Journal Article

Endemic paracoccidioidomycosis: relationship between clinical presentation and patients’ demographic features

Fernando Bellissimo-Rodrigues, Valdes Roberto Bollela, Benedito Antônio Lopes Da Fonseca and Roberto Martinez

in Medical Mycology

Published on behalf of International Society for Human and Animal Mycology

Volume 51, issue 3, pages 313-318
Published in print April 2013 | ISSN: 1369-3786
Published online April 2013 | e-ISSN: 1460-2709 | DOI: https://dx.doi.org/10.3109/13693786.2012.714529
Endemic paracoccidioidomycosis: relationship between clinical presentation and patients’ demographic features

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  • Mycology and Fungi
  • Infectious Diseases
  • Medical Toxicology
  • Veterinary Medicine
  • Environmental Science

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Paracoccidioidomycosis (PCM) is a systemic fungal disease endemic to Latin America and characterized by two clinical presentations, i.e., patients develop either acute/ subacute or chronic clinical manifestations. The differences in clinical presentations are mainly dependent on the host immune response, but may also be related to demographic characteristics of some patients. In this retrospective study, 1,219 PCM cases treated between 1970 and 2009 in a university medical center, located in southeastern Brazil, were analyzed according to their clinical and demographic features. The most affected anatomical sites were lungs (63.8%) and oral mucosa (50.0%), with increasing involvement of these sites in accord with the age of the patients. Generalized lymphadenopathy (28.1%) and skin lesions (29.6%) were more frequent on the first decades of life. Involvement of the larynx (16.1%), gut (7.5%), spleen (4.7%), central nervous system (3.4%), bones and joints (2.2%), and adrenal (2.1%) were also variable according to the age of the host. The acute/subacute form of the disease accounted for 26.4% of PCM cases and, on a multivariate analysis, was inversely associated with aging (OR = 0.8 per year, P < 0.001), and directly associated with female sex (OR = 7.2, P < 0.001), mixed black and white racial background (OR = 2.3, P < 0.001) or black skin color (OR = 4.6, P < 0.001). Based on these findings, we have shown that host immune response, as well as age, gender and ethnicity may influence the clinical presentation of PCM.

Keywords: paracoccidioidomycosis; clinical presentation; age; sex; ethnicity

Journal Article.  3176 words.  Illustrated.

Subjects: Mycology and Fungi ; Infectious Diseases ; Medical Toxicology ; Veterinary Medicine ; Environmental Science

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