scholarly journals Paracoccidioidomicosis diseminada en paciente inmunocompetente: reporte de caso

Infectio ◽  
2021 ◽  
Vol 26 (1) ◽  
pp. 95
Author(s):  
Ayleen Rivera-Tenorio ◽  
José Mauricio Ocampo-Chaparro ◽  
José Mauricio Cárdenas ◽  
María Eugenia Casanova ◽  
Lina Villa ◽  
...  
Keyword(s):  
Paracoccidioides Spp

La Paracoccidioidomicosis (PCM) es una infección micótica endémica en Latinoamérica que se caracteriza por compromiso multiorgánico. El diagnóstico tardío y la diseminación sistémica favorecen complicaciones como falla respiratoria e insuficiencia suprarrenal que condicionan el desenlace del paciente. Se presenta el caso de un paciente de 51 años de edad, procedente de la costa pacífica colombiana, inmunocompetente con PCM diseminada a sistema nervioso central (SNC), pulmones y glándulas suprarrenales con debut clínico de síndrome neurológico. Durante estancia hospitalaria presenta pico febril, colapso hemodinámico, acidosis metabólica severa e hiperlactatemia. Se hemocultivó e inició tratamiento antimicrobiano de amplio espectro con piperacilina-tazobactam (4.5 gr/IV cada 8 horas), vancomicina (15 mg/kg) más anfotericina B desoxicolato (1 mg/kg/dia) y se trasladó a unidad de cuidado intensivo. En la muestras de tejido suprarrenal se identificaron levaduras multigemantes de Paracoccidioides spp e inflamacion crónica granulomatosa. A los seis días posteriores a su ingreso, el paciente continuó con deterioro hemodinámico, desequilibrio electrolítico, shock séptico e insuficiencia suprarrenal que conllevó a su deceso a pesar de las medidas terapéuticas establecidas. Se intenta exponer el desafío que representa el diagnóstico de PCM sistémica y promover su sospecha clínica para poder identificar la enfermedad de forma oportuna y evitar complicaciones que conduzcan a un desenlace fulminante.

scholarly journals Paracoccidioides spp. catalases and their role in antioxidant defense against host defense responses

2017 ◽  
Vol 100 ◽  
pp. 22-32 ◽  
Author(s):  
Diana Tamayo ◽  
José F. Muñoz ◽  
Agostinho J. Almeida ◽  
Juan D. Puerta ◽  
Ángela Restrepo ◽  
...  
Keyword(s):  
Host Defense ◽  
Antioxidant Defense ◽  
Defense Responses ◽  
Paracoccidioides Spp

scholarly journals PARACOCCIDIOIDOMYCOSIS: CHALLENGES IN THE DEVELOPMENT OF A VACCINE AGAINST AN ENDEMIC MYCOSIS IN THE AMERICAS

2015 ◽  
Vol 57 (suppl 19) ◽  
pp. 21-24 ◽  
Author(s):  
Carlos. P. TABORDA ◽  
M.E. URÁN ◽  
J. D. NOSANCHUK ◽  
L.R. TRAVASSOS
Keyword(s):  
Immune Response ◽  
Latin America ◽  
Monoclonal Antibodies ◽  
Clinical Practice ◽  
Therapeutic Vaccines ◽  
Endemic Mycosis ◽  
Paracoccidioides Spp ◽  
Important Means ◽  
Cellular Immune ◽  
Stimulation Of

SUMMARYParacoccidioidomycosis (PCM), caused by Paracoccidioides spp, is an important endemic mycosis in Latin America. There are two recognized Paracoccidioides species, P. brasiliensis and P. lutzii, based on phylogenetic differences; however, the pathogenesis and disease manifestations of both are indistinguishable at present. Approximately 1,853 (~51,2%) of 3,583 confirmed deaths in Brazil due to systemic mycoses from 1996-2006 were caused by PCM. Antifungal treatment is required for patients with PCM. The initial treatment lasts from two to six months and sulfa derivatives, amphotericin B, azoles and terbinafine are used in clinical practice; however, despite prolonged therapy, relapses are still a problem. An effective Th1-biased cellular immune response is essential to control the disease, which can be induced by exogenous antigens or modulated by prophylactic or therapeutic vaccines. Stimulation of B cells or passive transference of monoclonal antibodies are also important means that may be used to improve the efficacy of paracoccidioidomycosis treatment in the future. This review critically details major challenges facing the development of a vaccine to combat PCM.

