Leal Filho Manoel Baldoino, Borges Guilherme, da Silva Raimundo Gerônimo, de Almeida Xavier Aguiar Aline, de Almeida Bruno Ribeiro, da Cunha E Silva Vieira Marcelo Adriano, Pinheiro Luciana Maria Ribeiro
Universidade Estadual de Campinas SP, Brazil.
Arq Neuropsiquiatr. 2006 Sep;64(3A):686-9. doi: 10.1590/s0004-282x2006000400033.
We report on a 36 years-old man that had been at the Amazon forest four years before. Six months before the admission he had developed a progressive quadriparesis, gait ataxia, dysphagia, dysarthria, difficulty in breathing and hiccup. The gadolinium-enhanced T1-weighted MRI showed a lesion into the right parietoccipital area and another into the medulla, that was the largest. There was any evidence of tuberculosis or AIDS. The patient was submitted to microsurgical approach to the medulla. Pathological examination revealed paracoccidioidomycosis. Treatment with anphotericin B till 2100 mg was administered followed by sulfamethoxazole-trimetoprim for three months plus physical therapy. The patient went back to his activities six months after the end of the treatment. Comments are presented about the participation of the immunological system and of the cytokines (interleukines).
我们报告了一名36岁男性，他四年前曾在亚马逊森林。入院前六个月，他出现进行性四肢瘫痪、步态共济失调、吞咽困难、构音障碍、呼吸困难和打嗝。钆增强T1加权磁共振成像显示右侧顶枕区有一个病变，延髓有另一个病变，后者最大。没有结核病或艾滋病的证据。患者接受了延髓显微手术。病理检查显示为副球孢子菌病。给予两性霉素B治疗直至2100毫克，随后给予磺胺甲恶唑-甲氧苄啶治疗三个月并辅以物理治疗。治疗结束六个月后，患者恢复了日常活动。文中还对免疫系统和细胞因子（白细胞介素）的作用进行了评论。
