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Paracoccidioides brasiliensis PS2: First Autochthonous Paracoccidioidomycosis Case Report in Rio de Janeiro, Brazil, and Literature Review

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Abstract

Paracoccidioidomycosis (PCM) is a systemic mycosis caused by pathogenic dimorphic fungi of the Paracoccidioides brasiliensis complex. It is the most important systemic mycosis in Latin America, mainly in Brazil. Despite its severity and high mortality rates, it is considered a neglected disease. Species within the genus Paracoccidioides present genetics and morphological variations with probable clinical, diagnostic and therapeutic consequences. In fact, there are a very small number of detailed case reports with molecular identification of these fungal agents. Here, it is reported a case of PCM due to Paracoccidioides brasiliensis PS2. Molecular identification of the isolate was performed by amplification and sequencing of the arf and gp43 genes. Clinical cases and strain reports with molecular identification in the literature are also reviewed. The case herein presented is the first autochthonous report of PCM due to Paracoccidioides brasiliensis PS2 species in the state of Rio de Janeiro, Brazil, an important endemic area. The patient presented a chronic pulmonary form of PCM and had a satisfactory response to sulfamethoxazole/trimethoprim although sequelae such as adrenal insufficiency and dysphonia were observed. This study may contribute to improve the knowledge about this severe disease, its causative cryptic species and their consequences to patients.

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Acknowledgments

We thank the staffs of the Immunodiagnosis Section of Mycology Laboratory for the assistance in DNA extraction and in serology of paracoccidioidomycosis.

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Authors and Affiliations

  1. Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 21045-900, Brazil

    Priscila Marques de Macedo & Antonio Carlos Francesconi do Valle

  2. Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil

    Rodrigo Almeida-Paes, Mauro de Medeiros Muniz, Manoel Marques Evangelista Oliveira & Rosely Maria Zancopé-Oliveira

  3. Coordenação de Pesquisa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil

    Regina Lana Braga Costa

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  1. Priscila Marques de Macedo
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  3. Mauro de Medeiros Muniz
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Correspondence to Priscila Marques de Macedo.

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de Macedo, P.M., Almeida-Paes, R., de Medeiros Muniz, M. et al. Paracoccidioides brasiliensis PS2: First Autochthonous Paracoccidioidomycosis Case Report in Rio de Janeiro, Brazil, and Literature Review. Mycopathologia 181, 701–708 (2016). https://doi.org/10.1007/s11046-016-0015-6

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