Report of two cases of neuro-paracoccidiomycosis
DOI:
https://doi.org/10.53732/rccsalud/2023.e5202Keywords:
paracoccidioidomycosis, invasive fungal infections, brain abscessAbstract
Paracoccidioidomycosis is the most common systemic mycosis in Latin America. Central nervous system (CNS) involvement is described in 10-27%. The objective is to present two male patients with neuroparacoccidioidomycosis admitted to the Department of Internal Medicine of the National Hospital, one in 2017 and the other in 2021. Both patients presented neurological symptoms with improvement of the lesions with amphotericin B. The granulomas brain cells of PCM may have pseudotumor behavior. Regression of the lesions was complete with amphotericin B and trimethoprim sulfamethoxazole in the first case and amphotericin B and itraconazole in the second case.
References
Gomes Carvalho Neto E, Coletto A, Biazus PG, Pereira Dos Santos I, Rieder CRM, de Castro Ribeiro M. Neuroparacoccidioidomycosis. Neurol Neuroimmunol Neuroinflamm. 2018 Nov 7;6(1):e519. 10.1212/NXI.0000000000000519
Freitas APPO, Moll Souza RS, Falqueto A, Mendes Peçanha P. Extensive Neuroparacoccidioidomycosis Lesions with Mild Neurological Manifestations. Am J Trop Med Hyg. 2021 Sep 27;105(5):1127-1128. 10.4269/ajtmh.19-0694
Rojas-Jaimes Jesús, Castillo Cordova Raul, Tárraga Gonzales Delza. Paracoccidiomicosis en el sistema nervioso central: reporte de un caso. Rev. perú. med. exp. salud publica [Internet]. 2015[citado 2022 Ago 24] ; 32(1): 183-186. http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1726-46342015000100026&lng=es.
Alves Júnior SF, Marchiori E, Ventura N. Paracoccidioidomycosis of the central nervous system with pulmonary involvement: typical imaging findings. Acta Neurol Belg. 2021 Jan 4. 10.1007/s13760-020-01571-4.
Rosa Junior M, Amorim AC, Baldon IV et al. Paracoccidioidomycosis of the central nervous system: CT and MR imaging findings. AJNR Am J Neuroradiol. 2019. 40(10):1681–1688. 10.3174/ajnr.A6203
Grossman R, Ram Z. Posterior fossa intra-axial tumors in adults. World Neurosurg. 2016. 88:140–145. 10.1016/j.wneu.2015.12.066
Elias J Jr, dos Santos AC, Carlotti CG Jr, Colli BO, Canheu A, Matias C, Furlanetti L, Martinez R, Takayanagui OM, Sakamoto AC, Serafini LN, Chimelli L. Central nervous system paracoccidioidomycosis: diagnosis and treatment. Surg Neurol. 2005;63 Suppl 1:S13-21; discussion S21. 10.1016/j.surneu.2004.09.019
Narayan M, Jayavelu S, Goel H, Rosenthal JR, Aisenberg GM. A Case of Neuroparacoccidioidomycosis in Houston, Texas. Cureus. 2022;14(1):e21129. 10.7759/cureus.21129
de Macedo PM, Falcão EMM, Freitas DFS, Freitas AD, Coutinho ZF, Muniz MM, et al. Neuroparacoccidioidomycosis: A 13-Year Cohort Study, Rio de Janeiro, Brazil. J Fungi (Basel). 2020;6(4):303. 10.3390/jof6040303
Riechelmann RS, Rodríguez LH, Avelar TM, Xander PA, da Costa GH, Cannoni LF, de Aguiar GB, Veiga JC. Isolated neuroparacoccidioidomycosis as a pseudotumoral lesion in the absence of systemic disease. Surg Neurol Int. 2020 Jun 13;11:151. 10.25259/SNI_224_2020
Carvalho de Medeiros F, Curcio de Moraes A, Buzelin Nunes M, Dellaretti M. Neuroparacoccidioidomycosis mimicking brain tumor in an immunocompetent patient. Rev Neurol (Paris). 2018 Apr;174(4):268-271. 10.1016/j.neurol.2017.10.015