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NEUROPARACOCCIDIOIDOMYCOSIS: ANALYSIS OF 13 CASES OBSERVED IN AN ENDEMIC AREA IN BRAZIL
Paniago, Anamaria Mello Miranda et al. | Date Issued: 2006
Author
Paniago, Anamaria Mello Miranda
Oliveira, Priscilla Alexandrino de
Aguiar, Eliana Setti Albuquerque
Aguiar, José Ivan Albuquerque
Cunha, Rivaldo Venâncio da
Leme, Ligia Maria
Salgado, Pedro Rippel
Domingos, João Américo
Ferraz, Renato Lima
Chang, Marilene Rodrigues
Bóia, Márcio Neves
Wanke, Bodo
Affilliation
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Programa de Pós Graduação em Medicina Tropical. Rio de Janeiro, RJ, Brasil / Universidade Federal de Mato Grosso do Sul. Departamento de Medicina Tropical. Campo Grande, MS, Brasil.
Universidade Federal de Mato Grosso do Sul. Departamento de Medicina Tropical. Campo Grande, MS, Brasil.
Universidade Federal de Mato Grosso do Sul. Departamento de Medicina Tropical. Campo Grande, MS, Brasil.
Universidade Federal de Mato Grosso do Sul. Departamento de Medicina Tropical. Campo Grande, MS, Brasil.
Universidade Federal de Mato Grosso do Sul. Departamento de Medicina Tropical. Campo Grande, MS, Brasil.
Universidade Federal de Mato Grosso do Sul. Departamento de Medicina Tropical. Campo Grande, MS, Brasil.
Universidade Federal de Mato Grosso do Sul. Departamento de Medicina Tropical. Campo Grande, MS, Brasil.
Universidade Federal de Mato Grosso do Sul. Departamento de Medicina Tropical. Campo Grande, MS, Brasil.
Universidade Federal de Mato Grosso do Sul. Departamento de Medicina Tropical. Campo Grande, MS, Brasil.
Universidade Federal de Mato Grosso do Sul. Hospital Universitário. Laboratório de Análises Clínicas. Campo Grande, MS, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Programa de Pós Graduação em Medicina Tropical. Rio de Janeiro, RJ, Brasil / Universidade Federal de Mato Grosso do Sul. Departamento de Medicina Tropical. Campo Grande, MS, Brasil.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Serviço de Micologia. Rio de Janeiro, RJ, Brasil.
Abstract
The epidemiological, clinical and laboratory features of 13 cases of neuroparacoccidioidomycosis (NPCM) were analysed. All patients were men, with a mean age of 41.6 years. The lungs were involved in 11 cases (84.6%) and only two cases had mycosis limited to the central nervous system. Co-morbidity was observed in four patients (malignant neoplasm in three and diabetes mellitus in one). The most frequent neurological manifestations were paresis (eight cases), headache (five cases) and gait disturbance (four cases). Neuroimaging diagnosis showed a predominance of multiple round lesions with ring enhancement following contrast medium injection. Lesions were seen in the brain hemispheres (nine cases), thalamus (nine cases), cerebellum (four cases), brainstem (four cases) and spinal cord (four cases). Most cases responded well to therapy. Lesions with enhancement following contrast medium injection persisted in four patients for a period of 6 months to 8 years. These findings emphasize the importance of considering NPCM in the differential diagnosis of brain and spinal cord lesions in endemic areas of paracoccidioidomycosis.
Keywords in Portuguese
Paracoccidioidomycosis
Paracoccidioides brasiliensis
Sistema nervoso central
Medula espinhal
Manifestações neurológicas
Brasil
 
Keywords
Paracoccidioidomycosis
Paracoccidioides brasiliensis
Central nervous system
Spinal cord
Neurological manifestations
Brazil
 
Publisher
Elsevier
Citation
PANIAGO, Anamaria Mello Miranda et al. Neuroparacoccidioidomycosis: analysis of 13 cases observed in an endemic area in Brazil. Transactions of the Royal Society of Tropical Medicine and Hygiene, v. 101, p. 414-420, 2007.
DOI
10.1016/j.trstmh.2006.07.006
ISSN
0035-9203