Paracoccidioidomycosis Mimicking Sarcoidosis: A Review of 8 Cases.

Sarcoidosis is a multisystem disorder that is characterized by noncaseous epithelioid cell granulomas, which may affect almost any organ. Thoracic involvement is common and accounts for most of the morbidity and mortality associated with this disease. The diagnosis is based on exhaustive exclusion of differential diagnoses, particularly granulomatous infections. We report data on eight patients with paracoccidioidomycosis mimicking sarcoidosis. Five patients presented with a chronic pulmonary type infection and three had a disseminated form after immunosuppressive treatment. The mycological diagnosis in noncaseating granulomas is emphasized and reviewed.

Sphenoid sinus fungus ball by filaments of actinomycetes and Aspergillus fumigatus.

We present a case of sphenoid sinus fungus ball caused by Aspergillus fumigatus associated with actinomycosis. This case represents the first known reported infection caused by this rare association.

Pulmonary diseases with imaging findings mimicking aspergilloma.

Patients with preexisting lung cavities are at risk of developing intracavitary fungal colonization. Because Aspergillus spp. are the most commonly implicated fungi, these fungal masses are called aspergillomas. Their characteristic "ball-in-hole" appearance, however, may be found in a variety of other conditions that can produce radiologic findings mimicking aspergilloma. In this paper, we review the main diseases that may mimic the radiographic findings of aspergilloma, with brief descriptions of clinical, radiologic, and histopathologic findings.

[Saccharomyces cerevisiae infections]. / Infección por Saccharomyces cerevisiae.

BACKGROUND: Saccharomyces cerevisiae is an ubiquitous yeast widely used in industry and it is also a common colonizer of the human mucosae. However, the incidence of invasive infection by these fungi has significantly increased in the last decades. AIMS: To evaluate the infection by S. cerevisiae in a hospital in southern Brazil during a period of 10 years (2000-2010). METHODS: Review of medical records of patients infected by this fungus. RESULTS: In this period, 6 patients were found to be infected by S. cerevisiae. The age range of the patients was from 10 years to 84. Urine, blood, ascitic fluid, peritoneal dialysis fluid, and esophageal biopsy samples were analyzed. The predisposing factors were cancer, transplant, surgical procedures, renal failure, use of venous catheters, mechanical ventilation, hospitalization in Intensive Care Unit, diabetes mellitus, chemotherapy, corticosteroid use, and parenteral nutrition. Amphotericin B and fluconazole were the treatments of choice. Three of the patients died and the other 3 were discharged from hospital. CONCLUSIONS: We must take special precautions in emerging infections, especially when there are predisposing conditions such as immunosuppression or patients with serious illnesses. The rapid and specific diagnosis of S. cerevisiae infections is important for therapeutic decision. Furthermore, epidemiological and efficacy studies of antifungal agents are necessary for a better therapeutic approach.

Sinusitis caused by the fungus Xylaria enteroleuca in a lung transplant recipient.

We report the 1st case of sinusitis and human infection by Xylaria enteroleuca (anamorph Nodulisporium sp.), a rare fungal endophyte of rain forest trees. The patient was a Brazilian woman who had her lung transplanted. Diagnosis was established by direct microscopic examination, computed tomographic scan, cultures, and sequencing of a ribosomal RNA gene. The in vitro antifungal susceptibility of the isolate is provided.

Cryptococcemia. An analysis of 28 cases with emphasis on the clinical outcome and its etiologic agent.

Clinical protocols of 28 cases of cryptococcemia studied between April 1995 and November 2002 were reviewed. The varieties of Cryptococcus neorformans, the underlying disease, and the severity and outcome of the disease were emphasized. Most patients were immunossupressed (89.3% with AIDS) and Cryptococcus neoformans var. grubii was the main recovered variety (92.8%). Regardless of antifungal treatment, in-hospital mortality was 41% strongly associated with APACHE II score, >14 (p<0.01).