of the paper is to present a review of the topic through research findings that contribute to the prevention and control of these mycosis.


Subject(s)
Humans , Paracoccidioidomycosis/prevention & control , Sporotrichosis/prevention & control , Biomedical Research , Paracoccidioidomycosis/epidemiology , Peru/epidemiology , Sporotrichosis/epidemiology
12.
Rev. Inst. Med. Trop. Säo Paulo ; 56(2): 121-125, Mar-Apr/2014. tab
Article in English | LILACS | ID: lil-703749

ABSTRACT

With the objective to evaluate the behavior of paracoccidioidomycosis in the last three decades, clinical and epidemiological data of 595 patients admitted to clinical services of the Federal University of Mato Grosso do Sul from 1980 to 2009 were investigated. Gender, age distribution, clinical form, comorbidity with tuberculosis or AIDS, and mortality were compared by decades of clinical admission. It was shown that during the three decades there was a decrease in women percentage, and the same manner occurred a reduction in participants in the age group of 20 to 39 years. Moreover, the acute/subacute forms have been diminished in the period. These fluctuations are closely related and can be simultaneously analyzed. Increased AIDS co-infection prevalence from the first to the second decade was also revealed, coinciding with the appearance of the retroviral epidemic and stabilizing during the third decade. No change in the tuberculosis co-infection rate was observed (overall = 6.9%). It reinforces the importance of this co-morbidity. The overall mortality rate remained steady at 6.7%, not varying significantly from one decade to another. The persistent mortality rate calls attention to the importance of this neglected disease.


Com o objetivo de avaliar o comportamento da paracoccidioidomicose nas últimas três décadas, dados clínicos e epidemiológicos de 595 pacientes atendidos dentre 1980 a 2009 no Hospital da Universidade Federal de Mato Grosso do Sul foram estudados. Sexo, faixa etária, forma clínica, associação com tuberculose ou AIDS e mortalidade foram comparados por década em que a doença foi diagnosticada. Observou-se, nas três décadas do estudo, uma redução do percentual de mulheres, de pacientes do grupo de 20 a 39 anos, assim como de casos com a forma aguda/subaguda. Estas alterações estão intimamente relacionadas e podem ser analisadas simultaneamente. Houve aumento de casos de coinfecção com AIDS da primeira para segunda década, coincidindo com o surgimento da epidemia, e manteve-se estável durante a década seguinte. Não houve alteração da taxa de coinfecção com tuberculose, que no geral foi de 6,9% o que reforça a importância desta comorbidade. A taxa geral de mortalidade foi de 6,7% e também não variou entre as décadas estudadas. A manutenção da taxa de óbitos chama a atenção para a relevância dessa doença negligenciada.


Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Young Adult , Paracoccidioidomycosis/epidemiology , Acute Disease , Age Distribution , Brazil/epidemiology , Prevalence , Sex Distribution
13.
Rev. méd. Minas Gerais ; 24(1)jan.-mar. 2014.
Article in Portuguese | LILACS | ID: lil-720002

ABSTRACT

A paracoccidioidomicose (PCM), doença provocada pelo Paracoccidioidis brasiliensis, é a mais importante micose profunda existente na América Latina. Foi descrita inicialmente no Brasil em 1908 por Adolfo Lutz, comcontribuições posteriores de relevância, para seu entendimento, de Splendore e Almeida. Pode acometer pessoas de todas as faixas etárias, evoluindo de forma aguda-subaguda ou crônica, respectivamente, em crianças-adolescentes e adultos após os 30 anos de idade. Possui desde manifestações benignas até formas graves com risco de morte. Apresenta anatomopatologicamente caráter granulomatoso e supurativo, acometendo principalmente os pulmões, mucosas das vias aéreas superiores e boca, pele e linfonodos, podendo afetar todos os órgãos e sistemas.


Subject(s)
Humans , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/epidemiology , Diagnosis, Differential , Tuberculosis, Lymph Node
14.
Rev. méd. Minas Gerais ; 24(1)jan.-mar. 2014.
Article in Portuguese | LILACS | ID: lil-720011

ABSTRACT

A paracoccidioidomicose (PCM) é uma micose granulomatosa sistêmica, polimórfica, determinada pelos Paracoccidioides brasiliensis e P. lutzii e constitui-se em uma das 10 causas de morbimortalidade entre as doenças endêmicas parasitárias no Brasil. A atualização do conhecimento sobre sua etiologia, epidemiologia e patogênese constitui estímulo para que seja incluída no espectro do diagnóstico diferencial da prática médicarotineira, reconhecida com precocidade e tratada convenientemente, evitando-se que evolua com sequelas e morte.


Paracoccidioidomycosis (PCM) is a polymorphic systemic granulomatous mycosis determined by Paracoccidioides brasiliensis and P. lutzii and constitutes one of the 10 leading causes of morbidity and mortality by the parasitic diseases endemic in Brazil. The need for updates on the etiology, epidemiology, and pathogenesis is a for routinely including this disease in the differential diagnosis of current medical practice, recognizing it early and treating it properly, so as to avoid progression with sequelae and death.


Subject(s)
Humans , Paracoccidioidomycosis/epidemiology , Paracoccidioidomycosis/etiology , Paracoccidioidomycosis/pathology , Diagnosis, Differential
15.
Rev. méd. Minas Gerais ; 24(1)jan.-mar. 2014.
Article in Portuguese | LILACS | ID: lil-720012

ABSTRACT

A paracoccidioidomicose possui clínica polimórfica, com manifestações localizadas em pele e mucosas até comprometimento de vários órgãos e sistemas, potencialmente capaz de provocar sequelas graves e morte. Deve ser incluída no diagnóstico diferencial das doenças granulomatosas, em áreas endêmicas, como ocorre no Brasil, para que seja reconhecida com precocidade, tratada convenientemente e evitada sua evolução para sequelas e morte prematura.


