The lung in paracoccidioidomycosis: new insights into old problems

Detalhes bibliográficos
Autor(a) principal: Costa, Andre Nathan
Data de Publicação: 2013
Outros Autores: Benard, Gil, Albuquerque, Andre Luis Pereira, Fujita, Carmem Lucia, Magri, Adriana Satie Kono, Salge, João Marcos, Shikanai-Yasuda, Maria Aparecida, Carvalho, Carlos Roberto Ribeiro
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Clinics
Texto Completo: https://www.revistas.usp.br/clinics/article/view/76785
Resumo: OBJECTIVES: Chronic paracoccidioidomycosis can diffusely affect the lungs. Even after antifungal therapy, patients may present with residual respiratory abnormalities due to fungus-induced lung fibrosis. METHODS: A cross-sectional analysis of 50 consecutive inactive, chronic paracoccidioidomycosis patients was performed using high resolution computed tomography, pulmonary function tests, ergospirometry, the six-minute walk test and health-related quality of life questionnaires. RESULTS: Radiological abnormalities were present in 98% of cases, the most frequent of which were architectural distortion (90%), reticulate and septal thickening (88%), centrilobular and paraseptal emphysema (84%) and parenchymal bands (74%). Patients typically presented with a mild obstructive disorder and a mild reduction in diffusion capacity with preserved exercise capacity, including VO2max and six-minute walking distance. Patient evaluation with the Saint-George Respiratory Questionnaire showed low impairment in the health-related quality of life, and the Medical Research Council questionnaire indicated a low dyspnea index. There were, however, patients with significant oxygen desaturation upon exercise that was associated with respiratory distress compared with the non-desaturated patients. The initial counterimmunoelectrophoresis of these patients was higher and lung emphysema was more prominent; however, there were no differences in the interstitial fibrotic tomographic abnormalities, tobacco exposure, functional responses, exercise capacity or quality of life. CONCLUSIONS: Inactive, chronic paracoccidioidomycosis patients show persistent and disseminated radiological abnormalities by high resolution computed tomography, short impairments in pulmonary function and low impacts on aerobic capacity and quality of life. However, there was a subset of individuals whose functional impairment was more severe. These patients present with higher initial serology and more severe emphysema, stressing the importance of adequate treatment associated with tobacco exposure cessation.
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spelling The lung in paracoccidioidomycosis: new insights into old problemsOBJECTIVES: Chronic paracoccidioidomycosis can diffusely affect the lungs. Even after antifungal therapy, patients may present with residual respiratory abnormalities due to fungus-induced lung fibrosis. METHODS: A cross-sectional analysis of 50 consecutive inactive, chronic paracoccidioidomycosis patients was performed using high resolution computed tomography, pulmonary function tests, ergospirometry, the six-minute walk test and health-related quality of life questionnaires. RESULTS: Radiological abnormalities were present in 98% of cases, the most frequent of which were architectural distortion (90%), reticulate and septal thickening (88%), centrilobular and paraseptal emphysema (84%) and parenchymal bands (74%). Patients typically presented with a mild obstructive disorder and a mild reduction in diffusion capacity with preserved exercise capacity, including VO2max and six-minute walking distance. Patient evaluation with the Saint-George Respiratory Questionnaire showed low impairment in the health-related quality of life, and the Medical Research Council questionnaire indicated a low dyspnea index. There were, however, patients with significant oxygen desaturation upon exercise that was associated with respiratory distress compared with the non-desaturated patients. The initial counterimmunoelectrophoresis of these patients was higher and lung emphysema was more prominent; however, there were no differences in the interstitial fibrotic tomographic abnormalities, tobacco exposure, functional responses, exercise capacity or quality of life. CONCLUSIONS: Inactive, chronic paracoccidioidomycosis patients show persistent and disseminated radiological abnormalities by high resolution computed tomography, short impairments in pulmonary function and low impacts on aerobic capacity and quality of life. However, there was a subset of individuals whose functional impairment was more severe. These patients present with higher initial serology and more severe emphysema, stressing the importance of adequate treatment associated with tobacco exposure cessation.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2013-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/7678510.1590/clin.v68i4.76785Clinics; Vol. 68 No. 4 (2013); 441-448Clinics; v. 68 n. 4 (2013); 441-448Clinics; Vol. 68 Núm. 4 (2013); 441-4481980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/76785/80647Costa, Andre NathanBenard, GilAlbuquerque, Andre Luis PereiraFujita, Carmem LuciaMagri, Adriana Satie KonoSalge, João MarcosShikanai-Yasuda, Maria AparecidaCarvalho, Carlos Roberto Ribeiroinfo:eu-repo/semantics/openAccess2014-03-21T18:32:40Zoai:revistas.usp.br:article/76785Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2014-03-21T18:32:40Clinics - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv The lung in paracoccidioidomycosis: new insights into old problems