scholarly journals Estudio epidemiológico de histoplasmosis, paracoccidioidomicosis y criptococosis en una zona urbana de Ciudad Guayana, estado Bolívar, Venezuela

2021 ◽  
Vol 62 (3) ◽  
pp. 193-207
Author(s):  
Julman R Cermeño ◽  
Ernesto Alayo ◽  
Julmery J. Cermeño ◽  
Alfredo Calzadilla ◽  
Alfredo Rodríguez ◽  
...  
Keyword(s):  
Histoplasma Capsulatum ◽  
Paracoccidioides Spp ◽  
Cryptococcus Spp ◽  
Ciudad Guayana

Se realizó un estudio prospectivo con el objetivo de determinar la prevalencia de infecciones por Histoplasma capsulatum, Complejo Paracoccidioides spp. y Complejo Cryptoccocus en individuos que viven o trabajan en la Plaza de las Ciencias del Sur, Puerto Ordaz, en el estado Bolívar, Venezuela, donde se refugian aves migratorias. Se aplicó una encuesta clínico-epidemiológica y se administraron pruebas intradérmicas de histoplasmina y paracoccidiodina, a todos los sujetos participantes en el estudio. A aquellos individuos sintomáticos respiratorios crónicos, se les realizó una evaluación clínica, radiológica, cultivo micológico y estudio serológico (anticuerpos específicos para Histoplasma capsulatum, Complejo Paracoccidioides spp. y del antígeno capsular del Complejo Cryptococcus spp.). Se aplicaron 632 pruebas intradérmicas a 316 individuos. De estos, sólo 296 (93,7%) acudieron a la lectura de las pruebas. Los sujetos tenían una media de edad de 40,3 años (rango: 7-76 años). Las manifestaciones clínicas más frecuentes fueron: tos (n=49; 16,5%), expectoración (n=17; 5,7%) y fiebre (n=8; 2,7%). La prueba para la histoplasmina fue positiva en el 47,3% (n=140) y a la paracoccidioidina, en el 32,4% (n=96). Los factores de riesgos fueron: contacto con palomas 30,4% (n=90) y visitas a fincas con gallineros 29,1% (n=86). Se identificaron dos casos de paracoccidioidomicosis pulmonar (0,7%) y un caso (0,3%) de criptococosis pulmonar. La elevada prevalencia de infección por Histoplasma capsulatum (47,3%) y Paracoccidioides spp. (32,4%) en ambientes urbanos del estado Bolívar, demuestra la necesidad de promover la búsqueda activa de estos hongos patógenos en quienes tienen síntomas respiratorios crónicos, que no mejoran con terapia antibacteriana y que habitan en zonas con características ambientales y geográficas, propicias para el desarrollo de estos hongos.

scholarly journals IgG reactivity profile to Paracoccidioides spp. antigens in people with asymptomatic Paracoccidioidomycosis

2020 ◽  
Author(s):  
Adriane Lenhard-Vidal ◽  
Flávia Raquel Bender ◽  
João Paulo Assolini ◽  
Ana Elisa Mayumi Maruo ◽  
Luiz Tiago Vieira ◽  
...  
Keyword(s):  
Mandatory Reporting ◽  
Endemic Region ◽  
Serological Screening ◽  
Sodium Metaperiodate ◽  
Epidemiological Surveys ◽  
Paracoccidioides Spp ◽  
Prevalent Strain ◽  
True Frequency ◽  
Epidemiological Profile ◽  
Low Prevalence

