巴西东南部由巴西副球孢子菌引起的副球孢子菌病病例。
Paracoccidioidomycosis cases by Paracoccidioides lutzii in southeastern Brazil.
机构信息
Cassiano Antônio Moraes University Hospital (HUCAM), Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil.
Department of General and Specialized Surgery, Federal Fluminense University (UFF), Niterói, Rio de Janeiro, Brazil.
出版信息
Braz J Microbiol. 2023 Sep;54(3):1761-1767. doi: 10.1007/s42770-023-01019-w. Epub 2023 Jun 8.
BACKGROUND AND OBJECTIVE
Paracoccidioidomycosis (PCM) is a systemic fungal disease caused by the thermodimorphic fungi Paracoccidioides spp. Their distribution is highly variable. Paracoccidioides lutzii is predominantly found in North and Middle-West Brazil and Ecuador. This study evaluated the clinicopathological characteristics of 10 patients diagnosed with PCM caused by P. lutzii in a reference center located in southeastern Brazil.
DESIGN
Double immunodiffusion assay (DID) was used to investigate 35 patients' sera with negative serology for P. brasiliensis against a P. lutzii CFA (cell-free antigen).
RESULTS
Out of the 35 retested patients, 10 (28.6%) were positive for P. lutzii CFA. Four patients did not report any displacement to P. lutzii endemic areas. Our results reinforce the importance of using different antigens when testing patients with clinical manifestations of PCM and negative serological tests for P. brasiliensis, primarily in cases of the report of displacement to or former residence in P. lutzii endemic regions.
CONCLUSIONS
The availability of tests for different Paracoccidioides species antigens is fundamental for reaching an adequate diagnosis, patient follow-up, and definition of prognosis.
背景与目的
球孢子菌病（PCM）是一种由热双相真菌球孢子菌属引起的系统性真菌病。其分布具有高度变异性。副球孢子菌主要分布于巴西中北部和厄瓜多尔。本研究评估了位于巴西东南部的一个参考中心诊断为副球孢子菌引起的 PCM 的 10 例患者的临床病理特征。
设计
双扩散免疫测定法（DID）用于检测 35 例对巴西副球孢子菌阴性血清针对副球孢子菌无细胞抗原（CFA）的血清。
结果
在 35 例重新检测的患者中，有 10 例（28.6%）对副球孢子菌 CFA 呈阳性。4 例患者未报告有任何迁往副球孢子菌流行地区的情况。我们的结果强调了在出现 PCM 临床表现且巴西副球孢子菌血清学检测呈阴性的患者中使用不同抗原进行检测的重要性，尤其是在报告有迁往副球孢子菌流行地区或曾居住在副球孢子菌流行地区的情况下。
结论
不同的副球孢子菌种抗原检测的可用性对于获得适当的诊断、患者随访和预后定义至关重要。
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