Ocular and central nervous system paracoccidioidomycosis in a pregnant woman with acquired immunodeficiency syndrome.
OBJECTIVE
To describe an atypical case of central nervous system and ocular paracoccidioidomycoses simulating ocular toxoplasmosis in a pregnant woman with acquired immunodeficiency syndrome (AIDS).


METHODS
Interventional case report.


METHODS
Case report.


RESULTS
A 25-year-old pregnant woman with AIDS, presented with a severe ocular inflammation in the right eye involving the choroid, retina, and the optic disk, which rapidly progressed to retinal detachment, iris neovascularization, and neovascular glaucoma. The left eye was normal. Magnetic resonance imaging (MRI) showed a focal hypodense contrast-enhanced ring lesion in the brain. Serum antibody titers were negative for Toxoplasma gondii, but the polymerase chain reaction was positive for the parasite in the vitreous sample. The patient responded partially to specific treatment for toxoplasmosis, and there was a small reduction in size of the brain lesion. She progressed to a blind painful eye, which was enucleated. Paracoccidioides brasiliensis was found in the histopathological studies of the eye and oropharynx. With the diagnosis of disseminated ocular paracoccidioidomycoses, the patient was treated with trimethoprim-sulfamethoxazole with a satisfactory outcome and reduction in size of the brain lesion.


CONCLUSIONS
Although ocular infection with ocular paracoccidioidomycoses is rare, this diagnosis should be considered when investigating ocular inflammation in a patient with AIDS.
Department of Ophthalmology, Federal University of São Paulo, Brazil.
Luciana P
LP
Finamor
Cristina
C
Muccioli
Maria C
MC
Martins
Luiz V
LV
Rizzo
Rubens
R
Belfort
D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000382:microbiology*; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001927:Brain Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015353:Eye Enucleation; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010228:Paracoccidioides / Q000302:isolation & purification*; D010229:Paracoccidioidomycosis / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination