Un caso excepcional de paracoccidioidomicosis e histoplasmosis pulmonares de presentación concomitante / Concomitant pulmonary paracoccidioidomycosis and pulmonary histoplasmosis: a rare case
J. bras. pneumol
;
38(2): 264-268, mar.-abr. 2012. ilus
Article
in Spanish
| LILACS
| ID: lil-623406
RESUMEN
La incidencia de las micosis pulmonares en Uruguay es muy baja, y estas usualmente aparecen en pacientes inmunocomprometidos. Se discute el caso de un paciente inmunocompetente proveniente de área rural, que presenta tos, disnea y fiebre de dos meses de evolución. La imagenología mostró una neumonitis extensa y fibrosis pulmonar. Los test micológicos directos, cultivo y serológicos muestran histoplasmosis y paraccocidioidomicosis en forma concomitante. El paciente presentó hipotensión arterial diagnosticándose una insuficiencia suprarrenal. A pesar de que la extensa fibrosis pulmonar y la neumonitis no fueron reversibles, el paciente mejoró clínicamente con el tratamiento antifúngico. Se trata de un caso excepcional de dos micosis pulmonares en un mismo paciente.
ABSTRACT
The incidence of pulmonary fungal infections is very low in Uruguay, and such infections typically affect immunocompromised patients. We report the case of an immunocompetent patient presenting with a two-month history of cough, dyspnea, and fever. The patient resided in a rural area. Imaging tests revealed extensive pneumonitis and pulmonary fibrosis. On the basis of direct mycological examination, culture, and serological testing, we made a diagnosis of concomitant histoplasmosis and paracoccidioidomycosis. The patient presented arterial hypotension that was diagnostic of adrenocortical insufficiency. Although the pulmonary fibrosis and pneumonia were irreversible, the clinical condition of the patient improved after antifungal treatment. This was an exceptional case of two pulmonary fungal infections occurring simultaneously in the same patient.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Paracoccidioidomycosis
/
Coinfection
/
Histoplasmosis
/
Lung Diseases, Fungal
Limits:
Humans
/
Male
Country/Region as subject:
South America
/
Uruguay
Language:
Spanish
Journal:
J. bras. pneumol
Journal subject:
Pulmonary Disease (Specialty)
Year:
2012
Type:
Article
Affiliation country:
Uruguay
Institution/Affiliation country:
Hospital Maciel/UY
/
Universidad de la República Uruguay/UY
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