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CHYLOTHORAX IN PARACOCCIDIOIDOMYCOSIS
Flávia Fonseca Fernandes1, Victor Oliveira Alves1, Tarquino Erastides Gavilanes Sánchez2
1Escola Superior de Ciências da Saúde, Hospital Regional da Asa Norte, Medical School, Internal Medicine Unit. Brasília, DF, Brazil.
Revista Do Instituto De Medicina Tropical De Sao Paulo
|July 14, 2016
Summary
This case report details a fatal instance of paracoccidioidomycosis presenting with unusual chylothorax and breast mass. It highlights the critical need to consider this fungal infection in differential diagnoses for such conditions.
Area of Science:
- Mycology
- Infectious Diseases
- Clinical Medicine
Background:
- Paracoccidioidomycosis is a systemic fungal infection endemic to Latin America.
- It typically affects the lungs and reticuloendothelial system but can manifest with diverse clinical presentations.
Observation:
- A 52-year-old woman presented with prolonged fever, significant weight loss, generalized lymphadenopathy, skin lesions, and a breast mass.
- Imaging revealed widespread lymphadenopathy, splenomegaly, pleural effusion, and ascites consistent with chylous effusions.
- Histopathology of biopsies confirmed Paracoccidioides brasiliensis, identifying large yeast cells with characteristic budding.
Findings:
- The patient was diagnosed with paracoccidioidomycosis, complicated by chylothorax and chylous ascites.
- Despite treatment with liposomal amphotericin B and dietary modifications, her condition rapidly deteriorated.
- She developed pneumonia, septic shock, and respiratory failure, ultimately succumbing to the illness.
Implications:
- This case underscores the importance of including paracoccidioidomycosis in the differential diagnosis of chylothorax and breast masses, particularly in endemic regions.
- It highlights the potential for rare and severe presentations of this mycosis.
- Further research into the mechanisms of chylous effusion development in paracoccidioidomycosis is warranted.
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