Introduction. Paracoccidioidomycosis (PCM) is a systemic mycosis caused by Paracoccidioides spp. As the disease is known to affect mostly men over 40 years old who previously worked handling soil, some cities of agricultural economy in endemic regions may have more cases of paracoccidioidal infection. Gap statement. The true frequency of PCM cannot be established in Brazil because it is not a disease of mandatory reporting. The detection of paracoccidioidal infection may assist in the planning of health services, in order to provide early detection of the disease and to prevent its worsening or even progression to death. In addition, little is described about sera reactivity with antigens from different species of Paracoccidiodes, especially P. lutzii. Aim. Current research was conducted in an inland municipality of southern Brazil, in order to assess infection rate within this endemic region of PCM disease. Methodology. ELISA was employed to evaluate 359 sera from random volunteers from Guarapuava, Paraná, Brazil, to detect IgG against cell-free antigens (CFA) from P. restrepiensis B339, P. americana LDR3 and P. lutzii LDR2. Confirmatory ELISA employed gp43 from B339. Reduction of cross-reactions was sought by treatment with sodium metaperiodate (SMP-CFA, SMP-gp43). Immunoblot was performed with 37 selected sera among those reactive in ELISA. Epidemiological profile was assessed by questionnaire. Results. ELISA reactivity was: CFA/SMP-CFA in general 37.3/17.8 %, B339 25.3/14.5 %, LDR3 24.5/1.4 %, LDR2 8.3/5.8 %; gp43/SMP-gp43 7.2/4.7 %. There were sera reactive with multiple CFAs. In immunoblot, five sera showed the same reaction profile with P. lutzii’s antigens as PCM disease sera. Rural residence and soil-related professions were risk factors for paracoccidioidal infection. Conclusion. The low prevalence is in accordance with previous reports of lower PCM disease endemicity in Guarapuava than in other areas of Paraná. Although P. brasiliensis seems to be the prevalent strain of the region, 21 sera from people who only lived in Guarapuava reacted with P. lutzii LDR2. CFA-ELISA with whole antigens seems a good option for serological screening in epidemiological surveys.

PERFIL EPIDEMIOLÓGICO DE FUNGEMIA EM HEMOCULTURA AUTOMATIZADA E EM CULTURA MICOLÓGICA

RAHIS ◽  
2021 ◽  
Vol 18 (4) ◽  
pp. 81-86
Author(s):  
Vanessa Caroline Randi Magalhães ◽  
Daniel Assis Santos
Keyword(s):  
Minas Gerais ◽  
Candida Spp ◽  
Paracoccidioides Spp ◽  
Cryptococcus Spp

