Intestinal Paracoccidioidomycosis: Case report and systematic review.
Amphotericin B
Colectomy
Gastroenteritis
Inflammation
Inflammatory Bowel Diseases
Mycoses
Paracoccidioides
Journal
The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases
ISSN: 1678-4391
Titre abrégé: Braz J Infect Dis
Pays: Brazil
ID NLM: 9812937
Informations de publication
Date de publication:
Historique:
received:
13
05
2021
revised:
07
07
2021
accepted:
29
07
2021
pubmed:
31
8
2021
medline:
5
10
2021
entrez:
30
8
2021
Statut:
ppublish
Résumé
Paracoccidioidomycosis is a systemic mycosis considered endemic and limited to Latin America with the majority of registered cases originating from Brazil. The purpose of this paper was to report a case of a female patient with paracoccidioidomycosis mimicking inflammatory bowel disease and to systematically review available cases of the intestinal presentation of this infectious disease. Female patient, 32-years old, previously asymptomatic, presenting with acute pain in the lower right abdomen, associated with signs of peritoneal irritation and abdominal distension. Urgent surgery was performed, which identified a severe suppurative perforated ileitis. The anatomopathological study revealed fungal structures shaped as a ship's pilot wheel in Grocott-Gomori's staining, suggestive of Paracoccidioides spp. Studies were retrieved based on Medical Subject Headings and Health Sciences Descriptors, which were combined using Boolean operators. Searches were run on the electronic databases Scopus, Web of Science, MEDLINE (PubMed), BIREME (Biblioteca Regional de Medicina), LILACS (Latin American and Caribbean Health Sciences Literature), SciELO (Scientific Electronic Library Online), Embase, and Opengray.eu. Languages were restricted to English, Spanish and Portuguese. There was no date of publication restrictions. The reference lists of the studies retrieved were searched manually. Simple descriptive analysis was used to summarize the results. Our search strategy retrieved 581 references. In the final analysis, 34 references were included, with a total of 46 case reports. The most common clinical finding was abdominal pain and weight loss present in 31 (67.3%) patients. Most patients were treated with itraconazole (41.3%) and amphotericin B (36.9%). All-cause mortality was 12.8%. Paracoccidioidomycosis should be suspected in endemics areas, specially as a differential diagnosis for inflammatory bowel disease. Endoscopic tests and biopsy are useful for diagnosis and treatment with antifungal drugs seem to be the first treatment option to achieve a significant success rate.
Sections du résumé
BACKGROUND
BACKGROUND
Paracoccidioidomycosis is a systemic mycosis considered endemic and limited to Latin America with the majority of registered cases originating from Brazil. The purpose of this paper was to report a case of a female patient with paracoccidioidomycosis mimicking inflammatory bowel disease and to systematically review available cases of the intestinal presentation of this infectious disease.
CASE REPORT
METHODS
Female patient, 32-years old, previously asymptomatic, presenting with acute pain in the lower right abdomen, associated with signs of peritoneal irritation and abdominal distension. Urgent surgery was performed, which identified a severe suppurative perforated ileitis. The anatomopathological study revealed fungal structures shaped as a ship's pilot wheel in Grocott-Gomori's staining, suggestive of Paracoccidioides spp.
METHODS
METHODS
Studies were retrieved based on Medical Subject Headings and Health Sciences Descriptors, which were combined using Boolean operators. Searches were run on the electronic databases Scopus, Web of Science, MEDLINE (PubMed), BIREME (Biblioteca Regional de Medicina), LILACS (Latin American and Caribbean Health Sciences Literature), SciELO (Scientific Electronic Library Online), Embase, and Opengray.eu. Languages were restricted to English, Spanish and Portuguese. There was no date of publication restrictions. The reference lists of the studies retrieved were searched manually. Simple descriptive analysis was used to summarize the results.
RESULTS
RESULTS
Our search strategy retrieved 581 references. In the final analysis, 34 references were included, with a total of 46 case reports. The most common clinical finding was abdominal pain and weight loss present in 31 (67.3%) patients. Most patients were treated with itraconazole (41.3%) and amphotericin B (36.9%). All-cause mortality was 12.8%.
