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Published on: March 18, 2020
Neuroparacoccidioidomycosis: A 13-Year Cohort Study, Rio de Janeiro, Brazil
Priscila Marques de Macedo1, Eduardo Mastrangelo Marinho Falcão1, Dayvison Francis Saraiva Freitas1
1Clinical Research Laboratory on Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro 21040-900, Brazil.
Abstract:
Neuroparacoccidioidomycosis (NPCM) is a rare and severe clinical presentation of paracoccidioidomycosis (PCM). We performed a retrospective cohort study at the Evandro Chagas National Institute of Infectious Diseases (INI/Fiocruz), a reference center for PCM in the state of Rio de Janeiro, Brazil. All cases of PCM admitted to the INI/Fiocruz from January 2007 to December 2019 were reviewed. Eight (3.9%) among 207 patients met the diagnostic criteria for NPCM. The mean age was 44.6 years and the male:female ratio was 7:1. All cases presented multifocal disease, 5 (62.5%) the chronic form and 3 (37.5%) the acute/subacute form. All patients presented the pseudotumoral pattern and 6 (75.0%) had multiple lesions in the cerebral hemispheres. Seizures and motor symptoms were the most frequent clinical manifestations (50.0%, each). The treatment of choice was sulfamethoxazole/trimethoprim (SMZ-TMP) and fluconazole, in association (87.5%). Most patients responded well to the treatment. Sequela and death occurred in one (12.5%) patient, each.
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