Diagnóstico de paracoccidioidomicosis en el Laboratorio de Micología de la Universidad de Carabobo durante 14 años (1992-2005)  <span class="so-article-trans-title" dir="auto"> Translated title: Paracoccidioidomycosis diagnosis during 14 years (1992-2005) at the Mycology Laboratory of Universidad de Carabobo </span>

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Abstract

La paracoccidioidomicosis (PCM), es una micosis profunda sistémica, restringida a América Latina, causada por el hongo Paracoccidioides brasiliensis. En el laboratorio de Micología de la Universidad de Carabobo, (1992-2005), se estudiaron 2.407 pacientes y se diagnosticó PCM en 97 de ellos (4,0%). Las características epidemiológicas más resaltantes fueron: edades comprendidas entre 29-83 años, relación masculino/femenino de 6:1 y enfermedad más frecuente en hombres con edades entre: 40-50 (29,6 %) y 51-61 (24,7 %) años de edad. Los pacientes provenían del estado Carabobo 88 (90,7 %) y de todos los municipios, especialmente del Carlos Arvelo 24 (27,3 %), así como de los estados Yaracuy, Trujillo, Barinas, Monagas y Lara. En su mayoría eran agricultores (86/97: 88,7 %). Las formas clínicas de la enfermedad, evaluadas según el criterio del III Encuentro Internacional sobre Paracoccidioidomicosis, fueron: Crónica Multifocal 50 (51,6 %) y Crónica Pulmonar Unifocal, 47 (48,4%). Los pacientes con estudio serológico positivo fueron 94 (96,9%). El diagnóstico fue confirmado mediante estudio micológico en 88 pacientes (90,7%) e histopatológico en 13. Estos resultados contribuyen al conocimiento de la PCM en Venezuela.

Translated abstract

Paracoccidioidomycosis (PCM), is a systemic deep mycoses restricted to Latin America, produced by the fungus Paracoccidioides brasiliensis. The Mycology Laboratory of Universidad de Carabobo (1992- 2005) studied 2.407 patients and diagnosed PCM in 97 (4,0%) of them. The most outstanding epidemiological characteristics were: ages, between 29-83 years, male/female relationship 6:1; the disease was more frequent in men with ages between: 40-50 (29,6%) and 51-61 (24,7%) years. Most patients came from Carabobo State, 88 (90,7%) and all off its municipalities, especially Carlos Arvelo one 24 (27,3 %); there were also patients from Yaracuy, Trujillo, Barinas, Monagas and Lara States. Most were agricultural workers 86 (88,7%). The clínical forms of the disease, evaluated according to the criteria of the III Internacional Encounter on Paracoccidioidomycosis, were: Chronic Multifocal 50 (51,5 %) and Pulmonary Chronic Unifocal, 47 (48,4%). Patients with positive serologic results were, 94 (96,9%). Diagnosis was confirmed through mycological study in 88 patients (90,7%) and histopatológical study in 13. These results contribute to the knowledge about PCM in Venezuela.

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Endemic regions of paracoccidioidomycosis in Brazil: a clinical and epidemiologic study of 584 cases in the southeast region.

Simonne S Nouer, P M Papaiordanou, A Goveia … (1999)

This paper describes the clinical-seroepidemiologic characteristics of patients with paracoccidioidomycosis (PCM) who visited the University Hospital at the State University of Campinas (Campinas, Sao Paulo, Brazil). The study group consisted of 584 individuals (492 males and 92 females) with ages ranging from 5 to 87 years. The highest incidence of the disease occurred between the ages of 41 and 50 years for men and between 11 and 40 years for women. Rural activities were the principal occupation of 46% of the patients. The diagnosis was confirmed by histopathologic examination and demonstration of fungus in scrapings, secretions, or in the sputum. Serologic test results for PCM were positive in 80% of the 584 patients studied. The significant number of patients, including 33 children less than 14 years old, indicates the presence of the fungus in the area and that this region is an important endemic area for PCM.

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Residual pulmonary abnormalities in adult patients with chronic paracoccidioidomycosis: prolonged follow-up after itraconazole therapy.

Frances Joan D Alvarez, Nicole A. Restrepo, Carla Cano … (2003)

Itraconazole effectively controls active paracoccidioidomycosis but appears not to hinder lung fibrosis. Clinical records and chest radiographs from 47 itraconazole-treated patients with prolonged posttherapy follow-up (mean follow-up period, 5.6 years) were analyzed; the radiographs were interpreted following pneumoconiosis standards that consider the lungs as 6 fields and grade damage according to the number of fields involved. Infiltrative lesions were observed at diagnosis in 93.6% of the patients. Fibrosis was observed in 31.8% of the patients at diagnosis and had not cleared at the end of the observation period in any of these patients. Fibrosis also developed de novo in 11 patients (25%), so that by the end of the follow-up period it was seen in 53.2% of patients overall. Fibrosis correlated with severity of infiltrates at diagnosis: fibrosis was present in 83% of patients with very severe infiltration and in 12.5% of patients with minor infiltration. Among patients with severe infiltration, fibrosis was present in 30%; this increased (to 75%) when bullae were concomitantly present at diagnosis. Prompt initiation of treatment is necessary to avoid the development of fibrosis.