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[Paracoccidioidomycosis in cerebral hemisphere and brainstem: case report]
Manoel Baldoino Leal Filho1, Guilherme Borges, Raimundo Gerônimo da Silva
1Universidade Estadual de Campinas SP, Brazil. manoelbaldoino@uol.com.br
Arquivos De Neuro-Psiquiatria
|November 23, 2006
Summary
A rare fungal infection, paracoccidioidomycosis, caused severe neurological symptoms in a patient returning from the Amazon. Prompt diagnosis and treatment led to a full recovery, highlighting the importance of considering endemic diseases.
Area of Science:
- Neurology
- Infectious Diseases
- Mycology
Background:
- Paracoccidioidomycosis is a systemic fungal infection endemic to Latin America, primarily affecting the lungs but capable of disseminating to other organs.
- Neurological involvement, though less common, can lead to significant morbidity and diagnostic challenges.
Observation:
- A 36-year-old male presented with progressive quadriparesis, ataxia, dysphagia, dysarthria, respiratory difficulty, and hiccups after Amazon forest exposure.
- MRI revealed lesions in the parietoccipital area and medulla, with the latter being the largest. Tuberculosis and AIDS were ruled out.
Findings:
- Microsurgical medulla exploration and pathological examination confirmed paracoccidioidomycosis.
- Treatment involved amphotericin B followed by sulfamethoxazole-trimethoprim and physical therapy.
Implications:
- This case underscores the importance of considering endemic mycoses in patients with neurological deficits and a relevant travel history.
- Successful management highlights the efficacy of combined antifungal therapy and supportive care for neuroparacoccidioidomycosis.
- Further research into the role of the immune system and cytokines in paracoccidioidomycosis pathogenesis is warranted.
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