PMID- 16791368
OWN - NLM
STAT- MEDLINE
DCOM- 20061218
LR  - 20201209
IS  - 0004-282X (Print)
IS  - 0004-282X (Linking)
VI  - 64
IP  - 2A
DP  - 2006 Jun
TI  - [Central nervous system paracoccidioidomycosis: analysis of 13 cases].
PG  - 269-76
AB  - Paracoccidioidomycosis (PCM) is a systemic granulomatous disease caused by 
      Paracoccidioides brasiliensis, prevalent in Latin America, particularly in 
      Brazil. Central nervous system (CNS) involvement occur in about 10% of cases. 
      Thirteen patients with PCM involving CNS were studied considering clinical 
      manifestation, neuroradiology and treatment modalities. Age ranged from 30 to 71 
      years-old (M=47.1+/-11.6 Me=46). There were eleven men and two women. The most 
      frequent symptoms were motor deficits (53.8%), cognitive disturbance (53.8%), 
      weight loss (46.1%), headaches (46.1%) and seizures (46.1%). The diagnosis was 
      confirmed by the demonstration of P. brasiliensis. Granulomatous forms were 
      present in all patients. Four (30.8%) of them had also meningeal involvement 
      (mixed form). Computerized tomography (CT) scans were obtained in all cases and 
      magnetic resonance imaging (MRI) was used in one case. Serology for HIV was done 
      in ten patients (76.9%), and all the tests were negatives. Amphotericin B was 
      used in twelve patients (92.3%), one of them by intraventricular infusion. In 
      eight patients (61.5%), trimethopim and sulfamethoxazole were used, and, in two 
      (15.4%), sulfadiazine and pirimetamine. Fluconazole, ketoconazole and 
      itraconazole were each one used in a different patient as well. Six patients died 
      (46.1%) and seven (53.9%) had satisfatory outcome. The follow-up period ranged 
      from 2 to 74 (M=30.9) months. In conclusion, the CNS involvement in 
      paracoccidioidomycosis is more frequent and more serious than thought before. The 
      clinical manifestations, CT scans and MRI findings are not specific of 
      paracoccidioidomycosis.
FAU - Fagundes-Pereyra, Walter J
AU  - Fagundes-Pereyra WJ
AD  - Clinica Neurologica e Neurocirurgica da Santa Casa de Belo Horizonte, MG, and 
      Centro Universitario de Vila Velha, Brazil. walter@neurocirugia.com
FAU - Carvalho, Gervasio Teles Cardoso
AU  - Carvalho GT
FAU - Goes, Alfredo de Miranda
AU  - Goes AM
FAU - das Chagas Lima e Silva, Francisco
AU  - das Chagas Lima e Silva F
FAU - de Sousa, Atos Alves
AU  - de Sousa AA
LA  - por
PT  - Journal Article
TT  - Paracoccidioidomicose do sistema nervoso central: analise de 13 casos.
DEP - 20060609
PL  - Germany
TA  - Arq Neuropsiquiatr
JT  - Arquivos de neuro-psiquiatria
JID - 0125444
RN  - 0 (Antifungal Agents)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antifungal Agents/*therapeutic use
MH  - Central Nervous System Fungal Infections/*diagnosis/drug therapy
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Paracoccidioides/*isolation & purification
MH  - Paracoccidioidomycosis/*diagnosis/drug therapy
MH  - Tomography, X-Ray Computed
EDAT- 2006/06/23 09:00
MHDA- 2006/12/19 09:00
CRDT- 2006/06/23 09:00
PHST- 2006/06/23 09:00 [pubmed]
PHST- 2006/12/19 09:00 [medline]
PHST- 2006/06/23 09:00 [entrez]
AID - S0004-282X2006000200018 [pii]
AID - 10.1590/s0004-282x2006000200018 [doi]
PST - ppublish
SO  - Arq Neuropsiquiatr. 2006 Jun;64(2A):269-76. doi: 10.1590/s0004-282x2006000200018. 
      Epub 2006 Jun 9.