Montalvo Raúl, Díaz Anibal, Montalvo Josdan, Pomazongo Manuel, Montalvo Miguel, Tunque Edison
Universidad Cesar Vallejo, Peru.
Universidad de Huánuco, Peru.
IDCases. 2022 May 20;29:e01507. doi: 10.1016/j.idcr.2022.e01507. eCollection 2022.
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.
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。