Evandro Chagas Institute, Bacteriology and Mycology Section, Mycology Laboratory, Ananindeua, Pará, Brazil.
Am J Trop Med Hyg. 2012 Oct;87(4):710-4. doi: 10.4269/ajtmh.2012.12-0340. Epub 2012 Aug 27.
Paracoccidioidomycosis (PCM), the most important human systemic mycosis in Latin America, is known to be caused by at least four different phylogenetic lineages within the Paracoccidioides brasiliensis complex, including S1, PS2, PS3, and Pb01-like group. Herein, we describe two cases of PCM in patients native from the Amazon region. The disease was originally thought to have been caused by P. brasiliensis. Despite the severity of the cases, sera from the patients were negative in immunodiffusion tests using the standard exoantigen from P. brasiliensis B-339. However, a positive response was recorded with an autologous preparation of Paracoccidioides lutzii exoantigen. A phylogenetic approach based on the gp43 and ARF loci revealed high similarity between our clinical isolates and the Pb01-like group. The occurrence of PCM caused by P. lutzii in the Brazilian Amazon (Pará State) was thus proven. The incidence of PCM caused by P. lutzii may be underestimated in northern Brazil.
副球孢子菌病(PCM)是拉丁美洲最重要的人类系统性真菌病,已知由副球孢子菌复合体中的至少四个不同的系统发育谱系引起,包括 S1、PS2、PS3 和 Pb01 样群。在此,我们描述了来自亚马逊地区的两名 PCM 患者的病例。最初认为该疾病是由巴西副球孢子菌引起的。尽管病情严重,但患者的血清在使用巴西副球孢子菌 B-339 标准外抗原的免疫扩散试验中呈阴性。然而,与 Paracoccidioides lutzii 外抗原的自身制剂反应呈阳性。基于 gp43 和 ARF 基因座的系统发育方法显示,我们的临床分离株与 Pb01 样群高度相似。因此,证明了在巴西亚马逊地区(帕拉州)发生了由 P. lutzii 引起的 PCM。在巴西北部,由 P. lutzii 引起的 PCM 的发病率可能被低估。