title: [Clinical problems in medical mycology: Problem number 47].
abstract: A 66 year-old man, who had lived in Paraguay and was a rural worker, was admitted to Infectious Diseases Hospital F. J. Muñiz in Buenos Aires. He presented fever, loss of body weight, cough, mucopurulent expectoration, wide perianal ulceration, paresthesia and paresis of both legs as well as vesical and anal sphincter dysfunction. He was a heavy smoker and drinker. Thorax X-ray examination showed bilateral micronodular interstitial lesions. With a NMR of the dorsolumbar spine region a nodular lesion outside the spinal cord (which produced compression of this organ) was shown. The diagnosis of disseminated paracoccidiodomycosis was based on the finding of Paracoccidioides brasiliensis in the skin ulcer in histopathology and mycology studies, and on the positive results of serologic tests with paracoccidioidin antigen. The patient was treated with trimethoprim-sulfamethoxazole with good clinical outcome.
authors: División B HIV-Sida, Hospital de Infecciosas F.J. Muñiz, Buenos Aires, Argentina.
authors: Marcelo
authors: M
authors: Corti
authors: Estela
authors: E
authors: Muzzio
authors: María Florencia
authors: MF
authors: Villafañe
authors: María Marta
authors: MM
authors: Priarone
authors: Fernando
authors: F
authors: Messina
authors: Alicia
authors: A
authors: Arechavala
authors: Elena
authors: E
authors: Maiolo
authors: Ricardo
authors: R
authors: Negroni
authors: Oscar
authors: O
authors: Franze
mesh_terms: D000382:Agricultural Workers' Diseases / Q000175:diagnosis / Q000382:microbiology; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000908:Antibodies, Fungal / Q000097:blood; D005656:Fungal Proteins / Q000276:immunology; D016469:Fungemia / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D010228:Paracoccidioides / Q000302:isolation & purification*; D010229:Paracoccidioidomycosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D010292:Paresthesia / Q000209:etiology; D012883:Skin Ulcer / Q000382:microbiology; D013117:Spinal Cord Compression / Q000209:etiology; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D000890:Anti-Infective Agents; D000908:Antibodies, Fungal; D005656:Fungal Proteins; C008765:paracoccidioidin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination