Central nervous system paracoccidioidomycosis: imaging findings in 17 cases.
OBJECTIVE
To quantify the imaging findings of 17 patients with central nervous system (CNS) paracoccidioidomycosis.


METHODS
Retrospective analysis of the clinical data, films, and laboratory findings of 17 patients with CNS paracoccidioidomycosis. The clinical data were obtained by medical records review. Plain chest films, cranial computed tomography scans (CT), and serum and liquor analysis were evaluated.


RESULTS
All the patients were male, with a mean age of 46.5 years. Headache and hemiparesis were the most frequent symptoms. The head CT scans revealed two or more granulomas in 53% of the cases, frequently confined to the parietal lobes (35%) and cerebellar hemispheres (35%). The lesions were hypodense (53%) and irregular (76%) and showed ring-like contrast enhancement (94%). Perilesional edema was seen in 82% of the patients, and hydrocephalus was seen in 41%.


CONCLUSIONS
Although CNS paracoccidioidomycosis might represent a suspicious lesion pattern on CT scan examination, correlation of the CT scan findings, clinical data, plain chest films, and laboratory results is necessary to define the diagnosis of this uncommon entity.
Gasparetto
Emerson L
EL
Section of Diagnostic Radiology, Hospital de Clínicas, University of Paraná, Curitiba, PR, Brazil. gasparetto@hotmail.com
Liu
Christian B
CB
de Carvalho Neto
Arnolfo
A
Rogacheski
Enio
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging; D001927:Brain Diseases / Q000000981:diagnostic imaging*; D020314:Central Nervous System Fungal Infections / Q000000981:diagnostic imaging*; D002648:Child; D006801:Humans; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010229:Paracoccidioidomycosis / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed