Paracoccidioidomycosis and pregnancy: A 40-year single-center cohort study in the endemic area of Rio de Janeiro, Brazil.
The occurrence of acute paracoccidioidomycosis (PCM) in urban areas of the Rio de Janeiro state, Brazil, has emerged in recent years. Therefore, young populations, including pregnant women, are at a higher risk of infection. Furthermore, young women undergoing itraconazole treatment for PCM have inc...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2023-09-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://doi.org/10.1371/journal.pntd.0011645 |
| _version_ | 1797671909981159424 |
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| author | Lorena Macedo Pestana Benko Mariana Evangelista de Souza Vieira da Silva Eduardo Mastrangelo Marinho Falcão Dayvison Francis Saraiva Freitas Guilherme Amaral Calvet Marcos de Abreu Almeida Rodrigo Almeida-Paes Rosely Maria Zancopé-Oliveira Antonio Carlos Francesconi do Valle Priscila Marques de Macedo |
| author_facet | Lorena Macedo Pestana Benko Mariana Evangelista de Souza Vieira da Silva Eduardo Mastrangelo Marinho Falcão Dayvison Francis Saraiva Freitas Guilherme Amaral Calvet Marcos de Abreu Almeida Rodrigo Almeida-Paes Rosely Maria Zancopé-Oliveira Antonio Carlos Francesconi do Valle Priscila Marques de Macedo |
| author_sort | Lorena Macedo Pestana Benko |
| collection | DOAJ |
| description | The occurrence of acute paracoccidioidomycosis (PCM) in urban areas of the Rio de Janeiro state, Brazil, has emerged in recent years. Therefore, young populations, including pregnant women, are at a higher risk of infection. Furthermore, young women undergoing itraconazole treatment for PCM have increased chances to get pregnant because this medication may reduce the effectiveness of contraceptives. Acute PCM is invasive, reaching abdominal organs, posing a maternal-fetal risk. PCM treatment in pregnant women is also challenging due to the teratogenicity associated with the currently available oral drugs. There are scarce studies on PCM and pregnancy, mainly consisting of case reports and experimental murine models that highlight the severity of this association. We conducted a database research at a PCM reference center in Rio de Janeiro state from 1980 to 2020. We included patients diagnosed with PCM who were pregnant shortly before, at admission, or at any moment of their PCM follow-up care. Data related to pregnancy, childbirth, and the newborn were obtained from the Brazilian official public databases. We also reviewed the epidemiological and clinical features of these patients. During the study period, we identified 18 pregnant patients, with a median age of 26 years (range: 16-38). Among these cases, six (33.3%) were detected in the last 5 years, and 14 (77.8%) presented acute PCM, supporting the recent shift in the epidemiological profile towards acute PCM. Most pregnancies occurred during PCM treatment (n = 11, 61.1%), which led to challenges in the therapeutic management. Maternal-fetal complications occurred in some of these cases, including vaginal bleeding (n = 1), preeclampsia (n = 1), prematurity (n = 2), low birth weight (n = 4), and fetal deaths (n = 2). PCM during pregnancy presents a significant public health concern in the context of the emergence of acute PCM in urban areas. |
| first_indexed | 2024-03-11T21:22:23Z |
| format | Article |
| id | doaj.art-d58fe3881f4a48dabe91cf19994676be |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2024-03-11T21:22:23Z |
| publishDate | 2023-09-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-d58fe3881f4a48dabe91cf19994676be2023-09-28T05:31:52ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352023-09-01179e001164510.1371/journal.pntd.0011645Paracoccidioidomycosis and pregnancy: A 40-year single-center cohort study in the endemic area of Rio de Janeiro, Brazil.Lorena Macedo Pestana BenkoMariana Evangelista de Souza Vieira da SilvaEduardo Mastrangelo Marinho FalcãoDayvison Francis Saraiva FreitasGuilherme Amaral CalvetMarcos de Abreu AlmeidaRodrigo Almeida-PaesRosely Maria Zancopé-OliveiraAntonio Carlos Francesconi do VallePriscila Marques de MacedoThe occurrence of acute paracoccidioidomycosis (PCM) in urban areas of the Rio de Janeiro state, Brazil, has emerged in recent years. Therefore, young populations, including pregnant women, are at a higher risk of infection. Furthermore, young women undergoing itraconazole treatment for PCM have increased chances to get pregnant because this medication may reduce the effectiveness of contraceptives. Acute PCM is invasive, reaching abdominal organs, posing a maternal-fetal risk. PCM treatment in pregnant women is also challenging due to the teratogenicity associated with the currently available oral drugs. There are scarce studies on PCM and pregnancy, mainly consisting of case reports and experimental murine models that highlight the severity of this association. We conducted a database research at a PCM reference center in Rio de Janeiro state from 1980 to 2020. We included patients diagnosed with PCM who were pregnant shortly before, at admission, or at any moment of their PCM follow-up care. Data related to pregnancy, childbirth, and the newborn were obtained from the Brazilian official public databases. We also reviewed the epidemiological and clinical features of these patients. During the study period, we identified 18 pregnant patients, with a median age of 26 years (range: 16-38). Among these cases, six (33.3%) were detected in the last 5 years, and 14 (77.8%) presented acute PCM, supporting the recent shift in the epidemiological profile towards acute PCM. Most pregnancies occurred during PCM treatment (n = 11, 61.1%), which led to challenges in the therapeutic management. Maternal-fetal complications occurred in some of these cases, including vaginal bleeding (n = 1), preeclampsia (n = 1), prematurity (n = 2), low birth weight (n = 4), and fetal deaths (n = 2). PCM during pregnancy presents a significant public health concern in the context of the emergence of acute PCM in urban areas.https://doi.org/10.1371/journal.pntd.0011645 |
| spellingShingle | Lorena Macedo Pestana Benko Mariana Evangelista de Souza Vieira da Silva Eduardo Mastrangelo Marinho Falcão Dayvison Francis Saraiva Freitas Guilherme Amaral Calvet Marcos de Abreu Almeida Rodrigo Almeida-Paes Rosely Maria Zancopé-Oliveira Antonio Carlos Francesconi do Valle Priscila Marques de Macedo Paracoccidioidomycosis and pregnancy: A 40-year single-center cohort study in the endemic area of Rio de Janeiro, Brazil. PLoS Neglected Tropical Diseases |
| title | Paracoccidioidomycosis and pregnancy: A 40-year single-center cohort study in the endemic area of Rio de Janeiro, Brazil. |
| title_full | Paracoccidioidomycosis and pregnancy: A 40-year single-center cohort study in the endemic area of Rio de Janeiro, Brazil. |
| title_fullStr | Paracoccidioidomycosis and pregnancy: A 40-year single-center cohort study in the endemic area of Rio de Janeiro, Brazil. |
| title_full_unstemmed | Paracoccidioidomycosis and pregnancy: A 40-year single-center cohort study in the endemic area of Rio de Janeiro, Brazil. |
| title_short | Paracoccidioidomycosis and pregnancy: A 40-year single-center cohort study in the endemic area of Rio de Janeiro, Brazil. |
| title_sort | paracoccidioidomycosis and pregnancy a 40 year single center cohort study in the endemic area of rio de janeiro brazil |
| url | https://doi.org/10.1371/journal.pntd.0011645 |
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