Paracoccidioidomycosis due to Paracoccidioides lutzii complicated with adrenal injury and pulmonary arterial hypertension
ABSTRACT Paracoccidioidomycosis caused by Paracoccidioides lutzii is endemic in the Midwest of Brazil and its clinical spectrum is still little known due to the recent identification of this fungal species. A patient resident in Southeast Brazil, but who had lived for many years in the Midwest region, presented with skin injuries, chronic cough and bilateral adrenal involvement. Paracoccidioides spp. was isolated in culture from a skin lesion biopsy. This isolate was later identified as P. lutzii using gene sequencing. A favorable initial response to treatment with itraconazole was observed, but a few weeks later, the patient developed respiratory failure and worsening of lung lesions. Evaluation by computed tomography and echocardiography were suggestive of pulmonary arterial hypertension, and a bronchoscopic biopsy showed peribronchial remodeling. The patient completed the antifungal treatment but maintained the respiratory dysfunction. The reported case shows that P. lutzii can be isolated from patients in a geographic area far from the place of infection acquisition and that, as P. brasiliensis , it can cause adrenal injury and cardio-respiratory complications as a consequence of excessive necrosis and fibrosis.
Main Authors: | Gaspar,Gilberto Gambero, Cocio,Tiago Alexandre, Guioti-Puga,Fernanda, Nascimento,Erika, Fabro,Alexandre Todorovic, Kress,Marcia Regina von Zeska, Bagagli,Eduardo, Martinez,Roberto |
---|---|
Format: | Digital revista |
Language: | English |
Published: |
Instituto de Medicina Tropical de São Paulo
2020
|
Online Access: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652020000100522 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
Similar Items
-
Paracoccidioides brasiliensis AND Paracoccidioides lutzii, A SECRET LOVE AFFAIR
by: ARANTES,Thales Domingos, et al.
Published: (2015) -
Use of fluorescent oligonucleotide probes for differentiation between Paracoccidioides brasiliensis and Paracoccidioides lutzii in yeast and mycelial phase
by: Arantes,Thales Domingos, et al.
Published: (2017) -
Identification of Paracoccidioides brasiliensis in adrenal glands biopsies of two patients with paracoccidioidomycosis and adrenal insufficiency
by: Agudelo,Carlos Andrés, et al.
Published: (2009) -
Serological diagnosis of paracoccidioidomycosis using a Paracoccidioides spp. comercial antigen and the counterimmunoelectrophoresis method
by: Cocio,Tiago Alexandre, et al.
Published: (2021) -
Proteomic profile response of Paracoccidioides lutzii to the antifungal argentilactone.
by: PRADO, R. S., et al.
Published: (2015-09-09)