Laboratório de Microbiologia da Faculdade de Medicina de São José do Rio Preto, SP, Brazil.
Pathol Res Pract. 2012 Sep 15;208(9):549-52. doi: 10.1016/j.prp.2012.06.004. Epub 2012 Jul 27.
The purpose of the Death Verification Service is to elucidate the causes of deaths that occur without medical assistance and of ill-defined deaths. In recent decades, the epidemiological reality of fungal infections has changed due to the rise in opportunistic infections chiefly in immunocompromised patients. A study of fungal diseases in autopsies performed in the Death Verification Service of the Medicine School in São José do Rio Preto between January 2000 and December 2009 was made. Sixty-seven cases of fungal disease, most involving men (70%), were found in 4824 autopsies. Cryptococcosis was the most prevalent (45%), followed by paracoccidioidomycosis, candidiasis, histoplasmosis, aspergillosis and mucormycosis. Associations between AIDS (n=14) and fungal diseases were identified for cryptococcosis (36%), candidiasis (28.5%) and histoplasmosis (28.5%). Pneumonia, AIDS and fungal diseases were evident in 26% of the cases, with the most prevalent etiologies being Cryptococcus neoformans (55.5%) and Histoplasma capsulatum (22%). Pneumonia alone occurred in 43% of cases, with cryptococcosis (53%) and paracoccidioidomycosis (33%) being the main infectious agents. Diabetes mellitus was associated with candidiasis in two cases and aspergillosis in one. One case of renal transplantation linked to paracoccidioidomycosis and one case of bone marrow aplasia with mucormycosis were reported. Despite the reduction in the number of autopsies over recent decades, these findings suggest that this procedure is useful to provide additional data on the etiology, underlying disease and specific risk factors, essential for quality control and to improve treatment protocols.
死亡验证服务的目的是阐明没有医疗协助和死因不明的死亡原因。近几十年来，由于机会性真菌感染在免疫功能低下患者中的上升，真菌病的流行病学现实发生了变化。对 2000 年 1 月至 2009 年 12 月期间在圣若泽杜里奥普雷托医学院死亡验证服务处进行的尸检中的真菌病进行了研究。在 4824 例尸检中发现了 67 例真菌病，大多数涉及男性（70%）。隐球菌病最为常见（45%），其次是副球孢子菌病、念珠菌病、组织胞浆菌病、曲霉病和毛霉病。在艾滋病（n=14）和真菌病之间发现了隐球菌病（36%）、念珠菌病（28.5%）和组织胞浆菌病（28.5%）的关联。26%的病例存在肺炎、艾滋病和真菌病，最常见的病原体是新型隐球菌（55.5%）和荚膜组织胞浆菌（22%）。单纯肺炎占 43%，其中隐球菌病（53%）和副球孢子菌病（33%）是主要的感染源。糖尿病与念珠菌病有关的有两例，与曲霉病有关的一例。报告了一例与副球孢子菌病有关的肾移植病例和一例与骨髓发育不良有关的毛霉病病例。尽管最近几十年来尸检数量有所减少，但这些发现表明，该程序有助于提供病因、潜在疾病和特定风险因素的额外数据，这对质量控制和改善治疗方案至关重要。
