Medical Pathology Department, Medicine School, Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
Virology Laboratory, Hospital de Clinicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
J Neurovirol. 2017 Dec;23(6):913-918. doi: 10.1007/s13365-017-0577-1. Epub 2017 Sep 11.
Paracoccidioidomycosis (PCM), caused by Paracoccidioides brasiliensis, is the most prevalent systemic mycosis among immunocompetent patients in Latin America; it is rare in immunocompromised patients. The estimated frequency of central nervous system (CNS) involvement in the HIV/PCM population was 2.5%. We report a case of HIV/P. brasiliensis co-infection, with neurological (NPCM) and multiple organ involvement, indicating a diagnosis of AIDS. PCM diagnosis was established during the autopsy. This is the first described case of HIV/P. brasiliensis co-infection with CNS involvement diagnosed at autopsy. In conclusion, the diagnosis of NPCM is challenging, and it must be considered in the differential diagnosis in HIV-positive patients who reside in or have visited areas in which the condition is endemic and who present with neurological symptoms.
巴西副球孢子菌引起的副球孢子菌病（PCM）是拉丁美洲免疫功能正常患者中最常见的系统性真菌病；在免疫功能低下的患者中则较为罕见。HIV/PCM 人群中中枢神经系统（CNS）受累的估计频率为 2.5%。我们报告了一例 HIV/巴西副球孢子菌合并感染的病例，伴有神经（NPCM）和多器官受累，提示诊断为艾滋病。PCM 的诊断是在尸检时确定的。这是首例在尸检中诊断出的伴有中枢神经系统受累的 HIV/巴西副球孢子菌合并感染病例。总之，NPCM 的诊断具有挑战性，对于居住在或曾前往副球孢子菌病流行地区且出现神经系统症状的 HIV 阳性患者，必须在鉴别诊断中考虑到这一点。
