PMID- 22928923
OWN - NLM
STAT- MEDLINE
DCOM- 20131211
LR  - 20131213
IS  - 1460-2709 (Electronic)
IS  - 1369-3786 (Linking)
VI  - 51
IP  - 3
DP  - 2013 Apr
TI  - Endemic paracoccidioidomycosis: relationship between clinical presentation and 
      patients' demographic features.
PG  - 313-8
LID - 10.3109/13693786.2012.714529 [doi]
AB  - Paracoccidioidomycosis (PCM) is a systemic fungal disease endemic to Latin 
      America and characterized by two clinical presentations, i.e., patients develop 
      either acute/subacute or chronic clinical manifestations. The differences in 
      clinical presentations are mainly dependent on the host immune response, but may 
      also be related to demographic characteristics of some patients. In this 
      retrospective study, 1,219 PCM cases treated between 1970 and 2009 in a 
      university medical center, located in southeastern Brazil, were analyzed 
      according to their clinical and demographic features. The most affected 
      anatomical sites were lungs (63.8%) and oral mucosa (50.0%), with increasing 
      involvement of these sites in accord with the age of the patients. Generalized 
      lymphadenopathy (28.1%) and skin lesions (29.6%) were more frequent on the first 
      decades of life. Involvement of the larynx (16.1%), gut (7.5%), spleen (4.7%), 
      central nervous system (3.4%), bones and joints (2.2%), and adrenal (2.1%) were 
      also variable according to the age of the host. The acute/subacute form of the 
      disease accounted for 26.4% of PCM cases and, on a multivariate analysis, was 
      inversely associated with aging (OR = 0.8 per year, P < 0.001), and directly 
      associated with female sex (OR = 7.2, P < 0.001), mixed black and white racial 
      background (OR = 2.3, P < 0.001) or black skin color (OR = 4.6, P < 0.001). Based 
      on these findings, we have shown that host immune response, as well as age, 
      gender and ethnicity may influence the clinical presentation of PCM.
FAU - Bellissimo-Rodrigues, Fernando
AU  - Bellissimo-Rodrigues F
AD  - Social Medicine Department, Faculdade de Medicina de Ribeirao Preto, Sao Paulo 
      University, Ribeirao Preto, Sao Paulo State, Brazil.
FAU - Bollela, Valdes Roberto
AU  - Bollela VR
FAU - Da Fonseca, Benedito Antonio Lopes
AU  - Da Fonseca BA
FAU - Martinez, Roberto
AU  - Martinez R
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120828
PL  - England
TA  - Med Mycol
JT  - Medical mycology
JID - 9815835
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Brazil/epidemiology
MH  - Child
MH  - Child, Preschool
MH  - Demography
MH  - *Endemic Diseases
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Paracoccidioidomycosis/*epidemiology/*pathology
MH  - Prevalence
MH  - Retrospective Studies
MH  - Young Adult
EDAT- 2012/08/30 06:00
MHDA- 2013/12/16 06:00
CRDT- 2012/08/30 06:00
PHST- 2012/08/30 06:00 [entrez]
PHST- 2012/08/30 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
AID - 10.3109/13693786.2012.714529 [doi]
PST - ppublish
SO  - Med Mycol. 2013 Apr;51(3):313-8. doi: 10.3109/13693786.2012.714529. Epub 2012 Aug 
      28.