PMID- 16463090
OWN - NLM
STAT- MEDLINE
DCOM- 20060502
LR  - 20181113
IS  - 0301-486X (Print)
IS  - 0301-486X (Linking)
VI  - 161
IP  - 2
DP  - 2006 Feb
TI  - Clinical evolution of paracoccidioidomycosis in 38 children and teenagers.
PG  - 73-81
AB  - Paracoccidioidomycosis (PCM) in children is rare, and its clinical progression is 
      not clearly understood. The admission and post-admission clinical records of 38 
      children and teenagers aged up to 14 were studied who had been under treatment 
      for 24-30 months. It is a consecutive case series, 17 retrospective and 21 
      prospective, from 1977 to 2000, admitted before and after 1990, respectively. The 
      main clinical presentations were lymphatic, abdominal and cutaneous involvement, 
      and fever. The alterations which disappeared more slowly were lymphadenomegaly, 
      hepatomegaly, splenomegaly, and osteoarticular pain. Poor intestinal absorption, 
      esophageal varices and splenic calcification were observed before treatment and 
      persisted as sequelae. There was a satisfactory response to initial treatment in 
      56.7% of cases. Half the patients became asymptomatic in the ninth month of 
      treatment, and 17+/-8% of cases presented with at least one symptom of the 
      disease after 30 months of treatment. There were five deaths, and treatment 
      failure was frequent and associated in part with the irregular use of antifungal. 
      Treatment with ketoconazole was safe and effective. PCM is a serious systemic 
      disease with slow evolution and high lethality, requiring treatment maintenance 
      for a minimum of 24 months with careful and prolonged follow-up. Studies are 
      necessary to evaluate the efficacy of different antifungals and the ideal 
      treatment length for children with PCM.
FAU - Nogueira, Maria Gorete Dos Santos
AU  - Nogueira MG
AD  - Setor de Infectologia Pediatrica do Hospital das Clinicas da Universidade Federal 
      de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil.
FAU - Andrade, Glaucia Manzan Queiroz
AU  - Andrade GM
FAU - Tonelli, Edward
AU  - Tonelli E
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Netherlands
TA  - Mycopathologia
JT  - Mycopathologia
JID - 7505689
RN  - 0 (Antifungal Agents)
RN  - 0 (Sulfonamides)
RN  - 7XU7A7DROE (Amphotericin B)
RN  - 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
RN  - R9400W927I (Ketoconazole)
SB  - IM
MH  - Adolescent
MH  - Amphotericin B/therapeutic use
MH  - Antifungal Agents/therapeutic use
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Ketoconazole/therapeutic use
MH  - Male
MH  - Paracoccidioides/*growth & development
MH  - Paracoccidioidomycosis/drug therapy/microbiology/*pathology
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Sulfonamides/therapeutic use
MH  - Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use
EDAT- 2006/02/08 09:00
MHDA- 2006/05/04 09:00
CRDT- 2006/02/08 09:00
PHST- 2004/04/04 00:00 [received]
PHST- 2005/09/09 00:00 [accepted]
PHST- 2006/02/08 09:00 [pubmed]
PHST- 2006/05/04 09:00 [medline]
PHST- 2006/02/08 09:00 [entrez]
AID - 10.1007/s11046-005-3653-7 [doi]
PST - ppublish
SO  - Mycopathologia. 2006 Feb;161(2):73-81. doi: 10.1007/s11046-005-3653-7.