Paracoccidioidomycosis has polymorphic clinical features with lesions located in the skin and mucous membranes, as well as involvement of various organs and systems, as is potentially capable of causing death and serious sequelae. It should be included in the differential diagnosis of granulomatous diseases in endemic areas, including Brazil, so that it is recognized early, for more convenient treatment as to prevent progression with sequelae or premature death.


Subject(s)
Humans , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/epidemiology , Paracoccidioidomycosis/etiology , Diagnosis, Differential , Paracoccidioidomycosis/classification
16.
Rev. méd. Minas Gerais ; 24(1)jan.-mar. 2014.
Article in Portuguese | LILACS | ID: lil-720013

ABSTRACT

A paracoccidioidomicose, apesar de ser a micose profunda mais importante da América Latina, ainda possui muitas lacunas quanto à sua abordagem, especialmente em relação à duração de seu tratamento, controle de cura e profilaxia. Na dependência da sua gravidade podem ser usadas em seu tratamento: sulfas, azólicos (itraconazol e o cetoconazol)e anfotericina. O prognóstico depende da sua gravidade, do tempo para estabelecer o diagnóstico e da terapêutica instituída. Nas formas leves é bom; e nas formas moderadas e graves, em que há risco do desenvolvimento de sequelas e de morte, é reservado.


Paracoccidioidomycosis, despite being the most important deep mycosis in Latin America, still has many blindspots in terms of its approach, especially in relation to duration of treatment, cure control and prophylaxis. Depending on severity, the following can be used in the treatment: sulfonamides, azoles (itraconazole and ketoconazole), and amphotericin. The prognosis depends on severity, time between onset and diagnosis, and therapy instituted. In mild forms, prognosis is good; in moderate and severe forms, for which there is risk of developing sequelae and death, it is guarded.


Subject(s)
Humans , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/epidemiology , Paracoccidioidomycosis/etiology , Diagnosis, Differential , Paracoccidioidomycosis/classification , Paracoccidioidomycosis/drug therapy
17.
Rev. méd. Minas Gerais ; 24(1)jan.-mar. 2014.
Article in Portuguese | LILACS | ID: lil-720024

ABSTRACT

O diagnóstico da paracoccidioidomicose requer a presença de dados epidemiológicos e de algumas manifestações clínicas mais típicas, entretanto, depende da propedêutica complementar que ainda requer métodos intervencionistas, o diagnóstico diferencial com patologias de grande relevância como tuberculose e linfomas, e o controle de cura.Nesta atualização são discutidos os avanços nessas várias áreas que inclui a propedêutica complementar, o diagnóstico diferencial e o controle de cura, apontando para as perspectivas de desenvolvimento que poderão ajudar a definir melhor a sua abordagem.


The diagnosis of paracoccidioidomycosis requires epidemiological data to be available and for the presence of some more typical clinical manifestations.It requires complementary investigation with interventional methods, differential diagnosis of pathologies of great importance such as tuberculosis and lymphomas, and cure control. This update discussesthe advances in these various areas, which include complementary investigation, differential diagnosis and cure control, pointing to development prospects that may help better define the best approach to this disease.


Subject(s)
Humans , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/epidemiology , Brazil , Diagnosis, Differential , Diagnostic Techniques and Procedures
19.
Rev. Soc. Bras. Med. Trop ; 47(1): 63-68, Jan-Feb/2014. tab, graf
Article in English | LILACS | ID: lil-703155

ABSTRACT

Introduction: Paracoccidioidomycosis (PCM) is a systemic infection caused by the fungus Paracoccidioides brasiliensis. PCM is considered one of the most important systemic mycoses in Latin America. Methods: This is a clinical, epidemiological, retrospective, quantitative study of PCM cases in patients attending the National Health Service in the State of Rondônia in 1997-2012. The examined variables included sex, age group, year of diagnosis, education level, profession, place of residence, diagnostic test, prior treatment, medication used, comorbidities and case progress. Results: During the study period, 2,163 PCM cases were registered in Rondônia, and the mean annual incidence was 9.4/100,000 people. The municipalities with the highest rates were located in the southeastern region of Rondônia, and the towns of Pimenteiras do Oeste and Espigão do Oeste had the highest rates in the state, which were 39.1/100,000 and 37.4/100,000 people, respectively. Among all cases, 90.2% and 9.8% were observed in men and women, respectively, and most cases (58.2%) were observed in patients aged between 40 and 59 years. Itraconazole was used to treat 91.6% (1,771) of cases, followed by sulfamethoxazole in combination with trimethoprim (4.4% [85] of cases). One hundred thirty-one (6%) patients died. Conclusions: The State of Rondônia has a high incidence of PCM, and the municipalities in the southeastern region of the state were found to have the highest incidence rates of this disease. Our findings suggest that Rondônia is the state in the northern region with the highest mortality rate for PCM. .


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Paracoccidioidomycosis/epidemiology , Age Distribution , Antifungal Agents/therapeutic use , Brazil/epidemiology , Paracoccidioidomycosis/drug therapy , Paracoccidioidomycosis/mortality , Retrospective Studies , Socioeconomic Factors , Space-Time Clustering , Topography, Medical
20.
Braz. j. microbiol ; 45(1): 243-247, 2014. ilus
Article in English | LILACS | ID: lil-709486

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.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Paracoccidioides/isolation & purification , Paracoccidioidomycosis/epidemiology , Age Distribution , Brazil/epidemiology , Endemic Diseases , Histocytochemistry , Paracoccidioidomycosis/pathology , Retrospective Studies , Rural Population , Sex Distribution
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