title: [Paracoccidioidomycosis compromising the central nervous system: a systematic review of the literature].
abstract: This study is the first systematic review of cases of neuroparacoccidioidomycosis available in the literature. Through searches in the MEDLINE and LILACS databases, 257 cases were found in 81 published studies, mainly after the 1970s-1980s. Approximately 93% of the patients were men, especially farm laborers, with a mean age of 43 years. The characteristic symptoms were motor deficits or intracranial hypertension. The chronic pseudotumoral form predominated. The mean period of evolution was 4.9 months. The lesions were mainly supratentorial (66.8%), located in the frontal and parietal lobes. The diagnosis was determined by biopsy in 57.2% of the cases and neuroimaging methods were used in 64.6% of them. A large proportion of the cases were associated with the pulmonary form of the disease (59.1%). The mortality rate was 44.1%, and 50.1% of the survivors developed sequelae, especially motor impairment. Thus, neuroparacoccidioidomycosis should be considered in the differential diagnosis for expansive and meningoencephalitic processes in the central nervous system, in order to establish early treatment and to avoid disabling sequelae.
authors.affiliation: Curso de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG.
authors.forename: Vinicius Sousa Pietra
authors.initials: VS
authors.lastname: Pedroso
authors.forename: Márcia de Carvalho
authors.initials: Mde C
authors.lastname: Vilela
authors.forename: Enio Roberto Pietra
authors.initials: ER
authors.lastname: Pedroso
authors.forename: Antônio Lúcio
authors.initials: AL
authors.lastname: Teixeira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D020314:Central Nervous System Fungal Infections / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010229:Paracoccidioidomycosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D055815:Young Adult