title: Paracoccidioidomycosis case series with and without central nervous system involvement.
abstract: BACKGROUND
  Paracoccidioidomycosis (PCM) is the most important systemic mycosis in South America. Central nervous system involvement is potentially fatal and can occur in 12.5% of cases. This paper aims to contribute to the literature describing eight cases of neuroparacoccidioidomycosis (NPMC) and compare their characteristics with patients without neurological involvement, to identify unique characteristics of NPCM.
  
  
  METHODS
  A cohort of 213 PCM cases was evaluated at the Infectious Diseases Clinic of the University Hospital, Federal University of Minas Gerais, Brazil, from October 1976 to August 2008. Epidemiological, clinical, laboratory, therapeutic and follow-up data were registered.
  
  
  RESULTS
  Eight patients presented NPCM. The observed NPCM prevalence was 3.8%. One patient presented the subacute form of PCM and the other seven presented the chronic form of the disease. The parenchymatous form of NPCM occurred in all patients. 60% of the patients who proceeded from the north/ northeast region of Minas Gerais State developed NPCM. The neurological involvement of a mother and her son was observed. NPCM patients exhibited demographical and clinical profiles similar to what is described in the literature. When NPCM cases were compared to PCM patients, there were differences in relation to origin and positive PCM family history.
  
  
  CONCLUSIONS
  The results corroborate the clinical view that the neurological findings are extremely important in the evaluation of PCM patients. Despite the limitations of this study, the differences in relation to patient's origins and family history point to the need of further studies to determine the susceptibility factors involved in the neurological compromise.
authors.affiliation: Programa de Pós-Graduação em Infectologia e Medicina Tropical, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
authors.forename: Vinicius Sousa Pietra
authors.initials: VS
authors.lastname: Pedroso
authors.forename: Ana Claudia
authors.initials: AC
authors.lastname: Lyon
authors.forename: Stanley Almeida
authors.initials: SA
authors.lastname: Araújo
authors.forename: Juliana Márcia Ribeiro
authors.initials: JM
authors.lastname: Veloso
authors.forename: Enio Roberto Pietra
authors.initials: ER
authors.lastname: Pedroso
authors.forename: Antônio Lucio
authors.initials: AL
authors.lastname: Teixeira
mesh_terms: D000328:Adult; D001927:Brain Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000382:microbiology; D001938:Brazil / Q000453:epidemiology; D020314:Central Nervous System Fungal Infections / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000382:microbiology; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010229:Paracoccidioidomycosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015995:Prevalence; D014057:Tomography, X-Ray Computed; D055815:Young Adult