Transactions of the Royal Society of Tropical Medicine and Hygiene · 2006
Neuroparacoccidioidomycosis: analysis of 13 cases observed in an endemic area in Brazil.
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Paniago Anamaria Mello Miranda, de Oliveira Priscilla Alexandrino, Aguiar Eliana Setti Albuquerque, Aguiar José Ivan Albuquerque, da Cunha Rivaldo Venâncio, Leme Lígia Maria, Salgado Pedro Rippel, Domingos João Américo, Ferraz Renato Lima, Chang Marilene Rodrigues, Bóia Márcio Neves, Wanke Bodo
Аннотация
The epidemiological, clinical and laboratory features of 13 cases of neuroparacoccidioidomycosis (NPCM) were analysed. All patients were men, with a mean age of 41.6 years. The lungs were involved in 11 cases (84.6%) and only two cases had mycosis limited to the central nervous system. Co-morbidity was observed in four patients (malignant neoplasm in three and diabetes mellitus in one). The most frequent neurological manifestations were paresis (eight cases), headache (five cases) and gait disturbance (four cases). Neuroimaging diagnosis showed a predominance of multiple round lesions with ring enhancement following contrast medium injection. Lesions were seen in the brain hemispheres (nine cases), thalamus (nine cases), cerebellum (four cases), brainstem (four cases) and spinal cord (four cases). Most cases responded well to therapy. Lesions with enhancement following contrast medium injection persisted in four patients for a period of 6 months to 8 years. These findings emphasize the importance of considering NPCM in the differential diagnosis of brain and spinal cord lesions in endemic areas of paracoccidioidomycosis.