INTRODUÇÃO: As micoses sistêmicas representam um grande desafio mundial e ainda são um tema negligenciado pelas autoridades de saúde pública. Estima-se que mais de foram 300 milhões de pessoas em todo o mundo sofrem de infecções fúngicas a cada ano com cerca de 1,0 a 2,0 milhões de mortes. Sabe-se que o atraso do diagnóstico das micoses sistêmicas impossibilita o início da terapia antifúngica imediata podendo ocasionar mortes ou o agravamento destas. O diagnóstico micológico, usualmente, baseia-se na identificação dos fungos por meio da observação de suas características morfológicas, isolados do material clínico cultivado. No entanto, em se tratando de amostras sanguíneas, sistemas de hemocultura automatizados são utilizados. OBJETIVO: Este estudo teve como objetivo avaliar o perfil epidemiológico dos fungos isolados de amostras sanguíneas cultivados no sistema de hemocultura automatizado e nos meios usuais da micologia clássica. METODOLOGIA: Amostras sanguíneas de 596 pacientes internados no Hospital Eduardo de Menezes, Minas Gerais, no período de março de 2017 a dezembro de 2019, foram inoculadas pareadas nos meios ágar Sabouraud e ágar Mycosel e no frasco aeróbio do sistema BacT/ALERT®. RESULTADOS: Candida spp. 0,3% (2/596, IC 95% 0,09 - 1,22) Cryptococcus spp. 0,8% (5/596, IC 95% 0,36 - 1,95) e Sporothrix spp. 0,2 % (1/596, IC 95% 0,03 - 0,94) foram os fungos isolados na hemocultura automatizada. Por outro lado, recuperamos Cryptococcus spp. 1,0% (6/596, IC 95% 0,46 - 2,18), Histoplasma spp. 3,0% (18/596, IC 95% 1,92 - 4,72), Paracoccidioides spp. 0,5% (3/596, IC 95% 0,17 - 1,47) e Sporothrix spp. 0,2 % (1/596, IC 95% 0,03 - 0,94) nas culturas micológicas clássicas. CONCLUSÃO: Os fungos mostraram notável variabilidade entre os gêneros na preferência das metodologias utilizadas. Na prática, podemos concluir que as metodologias se complementam e dessa forma, a aplicação simultânea da hemocultura automatizada e das culturas micológicas em Sabouraud e Mycosel oferecem a possibilidade de detectar uma diversidade maior de agentes fúngicos e melhora a sensibilidade do diagnóstico. Palavras-chave: micoses sistêmicas, diagnóstico micológico, hemocultura automatizada.

scholarly journals Molecular Tools for Detection and Identification of Paracoccidioides Species: Current Status and Future Perspectives

2020 ◽  
Vol 6 (4) ◽  
pp. 293 ◽  
Author(s):  
Breno Gonçalves Pinheiro ◽  
Rosane Christine Hahn ◽  
Zoilo Pires de Camargo ◽  
Anderson Messias Rodrigues
Keyword(s):  
Current Status ◽  
Large Area ◽  
Mycelial Form ◽  
Dimorphic Fungi ◽  
Laboratory Techniques ◽  
Detection And Identification ◽  
Paracoccidioides Spp ◽  
Taxonomic Changes ◽  
Immunological Assays ◽  
Mycotic Disease

Paracoccidioidomycosis (PCM) is a mycotic disease caused by the Paracoccidioides species, a group of thermally dimorphic fungi that grow in mycelial form at 25 °C and as budding yeasts when cultured at 37 °C or when parasitizing the host tissues. PCM occurs in a large area of Latin America, and the most critical regions of endemicity are in Brazil, Colombia, and Venezuela. The clinical diagnosis of PCM needs to be confirmed through laboratory tests. Although classical laboratory techniques provide valuable information due to the presence of pathognomonic forms of Paracoccidioides spp., nucleic acid-based diagnostics gradually are replacing or complementing culture-based, biochemical, and immunological assays in routine microbiology laboratory practice. Recently, taxonomic changes driven by whole-genomic sequencing of Paracoccidioides have highlighted the need to recognize species boundaries, which could better ascertain Paracoccidioides taxonomy. In this scenario, classical laboratory techniques do not have significant discriminatory power over cryptic agents. On the other hand, several PCR-based methods can detect polymorphisms in Paracoccidioides DNA and thus support species identification. This review is focused on the recent achievements in molecular diagnostics of paracoccidioidomycosis, including the main advantages and pitfalls related to each technique. We discuss these breakthroughs in light of taxonomic changes in the Paracoccidioides genus.

Paracoccin overexpression in Paracoccidioides brasiliensis enhances fungal virulence by remodeling chitin properties of the cell wall

2020 ◽  
Author(s):  
Relber Aguiar Gonçales ◽  
Rafael Ricci-Azevedo ◽  
Vanessa C S Vieira ◽  
Fabrício F Fernandes ◽  
Sandra M de O Thomaz ◽  
...  
Keyword(s):  
Cell Wall ◽  
Paracoccidioides Brasiliensis ◽  
Chitinase Activity ◽  
Growth Media ◽  
Lung Pathology ◽  
Dimorphic Fungi ◽  
Fungal Virulence ◽  
Paracoccidioides Spp ◽  
Cell Growth And Viability ◽  
Etiological Agents

