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Placental involvement in paracoccidioidomycosis
M H Blotta1, A M Altemani, E Amaral
1Departamento de Patologia Clínica, Faculdade de Ciências Médicas da UNICAMP, Campinas, São Paulo, Brazil.
Summary
This case study reports on juvenile-type paracoccidioidomycosis in pregnancy. Despite maternal infection and treatment, the infant was born healthy, with placental evidence of fungal presence and antibody transfer.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Obstetrics and Gynecology
Background:
- Paracoccidioidomycosis (P. brasiliensis) is a systemic fungal infection endemic to Latin America.
- Juvenile-type paracoccidioidomycosis presents with different clinical and epidemiological characteristics than the adult form.
- Pregnancy can alter the immune response and disease progression in infectious conditions.
Observation:
- A pregnant woman with pre-existing juvenile-type paracoccidioidomycosis continued antifungal therapy upon conception.
- A premature male infant was delivered without clinical signs of paracoccidioidomycosis.
- Placental examination revealed extensive Paracoccidioides brasiliensis yeast forms within the intervillous space.
Findings:
- The placenta showed a significant macrophagic-phagocytic reaction surrounding the fungal elements.
- Damage to the trophoblastic layer was observed in the infected placental tissue.
- Demonstration of specific Paracoccidioides brasiliensis antibodies transferred across the placenta.
Implications:
- This case highlights the potential for vertical transmission of paracoccidioidomycosis, even with maternal antifungal treatment.
- Placental pathology indicates a localized host immune response to the fungus.
- The presence of transferred antibodies suggests a protective mechanism for the neonate against congenital infection.