CONCLUSIONS
CONCLUSIONS
Paracoccidioidomycosis should be suspected in endemics areas, specially as a differential diagnosis for inflammatory bowel disease. Endoscopic tests and biopsy are useful for diagnosis and treatment with antifungal drugs seem to be the first treatment option to achieve a significant success rate.
Identifiants
pubmed: 34461048
pii: S1413-8670(21)00074-X
doi: 10.1016/j.bjid.2021.101605
pmc: PMC9392167
pii:
doi:
Substances chimiques
Antifungal Agents
0
Itraconazole
304NUG5GF4
Amphotericin B
7XU7A7DROE
Types de publication
Case Reports
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
101605Informations de copyright
Copyright © 2021 Sociedade Brasileira de Infectologia. Published by Elsevier España, S.L.U. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of interest The authors have no conflict of interest to disclose.
Références
Case Rep Med. 2011;2011:960638
pubmed: 21837244
Dermatol Online J. 2017 Apr 15;23(4):
pubmed: 28541872
Arq Gastroenterol. 1979 Jan-Mar;16(1):24-9
pubmed: 475611
Syst Rev. 2015 Jan 01;4:1
pubmed: 25554246
Mycopathologia. 2013 Dec;176(5-6):353-7
pubmed: 23982286
Mycoses. 2021 Feb;64(2):108-122
pubmed: 33031605
J Fungi (Basel). 2017 Jan 03;3(1):
pubmed: 29371520
Rev Soc Bras Med Trop. 2012 Oct;45(5):649-51
pubmed: 23152353
Rev Inst Med Trop Sao Paulo. 2004 May-Jun;46(3):127-31
pubmed: 15286812
Case Rep Med. 2010;2010:140505
pubmed: 20671977
Braz J Infect Dis. 2010 Sep-Oct;14(5):540-3
pubmed: 21221488
Clin Dermatol. 2012 Nov-Dec;30(6):610-5
pubmed: 23068148
Rev Gastroenterol Peru. 1998 Sep-Dec;18(3):285-291
pubmed: 12209226
Rev Soc Bras Med Trop. 2017 Sep-Oct;50(5):715-740
pubmed: 28746570
Mycopathologia. 2018 Dec;183(6):987-993
pubmed: 29453699
Gastrointest Endosc. 2000 Jun;51(6):722-3
pubmed: 10840309
Int J Infect Dis. 2018 Jul;72:20-21
pubmed: 29746902
Rev Soc Bras Med Trop. 2001 Nov-Dec;34(6):583-6
pubmed: 11813067
Gut. 1979 Oct;20(10):896-9
pubmed: 533701
AMB Rev Assoc Med Bras. 1982 Feb;28(2):73-4
pubmed: 6984928
Mycoses. 2003 Sep;46(8):342-7
pubmed: 12950907
Radiol Bras. 2015 Mar-Apr;48(2):126-7
pubmed: 25987754
Open Microbiol J. 2017 Oct 31;11:224-282
pubmed: 29204222
Rev Soc Bras Med Trop. 2000 May-Jun;33(3):309-12
pubmed: 10967600
Rev Hosp Clin Fac Med Sao Paulo. 1981 Aug;36(4):172-8
pubmed: 7330559
Lancet. 2012 Nov 3;380(9853):1590-605
pubmed: 22914295
J Clin Gastroenterol. 2011 Feb;45(2):87-91
pubmed: 20975575
Histopathology. 1997 Jan;30(1):79-83
pubmed: 9023562
BMJ Case Rep. 2020 Jul 2;13(7):
pubmed: 32616533
Am J Trop Med Hyg. 2009 Mar;80(3):359-66
pubmed: 19270282
Clin Infect Dis. 2010 Jul 15;51(2):250-1
pubmed: 20560735
BMJ Evid Based Med. 2018 Apr;23(2):60-63
pubmed: 29420178
Rev Inst Med Trop Sao Paulo. 1984 May-Jun;26(3):160-4
pubmed: 6505514
J Med Case Rep. 2018 Apr 30;12(1):108
pubmed: 29706133
Surg Clin North Am. 2019 Dec;99(6):1051-1062
pubmed: 31676047
Rev Gastroenterol Peru. 2017 Jan-Mar;37(1):77-81
pubmed: 28489841
Radiology. 1978 Jun;127(3):607-9
pubmed: 663144