Abstract Background The thermo-dimorphic fungi Paracoccidioides spp. are the etiological agents of paracoccidioidomycosis. Although poorly studied, paracoccin (PCN) from P. brasiliensis has been shown to harbor lectinic, enzymatic, and immunomodulatory properties that impact disease development. Methods Mutants of P. brasiliensis overexpressing PCN (ov-PCN) were constructed by Agrobacterium tumefaciens-mediated transformation. Ov-PCN strains were analyzed and inoculated intranasally or intravenously to mice. Fungal burden, lung pathology, and survival were monitored to evaluate virulence. Electron microscopy was used to evaluate the size of chito-oligomer particles released by ov-PCN or wild-type strains to growth media. Results ov-PCN strains revealed no differences in cell growth and viability, although PCN overexpression favored cell separation, chitin processing that results in the release of smaller chito-oligomer particles, and enhanced virulence. Our data show that PCN triggers a critical effect in the cell wall biogenesis through the chitinase activity resulting from overexpression of PCN. As such, PCN overexpression aggravates the disease caused by P. brasiliensis. Conclusions Our data is consistent with a model in which PCN modulates the cell wall architecture via its chitinase activity. These findings highlight the potential for exploiting PCN function in future therapeutic approaches.

scholarly journals Thioredoxin Reductase 1 Is a Highly Immunogenic Cell Surface Antigen in Paracoccidioides spp., Candida albicans, and Cryptococcus neoformans

2020 ◽  
Vol 10 ◽  
Author(s):  
Fabiana Freire Mendes de Oliveira ◽  
Verenice Paredes ◽  
Herdson Renney de Sousa ◽  
Ágata Nogueira D’Áurea Moura ◽  
Juan Riasco-Palacios ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Cell Surface ◽  
Cryptococcus Neoformans ◽  
Surface Antigen ◽  
Thioredoxin Reductase ◽  
Cell Surface Antigen ◽  
Thioredoxin Reductase 1 ◽  
Paracoccidioides Spp

scholarly journals Innate Immune Receptors and Defense Against Primary Pathogenic Fungi

Vaccines ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 303
Author(s):  
Theo N. Kirkland ◽  
Joshua Fierer
Keyword(s):  
Immune Response ◽  
Pathogenic Fungi ◽  
Vital Role ◽  
Innate Immune ◽  
Natural Resistance ◽  
Opportunistic Fungi ◽  
Immune Receptors ◽  
Invasive Infections ◽  
Paracoccidioides Spp ◽  
Human Infections

The innate immune system is critical for natural resistance to all pathogenic microorganisms, including fungi. The innate response plays a vital role in resistance to infections before the antigen-specific immune response and also influences antigen-specific adaptive immunity. There are many different receptors for the innate immune response to fungi, and some receptors have been found to play a significant role in the response to human infections with opportunistic fungi. Most human infections are caused by opportunistic fungi, but a small number of organisms are capable of causing infections in normal hosts. The primary pathogenic fungi that cause invasive infections include Blastomyces spp., Cryptococcus gattii, Coccidioides spp., Histoplasma spp., and Paracoccidioides spp. In this review of innate immune receptors that play a role in infections caused by these organisms, we find that innate immunity differs between organisms.

scholarly journals Hydroxamate Production as a High Affinity Iron Acquisition Mechanism in Paracoccidioides Spp

PLoS ONE ◽  
2014 ◽  
Vol 9 (8) ◽  
pp. e105805 ◽  
Author(s):  
Mirelle Garcia Silva-Bailão ◽  
Elisa Flávia Luiz Cardoso Bailão ◽  
Beatrix Elisabeth Lechner ◽  
Gregory M. Gauthier ◽  
Herbert Lindner ◽  
...  
Keyword(s):  
Iron Acquisition ◽  
High Affinity ◽  
Paracoccidioides Spp
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