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Case Reports
. 2015 Dec;57(6):527-30.
doi: 10.1590/S0036-46652015000600013.

DISSEMINATED FUNGAL INFECTION WITH ADRENAL INVOLVEMENT: REPORT OF TWO HIV NEGATIVE BRAZILIAN PATIENTS

Graziella Hanna Pereira  1 , Valéria Pereira Barbosa Lanzoni  2 , Elisa Maria Beirão  1 , Artur Timerman  1 , Marcia de Souza Carvalho Melhem  3
Affiliations
Case Reports

DISSEMINATED FUNGAL INFECTION WITH ADRENAL INVOLVEMENT: REPORT OF TWO HIV NEGATIVE BRAZILIAN PATIENTS

Graziella Hanna Pereira et al. Rev Inst Med Trop Sao Paulo. 2015 Dec.

Abstract
in English, Portuguese

Paracoccidioidomycosis and histoplasmosis are systemic fungal infections endemic in Brazil. Disseminated clinical forms are uncommon in immunocompetent individuals. We describe two HIV-negative patients with disseminated fungal infections, paracoccidioidomycosis and histoplasmosis, who were diagnosed by biopsies of suprarenal lesions. Both were treated for a prolonged period with oral antifungal agents, and both showed favorable outcomes.

A paracoccidioidomicose e a histoplasmose são infecções fúngicas sistêmicas endêmicas no Brasil. As formas clínicas disseminadas são incomuns em pacientes imunocompetentes. Nós descrevemos dois pacientes HIV-negativos com infecções fúngicas disseminadas, paracoccidioidomicose e histoplasmose, que foram diagnosticadas por biópsias de lesões de supra-renal. Ambos foram tratados por períodos prolongados com antifúngicos orais, evoluindo com boa resposta terapêutica.

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Figures

Fig. 1
Fig. 1. - Skin lesions on face.
Fig. 2
Fig. 2. - Magnetic resonance imaging of the brain showing an expansive left frontal.
Fig. 3
Fig. 3. - Paracoccidioidomycosis in skin's sections. Clusters of Paracoccidioides spp. in giant cells (arrow). Gomori methenamine silver stain demonstrates peripheral buds (upper left).
Fig. 4
Fig. 4. - Histoplasmosis in suprarenal's sections. Granulomatous inflammatory process with histiocytes, besides necrosis with suggestive Histoplasma spp. structures.
See this image and copyright information in PMC

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