Felipe Carlos Rafael A, Silva Aline D, Moreira Guimarães Penido Maria Goretti
Nephrology Center, Santa Casa de Belo Horizonte Hospital, Belo Horizonte, BRA.
Cureus. 2021 Oct 24;13(10):e19007. doi: 10.7759/cureus.19007. eCollection 2021 Oct.
Paracoccidioidomycosis (PCM) is an endemic fungal infection in Latin America, which manifests as an acute or chronic form and is more frequent in adult males. It is caused by or , which are thermodimorphic fungi. The disease can present as a severe and disseminated form involving the lungs, skin, lymph nodes, spleen, liver, and lymphoid organs of the gastrointestinal tract. Most of the primary infections are subclinical, and the cell-mediated immune response contains the infection. It is rare in transplant patients, and there are few cases described in the literature. In solid organ transplant patients, it usually results from the reactivation of a latent infection, manifesting itself after a few years of transplantation with frequent pulmonary and skin involvement. PCM is an endemic infection in Brazil; however, as it is not classified as a notifiable disease, there is no accurate database on its incidence, and case reports are important sources of information. Clinical disease in kidney transplant patients is rare and has a high mortality rate. In this scope, the present clinical case reports the challenges of the clinical management of disseminated PCM caused by in a kidney transplant recipient who used immunosuppressive drugs and was treated with Itraconazole.
副球孢子菌病（PCM）是拉丁美洲的一种地方性真菌感染，表现为急性或慢性形式，在成年男性中更为常见。它由副球孢子菌属或巴西副球孢子菌引起，这两种都是双相真菌。该疾病可表现为严重的播散形式，累及肺部、皮肤、淋巴结、脾脏、肝脏和胃肠道的淋巴器官。大多数原发性感染是亚临床的，细胞介导的免疫反应可控制感染。在移植患者中较为罕见，文献中描述的病例也很少。在实体器官移植患者中，它通常是由潜伏感染的重新激活引起的，在移植几年后出现，常累及肺部和皮肤。PCM在巴西是一种地方性感染；然而，由于它未被列为须上报的疾病，因此没有关于其发病率的准确数据库，病例报告是重要的信息来源。肾移植患者的临床疾病罕见且死亡率高。在此范围内，本临床病例报告了一名使用免疫抑制药物并接受伊曲康唑治疗的肾移植受者中由巴西副球孢子菌引起的播散性PCM临床管理的挑战。
