Paracoccidioidomycosis in children: clinical presentation, follow-up and outcome
Autor(a) principal: | |
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Data de Publicação: | 2004 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista do Instituto de Medicina Tropical de São Paulo |
Texto Completo: | https://www.revistas.usp.br/rimtsp/article/view/30805 |
Resumo: | From February, 1981 to May, 2001, 63 children under 15 y old (ages 2 - 15 y, median = 8 y, mean ± 1 SD = 8 ± 3 y) presenting 70 episodes of Paracoccidioidomycosis were admitted. The main clinical manifestations and laboratory features observed upon admission were: lymph node enlargement (87.1%), fever (75.7%), weakness (48.6%), pallor (41.4%), hepatomegaly (40%), splenomegaly (35.7%), anemia (90%), hypergammaglobulinemia (88.5%), eosinophilia (75.5%) and hypoalbuminemia (72.5%). Moderate to severe malnutrition was detected in 35.7% of the episodes (Gomez's criterion). Radiographic and technetium studies showed bone lesions in 20 of the episodes, most of them being multiple lytic lesions, involving both long (70%) and plain bones (30%). First line treatment consisted of an association of sulfametoxazole-trimethoprin, which was used, exclusively, in 50 episodes. Follow-up of hemoglobin levels, number of eosinophils in the peripheral blood, albumin and gammaglobulin serum levels revealed significant sequential improvement one and six months after hospital admission, being quite useful to evaluate treatment effectiveness. Six patients died (9.3%) and four developed sequelae (6.3%) . In conclusion, the juvenile and disseminated forms can be observed in about 70% of the episodes of PCM occurring in children younger than 15 y old, most of them presenting with a febrile lymphoproliferative syndrome associated to anemia, eosinophilia and hypergammaglobulinemia. |
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Paracoccidioidomycosis in children: clinical presentation, follow-up and outcome Paracoccidioidomicose em crianças: apresentação clínica, seguimento e evolução ParacoccidioidomycosisParacoccidioides brasiliensisChildrenEosinophiliaHypergammaglobulinemiaSulfametoxazole-trimethoprin From February, 1981 to May, 2001, 63 children under 15 y old (ages 2 - 15 y, median = 8 y, mean ± 1 SD = 8 ± 3 y) presenting 70 episodes of Paracoccidioidomycosis were admitted. The main clinical manifestations and laboratory features observed upon admission were: lymph node enlargement (87.1%), fever (75.7%), weakness (48.6%), pallor (41.4%), hepatomegaly (40%), splenomegaly (35.7%), anemia (90%), hypergammaglobulinemia (88.5%), eosinophilia (75.5%) and hypoalbuminemia (72.5%). Moderate to severe malnutrition was detected in 35.7% of the episodes (Gomez's criterion). Radiographic and technetium studies showed bone lesions in 20 of the episodes, most of them being multiple lytic lesions, involving both long (70%) and plain bones (30%). First line treatment consisted of an association of sulfametoxazole-trimethoprin, which was used, exclusively, in 50 episodes. Follow-up of hemoglobin levels, number of eosinophils in the peripheral blood, albumin and gammaglobulin serum levels revealed significant sequential improvement one and six months after hospital admission, being quite useful to evaluate treatment effectiveness. Six patients died (9.3%) and four developed sequelae (6.3%) . In conclusion, the juvenile and disseminated forms can be observed in about 70% of the episodes of PCM occurring in children younger than 15 y old, most of them presenting with a febrile lymphoproliferative syndrome associated to anemia, eosinophilia and hypergammaglobulinemia. Foram analisados 70 episódios de Paracoccidioidomicose em 63 crianças com menos de 15 anos de idade (variação de 2 a 15 anos, mediana = 8 anos, média ± 1 DP = 8 ± 3 anos), no período de fevereiro de 1981 a maio de 2001. As principais manifestações clínicas e alterações laboratoriais à admissão foram: linfonodomegalia (87,1%), febre (75,7%), fraqueza (48,6%), palidez (41,4%), hepatomegalia (40,4%), esplenomegalia (35,7%), anemia (90%), hipergamaglobulinemia (88,5%), eosinofilia (75,5%) e hipoalbuminemia 72,5%. À admissão, 35,7% das crianças apresentavam desnutrição moderada e grave (critério de Gómez). Os resultados de radiografia simples e cintilografia óssea revelaram lesões ósseas em 20 episódios, a maioria constituída de lesões múltiplas e líticas, envolvendo ossos longos (70%) e planos (30%). A droga de escolha para o tratamento foi a associação sulfametoxazol-trimetoprina, sendo empregada isoladamente em 50 episódios. O seguimento de alguns resultados laboratoriais (dosagem de hemoglobina e contagem de eosinófilos no sangue periférico, dosagem de albumina e gamaglobulina séricas) revelou melhora significativa após o 1º e 6º mês da admissão, sendo muito útil para avaliação da eficácia terapêutica. Quatro pacientes evoluíram com seqüelas (6,3%) e seis (9,3%) morreram. Pode-se concluir que as formas juvenil e disseminada da PCM são prevalentes em crianças menores que 15 anos, ocorrendo em 70% dos episódios, apresentando-se como uma síndrome linfoproliferativa febril associada a anemia, eosinofilia e hipergamaglobulinemia. Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo2004-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rimtsp/article/view/30805Revista do Instituto de Medicina Tropical de São Paulo; Vol. 46 No. 3 (2004); 127-131 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 46 Núm. 3 (2004); 127-131 Revista do Instituto de Medicina Tropical de São Paulo; v. 46 n. 3 (2004); 127-131 1678-99460036-4665reponame:Revista do Instituto de Medicina Tropical de São Pauloinstname:Instituto de Medicina Tropical (IMT)instacron:IMTenghttps://www.revistas.usp.br/rimtsp/article/view/30805/32689Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Pauloinfo:eu-repo/semantics/openAccessPereira, Ricardo MendesBucaretchi, FábioBarison, Eliana de MeloHessel, GabrielTresoldi, Antonia Teresinha2012-07-07T18:28:03Zoai:revistas.usp.br:article/30805Revistahttp://www.revistas.usp.br/rimtsp/indexPUBhttps://www.revistas.usp.br/rimtsp/oai||revimtsp@usp.br1678-99460036-4665opendoar:2022-12-13T16:51:33.321473Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)true |
dc.title.none.fl_str_mv |
Paracoccidioidomycosis in children: clinical presentation, follow-up and outcome Paracoccidioidomicose em crianças: apresentação clínica, seguimento e evolução |
title |
Paracoccidioidomycosis in children: clinical presentation, follow-up and outcome |
spellingShingle |
Paracoccidioidomycosis in children: clinical presentation, follow-up and outcome Pereira, Ricardo Mendes Paracoccidioidomycosis Paracoccidioides brasiliensis Children Eosinophilia Hypergammaglobulinemia Sulfametoxazole-trimethoprin |
title_short |
Paracoccidioidomycosis in children: clinical presentation, follow-up and outcome |
title_full |
Paracoccidioidomycosis in children: clinical presentation, follow-up and outcome |
title_fullStr |
Paracoccidioidomycosis in children: clinical presentation, follow-up and outcome |
title_full_unstemmed |
Paracoccidioidomycosis in children: clinical presentation, follow-up and outcome |
title_sort |
Paracoccidioidomycosis in children: clinical presentation, follow-up and outcome |
author |
Pereira, Ricardo Mendes |
author_facet |
Pereira, Ricardo Mendes Bucaretchi, Fábio Barison, Eliana de Melo Hessel, Gabriel Tresoldi, Antonia Teresinha |
author_role |
author |
author2 |
Bucaretchi, Fábio Barison, Eliana de Melo Hessel, Gabriel Tresoldi, Antonia Teresinha |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Pereira, Ricardo Mendes Bucaretchi, Fábio Barison, Eliana de Melo Hessel, Gabriel Tresoldi, Antonia Teresinha |
dc.subject.por.fl_str_mv |
Paracoccidioidomycosis Paracoccidioides brasiliensis Children Eosinophilia Hypergammaglobulinemia Sulfametoxazole-trimethoprin |
topic |
Paracoccidioidomycosis Paracoccidioides brasiliensis Children Eosinophilia Hypergammaglobulinemia Sulfametoxazole-trimethoprin |
description |
From February, 1981 to May, 2001, 63 children under 15 y old (ages 2 - 15 y, median = 8 y, mean ± 1 SD = 8 ± 3 y) presenting 70 episodes of Paracoccidioidomycosis were admitted. The main clinical manifestations and laboratory features observed upon admission were: lymph node enlargement (87.1%), fever (75.7%), weakness (48.6%), pallor (41.4%), hepatomegaly (40%), splenomegaly (35.7%), anemia (90%), hypergammaglobulinemia (88.5%), eosinophilia (75.5%) and hypoalbuminemia (72.5%). Moderate to severe malnutrition was detected in 35.7% of the episodes (Gomez's criterion). Radiographic and technetium studies showed bone lesions in 20 of the episodes, most of them being multiple lytic lesions, involving both long (70%) and plain bones (30%). First line treatment consisted of an association of sulfametoxazole-trimethoprin, which was used, exclusively, in 50 episodes. Follow-up of hemoglobin levels, number of eosinophils in the peripheral blood, albumin and gammaglobulin serum levels revealed significant sequential improvement one and six months after hospital admission, being quite useful to evaluate treatment effectiveness. Six patients died (9.3%) and four developed sequelae (6.3%) . In conclusion, the juvenile and disseminated forms can be observed in about 70% of the episodes of PCM occurring in children younger than 15 y old, most of them presenting with a febrile lymphoproliferative syndrome associated to anemia, eosinophilia and hypergammaglobulinemia. |
publishDate |
2004 |
dc.date.none.fl_str_mv |
2004-06-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/30805 |
url |
https://www.revistas.usp.br/rimtsp/article/view/30805 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/30805/32689 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Paulo info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Paulo |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
dc.source.none.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo; Vol. 46 No. 3 (2004); 127-131 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 46 Núm. 3 (2004); 127-131 Revista do Instituto de Medicina Tropical de São Paulo; v. 46 n. 3 (2004); 127-131 1678-9946 0036-4665 reponame:Revista do Instituto de Medicina Tropical de São Paulo instname:Instituto de Medicina Tropical (IMT) instacron:IMT |
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Instituto de Medicina Tropical (IMT) |
instacron_str |
IMT |
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IMT |
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Revista do Instituto de Medicina Tropical de São Paulo |
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Revista do Instituto de Medicina Tropical de São Paulo |
repository.name.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT) |
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