Brazilian guidelines for the clinical management of paracoccidioidomycosis
Shikanai-Yasuda, Maria Aparecida
Mendes, Rinaldo Poncio
Colombo, Arnaldo Lopes [UNIFESP]
de Queiroz-Telles, Flavio
Goncalves Kono, Adriana Satie
Paniago, Anamaria M. M.
Francisconi do Valle, Antonio Carlos
Ferreira, Marcelo Simao
Teixeira, Marcus de Melo
Silva-Vergara, Mario Leon
Pereira, Ricardo Mendes
Cavalcante, Ricardo de Souza
Durlacher, Rui Rafael
de Camargo, Zoilo Pires [UNIFESP]
Moretti, Maria Luiza
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Paracoccidioidomycosis is a systemic fungal disease occurring in Latin America that is associated with rural environments and agricultural activities. However, the incidence and prevalence of paracoccidiodomycosis is underestimated because of the lack of compulsory notification. If paracoccidiodomycosis is not diagnosed and treated early and adequately, the endemic fungal infection could result in serious sequelae. While the Paracoccidioides brasiliensis (P. brasiliensis) complex has been known to be the causal agent of paracoccidiodomycosis, a new species, Paracoccidioides lutzii (P. lutzii), has been reported in Rondonia, where the disease has reached epidemic levels, and in the Central West and Para. Accurate diagnoses and availability of antigens that are reactive with the patients' sera remain significant challenges. Therefore, the present guidelines aims to update the first Brazilian consensus on paracoccidioidomycosis by providing evidence-based recommendations for bedside patient management. This consensus summarizes etiological, ecoepidemiological, molecular epidemiological, and immunopathological data, with emphasis on clinical, microbiological, and serological diagnosis and management of clinical forms and sequelae, as well as in patients with comorbidities and immunosuppression. The consensus also includes discussion of outpatient treatments, severe disease forms, disease prevalence among special populations and resource-poor settings, a brief review of prevention and control measures, current challenges and recommendations.
CitationRevista Da Sociedade Brasileira De Medicina Tropical. Brasilia, v. 50, n. 5, p. 715-740, 2017.
SponsorshipBrazilian Society of Tropical Medicine and Hygiene
Brazilian Society of Infectology and Sociedade Paulista de Infectologia
Departamento de Moléstias Infecciosas e Parasitárias da FMUSP
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