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Central Nervous System Paracoccidioidomycosis in an AIDS Patient: Case Report

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Abstract

Up to now, over 200 patients with paracoccidioidomycosis (PCM) associated to HIV infection have already been reported; however, the central nervous system involvement in this coinfection was rarely reported. This paper presents a 35-year-old Brazilian male AIDS patient who developed pulmonary PCM successfully treated with itraconazole. At the antiretroviral therapy starting, he had 32 CD4+ T cells baseline count and high viral load levels. After 9 months, he presented severe fungal meningoencephalitis diagnosed by sublenticular enhanced nodular lesion at computerized tomography and magnetic resonance brain imaging and a positive Paracoccidiodes brasiliensis smear and culture from cerebrospinal fluid. At the time, a sixfold increase in CD4+ T cell count and undetectable viral load level were evidenced. The patient received amphotericin B during 1 year presenting slow but progressive clinical improvement, and he is currently asymptomatic and without neurological disabilities. To our knowledge, this is the second case report of a patient with neuroparacoccidioidomycosis associated to HIV infection.

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Acknowledgments

Thanks to Mrs. Ângela Azôr for the technical assistance and to Fundação de Amparo a Pesquisa de Minas Gerais (FAPEMIG) for the financial support. Grant: APQ 01624-12.

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The authors report no conflict of interests.

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Authors and Affiliations

  1. Infectious Diseases Unit, Triângulo Mineiro Federal University, Avenida Frei Paulino, 30, Uberaba, Minas Gerais, CEP 38025-180, Brazil

    Mario León Silva-Vergara, Ivonete Helena Rocha, Rakel Rocha Vasconcelos, André Luiz Maltos, Fernando de Freitas Neves, Luciana de Almeida Silva Teixeira & Delio José Mora

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  1. Mario León Silva-Vergara
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  2. Ivonete Helena Rocha
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  3. Rakel Rocha Vasconcelos
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  6. Luciana de Almeida Silva Teixeira
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Correspondence to Delio José Mora.

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Silva-Vergara, M.L., Rocha, I.H., Vasconcelos, R.R. et al. Central Nervous System Paracoccidioidomycosis in an AIDS Patient: Case Report. Mycopathologia 177, 137–141 (2014). https://doi.org/10.1007/s11046-014-9729-5

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  • DOI: https://doi.org/10.1007/s11046-014-9729-5

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