Paracoccidioides brasiliensis: Difference between revisions
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Paracoccidioides brasiliensis
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= Microbiology = |
== Microbiology == |
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* Dimorphic fungus with four phylogenetic lineages |
* Dimorphic fungus with four phylogenetic lineages |
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* '''Mariner's wheel''' of budding conidia |
* '''Mariner's wheel''' of budding conidia |
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= Epidemiology = |
== Epidemiology == |
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* South and Central America, with Brazil being the largest endemic country |
* South and Central America, with Brazil being the largest endemic country |
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* Has been isolated from the feces of bats (''Artibeus lituratus'') and from internal organs of the nine-banded armadillo |
* Has been isolated from the feces of bats (''Artibeus lituratus'') and from internal organs of the nine-banded armadillo |
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= Clinical Presentation = |
== Clinical Presentation == |
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* Usually self-limited pulmonary infection |
* Usually self-limited pulmonary infection |
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* However, may remain latent following infection, and reactivate later as pulmonary or disseminated disease |
* However, may remain latent following infection, and reactivate later as pulmonary or disseminated disease |
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= Diagnosis = |
== Diagnosis == |
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* Serology |
* Serology |
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** Antigen |
** Antigen |
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= Management = |
== Management == |
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* Itraconazole 200 to 400 mg/day for 9 to 12 months |
* Itraconazole 200 to 400 mg/day for 9 to 12 months |
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Revision as of 19:42, 15 August 2019
Microbiology
- Dimorphic fungus with four phylogenetic lineages
- Disease is caused by P. brasiliensis and P. lutzii (newly discovered)
- Mariner's wheel of budding conidia
Epidemiology
- South and Central America, with Brazil being the largest endemic country
- Has been isolated from the feces of bats (Artibeus lituratus) and from internal organs of the nine-banded armadillo
Clinical Presentation
- Usually self-limited pulmonary infection
- Can cause acute/subacute pulmonary infection in children, adolescents, and immunocompromised individuals
- Fever, weight loss, lymphadenopathy, and hepatosplenomegaly
- Half have skin and mucosal lesions
- Can cause chronic disease in adults
- Pulmonary infiltrates on CXR
- Adrenal lesions with insufficiency are common
- However, may remain latent following infection, and reactivate later as pulmonary or disseminated disease
Diagnosis
- Serology
- Antibodies
- Antigen
Management
- Itraconazole 200 to 400 mg/day for 9 to 12 months
- If severe, consider amphotericin 1mg/kg/day
- ?Septra
