期刊
MYCOPATHOLOGIA
卷 182, 期 9-10, 页码 915-919出版社
SPRINGER
DOI: 10.1007/s11046-017-0152-6
关键词
Paracoccidioides brasiliensis S1; Acute juvenile paracoccidioidomycosis; Hepatic disease; Portal hypertension; Complications
类别
资金
- Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro [E-26/010.002203/2015] Funding Source: Medline
- Conselho Nacional de Desenvolvimento Científico e Tecnológico [304976/2013-0] Funding Source: Medline
Paracoccidioidomycosis (PCM) is a neglected systemic mycosis endemic to Latin America caused by dimorphic fungi of the genus Paracoccidioides. The acute juvenile PCM is a severe type of presentation that usually affects young vulnerable patients and rarely progresses to portal hypertension. Here, two cases of liver disease and portal hypertension as complications of acute juvenile PCM are reported. Diagnosis of PCM was performed by isolation of the fungus and molecular identification of the strains provided through partial sequencing of two protein encoding genes, arf and gp43. Genotypic analysis revealed that Paracoccidioides brasiliensis S1 was the phylogenic species involved in both cases. Patients presented a good clinical response to amphotericin B and sulfamethoxazole-trimethoprim. These results highlight the importance of the interdisciplinary approach in patients with severe forms of PCM to avoid and treat complications, and the necessity of further investigations focusing on host-pathogen interaction in order to explain the broad clinical spectrum in PCM as well as the severity and poor outcome in some clinical cases.
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