Paracoccidioidomicose é esporotricose associada à imunossupressão
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Abstract
Paracoccidioidomycosis is caused by Paracoccidioides brasiliensis, a dimorphic fungus, prevalent in tropical and subtropical America. It is rare in the United States of America, Canada, Asia and Europe and in these countries it is related to immigrants from endemic areas. Paracoccidioidomycosis associated with immunosuppression runs a course with rapid progression and dissemination of the disease, with many cutaneous lesions. The mortality rate is up to 35% when associated with HIV infection or AIDS. The diagnosis depends on visualization of the agent through direct examination, histopathology, or culture. First choice treatment is done with Amphotericin B deoxycholate. Itraconazole is an option for long term treatment. Sporotrichosis is caused by Sporothrix schenckii, the species of reference. Other species have been considered such as: Sporothrix brasiliensis, S.globosa and S.mexicana and the S.schenckii var. lurei. It is a ubiquitous disease although more prevalent in tropical and subtropical areas. Currently, it has been reported as a zoonotic disease of cats and dogs, with transmission to their owners in the city of Rio de Janeiro (Brazil). Sporotrichosis associated to immunosuppression is uncommon or underreported. There were 34 cases in association with HIV infection or AIDS reported so far. Presenting with disseminated disease and non cutaneous lesions including joints, lungs and central nervous system. Amphotericin B deoxycholate is the first choice for treatment and itraconazol considered an alternative.
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AIDS, Corticosteroid therapy, HIV infection, Immunosuppression, Paracoccidioidomycosis, Renal transplant, Sporotrichosis, amphotericin B deoxycholate, itraconazole, acquired immune deficiency syndrome, Asia, Brazil, Canada, cat, central nervous system, disease association, disease course, dog, drug choice, endemic disease, Europe, fungus culture, fungus transmission, histopathology, human, Human immunodeficiency virus infection, immigrant, immune deficiency, long term care, lung, mortality, nonhuman, Paracoccidioides brasiliensis, review, skin manifestation, South American blastomycosis, Sporothrix, Sporothrix brasiliensis, Sporothrix globosa, Sporothrix mexicana, Sporothrix schenckii, sporotrichosis, tropics, United States, zoonosis
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Portuguese
Citation
Medicina Cutanea Ibero-Latino-Americana, v. 37, n. 4, p. 159-170, 2009.
