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Paracoccidioidomycosis
Published in Rebecca A. Cox, Immunology of the Fungal Diseases, 2020
Beatriz Jimenez-Finkel, Angela Restrepo-Moreno
Based on these findings, a model for the pathogenesis of paracoccidioidomycosis was proposed.31 From its exogenous habitat and via the inhalation route, P. brasiliensis reaches the lungs, where the primary infection takes place. This initial form is asymptomatic and allows the fungus to accommodate to tissue conditions. Probably simultaneously with inhalation or soon thereafter, the fungus is disseminated via blood and/or lymph channels to colonize neighboring or distant reticuloendothelial structures, but still causing no symptoms.
Ketoconazole
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
The classic therapy for paracoccidioidomycosis was sulphonamides, which are inexpensive, effective in 70% of patients treated for 2–3 years, and associated with a 35% relapse rate (Restrepo, 1994). Ketoconazole treatment with doses of 200–400 mg daily for 6–12 months is associated with a 90% response rate and 10% relapse rate. Ketoconazole therapy was also associated with a lower mortality rate (Restrepo et al., 1985a; Restrepo et al., 1985b; Vargas and Recacoechea, 1988). Rapid healing of mucocutaneous lesions occurs within 2–6 months of treatment with ketoconazole, whereas the pulmonary and lymph node lesions require longer therapy (6 months) before improvement is noted. Pulmonary fibrosis often developed and was unaffected by treatment (Restrepo et al., 1985a; Brummer et al., 1993). Itraconazole is currently considered the drug of choice for paracoccidioidomycosis because of a lower rate of adverse reactions, greater potency with dosing of 100 mg daily, shorter treatment period (6 months), and reduced relapse rate compared with ketoconazole. Patients who have relapsed on ketoconazole have been successfully treated with itraconazole (Restrepo, 1994). A recent pilot study demonstrated that voriconazole is as effective as itraconazole for treatment of paracoccidioidomycosis (Queiroz-Telles et al., 2007).
Serodiagnosis: Antibody and Antigen Detection
Published in Johan A. Maertens, Kieren A. Marr, Diagnosis of Fungal Infections, 2007
Christine J. Morrison, David W. Warnock
The definitive diagnosis of paracoccidioidomycosis depends on microscopic examination and culture. However, isolation and identification of Paracoccidioides brasiliensis from clinical specimens may take up to four weeks. In this situation, serologic tests are useful for a rapid presumptive diagnosis, particularly in cases of disseminated disease (251). Levels of IgG antibodies to P. brasiliensis are usually elevated in immunocompetent patients with untreated infection, and these levels have been shown to be useful for monitoring the response to treatment of patients with acute or chronic forms of the disease (252). Antibody detection is less useful for the diagnosis of paracoccidioidomycosis in persons with AIDS.
Zoonotic fungal diseases and animal ownership in Nigeria
Published in Alexandria Journal of Medicine, 2018
Adebowale I. Adebiyi, Daniel O. Oluwayelu
Paracoccidioidomycosis is transmitted in an air-borne manner, in both humans and animals, by inhalation of infective conidia present in the environment or through injuries of the skin and mucous membranes.90,91 The disease has been shown to occur in several species of domestic and wild animals including cows, horses, armadillos, sheep, monkeys, guinea-pigs, raccoons, porcupine and chickens (reviewed in 92). Natural PCM has also been reported in dogs91,93 and cats94; dogs living in rural areas have been reported to have a higher rate of infection than those living in the urban areas.95 Furthermore, PCM has been associated with residence and professional occupation in the rural area and may be favoured by contact with coffee cultures, armadillos and bats.96–98 In addition, serological surveys or skin tests with P. brasiliensis antigens have revealed the existence of PCM infection in cats, dogs, chickens, pigs, cattle, horses, sheep, goats, rabbits, monkeys, and in other free or captive wild animals.99.
The expanding use of matrix-assisted laser desorption/ionization-time of flight mass spectroscopy in the diagnosis of patients with mycotic diseases
Published in Expert Review of Molecular Diagnostics, 2019
Thomas J. Walsh, Matthew W. McCarthy
Two species of the genus Paracoccidioides, P. brasiliensis and P. lutzii, are now considered the causal agents of paracoccidioidomycosis (PCM), the most important mycotic infection in immunocompetent hosts in Latin America [59]. One group demonstrated that these two species could be reliably identified with MALDI-TOF MS with log score values of >2.0 [60]. Similar work has been done with other dimorphic fungi [61,62].
Disseminated histoplasmosis: case report and review of the literature
Published in Acta Clinica Belgica, 2018
Séverine Evrard, Philippe Caprasse, Pierre Gavage, Myriam Vasbien, Jean Radermacher, Marie-Pierre Hayette, Rosalie Sacheli, Marjan Van Esbroeck, Lieselotte Cnops, Eric Firre, Laurent Médart, Filip Moerman, Jean-Marc Minon
Differential diagnosis should also be made with other deep mycoses such as coccidiomycosis, paracoccidioidomycosis, and blastomycosis. These mycoses all have a similar pathogenesis, as the inoculum enters the host through the respiratory tract. They can all cause TB-like pulmonary lesions. Nonetheless, they differ in epidemiology and morphological aspects. PCR techniques may also prove very useful [6].