title: Occurrence of Paracoccidioides lutzii in the Amazon region: description of two cases.
abstract: Paracoccidioidomycosis (PCM), the most important human systemic mycosis in Latin America, is known to be caused by at least four different phylogenetic lineages within the Paracoccidioides brasiliensis complex, including S1, PS2, PS3, and Pb01-like group. Herein, we describe two cases of PCM in patients native from the Amazon region. The disease was originally thought to have been caused by P. brasiliensis. Despite the severity of the cases, sera from the patients were negative in immunodiffusion tests using the standard exoantigen from P. brasiliensis B-339. However, a positive response was recorded with an autologous preparation of Paracoccidioides lutzii exoantigen. A phylogenetic approach based on the gp43 and ARF loci revealed high similarity between our clinical isolates and the Pb01-like group. The occurrence of PCM caused by P. lutzii in the Brazilian Amazon (Pará State) was thus proven. The incidence of PCM caused by P. lutzii may be underestimated in northern Brazil.
authors.affiliation: Evandro Chagas Institute, Bacteriology and Mycology Section, Mycology Laboratory, Ananindeua, Pará, Brazil. marquespb339@gmail.com
authors.forename: Silvia Helena
authors.initials: SH
authors.lastname: Marques-da-Silva
authors.forename: Anderson Messias
authors.initials: AM
authors.lastname: Rodrigues
authors.forename: G Sybren
authors.initials: GS
authors.lastname: de Hoog
authors.forename: Fabíola
authors.initials: F
authors.lastname: Silveira-Gomes
authors.forename: Zoilo Pires de
authors.initials: ZP
authors.lastname: Camargo
mesh_terms: D020823:ADP-Ribosylation Factor 1 / Q000235:genetics; D000328:Adult; D000946:Antigens, Fungal / Q000235:genetics; D001938:Brazil / Q000453:epidemiology; D004271:DNA, Fungal / Q000032:analysis / Q000302:isolation & purification; D005260:Female; D005656:Fungal Proteins / Q000235:genetics; D006023:Glycoproteins / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D010228:Paracoccidioides / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification*; D010229:Paracoccidioidomycosis / Q000453:epidemiology* / Q000382:microbiology; D010802:Phylogeny; D017422:Sequence Analysis, DNA
chemical_list: C103180:43 kDa protein, Paracoccidioides; D000946:Antigens, Fungal; D004271:DNA, Fungal; D005656:Fungal Proteins; D006023:Glycoproteins; D020823:ADP-Ribosylation Factor 1