title The lung in paracoccidioidomycosis: new insights into old problems
spellingShingle The lung in paracoccidioidomycosis: new insights into old problems
Costa, Andre Nathan
title_short The lung in paracoccidioidomycosis: new insights into old problems
title_full The lung in paracoccidioidomycosis: new insights into old problems
title_fullStr The lung in paracoccidioidomycosis: new insights into old problems
title_full_unstemmed The lung in paracoccidioidomycosis: new insights into old problems
title_sort The lung in paracoccidioidomycosis: new insights into old problems
author Costa, Andre Nathan
author_facet Costa, Andre Nathan
Benard, Gil
Albuquerque, Andre Luis Pereira
Fujita, Carmem Lucia
Magri, Adriana Satie Kono
Salge, João Marcos
Shikanai-Yasuda, Maria Aparecida
Carvalho, Carlos Roberto Ribeiro
author_role author
author2 Benard, Gil
Albuquerque, Andre Luis Pereira
Fujita, Carmem Lucia
Magri, Adriana Satie Kono
Salge, João Marcos
Shikanai-Yasuda, Maria Aparecida
Carvalho, Carlos Roberto Ribeiro
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Costa, Andre Nathan
Benard, Gil
Albuquerque, Andre Luis Pereira
Fujita, Carmem Lucia
Magri, Adriana Satie Kono
Salge, João Marcos
Shikanai-Yasuda, Maria Aparecida
Carvalho, Carlos Roberto Ribeiro
description OBJECTIVES: Chronic paracoccidioidomycosis can diffusely affect the lungs. Even after antifungal therapy, patients may present with residual respiratory abnormalities due to fungus-induced lung fibrosis. METHODS: A cross-sectional analysis of 50 consecutive inactive, chronic paracoccidioidomycosis patients was performed using high resolution computed tomography, pulmonary function tests, ergospirometry, the six-minute walk test and health-related quality of life questionnaires. RESULTS: Radiological abnormalities were present in 98% of cases, the most frequent of which were architectural distortion (90%), reticulate and septal thickening (88%), centrilobular and paraseptal emphysema (84%) and parenchymal bands (74%). Patients typically presented with a mild obstructive disorder and a mild reduction in diffusion capacity with preserved exercise capacity, including VO2max and six-minute walking distance. Patient evaluation with the Saint-George Respiratory Questionnaire showed low impairment in the health-related quality of life, and the Medical Research Council questionnaire indicated a low dyspnea index. There were, however, patients with significant oxygen desaturation upon exercise that was associated with respiratory distress compared with the non-desaturated patients. The initial counterimmunoelectrophoresis of these patients was higher and lung emphysema was more prominent; however, there were no differences in the interstitial fibrotic tomographic abnormalities, tobacco exposure, functional responses, exercise capacity or quality of life. CONCLUSIONS: Inactive, chronic paracoccidioidomycosis patients show persistent and disseminated radiological abnormalities by high resolution computed tomography, short impairments in pulmonary function and low impacts on aerobic capacity and quality of life. However, there was a subset of individuals whose functional impairment was more severe. These patients present with higher initial serology and more severe emphysema, stressing the importance of adequate treatment associated with tobacco exposure cessation.
publishDate 2013
dc.date.none.fl_str_mv 2013-04-01
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/clinics/article/view/76785
10.1590/clin.v68i4.76785
url https://www.revistas.usp.br/clinics/article/view/76785
identifier_str_mv 10.1590/clin.v68i4.76785
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/clinics/article/view/76785/80647
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
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dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
dc.source.none.fl_str_mv Clinics; Vol. 68 No. 4 (2013); 441-448
Clinics; v. 68 n. 4 (2013); 441-448
Clinics; Vol. 68 Núm. 4 (2013); 441-448
1980-5322
1807-5932
reponame:Clinics
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
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institution USP
reponame_str Clinics
collection Clinics
repository.name.fl_str_mv Clinics - Universidade de São Paulo (USP)
repository.mail.fl_str_mv ||clinics@hc.fm.usp.br
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