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一名非免疫功能低下儿童发生的播散性副球孢子菌病合并淋巴结结核。

Disseminated paracoccidioidomycosis associated with lymph node tuberculosis in a non immunocompromised child.

作者信息

Montalvo Raúl, Díaz Anibal, Montalvo Josdan, Pomazongo Manuel, Montalvo Miguel, Tunque Edison

机构信息

Universidad Cesar Vallejo, Peru.

Universidad de Huánuco, Peru.

出版信息

IDCases. 2022 May 20;29:e01507. doi: 10.1016/j.idcr.2022.e01507. eCollection 2022.

Abstract

The association of paracoccidioidomycosis (PCM) and tuberculosis (TB) produces an uncommon hyperinflammatory syndrome, causing multiorgan dysfunction. TB associated PCM is a rare condition, but it is fatal if not treated. Herein, we present a immunocompetent child who is admitted for fever and painful lymphadenopathy, with evidence of acid-alcohol-resistant bacillus (AARB) in cervical lymph node biopsy, antituberculous treatment was started with partial clinical improvement and is given discharge from hospital. At 3 weeks, he was readmitted by fever, weight loss, dyspnea and a greater number of adenopathies, in the new biopsy multiple yeasts were found compatible with PCM, our patient responded well to the combination of antituberculosis therapy(ATT), corticosteroid, and amphotericin B deoxycholate, presenting clinical improvement and subsequently continued with itraconazole.

摘要

副球孢子菌病(PCM)与结核病(TB)的关联会产生一种罕见的高炎症综合征,导致多器官功能障碍。结核相关的PCM是一种罕见病症,但如果不治疗则会致命。在此,我们报告一名免疫功能正常的儿童,因发热和疼痛性淋巴结病入院,颈部淋巴结活检有耐酸酒精杆菌(AARB)证据,开始抗结核治疗后临床有部分改善并出院。3周后,他因发热、体重减轻、呼吸困难和更多淋巴结肿大再次入院,新活检发现多个与PCM相符的酵母,我们的患者对抗结核治疗(ATT)、皮质类固醇和脱氧胆酸两性霉素B的联合治疗反应良好,临床症状改善,随后继续使用伊曲康唑治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7563/9157441/05afe086ba64/gr1.jpg

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