title: Paradoxical reaction to treatment in 2 patients with severe acute paracoccidioidomycosis: a previously unreported complication and its management with corticosteroids.
abstract: Paradoxical reactions have never been described in patients with paracoccidioidomycosis or other deep endemic mycoses out of the context of human immunodeficiency virus infection. We describe 2 patients with an acute form of paracoccidioidomycosis who presented with a worsening of their clinical manifestations while on appropriate antifungal treatment. These manifestations were severe and required adjunct corticosteroid therapy.
authors.affiliation: Division of Infectious Diseases, University of São Paulo, São Paulo, Brazil.
authors.forename: Ronaldo C B
authors.initials: RC
authors.lastname: Gryschek
authors.forename: Ricardo M
authors.initials: RM
authors.lastname: Pereira
authors.forename: Adriana
authors.initials: A
authors.lastname: Kono
authors.forename: Rosely A
authors.initials: RA
authors.lastname: Patzina
authors.forename: Antonia T
authors.initials: AT
authors.lastname: Tresoldi
authors.forename: Maria A
authors.initials: MA
authors.lastname: Shikanai-Yasuda
authors.forename: Gil
authors.initials: G
authors.lastname: Benard
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D002648:Child; D006651:Histocytochemistry; D006801:Humans; D007150:Immunohistochemistry; D007155:Immunologic Factors / Q000627:therapeutic use*; D008198:Lymph Nodes / Q000473:pathology; D008230:Lymphomatoid Granulomatosis / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D008853:Microscopy; D009333:Neck / Q000473:pathology; D010229:Paracoccidioidomycosis / Q000150:complications* / Q000188:drug therapy*; D012867:Skin / Q000473:pathology
chemical_list: D000305:Adrenal Cortex Hormones; D000935:Antifungal Agents; D007155:Immunologic Factors