Produção Nacional
Revisado por pares
Coccidioidomycosis in Brazil. A case report
1997; UNIVERSIDADE DE SÃO PAULO; Volume: 39; Issue: 5 Linguagem: Inglês
10.1590/s0036-46651997000500010
ISSN1678-9946
AutoresMarilena dos Anjos MARTINS, Evangelina da Motta Pacheco Alves de ARAÚJO, Marcelo Hisato KUWAKINO, Elisabeth Maria Heins‐Vaccari, Gilda Maria Bárbaro Del Negro, João Antonio VOZZA JÚNIOR, Carlos da Silva LACAZ,
Tópico(s)Nail Diseases and Treatments
ResumoCoccidioidomycosis is an endemic infection with a relatively limited geographic distribution: Mexico, Guatemala, Honduras, Colombia, Venezuela, Bolivia, Paraguay, Argentina and the southwest of the United States. In these countries, the endemic area is restricted to the semiarid desert like regions which are similar to the northeast of Brazil.The patient is a 32 year-old male, born in the state of Bahia (Northeast of Brazil) and has been living in São Paulo (Southeast) for 6 years. He was admitted at Hospital das Clínicas, at the Department of Pneumology in October 1996, with a 6 month history of progressive and productive cough, fever, malaise, chills, loss of weight, weakness and arthralgia in the small joints. Chest x-rays and computerized tomography disclosed an interstitial reticulonodular infiltrate with a cavity in the right upper lobe. The standard potassium hydroxide preparation of sputum and broncoalveolar lavage demonstrated the characteristic thickened wall spherules in various stages of development. Sabouraud dextrose agar, at 25 degrees C and 30 degrees C showed growth of white and cottony aerial miceleium. The microscopic morphology disclosed branched hyphae characterized by thick walled, barrel shaped arthroconidia alternated with empty cells. The sorological studies with positive double immunodiffusion test, and also positive complement fixation test in 1/128 dilution confirmed the diagnosis. The patient has been treated with ketoconazole and presents a favorable clinical and radiological evolution.
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