Resumen de Paracoccidioidomycosis due to Paracoccidioides brasiliensis S1associated with acquired immunodeficiency syndrome: A case report

Paulo Mendes Peçanha, Isabela Cruz Bahiense, Wdson Luis Lima Kruschewsky, Cláudia Biasutti, Carlos Urbano Gonçalves Ferreira Júnior, Breno Gonçalves Pinheiro, Simone Bravim Maifrede, Zoilo Pires de Camargo, Anderson Messias Rodrigues, Tânia Regina Grão Velloso, Aloísio Falqueto, Sarah Santos Gonçalves

• español

  Antecedentes: La paracoccidioidomicosis (PCM) es una enfermedad endémica en Latinoamérica. En lospacientes inmunocompetentes, la PCM cursa con dos principales formas: aguda y crónica. Sin embargo,los pacientes infectados por el VIH pueden presentar manifestaciones simultáneas de las dos formasclínicas.Caso clínico: Se presenta el caso de un paciente VIH-positivo, con lesiones cutáneas diseminadas, lin-fadenopatía generalizada y afectación del sistema nervioso central y respiratorio. El diagnóstico de PCMse confirmó mediante un examen directo con KOH, doble inmunodifusión y el aislamiento del hongoen cultivo, a partir de muestras de un absceso en la región subcostal. La cepa aislada se identificó comoParacoccidioides brasiliensis S1 mediante PCR especie-específica del gen codificador de la proteína GP43(exón 2), seguida de PCR-RFLP del gen de la alfa-tubulina

• English

  Background: Paracoccidioidomycosis (PCM) is an endemic disease in Latin America. In immunocompetenthosts, PCM occurs in two main clinical forms: acute and chronic. However, in HIV-infected patients PCMmay show up simultaneous manifestations of acute and chronic forms.Case report: We present the case of a patient diagnosed with HIV who had disseminated skin lesions andgeneralized lymphadenopathy, as well as respiratory and central nervous system involvement. The PCMdiagnosis was confirmed by direct KOH examination, double immunodiffusion and the isolation of thefungus in samples of an abscess in the subcostal region. The isolate was identified as Paracoccidioidesbrasiliensis S1 by species-specific PCR using primers for protein-coding gene GP43 (exon 2) followed byPCR-RFLP of the alpha-tubulin gene.Conclusions: There are few data in literature reporting species-specific molecular identification of Para-coccidioides in HIV/PCM patients. Therefore, this case report may contribute to improve the knowledgeabout this severe disease, its causative cryptic species, and its consequences to patients.