PMID- 15629337
OWN - NLM
STAT- MEDLINE
DCOM- 20050308
LR  - 20161124
IS  - 0090-3019 (Print)
IS  - 0090-3019 (Linking)
VI  - 63 Suppl 1
DP  - 2005
TI  - Central nervous system paracoccidioidomycosis: diagnosis and treatment.
PG  - S13-21; discussion S21
AB  - BACKGROUND: Paracoccidioidomycosis (PCM) is a systemic mycosis caused by 
      Paracoccidioides brasiliensis. The involvement of the central nervous system 
      (CNS) in paracoccidioidomycosis is higher than previously thought and 2 clinical 
      presentations have been reported, meningitis and pseudotumoral. METHODS: Twenty 
      medical records of patients with CNS paracoccidioidomycosis treated from 1986 to 
      2003 were analyzed. The follow-up ranged from 1 to 18 years (mean = 8.9 +/- 4.2). 
      RESULTS: Besides CNS paracoccidioidomycosis, all patients but one had the chronic 
      systemic form and the pseudotumoral clinical presentation was the most frequent. 
      Based on computed tomography scan findings, 4 image patterns were identified: 
      low-density lesion with ring enhancement, lesion with calcification and ring 
      enhancement, multiloculated low-density lesion with ring enhancement, and diffuse 
      subarachnoid enhancement. The magnetic resonance imaging was performed in 3 
      patients and showed subarachnoid enhancement in 1 patient and heterogeneous 
      lesion with ring enhancement in 2 patients. Eleven patients were submitted to 
      medical treatment and 9 needed neurosurgical treatment; ventriculoperitoneal 
      shunts in 4 patients, brain lesions resection in 3 patients, and partial 
      resection of spinal cord lesions in 2 patients. Eleven patients had excellent 
      outcome, 4 patients died, 3 are in good clinical condition with residual 
      pulmonary dysfunction, and 1 patient was lost to follow-up. CONCLUSIONS: The 
      diagnosis of paracoccidioidomycosis with involvement of the CNS is difficult and 
      clinical suspicion is a key point to achieve the correct diagnosis. Patients with 
      early diagnosis have a favorable outcome with clinical or surgical treatment.
FAU - Elias, Jorge Jr
AU  - Elias J Jr
AD  - Division of Imaging, Department of Internal Medicine, Hospital das Clinicas, 
      Ribeirao Preto Medical School, University of Sao Paulo, 14048-900 Ribeirao Preto, 
      SP, Brazil.
FAU - dos Santos, Antonio Carlos
AU  - dos Santos AC
FAU - Carlotti, Carlos Gilberto Jr
AU  - Carlotti CG Jr
FAU - Colli, Benedicto Oscar
AU  - Colli BO
FAU - Canheu, Alexandre
AU  - Canheu A
FAU - Matias, Caio
AU  - Matias C
FAU - Furlanetti, Luciano
AU  - Furlanetti L
FAU - Martinez, Roberto
AU  - Martinez R
FAU - Takayanagui, Osvaldo Massaiti
AU  - Takayanagui OM
FAU - Sakamoto, Americo Ceiki
AU  - Sakamoto AC
FAU - Serafini, Luciano Neder
AU  - Serafini LN
FAU - Chimelli, Leila
AU  - Chimelli L
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Surg Neurol
JT  - Surgical neurology
JID - 0367070
RN  - 0 (Antifungal Agents)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antifungal Agents/therapeutic use
MH  - Brain/diagnostic imaging/*microbiology/*pathology
MH  - Brain Neoplasms/diagnosis
MH  - Calcinosis/diagnostic imaging/microbiology/pathology
MH  - Central Nervous System Fungal Infections/*diagnosis/mortality/*therapy
MH  - Diagnosis, Differential
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hydrocephalus/diagnostic imaging/microbiology/pathology
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Meningitis, Fungal/diagnostic imaging/microbiology/pathology
MH  - Middle Aged
MH  - Neurosurgical Procedures/statistics & numerical data
MH  - Paracoccidioidomycosis/*diagnosis/mortality/*therapy
MH  - Retrospective Studies
MH  - Tomography, X-Ray Computed
MH  - Treatment Outcome
MH  - Ventriculoperitoneal Shunt/statistics & numerical data
EDAT- 2005/01/05 09:00
MHDA- 2005/03/09 09:00
CRDT- 2005/01/05 09:00
PHST- 2004/08/16 00:00 [received]
PHST- 2004/09/01 00:00 [accepted]
PHST- 2005/01/05 09:00 [pubmed]
PHST- 2005/03/09 09:00 [medline]
PHST- 2005/01/05 09:00 [entrez]
AID - S0090-3019(04)00692-5 [pii]
AID - 10.1016/j.surneu.2004.09.019 [doi]
PST - ppublish
SO  - Surg Neurol. 2005;63 Suppl 1:S13-21; discussion S21. doi: 
      10.1016/j.surneu.2004.09.019.