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. 2017 Sep;97(3):836-844.
doi: 10.4269/ajtmh.16-0790. Epub 2017 Jul 27.

Paracoccidioidomycosis: Epidemiological and Clinical Aspects in 546 Cases Studied in the State of Espírito Santo, Brazil

Paulo Mendes Peçanha  1 , Mayara Elisa Batista Ferreira  1 , Maria Angélica Massaroni Peçanha  1 , Edilaine Brandão Schmidt  1 , Mariceli Lamas de Araújo  1 , Raphael Lubiana Zanotti  1 , Felipe Fonseca Potratz  1 , Nilo Eduardo Delboni Nunes  1 , Carlos Urbano Gonçalves Ferreira  1 , Délio Delmaestro  1 , Aloísio Falqueto  1
Affiliations

Paracoccidioidomycosis: Epidemiological and Clinical Aspects in 546 Cases Studied in the State of Espírito Santo, Brazil

Paulo Mendes Peçanha et al. Am J Trop Med Hyg. 2017 Sep.

Abstract

Paracoccidioidomycosis (PCM) is an endemic disease in the southeast region of Brazil, which includes the state of Espírito Santo (ES). This historic case series analyses 546 patients treated in this state from 1978 to 2012. Patients aged from 7 to 83 years, 509 males and 37 females, yielding a ratio of 13.7:1. Most of the patients (81.4%) originated from rural areas in ES, 71.0% being farmers. A higher concentration of cases was observed in municipalities located along the western range of the state. Sixty patients (11.0%) had an acute/subacute form of the disease, 485 (88.9%) had a chronic form, and one had a subclinical form. The most affected organs included the lungs, oropharyngeal mucosa, lymph nodes, skin, and larynx. The diagnosis was confirmed by histopathology in 252 (46.2%) cases, direct examination in 168 (30.7%), both exams in 111 (20.3%) and serology in 15 (2.8%). Tuberculosis, acquired immune deficiency syndrome, leishmaniasis, and intestinal parasites were the most frequently associated infectious diseases. From 328 patients followed up, total regression of the lesions was observed in 17.4%, partial regression in 77.4%, and no regression in 17 (5.2%) cases. Regarding the number of cases in this series, ES emerges as an important endemic area for PCM in Brazil.

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Figures

Figure 1.
Figure 1.
Distribution by occupation of patients with paracoccidioidomycosis treated at Hospital Universitário Cassiano Antônio Moraes of the Universidade Federal do Espírito Santo between 1978 and 2012. This figure appears in color at www.ajtmh.org.
Figure 2.
Figure 2.
Map of the (A) geographical location of Espírito Santo State in Brazil and South America –and (B) distribution of paracoccidioidomycosis cases based on the place of origin of 444 patients treated at Hospital Universitário Cassiano Antônio Moraes of the Universidade Federal do Espírito Santo, Espírito Santo, from 1978 to 2012. This figure appears in color at www.ajtmh.org.
Figure 3.
Figure 3.
Age distribution and clinical presentation of patients with paracoccidioidomycosis treated at Hospital Universitário Cassiano Antônio Moraes of the Universidade Federal do Espírito Santo between 1978 and 2012. This figure appears in color at www.ajtmh.org.
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