title: [Paracoccidioidomycosis in cerebral hemisphere and brainstem: case report].
abstract: We report on a 36 years-old man that had been at the Amazon forest four years before. Six months before the admission he had developed a progressive quadriparesis, gait ataxia, dysphagia, dysarthria, difficulty in breathing and hiccup. The gadolinium-enhanced T1-weighted MRI showed a lesion into the right parietoccipital area and another into the medulla, that was the largest. There was any evidence of tuberculosis or AIDS. The patient was submitted to microsurgical approach to the medulla. Pathological examination revealed paracoccidioidomycosis. Treatment with anphotericin B till 2100 mg was administered followed by sulfamethoxazole-trimetoprim for three months plus physical therapy. The patient went back to his activities six months after the end of the treatment. Comments are presented about the participation of the immunological system and of the cytokines (interleukines).
authors.affiliation: Universidade Estadual de Campinas SP, Brazil. manoelbaldoino@uol.com.br
authors.forename: Manoel Baldoino
authors.initials: MB
authors.lastname: Leal Filho
authors.forename: Guilherme
authors.initials: G
authors.lastname: Borges
authors.forename: Raimundo Gerônimo
authors.initials: RG
authors.lastname: da Silva
authors.forename: Aline
authors.initials: A
authors.lastname: de Almeida Xavier Aguiar
authors.forename: Bruno Ribeiro
authors.initials: BR
authors.lastname: de Almeida
authors.forename: Marcelo Adriano
authors.initials: MA
authors.lastname: da Cunha E Silva Vieira
authors.forename: Luciana Maria Ribeiro
authors.initials: LM
authors.lastname: Pinheiro
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001927:Brain Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D003131:Combined Modality Therapy / Q000379:methods; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010229:Paracoccidioidomycosis / Q000175:diagnosis* / Q000628:therapy; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B; D015662:Trimethoprim, Sulfamethoxazole Drug Combination