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. 2013 May 13:7:126.
doi: 10.1186/1752-1947-7-126.

Prostatic paracoccidioidomycosis with a fatal outcome: a case report

Pedro Francisco Ferraz de Arruda  1 , Márcio Gatti, José Germano Ferraz de Arruda, Daniel Cernach Ayres, Eduardo Maciel Narvaes, Laísa Ferraz de Arruda, Moacir Fernandes de Godoy
Affiliations

Prostatic paracoccidioidomycosis with a fatal outcome: a case report

Pedro Francisco Ferraz de Arruda et al. J Med Case Rep. .

Abstract

Introduction: Paracoccidioidomycosis is a systemic mycosis in Latin America that can affect various organs. Few case reports of paracoccidioidomycosis affecting the prostate are found in the literature.

Case presentation: We present the case of a 79-year-old Caucasian man with a six-month history of irritative symptoms of the prostate (urgency, frequency and nocturia) and difficulty initiating urination that progressed to urinary retention and the use of a urinary catheter. The anatomopathological analysis of the transurethral resection of the prostate revealed chronic granulomatous prostatitis of fungal etiology (paracoccidioidomycosis) with extensive necrosis. The patient began treatment with itraconazole at a dose of 100mg/day for six months. Radiography of the thorax revealed bilaterally diffuse nodular reticular interstitial lesions. The patient progressed to respiratory failure and was sent to the intensive care unit, but suffered a cardiopulmonary arrest and was pronounced dead.

Conclusions: Due to the high incidence of paracoccidioidomycosis in countries like Brazil, urologists should suspect blastomycosis in all patients with symptoms of lower urinary obstruction with chronic abacterial prostatitis. Considering that paracoccidioidomycosis has the potential to affect various organs, following diagnosis, the treatment must be initiated as soon as possible.

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Figures

Figure 1
Figure 1
Photomicrographs of prostate tissue showing. (A) the chronic granulomatous inflammatory process with yeast fungi (arrow) (hematoxylin and eosin stain, 400×); (B) the chronic granulomatous inflammatory process with prostate acini in the upper left region (arrow) (hematoxylin and eosin stain, 100×); (C) the chronic granulomatous inflammatory process with yeast fungi (arrow) (hematoxylin and eosin stain, 400×); and (D) fungal cells with buds compatible with paracoccidioidomycosis (arrow) (Grocott’s methenamine silver stain, 400×).
Figure 2
Figure 2
Radiography of the thorax. Anteroposterior view (A) and lateral view (B) showing bilaterally diffuse nodular reticular interstitial lesions.
See this image and copyright information in PMC

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