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Intestinal Paracoccidioidomycosis: Case report and systematic review
Eduarda Renz da Cruz1, Amanda Dal Forno1, Suelen Apratto Pacheco1
1School of Medicine, Universidade de Caxias do Sul, Caxias do Sul, RS, Brazil.
Summary
Paracoccidioidomycosis, a Latin American fungal infection, can mimic inflammatory bowel disease. Early diagnosis through biopsy and antifungal treatment are crucial for successful outcomes in intestinal presentations.
Area of Science:
- Infectious Diseases
- Mycology
- Gastroenterology
Background:
- Paracoccidioidomycosis is a prevalent systemic mycosis in Latin America, particularly Brazil.
- This study focuses on the intestinal presentation of paracoccidioidomycosis, often mistaken for inflammatory bowel disease.
- A case of a female patient with paracoccidioidomycosis mimicking inflammatory bowel disease is presented.
Observation:
- A 32-year-old female presented with acute lower right abdominal pain and peritonitis.
- Urgent surgery revealed severe suppurative perforated ileitis.
- Anatomopathological examination identified fungal structures characteristic of Paracoccidioides spp.
Findings:
- A systematic review included 46 case reports of intestinal paracoccidioidomycosis.
- Abdominal pain and weight loss were the most frequent clinical findings (67.3%).
- Treatment involved itraconazole (41.3%) and amphotericin B (36.9%), with an all-cause mortality of 12.8%.
Implications:
- Paracoccidioidomycosis should be considered in endemic areas as a differential diagnosis for inflammatory bowel disease.
- Endoscopic procedures and biopsies are vital for accurate diagnosis.
- Antifungal therapy is the primary treatment, demonstrating significant success rates.
