title: Paracoccidioidomycosis in a western Brazilian Amazon State: clinical-epidemiologic profile and spatial distribution of the disease.
abstract: BACKGROUND
  Paracoccidioidomycosis (PCM) is a systemic infection caused by the fungus Paracoccidioides brasiliensis. PCM is considered one of the most important systemic mycoses in Latin America.
  
  
  METHODS
  This is a clinical, epidemiological, retrospective, quantitative study of PCM cases in patients attending the National Health Service in the State of Rondônia in 1997-2012. The examined variables included sex, age group, year of diagnosis, education level, profession, place of residence, diagnostic test, prior treatment, medication used, comorbidities and case progress.
  
  
  RESULTS
  During the study period, 2,163 PCM cases were registered in Rondônia, and the mean annual incidence was 9.4/100,000 people. The municipalities with the highest rates were located in the southeastern region of Rondônia, and the towns of Pimenteiras do Oeste and Espigão do Oeste had the highest rates in the state, which were 39.1/100,000 and 37.4/100,000 people, respectively. Among all cases, 90.2% and 9.8% were observed in men and women, respectively, and most cases (58.2%) were observed in patients aged between 40 and 59 years. Itraconazole was used to treat 91.6% (1,771) of cases, followed by sulfamethoxazole in combination with trimethoprim (4.4% [85] of cases). One hundred thirty-one (6%) patients died.
  
  
  CONCLUSIONS
  The State of Rondônia has a high incidence of PCM, and the municipalities in the southeastern region of the state were found to have the highest incidence rates of this disease. Our findings suggest that Rondônia is the state in the northern region with the highest mortality rate for PCM.
authors.affiliation: Departamento de Medicina, Faculdade São Lucas, Porto VelhoRO, Departamento de Medicina, Faculdade São Lucas, Porto Velho, RO.
authors.forename: Gabriel de Deus
authors.initials: Gde D
authors.lastname: Vieira
authors.affiliation: Departamento de Medicina, Faculdade São Lucas, Porto VelhoRO, Departamento de Medicina, Faculdade São Lucas, Porto Velho, RO.
authors.forename: Thaianne da Cunha
authors.initials: Tda C
authors.lastname: Alves
authors.affiliation: Departamento de Medicina, Faculdade São Lucas, Porto VelhoRO, Departamento de Medicina, Faculdade São Lucas, Porto Velho, RO.
authors.forename: Sônia Maria Dias de
authors.initials: SM
authors.lastname: Lima
authors.affiliation: Departamento de Medicina, Faculdade São Lucas, Porto VelhoRO, Departamento de Medicina, Faculdade São Lucas, Porto Velho, RO.
authors.forename: Luís Marcelo Aranha
authors.initials: LM
authors.lastname: Camargo
authors.affiliation: Departamento de Medicina, Faculdade São Lucas, Porto VelhoRO, Departamento de Medicina, Faculdade São Lucas, Porto Velho, RO.
authors.forename: Camila Maciel de
authors.initials: CM
authors.lastname: Sousa
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010229:Paracoccidioidomycosis / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013029:Space-Time Clustering; D019371:Topography, Medical; D055815:Young Adult
chemical_list: D000935:Antifungal Agents