Skip to main content

Advertisement

Log in

Chronic paracoccidioidomycosis in a female patient in Austria

  • Concise Article
  • Published:
European Journal of Clinical Microbiology and Infectious Diseases Aims and scope Submit manuscript

Abstract

Presented here is a case of chronic paracoccidioidomycosis that occurred in a Cuban female living in Austria and was first misdiagnosed as tuberculosis. The clinical picture was one of progressive pulmonary insufficiency with fever, weight loss and productive cough. Since antituberculous therapy was started but did not achieve a long-term clinical response, an intensive diagnostic work-up was performed. Paracoccidioides brasiliensis was then diagnosed by histopathology, serology, microbiology and molecular identification. Antifungal therapy was commenced immediately with amphotericin B (1 mg/kg/day) for 10 days, followed by voriconazole (200 mg/day po) for at least 3 months, and the lesions disappeared almost completely. This report presents the first published case of imported paracoccidioidomycosis in a female patient in Austria.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Gow N, Nino-Vega G (2002) Paracoccidioides brasiliensis—the man-hater. Mycologist 16(Part 2):77–78

    Article  Google Scholar 

  2. Kroll JJ, Walzer RA (1972) Paracoccidioidomycosis in the United States. Arch Dermatol 106:543–546

    Article  CAS  PubMed  Google Scholar 

  3. Silva-Vergara ML, Martinez R (1999) Role of the armadillo Dasypus novemcinctus in the epidemiology of paracoccidioidomycosis. Mycopathologia 144:131–133

    Article  Google Scholar 

  4. Horré R, Schumacher G, Alpers K, Seitz HM, Adler S, Lemmer K, De Hoog GS, Schaal KP, Tintelnot K (2002) A case of imported paracoccidioidomycosis in a German legionaire. Med Mycol 40:213–216

    PubMed  Google Scholar 

  5. Giraldo R, Restrepo A, Gutierrez F, Robledo M, Londoño F, Hernandez H, Sierra F, Calle G (1976) Pathogenesis of paracoccidioidomycosis: a model based on the study of 46 patients. Mycopathologia 58:63

    CAS  PubMed  Google Scholar 

  6. Brummer E, Castañeda E, Restrepo A (1993) Paracoccidioidomycosis: an update. Clin Microbiol Rev 6:89–117

    CAS  PubMed  Google Scholar 

  7. Restrepo A, Salazar ME, Cano LE, Stover EP, Feldman D, Stevens DA (1984) Estrogens inhibit mycelium-to-yeast transformation in the fungus Paracoccidioides brasiliensis: implications for resistance of females to paracoccidioidomycosis. Infect Immun 46:346–353

    CAS  PubMed  Google Scholar 

  8. Borges-Walmsley MI, Chen D, Shu X, Walmsley AR (2002) The pathobiology of Paracoccidioides brasiliensis. Trends Microbiol 10(2):80–87

    Article  CAS  PubMed  Google Scholar 

  9. Restrepo A, Robledo M, Gutierrez F, et al (1970) Paracoccidioidomycosis. Am J Trop Med 19:68–76

    CAS  Google Scholar 

  10. Fountain F, Sutliff W (1969) Paracoccidioidomycosis in the United States. Am Rev Respir Dis 99:89–93

    CAS  PubMed  Google Scholar 

  11. Gerrits van den Ende AHG, De Hoog GS (1999) Variability and molecular diagnostics of the neurotropic species Cladophialophora bantiana. Stud Mycol 43:151–162

    Google Scholar 

  12. Köhler C, Klotz M, Daus H, et al (1988) Viszerale Paracoccidioidomykose bei einem Goldgräber aus Brasilien [Visceral paracoccidioidomycosis in a gold-digger from Brazil]. Mycoses 31:395–403

    PubMed  Google Scholar 

  13. Benoldi D, Alinova A, Pezzarossa E, et al (1985) Paracoccidioidomycosis (South American blastomycosis): a report of an imported case previously diagnosed as tuberculosis. Eur J Epidemiol 1:150–152

    CAS  PubMed  Google Scholar 

  14. Ginarte M, Pereiro M Jr, Toribio J (2002) Imported paracoccidioidomycosis in Spain. Mycoses 46:407–411

    Article  Google Scholar 

  15. Bowler S, Woodcock A, Da Costa P, Turner-Warwick M (1986) Chronic pulmonary paracoccidioidomycosis masquerading as lymphangitis carcinomatosa. Thorax 41:72–73

    CAS  PubMed  Google Scholar 

  16. Stanisic M, Wegmann T, Kuhn E (1979) Südamerikanische Blastomykose (Parakokzidioidomykose) in der Schweiz. Schweiz Med Wochenschr 109:693–699

    CAS  PubMed  Google Scholar 

  17. Chandler FW, Watts JC (1987) Pathologic diagnosis of fungal infections. ASCP Press, Chicago, pp 177–183

    Google Scholar 

  18. Balestra DJ, Hennigan SH, Ross GS, et al (1992) Clinical prediction of Pneumocystis pneumonia. Arch Intern Med 152:623–624

    Article  CAS  PubMed  Google Scholar 

  19. Manns BJ, Baylis BW, Urbanski SJ, et al (1996) Paracoccidioidomycosis: a case report and review. Clin Infect Dis 23:1026–1032

    CAS  PubMed  Google Scholar 

  20. Loose DS, Stover EP, Restrepo A, et al (1983) Estradiol binds to a receptor-like cytosol binding protein and initiates a biological response in Paracoccidioides brasiliensis. Proc Natl Acad Sci USA 80:7659–7663

    CAS  PubMed  Google Scholar 

  21. Aristizabal BH, Clemons KV, Stevens DA, et al (1998) Morphological transition of Paracoccidioides brasiliensis conidia to yeast cells: in vivo inhibition in females. Infect Immun 66:5587–5591

    CAS  PubMed  Google Scholar 

  22. Aristizábal BH, Clemons KV, Byron JK, Minn Y, Stevens D (2002) Experimental Paracoccidioides brasiliensis infection in mice: influence of the hormonal status of the host on tissue responses. Med Mycol 40:161–168

    PubMed  Google Scholar 

  23. Lortholary O, Denning DW, Dupont B (1999) Endemic mycosis: a treatment update. J Antimicrob Chemother 43:21–331

    Article  PubMed  Google Scholar 

  24. Restrepo A, Gomez I, Cano LE, et al (1983) Treatment of paracoccidioidomycosis with ketokonazole: a three-year experience. Am J Med 74(suppl B):48–52

    CAS  PubMed  Google Scholar 

  25. Naranjo MS, Trujillo M, Múnera MI, Restrepo P, Gomez I, Restrepo A (1990) Treatment of paracoccidioidomycosis with itraconazole. J Med Vet Mycol 28:67–76

    CAS  PubMed  Google Scholar 

  26. Kappe R (1999) Antifungal activity of the new azole UK-109, 496 (voriconazole). Mycoses 42:83–86

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Mayr.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mayr, A., Kirchmair, M., Rainer, J. et al. Chronic paracoccidioidomycosis in a female patient in Austria. Eur J Clin Microbiol Infect Dis 23, 916–919 (2004). https://doi.org/10.1007/s10096-004-1239-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-004-1239-9

Keywords

Navigation