Paracoccidioidomycosis overview
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Overview
Paracoccidioidomycosis (also known as Lutz-Splendore-Almeida disease or Brazilian blastomycosis) is a mycosis caused by the fungus Paracoccidioides brasiliensis. Sometimes called South American blastomycosis, paracoccidioidomycosis is caused by a different fungus than that which causes blastomycosis.
Historical Perspective
Lutz-Splendore-de Almeida disease is named for the physicians Adolfo Lutz, Alfonso Splendore, and Floriano Paulo de Almeida, who first characterized the disease in Brazil in the early 20th century. [1]
Classification
Paracoccidioidomycosis may be classified according to Franco et al. in 1987 into: paracoccidioidomycosis infection, paracoccidioidomycosis disease, paracoccidioidomycosis associated with inmunosupression and residual form (sequela). Based on the duration of symptoms, paracoccidioidomycosis disease may be classified into: acute, subacute or chronic. The chronic form can be subclassified into: unifocal and multifocal.[2][3]
Pathophysiology
Spores of Paracoccidioides spp. are transmitted via the respiratory route to the human host. Following transmission, Paracoccidiodes spp. particles invade the terminal bronchioles and alveoli where granulomas are formed, but can be inactive for approximately 40 years. [3] On microscopic histopathological analysis, a pilot's wheel or Mickey mouse ears-like appearance are a characteristic finding of PMC. [4] [5] [6]
Causes
Differential Diagnosis
Paracoccidioidomycosis must be differentiated from tuberculosis, histoplasmosis and metastasis. [7]
Epidemiology and Demographics
Paracoccidioidomycosis has been reported as an autochthonous disease, that tends to affect agriculture workers from southern Mexico to northern Argentina. Paracoccidioidomycosis is prevalent in Brazil, Colombia, Venezuela, and Argentina, and is classically associated with individuals from rural areas. The typical patient is a man aged 30 to 50 years. [8] PMC disease affects men, more commonly than women. However, PMC infection can affect anyone. [3]
Risk Factors
Common risk factors in the development of paracoccidioidomycosis disease are: age, gender, poor hygiene, occupation, malnutrition, tabacco and alcohol consumption. [2] [9]
Natural History, Complications and Prognosis
In paracoccidioidomycosis disease, the majority of infected patients do not develop any symptoms.[3] The acute form affects 5% of the patients, and it has a more rapid and severe evolution. [10][11] Meanwhile, the chronic form which represents 90% of the patients, has a more slow evolution. Chronic PMC most frequently develops pulmonary symptoms which can leave severe sequela. [12] [13] Complications that can develop as a result of PMC are: chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, bullae, pulmonary hypertension, dyspnea, adrenal gland insufficiency, dysphonia, laryngeal lesions (such as glottis estenosis), microstomia, seizures, motor deficiency. [13] [14] [11] The prognosis of paracoccidioidomycosis is good with treatment. Without treatment, PMC will result in death due to disease complications. The presence of late diagnosis and sequelae is associated with a particularly poor prognosis among patients with PMC. [15]
References
- ↑ Paracoccidioidomycosis. Wikipedia.https://en.wikipedia.org/wiki/Paracoccidioidomycosis. Accessed on January 12, 2015
- ↑ 2.0 2.1 de Oliveira HC, Assato PA, Marcos CM, Scorzoni L, de Paula E Silva AC, Da Silva Jde F; et al. (2015). "Paracoccidioides-host Interaction: An Overview on Recent Advances in the Paracoccidioidomycosis". Front Microbiol. 6: 1319. doi:10.3389/fmicb.2015.01319. PMC 4658449. PMID 26635779.
- ↑ 3.0 3.1 3.2 3.3 Fortes MR, Miot HA, Kurokawa CS, Marques ME, Marques SA (2011). "Immunology of paracoccidioidomycosis". An Bras Dermatol. 86 (3): 516–24. PMID 21738969.
- ↑ Paracoccidioidomycosis. Wikipedia.https://en.wikipedia.org/wiki/Paracoccidioidomycosis. Accessed on January 12, 2015
- ↑ Manns B.J, Baylis B.W, Urbanski S.J, Gibb A.P, Rabin H.R. Paracoccidioidomycosis: Case Report and Review. CID. 1996; 23: 1026-1032
- ↑ Vargas J, Vargas R. Paracoccidiodomicosis. Rev. enferm. infecc. trop.2009(1):49-56
- ↑ Manns B.J, Baylis B.W, Urbanski S.J, Gibb A.P, Rabin H.R. Paracoccidioidomycosis: Case Report and Review. CID. 1996; 23:1026-1032
- ↑ Paracoccidioidomycosis. Wikipedia.https://en.wikipedia.org/wiki/Paracoccidioidomycosis. Accessed on January 12, 2015
- ↑ Magalhães EM, Ribeiro Cde F, Dâmaso CS, Coelho LF, Silva RR, Ferreira EB; et al. (2014). "Prevalence of paracoccidioidomycosis infection by intradermal reaction in rural areas in Alfenas, Minas Gerais, Brazil". Rev Inst Med Trop Sao Paulo. 56 (4): 281–5. PMC 4131811. PMID 25076426.
- ↑ Barreto MM, Marchiori E, Amorim VB, Zanetti G, Takayassu TC, Escuissato DL; et al. (2012). "Thoracic paracoccidioidomycosis: radiographic and CT findings". Radiographics. 32 (1): 71–84. doi:10.1148/rg.321115052. PMID 22236894.
- ↑ 11.0 11.1 Brummer E, Castaneda E, Restrepo A. Paracoccidioidomycosis: An Update. 'Clin. Microbiol. Rev.1993;Vol 6(2):89-117
- ↑ Vargas J, Vargas R. Paracoccidiodomicosis. Rev. enferm. infecc. trop.2009(1):49-56
- ↑ 13.0 13.1 Wanke B, Aidê M. Chapter 6 - Paracoccidioidomycosis. J. bras. pneumol. 2009; 35(12):1245-1249
- ↑ Francesconi F, da Silva MT, Costa RL, et al. Long-term outcome of neuroparacoccidioidomycosis treatment. Rev Soc Bras Med Trop. 2011;44(1):22-25
- ↑ Martinez, R.Epidemiology of Paracoccidioidomycosis. Rev. Inst. Med. trop. S. Paulo. 2015;57(19), 11-20