Abdominal alterations in disseminated paracoccidioidomycosis: computed
tomography findings*

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Abstract

Objective

To evaluate the incidence and spectrum of abdominal computed tomography imaging findings in patients with paracoccidioidomycosis.

Materials and Methods

Retrospective analysis of abdominal computed tomography images of 26 patients with disseminated paracoccidioidomycosis.

Results

Abnormal abdominal tomographic findings were observed in 18 patients (69.2%), while no significant finding was observed in the other 8 (30.8%) patients.

Conclusion

Computed tomography has demonstrated to play a relevant role in the screening and detection of abdominal abnormalities in patients with disseminated paracoccidioidomycosis.

Translated abstract

Objetivo

Avaliar a frequência e variedade de achados de imagem por exames de tomografia computadorizada de abdome em indivíduos com paracoccidioidomicose disseminada.

Materiais e Métodos

Estudo retrospectivo dos exames de tomografia computadorizada de abdome de 26 pacientes com paracoccidioidomicose disseminada.

Resultados

Foram encontradas alterações tomográficas abdominais em 18 pacientes (69,2%) dos casos analisados e 8 pacientes (30,8%) apresentaram exames normais.

Conclusão

A tomografia computadorizada de abdome mostrou grande importância no rastreamento e identificação de alterações abdominais nos pacientes com paracoccidioidomicose disseminada.

Related collections

Most cited references 28

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Paracoccidioidomycosis: an update.

E. Brummer, E Castañeda, A. Restrepo (1993)

This review summarizes knowledge on various aspects of paracoccidioidomycosis. Mycelial propagules, chlamydospores, and arthroconidia exhibit thermal dimorphism; arthroconidia are infectious in animals and, by electron microscopy, appear well provided for survival. The mycelial-to-yeast-phase transformation requires a strict control of glucan synthesis probably mediated by membrane enzymes. Hormonal influences on the transformation of the fungus (mycelium or conidium to yeast phase) have been demonstrated. Estrogen-binding proteins have been detected in the fungal cytosol, and during the transformation novel proteins are produced as a result of estradiol incorporation. Clinical forms have been better defined on the basis of better experimental models. Emphasis has been placed on the lungs as the portal of entry and on the existence of silent pulmonary infections. A specific Paracoccidioides brasiliensis antigen, the 43-kDa glycoprotein (Gp43), has been identified, characterized, and cloned. This has led to improved reproducibility and specificity of serologic tests. The depression of cell-mediated immune responses has been associated with severe disease in humans and in the experimental host. T-cell subsets in patients' tissues were characterized by means of monoclonal antibodies, and a reduced CD4/CD8 ratio was demonstrated. This has been related to alterations in lymphokine and tumor necrosis factor production, production of antigen-antibody complexes, etc. Amphotericin B has provided effective therapy. Azole derivatives have also improved prognosis and facilitated therapy. Itraconazole is presently the drug of choice, yet incapacitating sequelae (mainly pulmonary fibrosis) still constitute major problems.

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[Guidelines in paracoccidioidomycosis].

Maria Aparecida Shikanai-Yasuda, Flavio de Queiroz Telles Filho, Rinaldo Poncio Mendes … (2015)

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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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Author and article information

Journal

Journal ID (nlm-ta): Radiol Bras

Journal ID (iso-abbrev): Radiol Bras

Journal ID (publisher-id): rb

Title: Radiologia Brasileira

Publisher: Colégio Brasileiro de Radiologia e Diagnóstico por Imagem

ISSN (Print): 0100-3984

ISSN (Electronic): 1678-7099

Publication date (Print and electronic): Mar-Apr 2015

Publication date (Print): Mar-Apr 2015

Volume: 48

Issue: 2

Pages: 81-85

Affiliations

[1 ]Titular Members of Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), MDs, Radiologists, Unit of Computed Tomography – Instituto de Infectologia Emílio Ribas (IIER), São Paulo, SP, Brazil.

[2 ]MD, Resident in Infectology at Instituto de Infectologia Emílio Ribas (IIER), São Paulo, SP, Brazil.

[3 ]Master, Technical Director, Division of Diagnostic and Therapeutic Support – Instituto de Infectologia Emílio Ribas (IIER), São Paulo, SP, Brazil.

[4 ]PhD, MD, Infectologist, Division of Deep Mycoses – Instituto de Infectologia Emílio Ribas (IIER), São Paulo, SP, Brazil.

[5 ]Post-doctoral Scholar, MD, Radiologist at Unit of Computed Tomography – Instituto de Infectologia Emílio Ribas (IIER), São Paulo, SP, Brazil.

Author notes

Mailing Address: Dra. Marli Batista Fernandes Vermelho. Divisão de Apoio Diagnóstico e Terapêutico – Instituto de Infectologia Emílio Ribas. Avenida Doutor Arnaldo, 165, Cerqueira César. São Paulo, SP, Brazil, 01246-900. E-mail: marlivermelho@ 123456globo.com .

Article

DOI: 10.1590/0100-3984.2013.0025

PMC ID: 4433296

PubMed ID: 25987748

SO-VID: f70c820f-92a2-4b71-852a-4fd395a7e007

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 13 December 2013

Date accepted : 20 August 2014

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Abdominal alterations in disseminated paracoccidioidomycosis: computed tomography findings* Translated title: Alterações abdominais da paracoccidioidomicose disseminada: achados por tomografia computadorizada

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Abstract

Objective

Materials and Methods

Results

Conclusion

Translated abstract

Related collections

Electron Channelling Contrast Imaging (ECCI)

Most cited references 28

Paracoccidioidomycosis: an update.

[Guidelines in paracoccidioidomycosis].

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

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Journal

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Author notes

Article

History

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Cited by 11

Most referenced authors 203