Long-term outcome of neuroparacoccidioidomycosis treatment
INTRODUCTION: Neuroparacoccidioidomycosis (NPCM) is a term used to describe the invasion of the central nervous system by the pathogenic fungus Paracoccidioides brasiliensis. NPCM has been described sporadically in some case reports and small case series, with little or no focus on treatment outcome...
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| Language: | English |
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Sociedade Brasileira de Medicina Tropical (SBMT)
2011-02-01
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| Series: | Revista da Sociedade Brasileira de Medicina Tropical |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822011000100006&lng=en&tlng=en |
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| author | Fabio Francesconi Marcus Tulius Teixeira da Silva Regina Lana Braga Costa Valeska Albuquerque Francesconi Eleonora Carregal Sinésio Talhari Antonio Carlos Francesconi do Valle |
| author_facet | Fabio Francesconi Marcus Tulius Teixeira da Silva Regina Lana Braga Costa Valeska Albuquerque Francesconi Eleonora Carregal Sinésio Talhari Antonio Carlos Francesconi do Valle |
| author_sort | Fabio Francesconi |
| collection | DOAJ |
| description | INTRODUCTION: Neuroparacoccidioidomycosis (NPCM) is a term used to describe the invasion of the central nervous system by the pathogenic fungus Paracoccidioides brasiliensis. NPCM has been described sporadically in some case reports and small case series, with little or no focus on treatment outcome and long-term follow-up. METHODS: All patients with NPCM from January 1991 to December 2006 were analyzed and were followed until December 2009. RESULTS: Fourteen (3.8%) cases of NPCM were identified out of 367 patients with paracoccidioidomycosis (PCM). A combination of oral fluconazole and sulfamethoxazole/trimethoprim (SMZ/TMP) was the regimen of choice, with no documented death due to Paracoccidioides brasiliensis infection. Residual neurological deficits were observed in 8 patients. Residual calcification was a common finding in neuroimaging follow-up. CONCLUSIONS: All the patients in this study responded positively to the association of oral fluconazole and sulfamethoxazole/trimethoprim, a regimen that should be considered a treatment option in cases of NPCM. Neurological sequela was a relatively common finding. For proper management of these patients, anticonvulsant treatment and physical therapy support were also needed. |
| first_indexed | 2024-04-12T14:43:07Z |
| format | Article |
| id | doaj.art-11f2f8ed541146108a33ae522c603b96 |
| institution | Directory Open Access Journal |
| issn | 1678-9849 |
| language | English |
| last_indexed | 2024-04-12T14:43:07Z |
| publishDate | 2011-02-01 |
| publisher | Sociedade Brasileira de Medicina Tropical (SBMT) |
| record_format | Article |
| series | Revista da Sociedade Brasileira de Medicina Tropical |
| spelling | doaj.art-11f2f8ed541146108a33ae522c603b962022-12-22T03:28:44ZengSociedade Brasileira de Medicina Tropical (SBMT)Revista da Sociedade Brasileira de Medicina Tropical1678-98492011-02-01441222510.1590/S0037-86822011000100006S0037-86822011000100006Long-term outcome of neuroparacoccidioidomycosis treatmentFabio Francesconi0Marcus Tulius Teixeira da Silva1Regina Lana Braga Costa2Valeska Albuquerque Francesconi3Eleonora Carregal4Sinésio Talhari5Antonio Carlos Francesconi do Valle6Manaus Oncology Control Foundation CenterFundação Oswaldo CruzFundação Oswaldo CruzManaus Oncology Control Foundation CenterFundação Oswaldo CruzFundação de Medicina Tropical do AmazonasFundação Oswaldo CruzINTRODUCTION: Neuroparacoccidioidomycosis (NPCM) is a term used to describe the invasion of the central nervous system by the pathogenic fungus Paracoccidioides brasiliensis. NPCM has been described sporadically in some case reports and small case series, with little or no focus on treatment outcome and long-term follow-up. METHODS: All patients with NPCM from January 1991 to December 2006 were analyzed and were followed until December 2009. RESULTS: Fourteen (3.8%) cases of NPCM were identified out of 367 patients with paracoccidioidomycosis (PCM). A combination of oral fluconazole and sulfamethoxazole/trimethoprim (SMZ/TMP) was the regimen of choice, with no documented death due to Paracoccidioides brasiliensis infection. Residual neurological deficits were observed in 8 patients. Residual calcification was a common finding in neuroimaging follow-up. CONCLUSIONS: All the patients in this study responded positively to the association of oral fluconazole and sulfamethoxazole/trimethoprim, a regimen that should be considered a treatment option in cases of NPCM. Neurological sequela was a relatively common finding. For proper management of these patients, anticonvulsant treatment and physical therapy support were also needed.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822011000100006&lng=en&tlng=enParacoccidioides brasiliensisNeuroparacoccidioidomicoseTratamentoInfecção do sistema nervoso central |
| spellingShingle | Fabio Francesconi Marcus Tulius Teixeira da Silva Regina Lana Braga Costa Valeska Albuquerque Francesconi Eleonora Carregal Sinésio Talhari Antonio Carlos Francesconi do Valle Long-term outcome of neuroparacoccidioidomycosis treatment Revista da Sociedade Brasileira de Medicina Tropical Paracoccidioides brasiliensis Neuroparacoccidioidomicose Tratamento Infecção do sistema nervoso central |
| title | Long-term outcome of neuroparacoccidioidomycosis treatment |
| title_full | Long-term outcome of neuroparacoccidioidomycosis treatment |
| title_fullStr | Long-term outcome of neuroparacoccidioidomycosis treatment |
| title_full_unstemmed | Long-term outcome of neuroparacoccidioidomycosis treatment |
| title_short | Long-term outcome of neuroparacoccidioidomycosis treatment |
| title_sort | long term outcome of neuroparacoccidioidomycosis treatment |
| topic | Paracoccidioides brasiliensis Neuroparacoccidioidomicose Tratamento Infecção do sistema nervoso central |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822011000100006&lng=en&tlng=en |
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