Paracoccidioidomycosis due to Paracoccidioides lutzii complicated with adrenal injury and pulmonary arterial hypertension
Autor(a) principal: | |
---|---|
Data de Publicação: | 2020 |
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/183536 |
Resumo: | 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. |
id |
IMT-1_24098e6def63d6873520c459caa2698b |
---|---|
oai_identifier_str |
oai:revistas.usp.br:article/183536 |
network_acronym_str |
IMT-1 |
network_name_str |
Revista do Instituto de Medicina Tropical de São Paulo |
repository_id_str |
|
spelling |
Paracoccidioidomycosis due to Paracoccidioides lutzii complicated with adrenal injury and pulmonary arterial hypertensionParacoccidioidomycosisParacoccidioides lutziiPulmonary arterial hypertensionParacoccidioidomycosis 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.Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo2020-11-13info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rimtsp/article/view/183536Revista do Instituto de Medicina Tropical de São Paulo; Vol. 62 (2020); e89Revista do Instituto de Medicina Tropical de São Paulo; Vol. 62 (2020); e89Revista do Instituto de Medicina Tropical de São Paulo; v. 62 (2020); e891678-99460036-4665reponame:Revista do Instituto de Medicina Tropical de São Pauloinstname:Instituto de Medicina Tropical (IMT)instacron:IMTenghttps://www.revistas.usp.br/rimtsp/article/view/183536/170075Copyright (c) 2021 Revista do Instituto de Medicina Tropical de São Paulohttp://creativecommons.org/licenses/by-nc/4.0info:eu-repo/semantics/openAccessGaspar, Gilberto Gambero Cocio, Tiago Alexandre Nascimento, Erika Fabro, Alexandre Todorovic Kress, Marcia Regina von Zeska Bagagli, Eduardo Martinez, Roberto 2021-03-24T17:18:15Zoai:revistas.usp.br:article/183536Revistahttp://www.revistas.usp.br/rimtsp/indexPUBhttps://www.revistas.usp.br/rimtsp/oai||revimtsp@usp.br1678-99460036-4665opendoar:2022-12-13T16:52:55.318809Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)true |
dc.title.none.fl_str_mv |
Paracoccidioidomycosis due to Paracoccidioides lutzii complicated with adrenal injury and pulmonary arterial hypertension |
title |
Paracoccidioidomycosis due to Paracoccidioides lutzii complicated with adrenal injury and pulmonary arterial hypertension |
spellingShingle |
Paracoccidioidomycosis due to Paracoccidioides lutzii complicated with adrenal injury and pulmonary arterial hypertension Gaspar, Gilberto Gambero Paracoccidioidomycosis Paracoccidioides lutzii Pulmonary arterial hypertension |
title_short |
Paracoccidioidomycosis due to Paracoccidioides lutzii complicated with adrenal injury and pulmonary arterial hypertension |
title_full |
Paracoccidioidomycosis due to Paracoccidioides lutzii complicated with adrenal injury and pulmonary arterial hypertension |
title_fullStr |
Paracoccidioidomycosis due to Paracoccidioides lutzii complicated with adrenal injury and pulmonary arterial hypertension |
title_full_unstemmed |
Paracoccidioidomycosis due to Paracoccidioides lutzii complicated with adrenal injury and pulmonary arterial hypertension |
title_sort |
Paracoccidioidomycosis due to Paracoccidioides lutzii complicated with adrenal injury and pulmonary arterial hypertension |
author |
Gaspar, Gilberto Gambero |
author_facet |
Gaspar, Gilberto Gambero Cocio, Tiago Alexandre Nascimento, Erika Fabro, Alexandre Todorovic Kress, Marcia Regina von Zeska Bagagli, Eduardo Martinez, Roberto |
author_role |
author |
author2 |
Cocio, Tiago Alexandre Nascimento, Erika Fabro, Alexandre Todorovic Kress, Marcia Regina von Zeska Bagagli, Eduardo Martinez, Roberto |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Gaspar, Gilberto Gambero Cocio, Tiago Alexandre Nascimento, Erika Fabro, Alexandre Todorovic Kress, Marcia Regina von Zeska Bagagli, Eduardo Martinez, Roberto |
dc.subject.por.fl_str_mv |
Paracoccidioidomycosis Paracoccidioides lutzii Pulmonary arterial hypertension |
topic |
Paracoccidioidomycosis Paracoccidioides lutzii Pulmonary arterial hypertension |
description |
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. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-11-13 |
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/183536 |
url |
https://www.revistas.usp.br/rimtsp/article/view/183536 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/183536/170075 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2021 Revista do Instituto de Medicina Tropical de São Paulo http://creativecommons.org/licenses/by-nc/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2021 Revista do Instituto de Medicina Tropical de São Paulo http://creativecommons.org/licenses/by-nc/4.0 |
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. 62 (2020); e89 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 62 (2020); e89 Revista do Instituto de Medicina Tropical de São Paulo; v. 62 (2020); e89 1678-9946 0036-4665 reponame:Revista do Instituto de Medicina Tropical de São Paulo instname:Instituto de Medicina Tropical (IMT) instacron:IMT |
instname_str |
Instituto de Medicina Tropical (IMT) |
instacron_str |
IMT |
institution |
IMT |
reponame_str |
Revista do Instituto de Medicina Tropical de São Paulo |
collection |
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) |
repository.mail.fl_str_mv |
||revimtsp@usp.br |
_version_ |
1798951653087379456 |