PMID- 28355221
OWN - NLM
STAT- MEDLINE
DCOM- 20170619
LR  - 20201209
IS  - 1935-2735 (Electronic)
IS  - 1935-2727 (Print)
IS  - 1935-2727 (Linking)
VI  - 11
IP  - 3
DP  - 2017 Mar
TI  - Acute juvenile Paracoccidioidomycosis: A 9-year cohort study in the endemic area 
      of Rio de Janeiro, Brazil.
PG  - e0005500
LID - 10.1371/journal.pntd.0005500 [doi]
LID - e0005500
AB  - BACKGROUND: Paracoccidioidomycosis (PCM) is a systemic mycosis caused by 
      pathogenic dimorphic fungi of the genus Paracoccidioides. It is the most 
      important systemic mycosis in Latin America and the leading cause of 
      hospitalizations and death among them in Brazil. Acute PCM is less frequent but 
      relevant because vulnerable young patients are affected and the severity is 
      usually higher than that of the chronic type. METHODS: The authors performed a 
      retrospective cohort study from 2001 to 2009 including acute juvenile PCM 
      patients from a reference center in Rio de Janeiro, Brazil. Clinical, 
      epidemiological, diagnostic, therapeutic, and prognostic data were reported. 
      RESULTS: Twenty-nine patients were included. The average age was 23 years old and 
      the male to female ratio was 1:1.07. All cases were referred from 3 of 9 existing 
      health areas in the state of Rio de Janeiro, predominantly from urban areas 
      (96.5%). Lymph nodes were the most affected organs (100%), followed by the skin 
      and the spleen (31% each). Twenty-eight patients completed treatment (median 25 
      months) and progressed to clinical and serological cure; 1 death occurred. 
      Twenty-four patients completed 48-month median follow-up. Four patients abandoned 
      follow-up after the end of treatment. The most frequent sequela was low adrenal 
      reserve. Paracoccidioides brasiliensis S1 was identified by partial sequencing of 
      the arf and gp43 genes from 4 patients who presented a viable fungal culture. 
      CONCLUSION: Acute juvenile PCM is a severe disease with a high rate of 
      complications. There are few cohort clinical studies of acute PCM in the 
      literature. More studies should be developed to promote improvement in patients' 
      healthcare.
FAU - de Macedo, Priscila Marques
AU  - de Macedo PM
AUID- ORCID: 0000-0002-6900-9703
AD  - Infectious Dermatology Clinical Research Laboratory, Evandro Chagas National 
      Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil.
FAU - Almeida-Paes, Rodrigo
AU  - Almeida-Paes R
AD  - Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases, 
      Fiocruz, Rio de Janeiro, Brazil.
FAU - Freitas, Dayvison Francis Saraiva
AU  - Freitas DF
AD  - Infectious Dermatology Clinical Research Laboratory, Evandro Chagas National 
      Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil.
FAU - Varon, Andrea Gina
AU  - Varon AG
AD  - Department of Inpatient Health Care, Evandro Chagas National Institute of 
      Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil.
FAU - Paixao, Ariane Gomes
AU  - Paixao AG
AD  - Department of Inpatient Health Care, Evandro Chagas National Institute of 
      Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil.
FAU - Romao, Anselmo Rocha
AU  - Romao AR
AD  - Geoprocessing Laboratory, Institute of Scientific and Technological Communication 
      and Information in Health, Fiocruz, Rio de Janeiro, Brazil.
FAU - Coutinho, Ziadir Francisco
AU  - Coutinho ZF
AD  - Sergio Arouca National School of Public Health, Fiocruz, Rio de Janeiro, Brazil.
FAU - Pizzini, Claudia Vera
AU  - Pizzini CV
AD  - Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases, 
      Fiocruz, Rio de Janeiro, Brazil.
FAU - Zancope-Oliveira, Rosely Maria
AU  - Zancope-Oliveira RM
AD  - Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases, 
      Fiocruz, Rio de Janeiro, Brazil.
FAU - Francesconi do Valle, Antonio Carlos
AU  - Francesconi do Valle AC
AD  - Infectious Dermatology Clinical Research Laboratory, Evandro Chagas National 
      Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil.
LA  - eng
PT  - Journal Article
DEP - 20170329
PL  - United States
TA  - PLoS Negl Trop Dis
JT  - PLoS neglected tropical diseases
JID - 101291488
RN  - 0 (Antifungal Agents)
RN  - 0 (Fungal Proteins)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antifungal Agents/therapeutic use
MH  - Brazil/epidemiology
MH  - Child
MH  - Cohort Studies
MH  - *Endemic Diseases
MH  - Female
MH  - Fungal Proteins/genetics
MH  - Genotype
MH  - Humans
MH  - Male
MH  - Paracoccidioides/classification/genetics/*isolation & purification
MH  - Paracoccidioidomycosis/diagnosis/drug therapy/*epidemiology/pathology
MH  - Retrospective Studies
MH  - Sequence Analysis, DNA
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC5386294
COIS- The authors have declared that no competing interests exist.
EDAT- 2017/03/30 06:00
MHDA- 2017/06/20 06:00
PMCR- 2017/03/29
CRDT- 2017/03/30 06:00
PHST- 2016/10/12 00:00 [received]
PHST- 2017/03/17 00:00 [accepted]
PHST- 2017/04/10 00:00 [revised]
PHST- 2017/03/30 06:00 [pubmed]
PHST- 2017/06/20 06:00 [medline]
PHST- 2017/03/30 06:00 [entrez]
PHST- 2017/03/29 00:00 [pmc-release]
AID - PNTD-D-16-01868 [pii]
AID - 10.1371/journal.pntd.0005500 [doi]
PST - epublish
SO  - PLoS Negl Trop Dis. 2017 Mar 29;11(3):e0005500. doi: 
      10.1371/journal.pntd.0005500. eCollection 2017 Mar.