title: Paracoccidioidomycosis: an unusual presentation in a young girl disclosing an unnoted HIV-infection.
abstract: The association of paracoccidioidomycosis with AIDS is apparently less frequent than expected. The authors present an unusual case of paracoccidioidomycosis in a 13-year-old female student which was later found to be the first opportunistic infection in the course of the patient's HIV-infection. The clinical presentation followed an accidental incised wound on the palmar region initially described as a 'sporotrichotic-chancre'. After good response under sulfamethoxazole-trimethoprin, the patient relapsed and presented an associated oral candidiasis. HIV-infection was documented and additional investigation showed CD4(+) T-cells=22/mm(3), CD8(+)=280 cell/mm(3) and viral load=4,043 log. This case report presents an uncommon dermatological-clinical picture in the youngest patient in which such association has been reported to date.
authors.affiliation: Departamento de Dermatologia e Radioterapia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, Brazil. smarques@fmb.unesp.br
authors.forename: Silvio Alencar
authors.initials: SA
authors.lastname: Marques
authors.forename: Rosangela M P
authors.initials: RM
authors.lastname: Camargo
authors.forename: Luciana P F
authors.initials: LP
authors.lastname: Abbade
authors.forename: Carlos Magno C B
authors.initials: CM
authors.lastname: Fortaleza
authors.forename: Mariangela E A
authors.initials: ME
authors.lastname: Marques
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000382:microbiology*; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002180:Candidiasis, Oral / Q000150:complications / Q000382:microbiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis*; D006230:Hand Injuries / Q000150:complications; D006801:Humans; D010229:Paracoccidioidomycosis / Q000150:complications* / Q000175:diagnosis*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014946:Wound Infection / Q000150:complications / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination